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We describe a 33-year-old man with giant hypertrophic gastropathy (Menetrier's disease), which, on operative biopsy of the stomach, showed a significant inflammatory component. The patient was treated with prednisone and quickly responded. Although a review of the literature revealed only two cases similarly treated, with equivocal results, spontaneous remission, does occur. Symptoms associated with this disease may respond to corticosteroids, which may offer effective therapy while awaiting involution of the gastropathy. Thus total gastrectomy may be avoided.

In an effort to avert the cumulative effects of unresolved emotional problems on children's social and school adjustment, a psychosocial phase was added to a pediatric multiphasic examination. Based upon a cumulative stress concept, the screening procedures included child behavior and family stress questionnaires for parents, and abbreviated standard psychological tests for children, administered by specially trained aides. Computerized results were reported to the child's pediatrician. Follow-up by mental health counselors attached to the pediatric clinic was provided for patients identified as being at high risk of serious psychosocial problems. Evidence of validity of the screen, factors affecting the scores, and effectiveness of clinical follow-up of high-risk patients are discussed. Valid semicomputerized screening of school-age children for serious psychosocial problems can be carried out routinely and at relatively low cost by paraprofessional personnel in a pediatric setting. Impediments to effective use of the screening results on the part of both health care provider and patient are discussed.

This longitudinal study examined factors related to healthy adjustment in young children who had experienced conditions and stresses known to carry a substantial risk of adverse outcome. Psychological adjustment of 109 children at age 6 to 7 years was examined for its relationship to infancy risk status, determined at age I month by means of a multifactor screen assessing perinatal stress, psychological problems and stresses in the family, maternal attitudes toward self and parenthood, and maternal perceptions of infant temperament. Several variables believed to mediate outcome for high-risk children were studied, including subsequent stressful life events, social support available to child and mother, and child's locus of control orientation. Interactions between predictor variables showed that life events magnify synergistically the adverse effects of infancy risk factors, and social support and internal control orientation potently buffer the effects of risk and stress. Considered jointly in conjunction with their interactions, the predictor variables were strongly predictive of outcome, explaining 56% of the variance observed in behavior problems and 64% of the variance in school problems.