ABSTRACT
BACKGROUND: Lily was born 7 years ago with an illness that did not have a name; she had only a constellation of anomalies. The hope of happiness that most parents experience when expecting a baby was lost halfway through my pregnancy when we heard the words "survival" and "termination of the pregnancy." Lily did survive and has taught us, her parents, and members of her medical team the meaning of courage and collaboration. PURPOSE: This article describes our journey. Today that lesson has blossomed into a patient/parent/family engagement program changing the culture of healthcare and the future for hospitalized infants. IMPLICATIONS FOR PRACTICE: We share our story so that others might learn from our experiences. Hope and survival are so important to parents and families and health professionals need to be aware that taking away hope can devastate a family. IMPLICATIONS FOR RESEARCH: More research is needed about when a baby who was expected to die lives anyway and how that experience can best be supported for families. This is an area where the experience is unique and little is really known.
Subject(s)
Anal Canal/abnormalities , Hypertelorism , Kidney/abnormalities , Syndactyly , Toes/abnormalities , Urogenital Abnormalities , Female , Humans , Hypertelorism/diagnosis , Hypertelorism/genetics , Hypertelorism/therapy , Intensive Care Units, Neonatal , Parents , Pregnancy , Prenatal Diagnosis , Professional-Family Relations , Syndactyly/diagnosis , Syndactyly/genetics , Syndactyly/therapy , Urogenital Abnormalities/diagnosis , Urogenital Abnormalities/genetics , Urogenital Abnormalities/therapyABSTRACT
This chapter deals with a few of the important childhood bone disorders associated with high bone mass as well as conditions associated with fragility fractures and limb deformities that have not been addressed in previous chapters. A couple of skeletal dysplasias that can sometimes be confused with rickets are also dealt with in this chapter.
Subject(s)
Bone Diseases, Developmental/diagnosis , Bone Diseases, Developmental/genetics , Bone Diseases, Developmental/therapy , Camurati-Engelmann Syndrome/diagnosis , Camurati-Engelmann Syndrome/genetics , Camurati-Engelmann Syndrome/therapy , Craniofacial Abnormalities/diagnosis , Craniofacial Abnormalities/genetics , Craniofacial Abnormalities/therapy , Humans , Hyperostosis/diagnosis , Hyperostosis/genetics , Hyperostosis/therapy , Hypertelorism/diagnosis , Hypertelorism/genetics , Hypertelorism/therapy , Myositis Ossificans/diagnosis , Myositis Ossificans/genetics , Myositis Ossificans/therapy , Osteochondrodysplasias/diagnosis , Osteochondrodysplasias/genetics , Osteochondrodysplasias/therapy , Osteopetrosis/diagnosis , Osteopetrosis/genetics , Osteopetrosis/therapy , Pycnodysostosis/diagnosis , Pycnodysostosis/genetics , Pycnodysostosis/therapy , Syndactyly/diagnosis , Syndactyly/genetics , Syndactyly/therapySubject(s)
Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/therapy , Craniofacial Abnormalities/diagnostic imaging , Craniofacial Abnormalities/therapy , Hyperostosis/diagnostic imaging , Hyperostosis/therapy , Hypertelorism/diagnostic imaging , Hypertelorism/therapy , Nasal Obstruction/diagnostic imaging , Nasal Obstruction/therapy , Diagnosis, Differential , Humans , Infant , Male , Tomography, X-Ray ComputedABSTRACT
Ocular hypertelorism is a congenital craniofacial malformation characterized by excessive distance between the eyes. It is one of the most expressive deformities of the human face. The aim of this case report was to discuss clinical aspects associated with the diagnosis, planning, and treatment of an orthodontic patient with ocular hypertelorism.
Subject(s)
Hypertelorism/therapy , Malocclusion, Angle Class II/therapy , Orthodontics, Corrective , Patient Care Planning , Anodontia/diagnosis , Bicuspid/abnormalities , Child , Extraoral Traction Appliances , Facial Asymmetry/diagnosis , Facial Asymmetry/therapy , Female , Humans , Hypertelorism/surgery , Incisor/abnormalities , Malocclusion, Angle Class II/diagnosis , Molar/pathology , Open Bite/diagnosis , Open Bite/therapy , Palatal Expansion Technique , Patient Satisfaction , Rhinoplasty , Root Resorption/diagnosis , Tooth Extraction , Tooth, Supernumerary/diagnosis , Treatment OutcomeABSTRACT
To identify potential risk factors among the therapeutic regimen and life style which may increase the risk for stroke, a pair matched case-control study was conducted in Gaza Strip among 112 patients, who had been hospitalized for acute stroke and history of hypertension, and 224 controls with history of hypertension. Conditional logistic regression models show significant associations between stroke and medication not taking as prescribed (OR = 6.07; 95% CI: 1.53, 24.07), using excessive salt at meals (OR = 4.51; 95% CI: 2.05, 9.90), eating diet high in fat (OR = 4.67; 95% CI: 2.09, 10.40), and high level of stress (OR = 2.77; 95% CI: 1.43, 5.38). No significant association between smoking and the development of stroke (OR = 2.12; 95% CI: 0.82, 5.51) was found. Regular physical exercise was a protective factor (OR=0.26; 95% CI: 0.12, 0.57). Using excessive salt at meals was a significant risk factor (OR = 16.61; 95% CI: 4.40, 62.80) in people having low level of stress, whereas it was not significant in people having high level of stress. (OR = 1.76; 95% CI: 0.58, 5.33). Smoking in combination with low level of stress was a significant risk factor for stroke (OR = 9.88; 95% CI: 2.52, 38.78), but a non-significant protective factor in combination with high level of stress (OR=0.52; 95% CI: 0.14, 1.99). An increase in compliance with the pharmacological and non-pharmacological therapeutic regimen might be a key to a reduction of stroke incidence and prevalence among hypertensive patients.
Subject(s)
Hypertelorism/therapy , Patient Compliance , Stroke/epidemiology , Stroke/etiology , Adult , Age Factors , Aged , Case-Control Studies , Dietary Fats/adverse effects , Exercise/physiology , Female , Humans , Hypertelorism/complications , Life Style , Logistic Models , Male , Middle Aged , Middle East/epidemiology , Risk Factors , Sex Factors , Smoking/adverse effects , Socioeconomic Factors , Sodium Chloride, Dietary/adverse effects , Stress, Physiological/complications , Stroke/prevention & control , Surveys and QuestionnairesABSTRACT
Normal blood pressure and hypertension were defined according to age and sex based on the data on Japanese children. When high blood pressure is found, both white-coat and secondary hypertension should be excluded. Subsequently lifestyle modifications should be initiated in children and adolescents with essential hypertension. These modifications include: weight reduction, reduction of dietary salt intake, high dietary potassium intake and increased physical activity. When nonpharmacologic treatment is not effective after 3 to 6 months, or when there is an evidence of target organ injury, antihypertensive drugs such as ACE inhibitors and Ca antagonists will be started to control blood pressure. Lifestyle modifications are also important for primary prevention of hypertension in normotensive children.
Subject(s)
Hypertelorism/therapy , Adolescent , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Blood Pressure Determination , Calcium Channel Blockers/administration & dosage , Child , Child, Preschool , Diet , Exercise , Female , Humans , Hypertelorism/prevention & control , Life Style , MaleABSTRACT
Se describe el diagnóstico y manejo preoperatorio, así como los procedimientos quirúrgicos por vía intracraneana que los autores empleana actualmente para el tratamiento quirúrgico de pacientes con diferentes grados de hipertelorismo. Este manejo es la conclusión de la experiencia obtenida en 324 pacientes operados a lo largo de 26 años. Se presentan tambien los diferentes criterios y las diversas variantes de las osteotomías empleadas en forma más frecuente. Se analizan detalles quirúrgicos que han dado pauta a obtener mejores resultados y prevenir complicaciones. Mencionamos las observaciones hechas de estos pacintes operados en el Hospital General de México, ®Dr. Manuel Gea González¼ y en el Hospital Infantil de México ®Dr. Federico Gómez¼ de 1971 a 1986 (25 años), Con un seguimiento máximo de 18 años, con buenos resultados y crecimiento normal
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Hypertelorism/diagnosis , Hypertelorism/etiology , Hypertelorism/surgery , Hypertelorism/therapy , Osteotomy , Osteotomy/statistics & numerical dataABSTRACT
Our experiences in managing 17 patients with nasofrontal-ethmoidal injuries is reviewed. The treatment of frontal injuries, cerebrospinal fluid leaks, and pseudohypertelorism is discussed.