Familiarity with the functional anatomy and physical examination of the wrist, accompanied by radiologic evaluation, may aid the physician in differentiating simple sprains from potentially debilitating wrist injuries. It is associated with significant disability and health care costs. A practical approach to diagnosis utilizes the symptom-based Rome criteria. Management of patients has been helped by recent findings relating to the pathophysiology of the disorder. Dysregulation of intestinal motor functions, sensory functions and central nervous system functions is currently believed to be the basis for irritable bowel symptoms.
Symptoms are a result of both abnormal intestinal motility and enhanced visceral sensitivity.
Psychosocial factors can affect the illness experience and the clinical outcome. An effective physician-patient relationship is required for a successful outcome. Individualized treatment involves an integrated pharmacologic and behavioral approach determined by the predominant symptom type, the severity of the symptoms and the degree of disability. M.D. University of Alabama School of Medicine, Tuscaloosa, Alabama Attention-deficit hyperactivity disorder is the most common pediatric psychiatric disorder, involving one of every 20 children. It is often a disabling condition and is frequently accompanied by high levels of frustration and comorbidity.