The document provides a summary of expert recommendations for standard of care in spinal muscular atrophy (SMA) from a consensus statement published in the Journal of Child Neurology. The summary outlines 5 key areas of care: 1) confirming SMA diagnosis, 2) managing breathing problems, 3) managing feeding problems, 4) managing movement and daily activities, and 5) preparing for illness. The recommendations emphasize developing individualized care plans, monitoring for complications, and ensuring access to specialists who understand SMA management.
Michael J. Fox has lived with Parkinson's disease for decades, struggling with tremors and mobility issues but maintaining an active lifestyle and advocacy work. Parkinson's is a neurodegenerative disorder caused by the death of cells in the substantia nigra, resulting in too little dopamine and motor symptoms. While medication can help control symptoms, there is no cure. Risk factors include genetics and environment like pesticide exposure. Researchers are working to stop cell loss to treat and cure Parkinson's.
Let's Talk Research Annual Conference - 24th-25th September 2014 (Jane Martin...NHSNWRD
This document summarizes a study on the experiences of older people living with ankylosing spondylitis (AS). The study found that AS remains active as people age, continuing to impact their functioning and symptoms. While some symptoms were attributed to normal aging, the spinal restriction from AS fusion clearly impacted health and well-being. Ageing with a long-term condition requires adapting to changes, but participants felt their symptoms were often normalized. Maintaining physical activity and a positive attitude, with support from healthcare providers, was seen as important for coping with AS in older age. However, living with AS over decades took both a physical and psychological toll on participants and their families.
Relacion de la Ecología con Otras Ciencias.gabita623
Este documento describe la ecología y sus relaciones con otras ciencias. La ecología estudia la interacción entre los seres vivos y su medio ambiente. Utiliza herramientas de ciencias como la física, química, geología, geografía, matemáticas, climatología y ética. Estas ciencias son importantes para la ecología porque ayudan a entender procesos como la transferencia de energía, reacciones químicas, distribución de especies, e impactos del clima.
Amplified musculoskeletal-pain-syndrome-fact-sheetNever Never Land
Amplified musculoskeletal pain syndrome (AMPS) is an umbrella term for chronic non-inflammatory musculoskeletal pain that is most commonly seen in childhood and adolescence. The exact cause is unknown but is thought to involve malfunction of the central and peripheral nervous systems overamplifying pain signals. Common symptoms include headaches, abdominal pain, and allodynia. Treatment focuses on pain management without medications and involves cognitive behavioral therapy, physical and occupational therapy, exercise, and stress reduction. The goal is to minimize pain and restore normal function and sleep through a team-based approach.
This document provides information on spinal muscular atrophy (SMA), including its genetics, epidemiology, classification, clinical features, diagnosis, management, and clinical trials of potential treatments. SMA is caused by a loss of motor neurons in the spinal cord due to a defect in the SMN1 gene and results in progressive muscle weakness. It is classified into five types based on age of onset and severity. Current management involves a multidisciplinary approach including nutritional and respiratory support as well as pharmacological treatments such as nusinersen, onasemnogene abeparvovec, and risdiplam which are being investigated in clinical trials as potential disease-modifying therapies.
Spinal muscular atrophy (SMA) is a genetic disorder that causes degeneration of motor neurons in the spinal cord, resulting in progressive muscle weakness. There are several types of SMA classified by age of onset and highest physical milestone achieved. Treatment focuses on maintaining respiratory and physical function through ventilation support, airway clearance techniques, and physical/occupational therapy.
spinal muscular atrophy sma by alleliehalengleng28
Spinal muscular atrophy (SMA) is a genetic disorder that attacks motor neurons, causing muscle weakness and wasting. It is caused by a deficiency of the SMN protein due to mutations in the SMN1 gene. There are several types of SMA classified by age of onset and highest physical milestone achieved. Treatment focuses on maintaining function, mobility, nutrition, and respiratory health to maximize quality of life. While there is no cure, ongoing research into new drugs and therapies provides hope for modifying the course of the disease.
Michael J. Fox has lived with Parkinson's disease for decades, struggling with tremors and mobility issues but maintaining an active lifestyle and advocacy work. Parkinson's is a neurodegenerative disorder caused by the death of cells in the substantia nigra, resulting in too little dopamine and motor symptoms. While medication can help control symptoms, there is no cure. Risk factors include genetics and environment like pesticide exposure. Researchers are working to stop cell loss to treat and cure Parkinson's.
Let's Talk Research Annual Conference - 24th-25th September 2014 (Jane Martin...NHSNWRD
This document summarizes a study on the experiences of older people living with ankylosing spondylitis (AS). The study found that AS remains active as people age, continuing to impact their functioning and symptoms. While some symptoms were attributed to normal aging, the spinal restriction from AS fusion clearly impacted health and well-being. Ageing with a long-term condition requires adapting to changes, but participants felt their symptoms were often normalized. Maintaining physical activity and a positive attitude, with support from healthcare providers, was seen as important for coping with AS in older age. However, living with AS over decades took both a physical and psychological toll on participants and their families.
Relacion de la Ecología con Otras Ciencias.gabita623
Este documento describe la ecología y sus relaciones con otras ciencias. La ecología estudia la interacción entre los seres vivos y su medio ambiente. Utiliza herramientas de ciencias como la física, química, geología, geografía, matemáticas, climatología y ética. Estas ciencias son importantes para la ecología porque ayudan a entender procesos como la transferencia de energía, reacciones químicas, distribución de especies, e impactos del clima.
Amplified musculoskeletal-pain-syndrome-fact-sheetNever Never Land
Amplified musculoskeletal pain syndrome (AMPS) is an umbrella term for chronic non-inflammatory musculoskeletal pain that is most commonly seen in childhood and adolescence. The exact cause is unknown but is thought to involve malfunction of the central and peripheral nervous systems overamplifying pain signals. Common symptoms include headaches, abdominal pain, and allodynia. Treatment focuses on pain management without medications and involves cognitive behavioral therapy, physical and occupational therapy, exercise, and stress reduction. The goal is to minimize pain and restore normal function and sleep through a team-based approach.
This document provides information on spinal muscular atrophy (SMA), including its genetics, epidemiology, classification, clinical features, diagnosis, management, and clinical trials of potential treatments. SMA is caused by a loss of motor neurons in the spinal cord due to a defect in the SMN1 gene and results in progressive muscle weakness. It is classified into five types based on age of onset and severity. Current management involves a multidisciplinary approach including nutritional and respiratory support as well as pharmacological treatments such as nusinersen, onasemnogene abeparvovec, and risdiplam which are being investigated in clinical trials as potential disease-modifying therapies.
Spinal muscular atrophy (SMA) is a genetic disorder that causes degeneration of motor neurons in the spinal cord, resulting in progressive muscle weakness. There are several types of SMA classified by age of onset and highest physical milestone achieved. Treatment focuses on maintaining respiratory and physical function through ventilation support, airway clearance techniques, and physical/occupational therapy.
spinal muscular atrophy sma by alleliehalengleng28
Spinal muscular atrophy (SMA) is a genetic disorder that attacks motor neurons, causing muscle weakness and wasting. It is caused by a deficiency of the SMN protein due to mutations in the SMN1 gene. There are several types of SMA classified by age of onset and highest physical milestone achieved. Treatment focuses on maintaining function, mobility, nutrition, and respiratory health to maximize quality of life. While there is no cure, ongoing research into new drugs and therapies provides hope for modifying the course of the disease.
Motor Neurone Disease (MND) is an incurable neurological disorder that leads to progressive paralysis and death within a few years. Palliative care is involved from the time of diagnosis to help patients live as fully as possible by managing symptoms, providing support, and encouraging advance care planning. While there are limited treatment options to slow the disease, palliative care aims to enable patients and their families through a team approach that addresses physical, psychological, and spiritual needs during all stages of the disease.
There are three main types of sleep apnea that affect many Americans: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. Sleep apnea involves interrupted breathing during sleep and is associated with health issues like hypertension and cardiovascular disease. Risk factors for sleep apnea include being overweight, smoking, and drinking alcohol. Treatment options include CPAP machines and dental devices, but many people do not seek treatment due to cost or lack of insurance coverage. Physical and social determinants like environment, access to healthcare, and social isolation can also impact people's health and risk of sleep apnea.
1. The OSHA program aims to help autistic children develop social, communication, language and academic skills through early intervention, preschool and school classes taught by specialists.
2. The program involves comprehensive assessment, individualized treatment plans, and regular re-evaluation. Treatment includes behavioral, educational, speech and social interaction therapies.
3. While autism was once considered untreatable, intensive early intervention programs like OSHA have been shown to significantly improve outcomes for many children. Certain medications can also help treat associated behaviors.
The document discusses the nursing process phase of diagnosing. It defines diagnosing as analyzing assessment data to derive meaning and form nursing diagnoses. Nursing diagnoses focus on the human response to health problems and are formulated using the NANDA taxonomy, which provides standardized labels. A nursing diagnosis consists of a label, definition, defining characteristics, and related/risk factors. It identifies actual or potential client health issues nurses can treat.
NURS11170 Professional Practice Placement 1.docxstirlingvwriters
This document discusses delirium, a disorder that causes confusion and impaired thinking in elderly patients. It identifies two main risk factors for delirium as brain disorders like dementia or Parkinson's disease, and sensory impairments. The document recommends strategies to minimize risks such as avoiding certain medications, using clear communication, and promoting good sleep, nutrition and hydration. It also discusses how registered nurses can provide safe care for delirium patients using standards of critical thinking and evidence-based practice. Family involvement is highlighted as essential for caring for cognitively impaired patients.
Running head ALZHEIMER DISEASE1ALZHEIMER DISEASE6.docxtoddr4
Running head: ALZHEIMER DISEASE 1
ALZHEIMER DISEASE 6
Alzheimer Disease
Dalia Catalan
Florida National University
Alzheimer Disease
Introduction
Alzheimer's disease tends to be a progressive, irreversible ailment that impacts the normal functioning of the brain slowly destroying the thinking and memory-related skills and as it progresses it limits the patient the ability to conduct simple tasks ("What Is Alzheimer's Disease?," 2020). Researchers suggest that approximately 6 million American citizens older than 65 years of age have dementia which is caused by Alzheimer's disease. In most patients, the symptoms of this condition begin to be identified when they are in their mid- the 60s. This condition is often ranked as one of the top ten causes of death in the United States, but following a recent investigation, the condition has climbed the ladder and it is currently ranked as the top five leading cause of death in the United States. Often the disease is categorized with cancer and heart disease as the main cause of death among the older population. This paper will focus on planning research that is focused on understanding Alzheimer's disease, its causes symptoms and its impact on the older population.
Problem identification
Alzheimer's disease tends to be the most common cause of dementia among the older population around the world. The condition impacts the normal functioning of the brain hence causing the loss of cognitive functioning such as reasoning, remembering and thinking. Also, it impacts behavioral abilities to the extent of the victim not being able to conduct various daily essential activities ("What Is Alzheimer's Disease?," 2020). The severity of the brain damage from the mildest stage where the normal function of a person is impact and it progresses to a most severe stage and the victim must be dependent on the people around him or her for basic activities related to daily living. The condition is most popular among the older population and its estimated that the condition has impacted about 6 million senior American citizens' normal function and also it is a leading cause of death among this population ("Alzheimer's Disease Fact Sheet," 2020).
Significance of the Problem to Nursing
With a significant population estimated to be victims of Alzheimer's disease in the United States, it is most likely that individuals in the nursing practice will encounter patients suffering from this condition either in their personal lives on in their careers. Thus, it is essential for the nurses to be able to understand and recognize the Alzheimer's Disease symptoms, treatment approaches, and options as well as learn how to effectively interact with this vulnerable population ("Update on Alzheimer’s: What Nurses Should Know," 2020).
To be able to provide quality health care services the nurse practitioner needs to understand the various vital components that support better working conditions .
American academy for cerebral palsy and developmental medicine e coursesSahar Hassanein
This document provides information about online courses offered by AACPDM (American Academy for Cerebral Palsy and Developmental Medicine). It explains how to enroll in courses, system requirements, and cancellation policies. Course descriptions are provided for several upcoming courses, including ones on aspiration pneumonia, autism diagnosis challenges, spinal fusion for children with cerebral palsy, and transition to adulthood for youth with chronic needs. Learning objectives are outlined for each course.
This document provides a teaching guide for a Grade 8 health education class on communicable disease prevention and control. The guide outlines 9 learning competencies that students are expected to achieve by the end of the lesson, which include discussing common communicable diseases, their causes, transmission factors, stages of infection, and prevention/control methods. An assessment plan is described to evaluate students' ability to demonstrate responsibility and healthful practices related to communicable disease prevention for themselves, their families, and communities.
The newsletter discusses several topics:
- An article summarizes recent updates from Uptodate including recommendations regarding venom immunotherapy for insect stings, tenofovir formulations for hepatitis B, and HPV vaccine dosing.
- Messages from IMA Kozhikode leadership emphasize the importance of the newsletter in keeping members informed and the relevance of discussing end-of-life care.
- An article reviews a shortened recommended treatment regimen for certain multidrug-resistant tuberculosis patients based on updated WHO guidelines.
Guides for asthma management and prevention for children 5 and younger(be a g...Hussain Okairy
This document provides guidance for healthcare professionals on diagnosing and managing asthma in children aged 5 years and younger. Asthma is common in childhood, but can be difficult to diagnose in young children due to frequent wheezing from other causes. The diagnosis is based on recurrent symptoms like wheezing and cough in response to triggers. Treatment follows a stepwise approach starting with education and environmental control, and adding low-dose inhaled corticosteroids as needed to control symptoms and prevent exacerbations. Acute exacerbations should be treated promptly at home or in primary care to avoid hospitalization.
The document discusses the concept of NANDA's nursing diagnosis. It begins with an introduction to nursing diagnosis, including its definition as a clinical judgment that helps nurses determine a patient's plan of care. The history of nursing diagnosis is then outlined, from its origins in the 1970s to the current 247 NANDA-I approved diagnoses. The types of nursing diagnoses according to NANDA-I are described as problem-focused, risk, health promotion, and syndrome. Components of a nursing diagnosis including the problem/definition, etiology/risk factors, and defining characteristics are also defined. The document concludes with discussing writing nursing diagnoses and providing a clinical example.
This document provides guidance on diagnosing and managing asthma in children aged 5 years and younger. It discusses risk factors for developing asthma such as sensitization to aeroallergens. For diagnosis, it recommends considering symptoms, tests, and ruling out other conditions. Treatment involves education, assessing control, and stepwise use of inhaled corticosteroids and bronchodilators. It provides guidance on acute exacerbations and monitoring treatment response. The goal is achieving long-term control of asthma symptoms with safe and effective pharmacotherapy.
DIETARY AVOIDANCE DURING PREGNANCY AND/OR LACTATION
Rheumatoid arthritis in infants topic.pdfuzair23236565
This document provides an outline for a presentation on rheumatoid arthritis (RA) in infants. It covers key topics such as the challenges of diagnosing RA in infants given its non-specific symptoms, the importance of collaboration between specialists, and treatment considerations for these fragile patients. It also discusses juvenile idiopathic arthritis (JIA) more broadly, outlining its different subtypes and treatment goals and strategies. The conclusion emphasizes the resilience of infant patients and the need for further research to improve diagnosis, refine treatments, and ultimately pave the way for a brighter future with minimal disease impacts.
This document discusses adaptive coping and stress management. It begins by defining stress as pressure experienced in response to life demands or stressors. It then discusses the general adaptation syndrome and its three stages of alarm reaction, resistance, and exhaustion. It also covers types of stressors and coping strategies. Adaptive coping helps deal with stress effectively while maladaptive coping occurs when conflict remains unresolved. Adaptive coping strategies discussed include awareness, relaxation, meditation, exercise, music therapy, adequate nutrition/sleep, and time management. Evidence-based stress management techniques taught include progressive muscle relaxation, autogenic training, guided imagery, and diaphragmatic breathing. The document ends with a problem-solving model and case vignette example of how stress
1. Amenorrhea, or the absence of menstrual periods, can be either primary or secondary. Primary amenorrhea refers to the lack of menses by age 15, while secondary amenorrhea is the absence of periods for 3 months after menarche.
2. A thorough history and physical exam is important to evaluate the potential causes of amenorrhea, which can include pregnancy, eating disorders, medical conditions, or anatomical abnormalities.
3. Laboratory tests and imaging may be needed to diagnose endocrine disorders, such as hypothalamic, pituitary, ovarian, or thyroid issues, which can cause amenorrhea. Genetic testing may be considered if Turner syndrome is suspected.
مهارات التواصل بين التمريض والمريض دكتور احمد ربيع FarragBahbah
This document discusses the importance of communication skills for doctors and nurses. It begins with an introduction on the definition of communication and its importance in healthcare. It then discusses several models of effective communication, including the partnership and RESPECT models. It also identifies some common obstacles to communication, such as unwillingness to accept a prognosis or physicians' and nurses' discomfort with end-of-life discussions. Throughout, it provides tips on how to improve verbal and non-verbal communication skills and deal with difficult patient situations. The overall message is that communication is a core part of providing quality patient care.
An individualized, evidence based approach to musFrancescaDwamena
This document discusses an approach to medically unexplained symptoms (MUS) in primary care. It describes a case of a 34-year-old woman with intractable symptoms and outlines a 5-step approach physicians can take to diagnose and treat MUS: 1) establish a successful doctor-patient relationship, 2) help patients understand their illness, 3) help patients commit to participating in their care, 4) help patients set realistic goals, and 5) negotiate treatment plans including pharmacologic and non-pharmacologic elements. The case study demonstrates how applying this approach helped the patient achieve long-term goals like improved work and relationships.
The document discusses health vulnerabilities of children with autism spectrum disorder (ASD). It defines ASD and outlines its signs and symptoms. It discusses challenges with diagnosis and various treatment approaches. It notes higher rates of health issues in people with ASD compared to the general population, including risks associated with alternative therapies promoted without evidence. Recommendations include improving support services, healthcare worker training, and inclusive environments to address needs of those with ASD.
1) Duas mães, Fátima e Rafaela, lutam pelo tratamento de seus filhos, Lucas e Tiago, que têm Amiotrofia Espinhal, uma doença degenerativa muscular.
2) A doença limita bastante as crianças, mas o tratamento pode melhorar sua qualidade de vida e sobrevida.
3) A Associação Brasileira de Amiotrofia Espinhal (ABRAME) ajuda famílias de crianças com AME e defende melhorias no atendimento público à doença.
Este documento apresenta as diretrizes do II Consenso Brasileiro sobre Ventilação Mecânica Não Invasiva e o Suporte Ventilatório Mecânico Artificial Domiciliar. Ele descreve os principais métodos de ventilação não invasiva, como CPAP e BIPAP, e fornece recomendações sobre suas indicações, contraindicações, monitorização e complicações. O documento também aborda o suporte ventilatório mecânico domiciliar, discutindo equipamentos, monitorização, controle de infecção e frequência do suporte.
Motor Neurone Disease (MND) is an incurable neurological disorder that leads to progressive paralysis and death within a few years. Palliative care is involved from the time of diagnosis to help patients live as fully as possible by managing symptoms, providing support, and encouraging advance care planning. While there are limited treatment options to slow the disease, palliative care aims to enable patients and their families through a team approach that addresses physical, psychological, and spiritual needs during all stages of the disease.
There are three main types of sleep apnea that affect many Americans: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. Sleep apnea involves interrupted breathing during sleep and is associated with health issues like hypertension and cardiovascular disease. Risk factors for sleep apnea include being overweight, smoking, and drinking alcohol. Treatment options include CPAP machines and dental devices, but many people do not seek treatment due to cost or lack of insurance coverage. Physical and social determinants like environment, access to healthcare, and social isolation can also impact people's health and risk of sleep apnea.
1. The OSHA program aims to help autistic children develop social, communication, language and academic skills through early intervention, preschool and school classes taught by specialists.
2. The program involves comprehensive assessment, individualized treatment plans, and regular re-evaluation. Treatment includes behavioral, educational, speech and social interaction therapies.
3. While autism was once considered untreatable, intensive early intervention programs like OSHA have been shown to significantly improve outcomes for many children. Certain medications can also help treat associated behaviors.
The document discusses the nursing process phase of diagnosing. It defines diagnosing as analyzing assessment data to derive meaning and form nursing diagnoses. Nursing diagnoses focus on the human response to health problems and are formulated using the NANDA taxonomy, which provides standardized labels. A nursing diagnosis consists of a label, definition, defining characteristics, and related/risk factors. It identifies actual or potential client health issues nurses can treat.
NURS11170 Professional Practice Placement 1.docxstirlingvwriters
This document discusses delirium, a disorder that causes confusion and impaired thinking in elderly patients. It identifies two main risk factors for delirium as brain disorders like dementia or Parkinson's disease, and sensory impairments. The document recommends strategies to minimize risks such as avoiding certain medications, using clear communication, and promoting good sleep, nutrition and hydration. It also discusses how registered nurses can provide safe care for delirium patients using standards of critical thinking and evidence-based practice. Family involvement is highlighted as essential for caring for cognitively impaired patients.
Running head ALZHEIMER DISEASE1ALZHEIMER DISEASE6.docxtoddr4
Running head: ALZHEIMER DISEASE 1
ALZHEIMER DISEASE 6
Alzheimer Disease
Dalia Catalan
Florida National University
Alzheimer Disease
Introduction
Alzheimer's disease tends to be a progressive, irreversible ailment that impacts the normal functioning of the brain slowly destroying the thinking and memory-related skills and as it progresses it limits the patient the ability to conduct simple tasks ("What Is Alzheimer's Disease?," 2020). Researchers suggest that approximately 6 million American citizens older than 65 years of age have dementia which is caused by Alzheimer's disease. In most patients, the symptoms of this condition begin to be identified when they are in their mid- the 60s. This condition is often ranked as one of the top ten causes of death in the United States, but following a recent investigation, the condition has climbed the ladder and it is currently ranked as the top five leading cause of death in the United States. Often the disease is categorized with cancer and heart disease as the main cause of death among the older population. This paper will focus on planning research that is focused on understanding Alzheimer's disease, its causes symptoms and its impact on the older population.
Problem identification
Alzheimer's disease tends to be the most common cause of dementia among the older population around the world. The condition impacts the normal functioning of the brain hence causing the loss of cognitive functioning such as reasoning, remembering and thinking. Also, it impacts behavioral abilities to the extent of the victim not being able to conduct various daily essential activities ("What Is Alzheimer's Disease?," 2020). The severity of the brain damage from the mildest stage where the normal function of a person is impact and it progresses to a most severe stage and the victim must be dependent on the people around him or her for basic activities related to daily living. The condition is most popular among the older population and its estimated that the condition has impacted about 6 million senior American citizens' normal function and also it is a leading cause of death among this population ("Alzheimer's Disease Fact Sheet," 2020).
Significance of the Problem to Nursing
With a significant population estimated to be victims of Alzheimer's disease in the United States, it is most likely that individuals in the nursing practice will encounter patients suffering from this condition either in their personal lives on in their careers. Thus, it is essential for the nurses to be able to understand and recognize the Alzheimer's Disease symptoms, treatment approaches, and options as well as learn how to effectively interact with this vulnerable population ("Update on Alzheimer’s: What Nurses Should Know," 2020).
To be able to provide quality health care services the nurse practitioner needs to understand the various vital components that support better working conditions .
American academy for cerebral palsy and developmental medicine e coursesSahar Hassanein
This document provides information about online courses offered by AACPDM (American Academy for Cerebral Palsy and Developmental Medicine). It explains how to enroll in courses, system requirements, and cancellation policies. Course descriptions are provided for several upcoming courses, including ones on aspiration pneumonia, autism diagnosis challenges, spinal fusion for children with cerebral palsy, and transition to adulthood for youth with chronic needs. Learning objectives are outlined for each course.
This document provides a teaching guide for a Grade 8 health education class on communicable disease prevention and control. The guide outlines 9 learning competencies that students are expected to achieve by the end of the lesson, which include discussing common communicable diseases, their causes, transmission factors, stages of infection, and prevention/control methods. An assessment plan is described to evaluate students' ability to demonstrate responsibility and healthful practices related to communicable disease prevention for themselves, their families, and communities.
The newsletter discusses several topics:
- An article summarizes recent updates from Uptodate including recommendations regarding venom immunotherapy for insect stings, tenofovir formulations for hepatitis B, and HPV vaccine dosing.
- Messages from IMA Kozhikode leadership emphasize the importance of the newsletter in keeping members informed and the relevance of discussing end-of-life care.
- An article reviews a shortened recommended treatment regimen for certain multidrug-resistant tuberculosis patients based on updated WHO guidelines.
Guides for asthma management and prevention for children 5 and younger(be a g...Hussain Okairy
This document provides guidance for healthcare professionals on diagnosing and managing asthma in children aged 5 years and younger. Asthma is common in childhood, but can be difficult to diagnose in young children due to frequent wheezing from other causes. The diagnosis is based on recurrent symptoms like wheezing and cough in response to triggers. Treatment follows a stepwise approach starting with education and environmental control, and adding low-dose inhaled corticosteroids as needed to control symptoms and prevent exacerbations. Acute exacerbations should be treated promptly at home or in primary care to avoid hospitalization.
The document discusses the concept of NANDA's nursing diagnosis. It begins with an introduction to nursing diagnosis, including its definition as a clinical judgment that helps nurses determine a patient's plan of care. The history of nursing diagnosis is then outlined, from its origins in the 1970s to the current 247 NANDA-I approved diagnoses. The types of nursing diagnoses according to NANDA-I are described as problem-focused, risk, health promotion, and syndrome. Components of a nursing diagnosis including the problem/definition, etiology/risk factors, and defining characteristics are also defined. The document concludes with discussing writing nursing diagnoses and providing a clinical example.
This document provides guidance on diagnosing and managing asthma in children aged 5 years and younger. It discusses risk factors for developing asthma such as sensitization to aeroallergens. For diagnosis, it recommends considering symptoms, tests, and ruling out other conditions. Treatment involves education, assessing control, and stepwise use of inhaled corticosteroids and bronchodilators. It provides guidance on acute exacerbations and monitoring treatment response. The goal is achieving long-term control of asthma symptoms with safe and effective pharmacotherapy.
DIETARY AVOIDANCE DURING PREGNANCY AND/OR LACTATION
Rheumatoid arthritis in infants topic.pdfuzair23236565
This document provides an outline for a presentation on rheumatoid arthritis (RA) in infants. It covers key topics such as the challenges of diagnosing RA in infants given its non-specific symptoms, the importance of collaboration between specialists, and treatment considerations for these fragile patients. It also discusses juvenile idiopathic arthritis (JIA) more broadly, outlining its different subtypes and treatment goals and strategies. The conclusion emphasizes the resilience of infant patients and the need for further research to improve diagnosis, refine treatments, and ultimately pave the way for a brighter future with minimal disease impacts.
This document discusses adaptive coping and stress management. It begins by defining stress as pressure experienced in response to life demands or stressors. It then discusses the general adaptation syndrome and its three stages of alarm reaction, resistance, and exhaustion. It also covers types of stressors and coping strategies. Adaptive coping helps deal with stress effectively while maladaptive coping occurs when conflict remains unresolved. Adaptive coping strategies discussed include awareness, relaxation, meditation, exercise, music therapy, adequate nutrition/sleep, and time management. Evidence-based stress management techniques taught include progressive muscle relaxation, autogenic training, guided imagery, and diaphragmatic breathing. The document ends with a problem-solving model and case vignette example of how stress
1. Amenorrhea, or the absence of menstrual periods, can be either primary or secondary. Primary amenorrhea refers to the lack of menses by age 15, while secondary amenorrhea is the absence of periods for 3 months after menarche.
2. A thorough history and physical exam is important to evaluate the potential causes of amenorrhea, which can include pregnancy, eating disorders, medical conditions, or anatomical abnormalities.
3. Laboratory tests and imaging may be needed to diagnose endocrine disorders, such as hypothalamic, pituitary, ovarian, or thyroid issues, which can cause amenorrhea. Genetic testing may be considered if Turner syndrome is suspected.
مهارات التواصل بين التمريض والمريض دكتور احمد ربيع FarragBahbah
This document discusses the importance of communication skills for doctors and nurses. It begins with an introduction on the definition of communication and its importance in healthcare. It then discusses several models of effective communication, including the partnership and RESPECT models. It also identifies some common obstacles to communication, such as unwillingness to accept a prognosis or physicians' and nurses' discomfort with end-of-life discussions. Throughout, it provides tips on how to improve verbal and non-verbal communication skills and deal with difficult patient situations. The overall message is that communication is a core part of providing quality patient care.
An individualized, evidence based approach to musFrancescaDwamena
This document discusses an approach to medically unexplained symptoms (MUS) in primary care. It describes a case of a 34-year-old woman with intractable symptoms and outlines a 5-step approach physicians can take to diagnose and treat MUS: 1) establish a successful doctor-patient relationship, 2) help patients understand their illness, 3) help patients commit to participating in their care, 4) help patients set realistic goals, and 5) negotiate treatment plans including pharmacologic and non-pharmacologic elements. The case study demonstrates how applying this approach helped the patient achieve long-term goals like improved work and relationships.
The document discusses health vulnerabilities of children with autism spectrum disorder (ASD). It defines ASD and outlines its signs and symptoms. It discusses challenges with diagnosis and various treatment approaches. It notes higher rates of health issues in people with ASD compared to the general population, including risks associated with alternative therapies promoted without evidence. Recommendations include improving support services, healthcare worker training, and inclusive environments to address needs of those with ASD.
1) Duas mães, Fátima e Rafaela, lutam pelo tratamento de seus filhos, Lucas e Tiago, que têm Amiotrofia Espinhal, uma doença degenerativa muscular.
2) A doença limita bastante as crianças, mas o tratamento pode melhorar sua qualidade de vida e sobrevida.
3) A Associação Brasileira de Amiotrofia Espinhal (ABRAME) ajuda famílias de crianças com AME e defende melhorias no atendimento público à doença.
Este documento apresenta as diretrizes do II Consenso Brasileiro sobre Ventilação Mecânica Não Invasiva e o Suporte Ventilatório Mecânico Artificial Domiciliar. Ele descreve os principais métodos de ventilação não invasiva, como CPAP e BIPAP, e fornece recomendações sobre suas indicações, contraindicações, monitorização e complicações. O documento também aborda o suporte ventilatório mecânico domiciliar, discutindo equipamentos, monitorização, controle de infecção e frequência do suporte.
This document provides recommendations for implementing a multidisciplinary approach to managing Duchenne muscular dystrophy (DMD). It discusses:
1) Physical therapy interventions like stretching, bracing, and assistive devices to prevent contractures and maintain mobility.
2) Surgical options for contractures depending on the patient's ambulatory stage, including tendon lengthening and transfers.
3) Recommendations for exercise emphasizing submaximum aerobic activity and avoiding high resistance to prevent injury.
Artigo do Fisioterapeuta Dr. Miguel GonçalvesFatima Braga
1) The document provides recommendations for the diagnosis and management of Duchenne muscular dystrophy (DMD) developed by an international group of 84 experts using the RAND/UCLA Appropriateness Method.
2) It describes DMD as a severe, progressive disease affecting 1 in 3,600-6,000 live male births and outlines its genetic basis and multi-system manifestations.
3) The recommendations are presented in two parts, with Part 1 covering diagnosis, pharmacological treatment, and psychosocial management, and Part 2 discussing implementation of multidisciplinary care.
Miguel Gonçalves:Extubation In Nmd Chest 2010 Miguel GonçAlvesFatima Braga
This document describes a new protocol for extubating patients with neuromuscular weakness who could not pass conventional spontaneous breathing trials. The protocol involved extubating 157 patients directly to noninvasive ventilation and aggressive mechanically assisted coughing. Extubation success was defined as not requiring re-intubation during hospitalization. Using this protocol, the first attempt extubation success rate was 95%. Factors associated with success included higher assisted cough peak flows, prior dependence on continuous noninvasive ventilation, and longer duration of prior noninvasive ventilation use. The protocol demonstrated that patients considered unweanable by conventional standards can often be safely extubated using noninvasive ventilation and cough assistance.
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1. A Family Guide to the Consensus Statement
for Standard of Care in Spinal Muscular Atrophy
This Family Guide to the Consensus Statement for Standard of Care in Spinal Muscular Atrophy was prepared by SMA Advocates
for families affected by SMA. The full text of the Consensus Statement (22 pages) was published in the August 2007 issue of the
Journal of Child Neurology and can be found on the journal’s website. A link to the document is provided on the last page of this Guide.
What is SMA?
Spinal muscular atrophy (SMA) is a rare, inherited disease that results in loss of nerves in the
spinal cord and weakness of the muscles connected with those nerves. The muscles most frequently
affected are those of the neck and trunk that control posture, those of the leg and arm that control
movement, and those in the area of the ribs that help breathing.
People with SMA generally appear normal at birth; the symptoms develop as early as 3 months in the
most severely affected, around 1 to 2 years of age in the moderately affected, and more rarely in late
childhood or adult years in mildly affected individuals.
There is no known treatment for SMA; historically, nearly half of babies born with the most severe
form of the disease have died before age two. All people with SMA have a higher than normal risk
for progressive disability. The most severely affected are at risk for breathing complications and
premature death.
What is a Consensus Statement and Why Do We Need One?
A consensus statement reflects general The following is a quick guide to the contents of
agreement among a group. In this case, the the consensus statement especially for families
Consensus Statement for Standard of and patients. We hope it will alert you to topics
Care in Spinal Muscular Atrophy (SMA) for discussion with your doctors and healthcare
was developed by a group of experts in the team. It is very important to understand that
care of people with SMA. The goal of the these are suggestions —− the consensus
consensus statement is to serve as a resource recommendations are for your general
for healthcare professionals and to provide consideration and should not be considered
recommendations for the most current absolute requirements for care. We hope
treatments. This is especially important for you will share this guide with SMA families and
people living with SMA, as many communities friends. The full Consensus Statement docu-
simply do not have access to specialists and ment (see reference on page 4) is available on
experts in SMA care. the journal’s website for you and your care team.
What Do the Experts Recommend for Care of Children with SMA?
It is important to know that there are things 1 Confirming the diagnosis of SMA
you can do to keep your child with SMA 2 Managing breathing
comfortable and safe and to help him or her
3 Managing eating and nutrition
learn and grow to fullest capacity. SMA experts
recommend five key areas for discussion with 4 Managing movement and daily activities
your doctors/therapists: 5 Preparing for illness
Prepared by the Patient Advisory Group of the International Coordinating Committee for SMA Clinical Trials ICC
International Coordinating Committee
for SMA Clinical Trials
2. What do Experts Recommend for Care of Children with SMA?
1 Confirming the Diagnosis of SMA
If you are reading this information sheet, you and your medical team guide for discussion and planning by SMA experts when they are
are probably already talking about the possibility that your child is working with families and the heathcare team. The classification by
affected by SMA. A simple blood test can confirm whether or not onset of weakness and functional level can help you and your doctor
your child has a mutation in the SMN gene that causes SMA. If understand how much your child will be affected by SMA. Generally,
the gene test is positive, then your child’s diagnosis is established. early weakness is associated with more severe disease and a greater
However, about 5% of children with symptoms of SMA can have a need for proactive care planning.
negative SMN gene test and may require further diagnostic tests.
The need for individualized planning for all people with SMA cannot be
These tests can include an electromyography study (EMG), a nerve
emphasized enough – it will help you and your family understand and
conduction study (NCS) and/or a muscle biopsy and blood tests to
prepare for daily life and how to respond to medical emergencies you
help rule out other forms of muscle disease.
might encounter in the course of your child’s disease.
If the blood test comes back positive
for SMA, your doctor will talk with you
and your family about planning for the Clinical Classification of SMA (commonly used by health professionals)
care of your child, including plans for
supporting breathing and feeding as well SMA Type Highest Function Attained Age of Onset
as physical and occupational therapy. (Weakness First Noticed)
Genetic counseling is also recommend- Type I Never sit independently 0-6 months
ed for families affected by SMA. Type II Can sit without support; cannot walk independently 7-18 months
The chart describes the spectrum of Type III Can stand and walk independently; may require aids >18 months
SMA seen in the clinic. It is used as a Type IV Walks during adult years 2nd or 3rd decade
REMEMbER
◊ If SMA is suspected, ask for a blood test to confirm or rule out the disease
◊ If SMA is confirmed, talk with your doctor or a genetic counselor about what this means for your family
◊ Learn more about the specific medical problems associated with SMA and work with your medical team to develop
1 a care plan personalized for you and your child
2 Managing Breathing Problems
Respiratory or breathing problems are the number one cause of diagnosis. The doctor will evaluate your child’s breathing and ability
illness for people affected by SMA and are the most common cause to cough effectively and make recommendations for helping to keep
of death among children with Type I and II disease. The muscle your child’s airway clear.
weakness associated with SMA makes it difficult to cough and clear
Depending on disease severity, tools that may help include manual or
lung secretions and can cause poor breathing during sleep. Muscle
mechanical cough assist devices and non-invasive ventilatory support
weakness can make your child more susceptible to respiratory
such as bi-level positive airway pressure devices (BiPAP). Protocols
infections. Repeated infections can permanently damage lung tissue
have been developed for the most effective use of these tools for
and make breathing even more difficult.
people with SMA and are available from many SMA clinics. Routine
Respiratory care of patients with SMA is essential to their survival immunizations and flu shots are also recommended.
and quality of life. It is critical that parents and patients be able to
The pulmonary specialist will work with families to develop
recognize breathing problems early and understand the steps needed
respiratory care goals personalized for each child. Specific
to help improve breathing.
attention should be given to planning for times when your child is
Since respiratory care planning is so important, discussions with a sick with colds or flu or in the event of surgery. Plans should be
pulmonologist (a lung and breathing specialist) familiar with SMA reviewed and revised periodically as your child grows older or as
management issues should take place as soon as possible after health status changes over time.
◊ Learn about maintaining a clear airway — it is important for all people with SMA
REMEMbER
◊ Discuss breathing support options with your medical team as needed
◊ Work with the medical team to develop a care plan to prevent problems
◊ Work with the medical team to develop a care plan for use during acute respiratory illness such as a cold or flu, or in
2 case your child develops more severe problems requiring hospitalization
A FAMILY GUIDE to the Consensus Statement for Standard of Care in Spinal Muscular Atrophy
3. What do Experts Recommend for Care of Children with SMA?
3 Managing Feeding Problems
People with SMA can suffer from under- or over-nourishment and from the stomach) can also cause aspiration pneumonia and preventive
both can affect your child’s quality of life. Your medical team should measures should be discussed with your medical team.
regularly monitor your child’s growth and work with you to develop an
For children with Type II and Type III SMA, weight gain can be
optimal nutritional and feeding plan personalized for your child.
challenging, resulting in further stress on weak muscles and potentially
It is important to recognize that swallowing difficulties may increase the more disability. SMA children are also often affected by constipation.
risk of inhaling food or drink, which may cause recurrent chest infections Many strategies have been developed to help children with these
(aspiration pneumonia) that can be serious and life-threatening eating or digestion problems. A dietician and therapists specializing in
complications for people with SMA. Mealtime strategies can be adopted speech, swallowing and physical movement can help the medical team
to help prevent food aspiration. Gastric reflux (food coming back up determine the best strategies for you and your child.
REMEMbER
◊ Monitor your child’s growth on a growth chart and work with your medical team to develop a personalized feeding plan
◊ If your child experiences trouble swallowing, has gastric reflux or is bothered by constipation, talk with your team
about developing workable solutions
3◊ Monitor for eating or digestive problems and develop strategies for preventing aspiration pneumonia
4 Managing Movement and Daily Activities
Muscle weakness, the most obvious symptom of SMA, varies from person for moving during work or play. These tools can also help manage and
to person, depending on disease severity. Care plans for managing muscle prevent muscle contractures, spinal deformity, pain and bone fractures
weakness of the arms, legs, trunk and neck are important for helping that can make your child’s disability worse.
your child achieve his or her highest level of function and independence.
Assistive devices ranging from orthotics and braces to motorized wheel-
Physical therapists, occupational therapists, speech therapists and/or chairs are important for your child’s health and daily activities. Consulting
rehabilitation specialists are the experts who can help you and the rest with a therapist who has experience in working with SMA patients can
of the medical team design the best plan for your child. Their evaluations be helpful in determining which assistive devices are most appropriate
may include range-of-motion, strength and mobility tests. They can for your child and how best to incorporate them into daily living. Chil-
recommend exercises and tools or assistive devices to help your child dren with SMA should be evaluated by an orthopedic doctor for spinal
maintain the best posture for lung function and eating, as well as tools curvature; surgical stabilization of the spine may be recommended.
◊ Work to develop a physical therapy plan to help your child achieve their highest personal level of function and independence
REMEMbER
◊ Consider use of assistive devices, tools and exercise to support breathing, eating, work and play
◊ Consider use of assistive devices to help slow or prevent complications of SMA
4 ◊ Consult with your medical team about evaluation by an orthopedic specialist
5 Preparing for Illness
Caring for your children is challenging enough in normal circumstances; are considered “supportive interventions.” When delivered in a planned
the complications of SMA can add another layer of complexity to family manner, these interventions are designed to help your child lead the fullest
life. In discussing care plans for your child, you and your medical team life possible. In the most severe cases of SMA, however, parents can be
are likely to talk about daily or chronic care, prevention and what to do faced with anguishing decisions regarding therapies that may be perceived
in case of medical emergencies. In many cases, planning is the single as prolonging suffering rather than relieving the burden of disease.
most important thing you can do to prevent a medical emergency.
Whenever possible, end-of-life care options need to be defined and
When a medical emergency occurs, the support of a knowledgeable
discussed openly with you and your family so that any decisions made
care team is essential. Whether done in advance or in a time of crisis,
reflect your values. It is important to have this discussion, however dif-
the most important thing to do is talk with the medical team about care
ficult, before a crisis occurs, so that the medical team is prepared and
options and their consequences for your child and your family.
can work through a medical emergency together with you and your
Given the lack of specific treatments for SMA, most care or therapy family. You may also want to inform emergency room staff at your local
choices for SMA (like the ones discussed in the consensus statement) hospital of your plans.
REMEMbER
◊ Develop a plan for medical emergencies
◊ Share your plans and management goals with all the healthcare professionals involved in caring for your child
◊ Maintain a notebook or folder of current treatment plans and your decisions about critical care, to help you and
5 healthcare professionals during a medical emergency
A FAMILY GUIDE to the Consensus Statement for Standard of Care in Spinal Muscular Atrophy
4. The Experts Agree ...
Recommendations, Not Rules
SMA experts agree: Care for children with for doctors and healthcare specialists, but they
SMA is often best accomplished with the help are only suggestions. You and your medical
of many specialists and primary care providers. team are the best people to decide what is
Parents are key members of this team and are appropriate for your child with SMA. Please
encouraged to participate as much as possible. contact your doctor with any questions you
The recommendations made in this Family might have about the consensus guidelines
Guide are based on the guidelines developed or care for your child.
To ACCESS ThE oRIgINAL PAPER
Consensus Statement for Standard of Care in Spinal Muscular Atrophy
Ching H. Wang, MD, PhD, Richard S. Finkel, MD, Enrico S. Bertini, MD, Mary Schroth, MD,
Anita Simonds, MD, Brenda Wong, MD, Annie Aloysius, MRCSLT, HPC, Leslie Morrison, MD,
Marion Main, MCSP, MA, Thomas O. Crawford, MD, Anthony Trela, BS, and Participants
of the International Conference on SMA Standard of Care
Journal of Child Neurology, Volume 22 Number 8, August 2007, 1027-1049.
Consensus statement available online: http://jcn.sagepub.com/cgi/reprint/22/8/1027
ICC
International Coordinating Committee
for SMA Clinical Trials
This document was prepared by the Patient Advisory Group of the International Coordinating Committee for SMA Clinical Trials
www.smafoundation.org www.mda.org www.fightsma.org www.fsma.org