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The Primary Care Pediatrician and the Care of Children with Cleft Lip And/Or Cleft Palate Charlotte W
CLINICAL REPORT Guidance for the Clinician in Rendering Pediatric Care The Primary Care Pediatrician Charlotte W. Lewis, MD, MPH, FAAP, a Lisa S. Jacob, DDS, MS, b Christoph U. andLehmann, MD, the FAAP, FACMI, Care c SECTION ON ORALof HEALTH Children With Cleft Lip and/or Cleft Palate Orofacial clefts, specifically cleft lip and/or cleft palate (CL/P), are among the abstract most common congenital anomalies. CL/P vary in their location and severity and comprise 3 overarching groups: cleft lip (CL), cleft lip with cleft palate (CLP), and cleft palate alone (CP). CL/P may be associated with one of many syndromes that could further complicate a child’s needs. Care of patients aDivision of General Pediatrics and Hospital Medicine, Department of with CL/P spans prenatal diagnosis into adulthood. The appropriate timing Pediatrics, University of Washington School of Medicine and Seattle Children’s Hospital, Seattle, Washington; bGeorgetown Pediatric and order of specific cleft-related care are important factors for optimizing Dentistry and Orthodontics, Georgetown, Texas; and Departments of cBiomedical Informatics and Pediatrics, Vanderbilt University Medical outcomes; however, care should be individualized to meet the specific needs Center, Nashville, Tennessee of each patient and family. Children with CL/P should receive their specialty All three authors participated extensively in developing, researching, cleft-related care from a multidisciplinary cleft or craniofacial team with and writing the manuscript and revising it based on reviewers’ comments; Dr Lehmann made additional revisions after review by the sufficient patient and surgical volume to promote successful outcomes. board of directors. The primary care pediatrician at the child’s medical home has an essential This document is copyrighted and is property of the American role in making a timely diagnosis and referral; providing ongoing health Academy of Pediatrics and its Board of Directors. -
Clinical Classification of Caroli's Disease: an Analysis of 30 Patients
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector DOI:10.1111/hpb.12330 HPB ORIGINAL ARTICLE Clinical classification of Caroli's disease: an analysis of 30 patients Zhong-Xia Wang1,2*, Yong-Gang Li2*, Rui-Lin Wang2, Yong-Wu Li3, Zhi-Yan Li3, Li-Fu Wang2, Hui-Ying Yang2, Yun Zhu2, Yao Wang2, Yun-Feng Bai2, Ting-Ting He2, Xiao-Feng Zhang2 & Xiao-He Xiao1,2 1Department of Graduate School, 301 Hospital, 2Integrative Medical Centre, and 3Imaging Centre, 302 Hospital, Beijing, China Abstract Background: Caroli's disease (CD) is a rare congenital disorder. The early diagnosis of the disease and differentiation of types I and II are of extreme importance to patient survival. This study was designed to review and discuss observations in 30 patients with CD and to clarify the clinical characteristics of the disease. Methods: The demographic and clinical features, laboratory indicators, imaging findings and pathology results for 30 patients with CD were reviewed retrospectively. Results: Caroli's disease can occur at any age. The average age of onset in the study cohort was 24 years. Patients who presented with symptoms before the age of 40 years were more likely to develop type II CD. Approximately one-third of patients presented without positive signs at original diagnosis and most of these patients were found to have type I CD on pathology. Anaemia, leucopoenia and thrombocytopoenia were more frequent in patients with type II than type I CD. Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) examinations were most useful in diagnosing CD. -
Soonerstart Automatic Qualifying Syndromes and Conditions 001
SoonerStart Automatic Qualifying Syndromes and Conditions 001 Abetalipoproteinemia 272.5 002 Acanthocytosis (see Abetalipoproteinemia) 272.5 003 Accutane, Fetal Effects of (see Fetal Retinoid Syndrome) 760.79 004 Acidemia, 2-Oxoglutaric 276.2 005 Acidemia, Glutaric I 277.8 006 Acidemia, Isovaleric 277.8 007 Acidemia, Methylmalonic 277.8 008 Acidemia, Propionic 277.8 009 Aciduria, 3-Methylglutaconic Type II 277.8 010 Aciduria, Argininosuccinic 270.6 011 Acoustic-Cervico-Oculo Syndrome (see Cervico-Oculo-Acoustic Syndrome) 759.89 012 Acrocephalopolysyndactyly Type II 759.89 013 Acrocephalosyndactyly Type I 755.55 014 Acrodysostosis 759.89 015 Acrofacial Dysostosis, Nager Type 756.0 016 Adams-Oliver Syndrome (see Limb and Scalp Defects, Adams-Oliver Type) 759.89 017 Adrenoleukodystrophy, Neonatal (see Cerebro-Hepato-Renal Syndrome) 759.89 018 Aglossia Congenita (see Hypoglossia-Hypodactylia) 759.89 019 Albinism, Ocular (includes Autosomal Recessive Type) 759.89 020 Albinism, Oculocutaneous, Brown Type (Type IV) 759.89 021 Albinism, Oculocutaneous, Tyrosinase Negative (Type IA) 759.89 022 Albinism, Oculocutaneous, Tyrosinase Positive (Type II) 759.89 023 Albinism, Oculocutaneous, Yellow Mutant (Type IB) 759.89 024 Albinism-Black Locks-Deafness 759.89 025 Albright Hereditary Osteodystrophy (see Parathyroid Hormone Resistance) 759.89 026 Alexander Disease 759.89 027 Alopecia - Mental Retardation 759.89 028 Alpers Disease 759.89 029 Alpha 1,4 - Glucosidase Deficiency (see Glycogenosis, Type IIA) 271.0 030 Alpha-L-Fucosidase Deficiency (see Fucosidosis) -
Biliary Tract
2016-06-16 The role of cytology in management of diseases of hepatobiliary ducts • Diagnosis in patients with radiologically/clinically detected lesions • Screening of dysplasia/CIS/cancer in risk groups biliary tract cytology • Preoperative evaluation of the candidates for liver transplantation (Patients with cytological low-grade and high-grade Mehmet Akif Demir, MD dysplasia/adenocarcinoma are currently referred for liver transplantation Sahlgrenska University Hospital in some institutions). Gothenburg Sweden Sarajevo 18th June 2016 • Diagnosis of the benign lesions and infestations False positive findings • majority of false positive cases have a Low sensitivity but high specificity! background of primary sclerosing cholangitis. – lymphoplasmacytic sclerosing pancreatitis and cholangitis, – primary sclerosing cholangitis, – granulomatous disease, – non-specific fibrosis/inflammation – stone disease. False negative findings • Repeat brushing increases the diagnostic yield and should be performed when sampling • Poor sampling biliary strictures with a cytology brush at ERCP. • Lack of diagnostic criteria for dysplasia-carcinoma in situ • Difficulties in recognition of special tumour types – well-differentiated cholangiocarcinoma with tubular architecture • Predictors of positive yield include – gastric foveolar type cholangiocarcinoma with mucin-producing – tumour cells. older age, •Underestimating the significance of the smear background – mass size >1 cm, and – stricture length of >1 cm. •The causes of false negative cytology –sampling -
The National Economic Burden of Rare Disease Study February 2021
Acknowledgements This study was sponsored by the EveryLife Foundation for Rare Diseases and made possible through the collaborative efforts of the national rare disease community and key stakeholders. The EveryLife Foundation thanks all those who shared their expertise and insights to provide invaluable input to the study including: the Lewin Group, the EveryLife Community Congress membership, the Technical Advisory Group for this study, leadership from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH), the Undiagnosed Diseases Network (UDN), the Little Hercules Foundation, the Rare Disease Legislative Advocates (RDLA) Advisory Committee, SmithSolve, and our study funders. Most especially, we thank the members of our rare disease patient and caregiver community who participated in this effort and have helped to transform their lived experience into quantifiable data. LEWIN GROUP PROJECT STAFF Grace Yang, MPA, MA, Vice President Inna Cintina, PhD, Senior Consultant Matt Zhou, BS, Research Consultant Daniel Emont, MPH, Research Consultant Janice Lin, BS, Consultant Samuel Kallman, BA, BS, Research Consultant EVERYLIFE FOUNDATION PROJECT STAFF Annie Kennedy, BS, Chief of Policy and Advocacy Julia Jenkins, BA, Executive Director Jamie Sullivan, MPH, Director of Policy TECHNICAL ADVISORY GROUP Annie Kennedy, BS, Chief of Policy & Advocacy, EveryLife Foundation for Rare Diseases Anne Pariser, MD, Director, Office of Rare Diseases Research, National Center for Advancing Translational Sciences (NCATS), National Institutes of Health Elisabeth M. Oehrlein, PhD, MS, Senior Director, Research and Programs, National Health Council Christina Hartman, Senior Director of Advocacy, The Assistance Fund Kathleen Stratton, National Academies of Science, Engineering and Medicine (NASEM) Steve Silvestri, Director, Government Affairs, Neurocrine Biosciences Inc. -
Paternal Factors and Schizophrenia Risk: De Novo Mutations and Imprinting
Paternal Factors and Schizophrenia Risk: De Novo Mutations and Imprinting by Dolores Malaspina Downloaded from https://academic.oup.com/schizophreniabulletin/article/27/3/379/1835092 by guest on 23 September 2021 Abstract (Impagnatiello et al. 1998; Kao et al. 1998), but there is no consensus that any particular gene plays a meaning- There is a strong genetic component for schizophrenia ful role in the etiology of schizophrenia (Hyman 2000). risk, but it is unclear how the illness is maintained in Some of the obstacles in genetic research in schiz- the population given the significantly reduced fertility ophrenia are those of any complex disorder, and include of those with the disorder. One possibility is that new incomplete penetrance, polygenic interaction (epista- mutations occur in schizophrenia vulnerability genes. sis), diagnostic instability, and variable expressivity. If so, then those with schizophrenia may have older Schizophrenia also does not show a clear Mendelian fathers, because advancing paternal age is the major inheritance pattern, although segregation analyses have source of new mutations in humans. This review variably supported dominant, recessive, additive, sex- describes several neurodevelopmental disorders that linked, and oligogenic inheritance (Book 1953; Slater have been associated with de novo mutations in the 1958; Garrone 1962; Elston and Campbell 1970; Slater paternal germ line and reviews data linking increased and Cowie 1971; Karlsson 1972; Stewart et al. 1980; schizophrenia risk with older fathers. Several genetic Risch 1990a, 1990fc; reviewed by Kendler and Diehl mechanisms that could explain this association are 1993). Furthermore, both nonallelic (Kaufmann et al. proposed, including paternal germ line mutations, 1998) and etiologic heterogeneity (Malaspina et al. -
Bhagwan Moorjani, MD, FAAP, FAAN • Requires Knowledge of Normal CNS Developmental (I.E
1/16/2012 Neuroimaging in Childhood • Neuroimaging issues are distinct from Pediatric Neuroimaging in adults Neurometabolic-degenerative disorder • Sedation/anesthesia and Epilepsy • Motion artifacts Bhagwan Moorjani, MD, FAAP, FAAN • Requires knowledge of normal CNS developmental (i.e. myelin maturation) • Contrast media • Parental anxiety Diagnostic Approach Neuroimaging in Epilepsy • Age of onset • Peak incidence in childhood • Static vs Progressive • Occurs as a co-morbid condition in many – Look for treatable causes pediatric disorders (birth injury, – Do not overlook abuse, Manchausen if all is negative dysmorphism, chromosomal anomalies, • Phenotype presence (syndromic, HC, NCS, developmental delays/regression) systemic involvement) • Predominant symptom (epilepsy, DD, • Many neurologic disorders in children weakness/motor, psychomotor regression, have the same chief complaint cognitive/dementia) 1 1/16/2012 Congenital Malformation • Characterized by their anatomic features • Broad categories: based on embryogenesis – Stage 1: Dorsal Induction: Formation and closure of the neural tube. (Weeks 3-4) – Stage 2: Ventral Induction: Formation of the brain segments and face. (Weeks 5-10) – Stage 3: Migration and Histogenesis: (Months 2-5) – Stage 4: Myelination: (5-15 months; matures by 3 years) Dandy Walker Malformation Dandy walker • Criteria: – high position of tentorium – dysgenesis/agenesis of vermis – cystic dilatation of fourth ventricle • commonly associated features: – hypoplasia of cerebellum – scalloping of inner table of occipital bone • associated abnormalities: – hydrocephalus 75% – dysgenesis of corpus callosum 25% – heterotropia 10% 2 1/16/2012 Etiology of Epilepsy: Developmental and Genetic Classification of Gray Matter Heterotropia Cortical Dysplasia 1. Secondary to abnormal neuronal and • displaced masses of nerve cells • Subependymal glial proliferation/apoptosis (gray matter) heterotropia (most • most common: small nest common) 2. -
Inherited Neuropathies
407 Inherited Neuropathies Vera Fridman, MD1 M. M. Reilly, MD, FRCP, FRCPI2 1 Department of Neurology, Neuromuscular Diagnostic Center, Address for correspondence Vera Fridman, MD, Neuromuscular Massachusetts General Hospital, Boston, Massachusetts Diagnostic Center, Massachusetts General Hospital, Boston, 2 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology Massachusetts, 165 Cambridge St. Boston, MA 02114 and The National Hospital for Neurology and Neurosurgery, Queen (e-mail: [email protected]). Square, London, United Kingdom Semin Neurol 2015;35:407–423. Abstract Hereditary neuropathies (HNs) are among the most common inherited neurologic Keywords disorders and are diverse both clinically and genetically. Recent genetic advances have ► hereditary contributed to a rapid expansion of identifiable causes of HN and have broadened the neuropathy phenotypic spectrum associated with many of the causative mutations. The underlying ► Charcot-Marie-Tooth molecular pathways of disease have also been better delineated, leading to the promise disease for potential treatments. This chapter reviews the clinical and biological aspects of the ► hereditary sensory common causes of HN and addresses the challenges of approaching the diagnostic and motor workup of these conditions in a rapidly evolving genetic landscape. neuropathy ► hereditary sensory and autonomic neuropathy Hereditary neuropathies (HN) are among the most common Select forms of HN also involve cranial nerves and respiratory inherited neurologic diseases, with a prevalence of 1 in 2,500 function. Nevertheless, in the majority of patients with HN individuals.1,2 They encompass a clinically heterogeneous set there is no shortening of life expectancy. of disorders and vary greatly in severity, spanning a spectrum Historically, hereditary neuropathies have been classified from mildly symptomatic forms to those resulting in severe based on the primary site of nerve pathology (myelin vs. -
Genes in Eyecare Geneseyedoc 3 W.M
Genes in Eyecare geneseyedoc 3 W.M. Lyle and T.D. Williams 15 Mar 04 This information has been gathered from several sources; however, the principal source is V. A. McKusick’s Mendelian Inheritance in Man on CD-ROM. Baltimore, Johns Hopkins University Press, 1998. Other sources include McKusick’s, Mendelian Inheritance in Man. Catalogs of Human Genes and Genetic Disorders. Baltimore. Johns Hopkins University Press 1998 (12th edition). http://www.ncbi.nlm.nih.gov/Omim See also S.P.Daiger, L.S. Sullivan, and B.J.F. Rossiter Ret Net http://www.sph.uth.tmc.edu/Retnet disease.htm/. Also E.I. Traboulsi’s, Genetic Diseases of the Eye, New York, Oxford University Press, 1998. And Genetics in Primary Eyecare and Clinical Medicine by M.R. Seashore and R.S.Wappner, Appleton and Lange 1996. M. Ridley’s book Genome published in 2000 by Perennial provides additional information. Ridley estimates that we have 60,000 to 80,000 genes. See also R.M. Henig’s book The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, published by Houghton Mifflin in 2001 which tells about the Father of Genetics. The 3rd edition of F. H. Roy’s book Ocular Syndromes and Systemic Diseases published by Lippincott Williams & Wilkins in 2002 facilitates differential diagnosis. Additional information is provided in D. Pavan-Langston’s Manual of Ocular Diagnosis and Therapy (5th edition) published by Lippincott Williams & Wilkins in 2002. M.A. Foote wrote Basic Human Genetics for Medical Writers in the AMWA Journal 2002;17:7-17. A compilation such as this might suggest that one gene = one disease. -
Genevista Microdeletion and Microduplication Syndromes
GeNeViSTA Microdeletion and Microduplication Syndromes: An Update Priya Ranganath, Prajnya Ranganath Department of Medical Genetics, Nizam’s Institute of Medical Sciences, Hyderabad, India Correspondence to: Dr Prajnya Ranganath Email: [email protected] Abstract containing dosage sensitive genes responsible for the phenotype is generally involved (Goldenberg, Microdeletion and microduplication syndromes 2018). Theoretically, for every microdeletion (MMS) also known as ‘contiguous gene syndrome there should be a reciprocal syndromes’ are a group of disorders caused microduplication syndrome, but microdeletions by sub-microscopic chromosomal deletions or are more common. Microduplications appear to duplications. Most of these conditions are typically result in a milder or no clinical phenotype. associated with developmental delay, autism, multiple congenital anomalies, and characteristic Molecular Etiopathology phenotypic features. These chromosomal abnormalities cannot be detected by conventional Copy number variation (CNV) is defined as the gain cytogenetic techniques like karyotyping and or loss of a stretch of DNA when compared with require higher resolution ‘molecular cytogenetic’ the reference human genome and may range in techniques. The advent of high throughput tests size from a kilobase to several megabases or even such as chromosomal microarray in the past one an entire chromosome. The CNVs associated with or two decades has led to a continuously growing MMS constitute only a small fraction of the total list of microdeletions and microduplication number of possible copy-number variants. There syndromes along with identification of the ‘critical are two major classes of CNVs: recurrent and region’ responsible for the main phenotypic non-recurrent. Recurrent CNVs generally result features associated with these syndromes. This from Non-Allelic Homologous Recombination review discusses the etiopathogenic mechanisms (NAHR) during meiosis. -
Global Journal of Medical Research: F Diseases Cancer, Ophthalmology & Pediatric
OnlineISSN:2249-4618 PrintISSN:0975-5888 DOI:10.17406/GJMRA CoronaryArteryBypassGrafting RelationshipofClinicalManifestations SynapticPruninginAlzheimerʼsDisease TreatmentofUpperandLowerRespiratory VOLUME20ISSUE6VERSION1.0 Global Journal of Medical Research: F Diseases Cancer, Ophthalmology & Pediatric Global Journal of Medical Research: F Diseases Cancer, Ophthalmology & Pediatric Volume 2 0 Issue 6 (Ver. 1.0) Open Association of Research Society Global Journals Inc. © Global Journal of Medical (A Delaware USA Incorporation with “Good Standing”; Reg. Number: 0423089) Sponsors:Open Association of Research Society Research. 2020. Open Scientific Standards All rights reserved. Publisher’s Headquarters office This is a special issue published in version 1.0 of “Global Journal of Medical Research.” By ® Global Journals Inc. Global Journals Headquarters 945th Concord Streets, All articles are open access articles distributed under “Global Journal of Medical Research” Framingham Massachusetts Pin: 01701, United States of America Reading License, which permits restricted use. Entire contents are copyright by of “Global USA Toll Free: +001-888-839-7392 Journal of Medical Research” unless USA Toll Free Fax: +001-888-839-7392 otherwise noted on specific articles. Offset Typesetting No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including Global Journals Incorporated photocopy, recording, or any information 2nd, Lansdowne, Lansdowne Rd., Croydon-Surrey, storage and retrieval system, without written permission. Pin: CR9 2ER, United Kingdom The opinions and statements made in this Packaging & Continental Dispatching book are those of the authors concerned. Ultraculture has not verified and neither confirms nor denies any of the foregoing and Global Journals Pvt Ltd no warranty or fitness is implied. E-3130 Sudama Nagar, Near Gopur Square, Engage with the contents herein at your own Indore, M.P., Pin:452009, India risk. -
Duchenne Muscular Dystrophy (DMD)
Pediatric Residents Review Session A bit of a hodge podge to keep you guessing December 20, 2018 Natarie Liu, FRCPC, Pediatric Neurology Email me for resources (OSCE handbook, etc) Thanks to Dr. K. Smyth and Dr. K Murias for inspiration for some of the slides Case 3mo girl with hypotonia, hypotonic facies, 1+ symmetric DTR. What is the most likely diagnosis? a. Congenital muscular dystrophy b. Myotonic dystrophy c. SMA1 d. Nemaline rod Stem not giving this picture OR this picture What is this? Dystrophinopathies Duchenne Muscular Dystrophy Becker Muscular Dystrophy Dystrophinopathies By convention, if boy stops walking before age 12, this is Duchenne Muscular Dystrophy (DMD) If they remain ambulatory after their 16th birthday, are typically considered to have Becker Muscular Dystrophy (BMD) Anything in between is an intermediate phenotype Some centres transition to using Dystrophinopathies as the term Dystrophinopathies are X-linked disorders Dystrophinopathies: Epidemiology Duchenne Muscular Dystrophy 1:3500 live male births but newborn screening places the incidence closer to 1:5000 live male births Mean lifespan 19 years traditionally, now greater than 25 years (with multidisciplinary team management and corticosteroid use) Becker Muscular Dystrophy Incidence 1/10th-1/5th of DMD Prevalence 60-90% more than DMD DMD: Clinical Features Boys often present between 3-5 years of age Delayed motor milestones and falls, difficulty running and jumping Gain motor milestones through 6-7 years of age, progressive weakness after Wheelchair before age 12, historically Examination Calf hypertrophy Mild lordotic posture Waddling of gait Poor hip excursion during running Head lag when pulled from sitting from supine Partial Gower maneuver when rising from floor.