MEDICAL CONCERNS Associated with Down Syndrome
|
|
- Patricia Simpson
- 5 years ago
- Views:
Transcription
1 MEDICAL CONCERNS Associated with Down Syndrome Persons with Down syndrome are at an increased risk for a number of associated medical concerns, the most significant of which are outlined below. Cardiac Conditions Forty-six to sixty-two percent of persons with Down syndrome are born with some form of cardiac defect. The most common is Atrioventricular Septal Defect (59%), followed by Ventricular Septal Defect (19%), Atrial Septal Defect (9%), Tetralogy of Fallot (6%), Patent Ductus Arteriosis (4%), and other cardiac abnormalities (3%). Significant defects are typically discovered and repaired during the first year of life. Despite this early intervention, some children with such history may require continuing cardiac care throughout their lives. Additionally, recent studies have suggested that children and adolescents with Down syndrome frequently demonstrate mitral valve prolapse or insufficiency, and/or atrial regurgitation. Antibiotic prophylaxis is recommended for these individuals prior to any surgical or dental intervention. Gastrointestinal Disorders Five percent of persons with Down syndrome experience gastrointestinal abnormalities. Included in this five percent are Duodenal Stenosis/Atresia (50%), Imperforate Anus (20%), Hirschsprung Disease (10%), Tracheoesophageal Fistula (9%), Pyloric Stenosis (6%), Malrotation (4%) and other gastrointestinal abnormalities (1%). Musculoskeletal Conditions Persons with Down syndrome are at high risk for musculoskeletal abnormalities, including ligamentous laxity and atlantoaxial instability. In the latter, excess mobility of the articulation of C1 (atlas) and C2 (axis) occurs. Fifteen percent of individuals with DS develop atlantoaxial instability. Of these 1-2% will develop subluxation and cord compression in this area. Clinicians should note that there is a higher incidence of individuals developing atlantoaxial instability during the rapid growth of adolescence. Cervical evaluation via x-ray is thus in order. Patients (and parents of children) exhibiting clinical atlantoaxial instability should be counseled to avoid contact sports, diving, trampoline exercises and/or other activities which may place undue stress on the neck area. Occasionally surgical stabilization of the atlas and axis may Copyright Interdisciplinary Human Development Institute, University of Kentucky. Individuals are hereby granted permission, without fees or further requests, to make photocopies of documents on this CD-ROM for noncommercial use in classrooms or
2 2 be required to prevent neurological compromise from spinal cord compression. Immunological Disorders Persons with Down syndrome are at an increased risk for several immune / infectious disorders, including juvenile rheumatoid arthritis, alopecia areata, celiac disease, deficiencies of cellular and humoral immunity, immunoglobulin deficiencies (such as low IgG Subclasses 2 & 4, with elevated 1 & 3, found in individuals with serious pyogenic infections), and frequent ENT infections such as nasopharyngitis/sinusitis/otitis media. Thyroid dysfunction in Down syndrome may be related to autoimmune factors as well. Dental Defects Dental abnormalities are common in persons with Down syndrome as well. Common problems include delayed eruption of primary teeth, misshapen or missing teeth, delayed loss of primary teeth, narrow palate, bruxism (grinding one s teeth), and periodontal disease. In addition, a small oral cavity is often seen in young persons with Down syndrome, potentially resulting in overcrowding of teeth and possible malocclusion. Orthodontic consultation may be required. Dermatological Disorders Skin problems are common in young people with Down syndrome. These may in part be related to immunologic factors (as in alopecia). Skin texture may be dry and rough. Up to 70% of individuals with Down syndrome are affected by xerosis (abnormally dry skin) by the teenage years. Hyperkeratotic lesions, elastic tissue defect, and alopecia areata are not uncommon. Localized hyperkeratotic lesions frequently occur on the anterior thighs, ankles, and wrists. Follicular skin infections of the buttocks, thighs, and perigenital area are more likely to occur in adolescents with Down syndrome. These infections may progress to abscess if left untreated. Fungal infections of the feet are frequently seen in patients with Down syndrome as well. Healthcare counseling should address preventative measures such as good hygiene, weight control, use of antibiotic ointments and emollients. Ophthalmologic Disorders Ophthalmologic disorders are very prevalent among individuals with Down syndrome. Of these the most common is strabismus, affecting percent of individuals with Down syndrome. Amblyopia (decreased vision in one eye) is also common, but less frequent, occurring approximately 12% of the time. Cataracts also occur more frequently in individuals with Down syndrome. Although usually considered an issue affecting mature adults, cataract
3 formation typically begins in adolescence, possibly as a result of the early aging process typically seen. Additionally, 5 to 8 percent of individuals are affected by keratoconus, or an anterior bulging of the cornea. Keratoconus is the second most common cause of blindness in individuals with Down syndrome. Blepharitis (inflammation of the eyelids) is also relatively common among adolescents, as are nasolacrimal duct stenosis and nystagmus. Refractive errors are also often present which may be easily corrected by optical lenses. Due to the increased incidence of these disorders in persons with Down syndrome, a thorough ophthalmologic exam is recommended with each check up. Thyroid Dysfunction Thyroid disorders are prevalent in persons with Down syndrome, with hypothyroidism occurring much more frequently than hyperthyroidism. Autoimmune factors may play a role in the etiology of hypothyroidism in Down syndrome, although the exact relationship is not completely understood. Studies have demonstrated that thyroid hormone levels may gradually decrease during the adolescent years. Symptoms of thyroid dysfunction may thus become more evident during this time. Thyroid dysfunction may have implications for multiple systems; cardiovascular, immune, and central nervous system effects are frequently seen. Undetected hypothyroidism may contribute to the decline in mental function over time frequently seen in individuals with Down syndrome, as well as to depression. Thyroid hormone levels should thus be monitored at least annually in affected individuals. Sensory/Other Other congenital malformations commonly associated with Down syndrome include: sensorineural hearing loss; ENT / Audiologic disorders such as hearing loss (either sensorineural, conductive, or mixed); midfacial hypoplasia; frequent purulent nasopharyngitis/ sinusitis; tracheomalacia; tracheal stenosis; and frequent croup and obstruction of airways from tonsillar and adenoidal tissue. Sleep Apnea Symptoms of sleep apnea include snoring, sleeping in unusual positions, and restless sleep. Being overweight may exacerbate symptoms of sleep apnea due to increased fatty deposits within the pharynx. Midfacial hypoplasia typically seen in individuals with Down syndrome also contributes to pharyngeal obstruction. If untreated, sleep apnea can lead to right sided heart failure and pulmonary hypertension - and may also cause behavior and learning problems. A sleep study should be used to confirm sleep 3
4 4 apnea when suspected. Treatment includes radio ablative tongue surgery and C-pap. Behavioral Concerns Children with Down syndrome all have their own unique personalities. Historically persons with Down syndrome have been stereotyped as having placid, amiable, dispositions. Recent studies reflect much more variety in temperament. An easy temperament alone, however, does not preclude development of behavioral problems. Any child or person may develop negative behaviors in certain situations/environments. No area of problem behavior seems to be specific to Down syndrome. Disruptive behavior disorders are the most frequently reported, with an incidence of between 11 and 12 percent. Difficult behavior may be precipitated and/or exacerbated by communication difficulties. It is important for clinicians to remember that although certain behaviors may appear immature for chronological age, they may not be immature for developmental age. It is best to consult a professional/therapist experienced in developmental disabilities when evaluating behavioral issues. Depression Persons with Down syndrome are just as susceptible to depression as the general population. Specifically, the incidence of depression in persons with intellectual disabilities in particular has been estimated at 6 to 7%. Depression can occur as a result of current stress (acute), such as the death of a family member, leaving school, loss of siblings for college or home, or illness. Depression rather may develop as a more chronic condition. A recent history of the person's life is necessary to define the problem, if possible, and identify available support systems. Mental health assessment must accommodate the individual's specific cognitive/developmental level. It is important that any of the signs and/or symptoms of depression be closely assessed to determine if they are symptoms of a biological/ medical condition (e.g., seizures, hypothyroidism) or a condition in itself (i.e., depression). Possible signs and/or symptoms of depression include withdrawal, sadness, sleep disturbances, behavioral changes (either quieting or aggressive), weight loss or gain, recurrent thoughts of death, lack of energy and/or feelings of worthlessness. Often the diagnosis of depression is missed because the family is told that the particular signs/symptoms are just Down syndrome. Signs and/or symptoms might also be misinterpreted as dementia or Alzheimer s disease. It is important when symptoms are present to consult a
5 5 therapist experienced in the treatment of individuals with developmental disabilities. Timely treatment may prevent or diminish the need for inpatient service. Many physicians, psychologists and other mental health professionals currently have had little training in the relationship of psychiatric conditions to persons with intellectual disabilities such as Down syndrome, leaving room for missed or misdiagnosis. The clinical presentation of depression in persons with Down syndrome may be quite different from someone without a cognitive deficit. As the person with Down syndrome ages, mental function and social support may decrease, creating an opportunity for depression to occur. Adults with Down syndrome may experience isolation, changes in residence, and a lacking of social opportunities and adaptive skills. All of these factors contribute to decreased selfesteem, an inability to care for themselves, and depression. It is often the case that adults with Down syndrome lack the opportunities to make their own decisions in areas where they are capable (e.g., social activities, hair style, clothing choice, etc.). They are often treated as children and thus feel they have little, if any, control over their lives. Additionally, individuals who care for adults with Down syndrome may overlook support systems, overprotect the person, and/or inappropriately take punitive actions toward the person with Down syndrome. Protective Genes on the 21ST Chromosome Trisomy 21 is protective in two ways; first, a gene present related to homocystine protects against atherosclerotic heart disease. Therefore, it is rare for a person with Down syndrome to have a heart attack or stroke unless heart defects have not been corrected; second, the 21st chromosome houses a tumor suppression gene. Except for testicular cancer, people with Down syndrome do not develop solid tumors. This material is adapted in part from: Patterson, Bonnie (2003). Down Syndrome Medical Issues Research. PowerPoint Presentation given at Healthcare Symposium. Shriner s Hospital, Lexington, Kentucky, June 21, Pueschel, S.M., and Sustrova, M. (1997). Selected medical conditions. In S.M. Pueschel & M. Sustrova (Eds.), Adolescents with Down syndrome: Toward a more fulfilling life (pp ). Baltimore, MD: Brookes Publishing. Funding and support for Brighter Tomorrows was provided by the U.S. Centers for Disease Control and Prevention, National Center
6 6 on Birth Defects and Developmental Disabilities, and the Association of University Centers on Disabilities (Grant No: AUCD RTOI ).
Medical Issues for Children with Down Syndrome
Medical Issues for Children with Down Syndrome Joanna Spahis, RN, CNS, APNG Genetics Clinical Nurse Specialist Children s Medical Center Dallas February 27, 2010 Facts About Down Syndrome Chromosome condition
More informationHEALTHCARE GUIDELINES
HEALTHCARE GUIDELINES Down Syndrome: 1999 Revision (Down Syndrome Preventive Medical Check List) Edited by William I. Cohen M.D. for the Down Syndrome Medical Interest Group 1 Dedicated to the memories
More informationAnna & John J. Sie Center for Down Syndrome Affiliates
Anna & John J. Sie Center for Down Syndrome Affiliates Types of Medical Research Bench or basic research: done in a controlled laboratory setting using nonhuman subjects Clinical research: answer questions
More informationAging. Objectives 13/02/2013
Deirdre Gillespie RN MN AHEADD (Assessment, Health, Education and Developmental Disabilities) dgillespie1@cogeco.ca 613-985-6154 Objectives Discussion about aging Aging and Developmental Disabilities Supporting
More informationDr. Amanda Votruba, M.D. FAAP
Dr. Amanda Votruba, M.D. FAAP Pediatrician with Methodist Physicians Clinic Board Certified in Pediatrics No disclosures Down s Syndrome: an Overview Dr. Amanda Votruba, M.D. FAAP dsaw.org Objectives Goal:
More informationAGING AND INTELLECTUAL & DEVELOPMENTAL DISABILITY AN OVERVIEW
AGING AND INTELLECTUAL & DEVELOPMENTAL DISABILITY AN OVERVIEW Presented by Julie A. Moran, DO Geriatrician, Aging and Intellectual/Developmental Disabilities Specialist Consultant, Tewksbury Hospital and
More informationDemodex canis mites living within the skin layers and producing an immunodeficiency syndrome. Fold dermatitis An inflammation of skin folds
ENGLISH BULLDOG HEALTH ISSUES AND INFORMATION Listed are some health concerns for your Bulldog, note that these diseases and conditions do not pertain only to the Bulldog. Entropion An abnormal rolling
More informationHealth Care Information for Families of Children with Down Syndrome
Health Care Information for Families of Children with Down Syndrome American Academy of Pediatrics Introduction Down syndrome is a common condition caused by having extra copies of genes on the 21st chromosome.
More informationHealth Watch Table - Down Syndrome - Adult
Health Watch Table - Down Syndrome - Adult Forster-Gibson, Cynthia, MD, PhD; Berg, Joseph M, MB, BCh, MSc, FRCPSYCH, FCCMG CONSIDERATION 1. HEENT (HEAD, EYES, EARS, NOSE, THROAT) Adults: ~15% have cataracts;
More informationLegal aspects in accidents and neglect.
Al-Al Bayt University Princess Salma Faculty of Nursing Adult Health nursing Course Title :Child Health Nursing Course Number :1001341 Credit Hours :3 Pre requisite :1001222 Placement : Instructor:,, Course
More informationIII. What Do We Know? Medical Facts about Down Syndrome
III. What Do We Know? Medical Facts about Down Syndrome 5 What is Down Syndrome? Down syndrome is the most common chromosomal aberration in human beings. Named after the English doctor John Langdon Down,
More informationMEDICAL HISTORY. Previous Nephrologist. Medication taken Insulin Oral Both. Who manages your diabetes? Blindness Yes No Hearing Problems Yes No
MEDICAL HISTORY Please mark YES or NO and fill in appropriate blanks as needed Chronic Yes No If yes, year diagnosed Previous Nephrologist Transplant Yes No If yes, date Donor type Living Deceased Related
More informationPEDIATRICS. Module Topic/Content Student Learning Outcomes Resources Clinical Assessment Activities Course/Clinical Outcomes
PEDIATRICS N332 Outline 1 Welcome back: Instructor Role and Student Role Discuss course requirements. Explain personal learning style and study patterns. Explain critical thinking and clinical judgment
More informationSubspecialty Rotation: Otolaryngology
Subspecialty Rotation: Otolaryngology Faculty: Evelyn Kluka, M.D. GOAL: Hearing Loss. Understand the morbidity of hearing loss, intervention strategies, and the pediatrician's and other specialists' roles
More informationPhysical and Medical Impairments in Elderly Drivers
Physical and Medical Impairments in Elderly Drivers Kam Hunter, MD PhD AzGS Summer Interdisciplinary Conference August 3 rd, 2011 Physiology Pertinent Systems Affected by Aging Visual Decreased central
More informationSLEEP DISORDERED BREATHING The Clinical Conditions
SLEEP DISORDERED BREATHING The Clinical Conditions Robert G. Hooper, M.D. In the previous portion of this paper, the definitions of the respiratory events that are the hallmarks of problems with breathing
More informationHealth Care Information for Families of Children with Down Syndrome
American Academy of Pediatrics Introduction Down syndrome is a common condition caused by having extra copies of genes on the 21st chromosome. Those extra genes change development during pregnancy, and
More informationCardiology Competency Based Goals and Objectives
Cardiology Competency Based Goals and Objectives COMPETENCY 1. Patient Care. Provide family centered patient care that is developmentally and age appropriate, compassionate, and effective for the treatment
More informationMusculoskeletal Development and Sports Injuries in Pediatric Patients
Dynamic Chiropractic October 21, 2010, Vol. 28, Issue 22 Musculoskeletal Development and Sports Injuries in Pediatric Patients By Deborah Pate, DC, DACBR Physical activity is extremely important for everyone,
More informationSupplemental Information
ARTICLE Supplemental Information SUPPLEMENTAL TABLE 6 Mosaic and Partial Trisomies Thirty-eight VLBW infants were identified with T13, of whom 2 had mosaic T13. T18 was reported for 128 infants, of whom
More informationPAGE 1 NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only)
PAGE 1 NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only) 1. What is the main problem that you are having? (If additional space is required, please use the back of this
More informationPremium Specialty: Pediatrics
Premium Specialty: Pediatrics Credentialed Specialties include: Adolescent Medicine, Pediatric Adolescent, and Pediatrics This document is designed to be used in conjunction with the UnitedHealth Premium
More informationHealth Care Information for Families of Children with Down Syndrome American Academy of Pediatrics
Syndrome American Academy of Pediatrics Introduction Down syndrome is a common condition caused by having extra copies of genes on the 21st chromosome. Those extra genes change development during pregnancy,
More informationThe University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Otolaryngology
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Otolaryngology 1. GOAL: Hearing Loss. Understand the morbidity of hearing loss, intervention strategies, and the pediatrician's
More informationProximal 18q- Treatment and Surveillance ICD-10 = Q99.9 or Q93.89
Proximal 18q- Treatment and Surveillance ICD-10 = Q99.9 or Q93.89 These recommendations are inclusive of the entire population of people with Proximal 18q deletions even though each person has a unique
More informationDepartment of Pediatric Otolarygnology. ENT Specialty Programs
Department of Pediatric Otolarygnology ENT Specialty Programs Staffed by fellowship-trained otolaryngologists, assisted by pediatric nurse practitioners, ENT (Otolaryngology) at Nationwide Children s Hospital
More informationPatient Name: Date of Birth: Preferred Pharmacy: (name/location/phone #)
Patient Name: Date of Birth: Referring Doctor: Primary Care Dr: Preferred Pharmacy: (name/location/phone #) CURRENT MEDICATIONS: Please list all Medication Dose Frequency 1 2 3 4 5 6 7 8 9 10 11 12 13
More informationBIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by June 30, 2009
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Division for Vital Records and Health Statistics MICHIGAN BIRTH DEFECTS SURVEILLANCE REGISTRY BIRTH DEFECTS IN MICHIGAN All Cases Reported and Processed by June
More information: Provide cardiovascular preventive counseling to parents and patients with specific cardiac diseases about:
Children s Hospital & Research Center Oakland Cardiology Primary Goals for this Rotation 5.13 GOAL: Prevention, Counseling and Screening (Cardiovascular). Understand the role of the pediatrician in preventing
More informationJanuary Intravenous Nurse Day ALL MONTH LONG SUN MON TUE WED THU FRI SAT. Blood Donor Month. Glaucoma Awareness Month
January 1 2 3 4 5 6 Blood Donor Month 7 8 9 10 11 12 13 Glaucoma Awareness Month Volunteer Blood Donor Month Cervical Health Awareness Month 14 15 16 17 18 19 20 Thyroid Awareness Month Birth Defects Prevention
More informationMedical Care of Your Child With Down Syndrome
Medical Care of Your Child With Down Syndrome Nasreen Talib, MD, MPH Medical Director Laurie Hornberger, MD, MPH Down Syndrome Clinic Children Mercy Hospital and Clinics Objectives Provide an overview
More informationSiegfried Pueschel, MD, PhD, JD, MPH Professor of Pediatrics Brown University Providence, Rhode Island, USA
Siegfried Pueschel, MD, PhD, JD, MPH Professor of Pediatrics Brown University Providence, Rhode Island, USA Previous Guidelines DSMIG: Health Care Guidelines For Individuals With Down Syndrome: 1999 Revision
More informationSleep Center. Have you had a previous sleep study? Yes No If so, when and where? Name of facility Address
Patient Label For office use only Appt date: Clinician: Sleep Center Main Campus Highlands Ranch Location 1400 Jackson Street 8671 S. Quebec St., Ste 120 Denver, CO 80206 Highlands Ranch, CO 80130 Leading
More informationICD -10 -CM Pediatric/Strabismus
ICD -10 -CM Pediatric/Strabismus Amblyopia Deprivation H53.011 H53.012 H53.013 H53.019 Refractive H53.021 H53.022 H53.023 H53.029 Strabismic H53.031 H53.032 H53.033 H53.039 Suspect H53.041 H53.042 H43.043
More informationRETURNING PATIENT HEALTH QUESTIONNAIRE ADULT DOWN SYNDROME CENTER ADVOCATE LUTHERAN GENERAL HOSPITAL
RETURNING PATIENT HEALTH QUESTIONNAIRE Date of Appointment ALL QUESTIONS REFER TO THE PERSON WITH DOWN SYNDROME Name Date of Birth Person Filling Out the Form: Do you have any specific concerns regarding
More informationRecognize the broad impact of hearing impairment on child and family, including social, psychological, educational and financial consequences.
Otolaryngology Note: The goals and objectives described in detail below are not meant to be completed in a single one month block rotation but are meant to be cumulative, culminating in a thorough and
More informationGenetic Diseases. Genetic diseases occur when an individual s DNA has one or more abnormalities.
Genetic Diseases Genetic diseases occur when an individual s DNA has one or more abnormalities. Autosomal dominant genetic disorders refer to diseases in which only one copy, the dominant allele, is needed
More informationPHYSICIAN S REPORT SPECIAL NEEDS Patient s Name: Date of Birth:
Guiding Eyes for the Blind 611 Granite Springs Road, Yorktown Heights, New York 10598 PHONE 914 243-2216 admissions@guidingeyes.org FAX 914 243-2232 PHYSICIAN S REPORT SPECIAL NEEDS Patient s Name: Date
More informationPatient Intake Form for Allegany Ear, Nose, & Throat
Patient Intake Form for Allegany Ear, se, & Throat Patient Name: What brings you to the office today? Who is your primary care doctor? Please list your current medications: Are you allergic to any medications?
More informationShabib A. Alhadheri, M.D.
Pediatrics in the Red Rocks Sedona, Arizona June 20-22, 2008 Shabib A. Alhadheri, M.D. Pediatric Cardiologist Disclosure I I have no relevant financial relationships with the manufacturer(s) of any commercial
More informationDIVISION OF CARDIOLOGY
Name: Date of Birth: / / Home Phone #: Cell Phone #: Work Phone #: Fax #: Address: City: State: Zip: Primary Care Physician: Office Address: Work #: Fax #: Referring Physician (if different): Office Address:
More informationEarly onset dementia in Down syndrome -Dental management considerations ASSCID Walkabout Conference 2017 Brisbane, Australia
Early onset dementia in Down syndrome -Dental management considerations ASSCID Walkabout Conference 2017 Brisbane, Australia Dr Zanab Malik, BDS Resident- Department of Oral Medicine, Oral Pathology and
More informationPAEDIATRIC EMQs. Andrew A Mallick Paediatrics.info.
PAEDIATRIC EMQs Andrew A Mallick Paediatrics.info www.paediatrics.info Paediatric EMQs Paediatrics.info First published in the United Kingdom in 2012. While the advice and information in this book is believed
More informationLab #10: Karyotyping Lab
Lab #10: Karyotyping Lab INTRODUCTION A karyotype is a visual display of the number and appearance of all chromosomes from a single somatic cell. A normal human karyotype would reveal 46 chromosomes (22
More informationChapter 13. DiGeorge Syndrome
Chapter 13 DiGeorge Syndrome DiGeorge Syndrome is a primary immunodeficiency disease caused by abnormal migration and development of certain cells and tissues during fetal development. As part of the developmental
More informationThe 14 th International Fragile X Conference, Garden Grove, CA, Friday, July 18 th, 2014
Presenters: Sharon Kidd, MPH, PhD; Ave Lachiewicz, MD; Deborah Barbouth, MD; Robin Blitz, MD; Carol Delahunty, MD; Dianne McBrien, MD; Elizabeth Berry-Kravis, MD, PhD The 14 th International Fragile X
More informationPreferred language: PATIENT INFORMATION. Date of birth (dd/mm/yyyy): Age: Sex: Male Female. City: State: Country: Zip code:
ADULT INTAKE QUESTIONNAIRE Please fill out this form as completely as possible. This information will help us to better assess whether you are a good candidate for the program. Today s date (dd/mm/yyyy):
More information04/ p. 18p deletions. 18p Critical Regions
18p 04/2017 18p deletions 18p Critical Regions 18p (cen) Newborn Physical Findings (N=31) Neonatal complications 74% Feeding Difficulties 42% Respiratory Difficulties 29% Jaundice 29% Hypoglycemia 10%
More informationInfective Endocarditis عبد المهيمن أحمد
Infective Endocarditis إعداد : عبد المهيمن أحمد أحمد علي Infective endocarditis Inflammation of the heart valve or endocardium of the heart. The agents are usually bacterial, but other organisms can also
More informationOrofacial function of persons having. Report from questionnaires. Turner syndrome
Orofacial function of persons having Turner syndrome Report from questionnaires The survey comprises questionnaires. Estimated occurrence: : girls born. Etiology: Girls with Turner syndrome are either
More informationThymic hypoplaisa/aplasia, very small thymus gland or none at all, increased risk of infection C
Orofacial function of persons having q deletion syndrome Report from questionnaires The survey comprises questionnaires. Synonyms: CATCH, Di George syndrome, Velocardiofacial syndrome Estimated incidence:
More informationKPA PFIZER EDUCATION GRANT
KPA PFIZER EDUCATION GRANT What every Paediatrician needs to know in Paediatric Ophthalmology Dr. Njambi Ombaba Paediatricians knowledge in ophthalmology Outline Visual development in a child Amblyopia
More informationWASHINGTON UNIVERSITY SCHOOL OF MEDICINE. Cranial Health History Form
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE Cranial Health History Form Welcome to the Neurosurgery Department at Washington University. To help us treat you, please fill this form out completely. Your Name:
More informationNEW PATIENT VISIT QUESTIONNAIRE
HeartHealth A Program of the Dalio Institute of Cardiovascular Imaging NEW PATIENT VISIT QUESTIONNAIRE Name: Date of Birth: / / Address: City: State: Zip: Home Phone #: Work Phone #: Cell #: Email: Preferred
More informationDevelopmental-Behavioral Pediatrics Questionnaire for New Patients
Developmental-Behavioral Pediatrics Questionnaire for New Patients Date: Name of person completing questionnaire: Relationship to child: Email: IDENTIFYING INFORMATION: Information Child Name Child Birthdate
More informationNew Patient Form. Patient Demographics. Emergency Information. Employment Information. Page 1 of 7. Family Health Chiropractic Care
Page 1 of 7 Patient Demographics First Name* Last Name* Date Of Birth* Home Phone* Mobile Phone Phone Gender* Email Preferred Communication Street Address 1* Street Addresss 2 Zip* City* State* Emergency
More information18p- Treatment and Surveillance ICD-10 = Q99.9 or Q93.89
18p- Treatment and Surveillance ICD-10 = Q99.9 or Q93.89 These recommendations are inclusive of the entire population of people with 18p deletions. Even though about half of this group have deletions of
More informationB G C F
D E I A B G H C F http://2.bp.blogspot.com/_hhudkwzdma4/s1hz6-trldi/aaaaaaaaax4/isdfm81zqcw/s400/blood+vesssel.jpg 495 D D E F G J L M B A C H I K N O P Q R S T U V W X Y 496 Z http://antranik.org/wp-content/uploads/2011/12/gross-anatomy-of-the-heart-anterior-view.jpg
More informationROUTINE SURVEILLANCE FOR INDIVIDUALS WITH DOWN SYNDROME
ROUTINE SURVEILLANCE FOR INDIVIDUALS WITH DOWN SYNDROME NEONATAL (Birth - 1 Month) Review parental concerns. Chromosomal karyotype; genetic counseling, if necessary. If vomiting or absence of stools, check
More informationThe following sections describe medical concerns related to specific organs or body. systems. Cardiac
Aniella was born in 2005 and was prenatally diagnosed with full trisomy 18. She lives in the United States. Participation in the TRIS project began in 2011. Mother was 36 and father was 32 years old at
More informationNew Patient Sleep Intake
New Patient Sleep Intake Name: Date of Birth: Primary Care Physician: Date of Visit: Referring Physician and/or Other Physicians: Retail Pharmacy: Mail Order Pharmacy: Address: Mail Order Phone #: Phone
More informationCentral nervous system
Central nervous system By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 7 th Lecture Lecture outline Review of structure & function. Symptoms, signs & tests. Specific diseases. Review of structure
More informationLaurence-Moon-Bardet-Biedl syndrome Report from questionnaires
7--8 Orofacial function of persons having Laurence-Moon-Bardet-Biedl syndrome Report from questionnaires The survey comprises questionnaires. Synonyms: Bardet-Biedl syndrome, Laurence-Moon syndrome, LMBBS
More informationOrofacial function of persons having. Report from questionnaires. Silver-Russell syndrome
Orofacial function of persons having Silver-Russell syndrome Report from questionnaires The survey comprises 7 questionnaires. Synonyms: Russell-Silver syndrome, Silver syndrome. Estimated occurrence:
More informationAPPENDIX G: THSTEPS DENTAL GUIDELINES
CHILDREN S SERVICES HANDBOOK APPENDIX G: THSTEPS DENTAL GUIDELINES G.1 American Academy of Pediatric Dentistry Periodicity Guidelines (9 Pages)........ CH-382 G.2 American Dental Association Guidelines
More informationImproving the Health of Our Athletes. Matt Holder, MD, MBA President, AADMD Global Medical Advisor, Special Olympics CEO, Lee Specialty Clinic
Improving the Health of Our Athletes Matt Holder, MD, MBA President, AADMD Global Medical Advisor, Special Olympics CEO, Lee Specialty Clinic Affiliations Special Olympics International www.specialolympics.org
More informationVision Care for Connecticut Children
Vision Care for Connecticut Children EXECUTIVE SUMMARY November 2003 Prepared by: Judith Solomon, JD Mary Alice Lee, PhD Children s Health Council With funding from: Children s Fund of Connecticut, Inc.
More informationLECOM Health Ophthalmology
Patient Name: Date of Birth: New Patient Questionnaire Your answers will be used by your healthcare provider get an accurate history of your medical conditions and ocular concerns. If you are uncomfortable
More informationAsking questions Misunderstood questions or inappropriate responses Presence of a aid Sign language or
1 Chapter 45 The Challenged Patient 2 Hearing Impairments 3 Types of Hearing Impairments Deafness: a blockage of the transmission of sound waves through the external ear canal to the middle or inner ear.
More informationPatient Registration. Additional Information. Insurance Information. Patient s Full Name: Date: Home Address:
Patient Registration Patient s Full Name: Home Address: Home Phone Number: Cell Phone Number: Social Security #: DOB: Relationship Status: Married Divorced Single Place of Employment: Work Address: Work
More informationPatient Name: Date of Birth:
Patient Name: Date of Birth: Marital Status: Single Married Divorced Widowed Height: Referring Doctor: Weight: Primary Care Dr.: Preferred Pharmacy:(name/address) ALLERGIES: Do you have any drug allergies?
More informationSorina Ratchford DDS 747 Bernardo Ave. T:(805) Morro Bay Family Dentistry Morro Bay, CA F:(805) Page 1 /4
Morro Bay Family Dentistry 747 Bernardo Ave. Morro Bay, CA 93442 (805) 772-8585 Date: Patient Information Name Birth date SS# Driver's License # Expiration Address City State Zip Home Phone Cell Phone
More informationSleep Medicine, Anti-Snoring, Sleep Apnoea Treatments at Amazing Dental
Sleep Medicine, Anti-Snoring, Sleep Apnoea Treatments at Amazing Dental What is sleep medicine? Sleep medicine is a relatively new medical specialty devoted to the diagnosis and treatment for patients
More informationNew Patient Questionnaire Pediatric Orthopaedic Surgery
Page 1 of 5 New Patient Questionnaire Pediatric Orthopaedic Surgery First Name: Last Name: Middle: DOB: Height: Weight: Primary Care Physician/Pediatrician Name: Address: Phone Number: Chief Compliant
More informationDefinition. Failure to Thrive. No clear consensus Growth below the 3 rd or 5 th percentile Decreased growth crossing 2 major growth percentiles
Failure to Thrive Karen Swarts, MD 6/4/2004 Definition No clear consensus Growth below the 3 rd or 5 th percentile Decreased growth crossing 2 major growth percentiles 1 Nelson Textbook of Pediatrics,
More informationTruDenta Pain Relief Life Changing Dentistry
Get Your Life Back! TruDenta Pain Relief Life Changing Dentistry Headache disorders impose a recognizable burden on sufferers including sometimessubstantial personal suffering, impaired quality of life
More informationWELCOME TO THE NORTHSHORE UNIVERSITY HEALTHSYSTEM SLEEP CENTERS
WELCOME TO THE NORTHSHORE UNIVERSITY HEALTHSYSTEM SLEEP CENTERS Prior to your office visit, we request that you complete this questionnaire. It asks questions not only about your sleeping habits and behavior
More informationSeptember 26, 2012 Philip Stockwell, MD Lifespan CVI Assistant Professor of Medicine (Clinical)
September 26, 2012 Philip Stockwell, MD Lifespan CVI Assistant Professor of Medicine (Clinical) Advances in cardiac surgery have created a new population of adult patients with repaired congenital heart
More informationFeeding and Oral Hygiene: How to Address the Challenges
Feeding and Oral Hygiene: How to Address the Challenges Paige W. Roberts, OTR/L Occupational Therapist Pediatric Feeding Disorders Program Marcus Autism Center Disclaimer: This content is for personal
More informationWhat is going on? What can we do about it?
What is going on? What can we do about it? Cindy Chatzis, RPN Healthcare Facilitator Southern Network of Specialized Care Intellectual / Developmental Disabilities (I/DD) & Health Trends Barriers Overview
More informationPreface... Contributors... 1 Embryology... 3
Contents Preface... Contributors... vii xvii I. Pediatrics 1 Embryology... 3 Pearls... 3 Branchial Arch Derivatives... 3 Branchial Arch Anomalies: Cysts, Sinus, Fistulae... 4 Otologic Development... 4
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acute-phase protein profiles age-associated changes in, 334 335 Adrenal disorders in geriatric horses, 309 310 Aerobic capacity age-related
More informationPediatric Surgery MUHC MCH Siste. Objectives of Training
Preamble A rotation in Pediatric Surgery must give residents the opportunity to become familiar with the unique needs of infants and children as surgical patients. Some of the surgical diseases encountered
More informationPLEASE LET US KNOW YOUR REASON FOR TODAY S VISIT : CURRENT MEDICATIONS (WITH DOSAGE) PLEASE INCLUDE VITAMINS AND HERBAL MEDICATIONS:
1 NAME: DATE OF BIRTH PLEASE LET US KNOW YOUR REASON FOR TODAY S VISIT : CURRENT MEDICATIONS (WITH DOSAGE) PLEASE INCLUDE VITAMINS AND HERBAL MEDICATIONS: PAST MEDICAL HISTORY (YOUR MEDICAL HISTORY) :
More informationBACKGROUND HISTORY QUESTIONNAIRE
BACKGROUND HISTORY QUESTIONNAIRE Name: Sex M F Address: Home Number: Work Number: Cell Number: Email: SSN: Name and Address of Employer: Date of Birth: Age: Ethnicity: Referred By: Referral Question or
More informationVI year (1 st semester) Scientific Field SPECIALISTIC DISCIPLINES TUTOR ECTS
VI year (1 st semester) Scientific Field SPECIALISTIC DISCIPLINES TUTOR ECTS NUCCI C. COORDINATOR MED/28 Dentistry Pasquantonio Guido 1 MED/30 Ophthalmology Nucci Carlo 1 MED/30 Ophthalmology Manni Gianluca
More informationJEFFERSON COLLEGE COURSE SYLLABUS OTA105 HEALTH CONDITIONS. 2 Credit Hours
JEFFERSON COLLEGE COURSE SYLLABUS OTA105 HEALTH CONDITIONS 2 Credit Hours Prepared by: Lisa Martin MS, OTR/L Occupational Therapy Assistant Program Director Revised Date: June 2014 By: Lisa Martin Dena
More informationESP 755A SUMMER Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Autosomal recessive disorders
ESP 755A SUMMER 2017 Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Autosomal recessive disorders a. affect only males c. are caused when the abnormal
More informationName: Date: Street Address: Referring Physician: How long have you had your current problem?
3851 Piper Street, Suite U464 Anchorage, AK 99508 p 907.339.4800 f 907.339.4801 New Patient Health Questionnaire Name: Date: Street Address: City: State Zip Sex: Age: Birth Date: Insurance: SS# Home Phone:
More informationConversations About Down Syndrome
Conversations About Down Syndrome Delivering and discussing a Down syndrome diagnosis Disclosure I have nothing to disclose. My husband, Chris Small, works at Genentech/Roche. He is not involved in marketing
More informationClinicians and Facilities: RESOURCES WHEN CARING FOR WOMEN WITH ADULT CONGENITAL HEART DISEASE OR OTHER FORMS OF CARDIOVASCULAR DISEASE!!
Clinicians and Facilities: RESOURCES WHEN CARING FOR WOMEN WITH ADULT CONGENITAL HEART DISEASE OR OTHER FORMS OF CARDIOVASCULAR DISEASE!! Abha'Khandelwal,'MD,'MS' 'Stanford'University'School'of'Medicine'
More informationOver. Signature of Patient/Parent/Guardian: Date: / / Date: / / Patient s Name: For ADULT Patients : Employer: Address: Occupation:
Date: / / Patient s Name: Address: Preferred Home: ( ) - Work: ( ) - Cell: ( ) - Text Message Reminders : Yes No Social Security #: Date of Birth: - - / / For ADULT Patients : Employer: Occupation: Spouse
More informationTransplantable Organs
Transplantable Organs Liver Kidneys Pancreas Intestine Organ Information Heart The body s hardest working muscle, the heart beats 70 times each minute as it pumps blood throughout the body. Some conditions
More informationMcLaren Cardiothoracic and Vascular PATIENT HISTORY FORM
McLaren Cardiothoracic and Vascular PATIENT HISTORY FORM Please complete this form and bring it with you to your appointment Appointment Date Appointment Time Name Referring Physician Date of Birth Please
More informationPhysician Approach to MSK Complains in Elderly. Dr Tjan Soon Yin, Consultant and Deputy Head, TTSH Rehab Medicine
Physician Approach to MSK Complains in Elderly Dr Tjan Soon Yin, Consultant and Deputy Head, TTSH Rehab Medicine Impact of MSK Conditions Neuro-musculoskeletal and cardiorespiratory systems determines
More informationPsychotropic Medication. Including Role of Gradual Dose Reductions
Psychotropic Medication Including Role of Gradual Dose Reductions What are they? The phrase psychotropic drugs is a technical term for psychiatric medicines that alter chemical levels in the brain which
More informationChapter 11. Hyper IgM Syndromes
Chapter 11 Hyper IgM Syndromes Patients with Hyper-IgM (HIGM) syndrome are susceptible to recurrent and severe infections and in some types of HIGM syndrome opportunistic infections and an increased risk
More informationUptofate Study Summary
CONGENITAL HEART DISEASE Uptofate Study Summary Acyanotic Atrial septal defect Ventricular septal defect Patent foramen ovale Patent ductus arteriosus Aortic coartation Pulmonary stenosis Cyanotic Tetralogy
More informationHow much do you know about illnesses or health problems for your parents, grandparents, brothers, sisters, and/or children? 1 A lot Some None at all
Family Health History Please answer each question as honestly as possible. There are no right or wrong answers to nay of the questions. It is important that you answer as many questions as you can. We
More information