This document provides information about clubfoot and developmental dysplasia of the hip. It defines clubfoot as a congenital deformity where the foot is twisted out of shape. It describes various types of clubfoot deformities and treatments which may include serial casting and surgery. It also defines developmental dysplasia of the hip as imperfect development of the hip joint which can lead to subluxation or dislocation. Clinical signs and tests for diagnosis are outlined as well as nonsurgical treatments like splinting and casting and potential surgical interventions.
The hip joint is a pivotal joint of the lower extremity, and its functional demands require great stability coupled with a wide range of motion that allows poly axial motion, including flexion, extension, abduction, adduction, internal and external rotation and circumduction.
The hip joint is a pivotal joint of the lower extremity, and its functional demands require great stability coupled with a wide range of motion that allows poly axial motion, including flexion, extension, abduction, adduction, internal and external rotation and circumduction.
Hip dysplasia describes a condition where the hip becomes partially or fully dislocated and/or the hip’s ball (femoral head) and socket (acetabulum) are misaligned. The condition primarily affects children but is also commonly diagnosed in adulthood. Treatment options range from simple bracing to extensive surgery and should be determined based on the patient’s age and the severity of their condition.
http://www.davidsfeldmanmd.com/specialties/hip-dysplasia
Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). Spina bifida can happen anywhere along the spine if the neural tube does not close all the way.
Hip dysplasia describes a condition where the hip becomes partially or fully dislocated and/or the hip’s ball (femoral head) and socket (acetabulum) are misaligned. The condition primarily affects children but is also commonly diagnosed in adulthood. Treatment options range from simple bracing to extensive surgery and should be determined based on the patient’s age and the severity of their condition.
http://www.davidsfeldmanmd.com/specialties/hip-dysplasia
Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). Spina bifida can happen anywhere along the spine if the neural tube does not close all the way.
Diagnosing TMJ /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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A fractured neck of femur (NOF) is a serious injury, especially in older people. It is likely to be life changing and for some people life threatening.
Neck of femur fractures (NOF) are common injuries sustained by older patients who are both more likely to have unsteadiness of gait and reduced bone mineral density, predisposing to fracture. Elderly osteoporotic women are at greatest risk.
Cervical Hybrid Arthroplasty by Pablo Pazmino MDPablo Pazmino
This video explains Cervical Arthroplasty in combination with a fusion. When people have more than one cervical disc which has degenerated or which has sustained a traumatic rupture they may need a procedure to address both levels. These herniations may begin to affect the surrounding nerves and/or spinal cord. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Herniations/ Radiculopathy at multiple levels feel free to look us up online www.beverlyspine.com or call toll free 1-8SPINECAL-1
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
4. t. calcaneoval´gus
the foot is turned outwards with the toes pointing
upwards
t. calcaneova´rus
the foot points inwards and up
t. equinoval´gus
the foot points outwards and down
t. equinova´rus
most common type
foot is fixed in plantar flexion (downward) and
deviated medially (inward)
Maria Carmela L. Domocmat, RN, MSN 4
8. o The true etiology of congenital clubfoot is
unknown
o Extrinsic associations include
Teratogenic agents (eg, sodium aminopterin)
Oligohydramnios
Congenital constriction rings
Maria Carmela L. Domocmat, RN, MSN 8
9. o Genetic associations include
o mendelian inheritance (eg, diastrophic dwarfism;
o autosomal recessive pattern of clubfoot inheritance).
o Cytogenetic abnormalities (eg, congenital talipes
equinovarus [CTEV]) can be seen in syndromes
involving chromosomal deletion.
Maria Carmela L. Domocmat, RN, MSN 9
10. o Talipes may be positional or structural.
Positional talipes is caused by abnormal pressures
compressing the foot while it's developing, as a result
of its position in the womb.
Structural talipes is a more complex condition and
probably caused by a combination of factors, such as
a genetic predisposition
http://www.bbc.co.uk/health/physical_health/conditions/talipes2.shtml
Maria Carmela L. Domocmat, RN, MSN 10
11. o deformity is readily apparent at birth
o can be detected antenatally during the routine
development ultrasound scan around 20 weeks.
o X-rays may be needed to confirm diagnosis.
Maria Carmela L. Domocmat, RN, MSN 11
12. o treatment is most successful when started
early in infancy because delay causes muscles
and bones of legs to develop abnormally,
with shortening of tendons
Maria Carmela L. Domocmat, RN, MSN 12
13. gentle, manipulation of foot with casting
done every few days for 1 to 2 weeks then at 1- to 2-week
intervals
Ponseti’s Method of treatment
Maria Carmela L. Domocmat, RN, MSN 13
15. involves serial manipulation and plaster casting of the
clubfoot.
The ligaments and tendons of the foot are gently
stretched with weekly, gently manipulations.
A plaster cast is then applied after each weekly
sessions to retain the degree of correction obtained
and to soften the ligaments. Thereby, the displaced
bones are gradually brought into the correct
alignment.
Four to five long leg (from the toes to the hip) are
applied with the knee at a right angle.
Maria Carmela L. Domocmat, RN, MSN 15
16. LONG LEG CAST DENNIS BROWN SPLINT
http://www2.massgeneral.org/ORTHO/BabyCast.gif http://www2.massgeneral.org/ORTHO/DennisBrownBrace.gif
Maria Carmela L. Domocmat, RN, MSN 16
18. Making A Difference: Caring For Clubfoot at
the Sinai Hospital of Baltimore at
http://www.youtube.com/watch?v=Rmkrrvw
MH4A&feature=player_embedded#!
Maria Carmela L. Domocmat, RN, MSN 18
19. done if nonsurgical treatment not effective
tight ligaments released
tendons lengthened or transplanted
Other surgical treatments
- circumferential release: "cincinati incision"
- Goldner four quadrant approach:
- medial release
- posterior release
- posteromedial release
- tendon transfers
Maria Carmela L. Domocmat, RN, MSN 19
20. extended medical supervision is required
bcoz there is a tendency for this deformity to recur
(considered cured when the child is able to wear
normal shoes and walk properly)
care emphasizes muscle reeducation (by
manipulation) and proper walking
Maria Carmela L. Domocmat, RN, MSN 20
21. heels and soles of braces or shoes
prescribed following correction must be
kept in repair
corrective shoes may have sole and heel lifts
on lateral border to maintain proper
positioning
Maria Carmela L. Domocmat, RN, MSN 21
22. • Approximately 50-60% of club feet in newborns
can be corrected non-operatively.
• About 20% of infants requiring surgery need
further surgery at a later stage.
Maria Carmela L. Domocmat, RN, MSN 22
25. • imperfect development of hip –can affect
femoral head, acetabulum, or both
• head of femur does not lie deep enough within
the acetabulum and slips out on movement
• occurs in females 7 times more often than males
Maria Carmela L. Domocmat, RN, MSN 25
27. o acetabular dysplasia
mildest form
femoral head remains in acetabulum
o subluxation
most common form
femoral head partially displaced
o dislocation
femoral head not in contact with acetabulum
displaced posteriorly and superiorly
Maria Carmela L. Domocmat, RN, MSN 27
28. o limitation in abduction of leg on affected
side
o asymmetry of gluteal, popliteal, and thigh
folds
o Waddling gait and lordosis when child
begins to walk
Maria Carmela L. Domocmat, RN, MSN 28
30. With child in a
supine position,
the right knee
on the side of
the subluxation
appears lower
than the left
because of
malposition of
the femur head.
Maria Carmela L. Domocmat, RN, MSN 30
31. infant on a supine position.
Doctor abducts the hips by moving the bent
hips and knees apart.
If the hip feels like it can be pushed out the
back of the socket, this is considered
abnormal.
This is called a positive Barlow's Test and is a
sign of instability in the hip.
Maria Carmela L. Domocmat, RN, MSN 31
32. As the hip is abducted further, the doctor
might feel the ball portion (the femoral head)
slide forward as it slips back into the socket.
Or audible click when abducting and
externally rotating hip on affected side:
Maria Carmela L. Domocmat, RN, MSN 32
34. directed toward enlarging and deepening the
acetabulum by placing the head of femur within the
acetabulum and applying constant pressure
proper positioning: legs slightly flexed and abducted
Surgical Ix
Maria Carmela L. Domocmat, RN, MSN 34
35. o proper positioning: legs slightly flexed and
abducted
Pavlik harness
Frejka pillow: a pillow splint that maintains
abduction of legs
Bryant’s traction
Spica cast
Closed reduction
Maria Carmela L. Domocmat, RN, MSN 35
36. Hip abduction splint
holds the hips in an
abduction position,
forcing the femur
head into the
acetabulum.
Maria Carmela L. Domocmat, RN, MSN 36
45. open reduction with casting
derotational osteotomy
Pelvic osteotomies
Maria Carmela L. Domocmat, RN, MSN 45
46. femur is cut and rotated to make it easier to
keep the femoral head inside the acetabulum.
When this procedure is done, the soft tissues
loosen up and the forces of the muscles tend to
keep the femoral head reduced.
Once again, the child is put in a spica cast for
several months while the bone heals.
A CT scan may be used to confirm successful
reduction before removing the cast.
Maria Carmela L. Domocmat, RN, MSN 46
48. for children older than 18 months which may require
additional surgery to change the acetabulum
(socket) in addition to the femur (thighbone)
The problem has been present longer and the anatomy has grown
more distorted over the longer period of time.
Maria Carmela L. Domocmat, RN, MSN 48
50. Several different types of osteotomies are used to
tilt the acetabulum in a more horizontal angle to the
floor. By doing this, the femoral head is less likely to
slide up and out of the socket with weightbearing.
Types : Steele osteotomy; Salter osteotomy;
Pemberton osteotomy
Maria Carmela L. Domocmat, RN, MSN 50
51. This can stop the femoral head from sliding
up and out of the socket.
Over time this shelf of bone above the
acetabulum remodels and forms a deeper
acetabulum.
the bone of the pelvis just above the
acetabulum is cut to allow the bone to slide
out and form a new roof over the hip joint.
Maria Carmela L. Domocmat, RN, MSN 51
53. uses a bone graft placed just above the hip
joint to create a new, wider roof, or shelf over
the acetabulum.
This keeps the femoral head from sliding up
and out of the socket and, as it heals, makes a
larger weightbearing surface to spread out
the weight that needs to be transferred from
the femoral head to the acetabulum and
pelvis.
Maria Carmela L. Domocmat, RN, MSN 53
55. not as common
the entire acetabulum is cut free of the pelvis
and moved or dialed at the best angle and
then allowed to heal in that position.
Maria Carmela L. Domocmat, RN, MSN 55
56. o Same with other clients with cast and
braces; pre- and post-op care
o Transportation and positioning
use wagon or stroller with back flat or mechanic’s
creeper
protect child from falling when positioned
never pick up child by the bar between the legs of
cast (use two people to provide adequate body
support if necessary)
Maria Carmela L. Domocmat, RN, MSN 56
57. A patient's guide to developmental dysplasia of the hip in children
retrieved on September 4, 2011 at
http://www.orthopediatrics.com/docs/Guides/dysplasia.html
Massachusets General Hospital. Pediatric orthopaedic ailments:
Clubfoot. Retrieved on September 4, 2011 at
http://www2.massgeneral.org/ORTHO/ClubFoot.htm
Saxton, Nugent, and Pelikan. (2006). Mosby’s comprehensive
review of nursing [18th ed]. St. Louis: Mosby
Talipes Equinovarus. Retrieved on September 4, 2011 at
http://www.patient.co.uk/doctor/Club-Foot.htm
Wheeless’ Textbook of Orthopaedics. Talipes
equinovarus/Clubfoot Retrieved on September 4, 2011 at
http://www.wheelessonline.com/ortho/talipes_equinovarus_clubf
oot
Maria Carmela L. Domocmat, RN, MSN 57