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Nutrition
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
2.21. A child with moderate malnutrition following a chronic diarrhoeal illness is likely to havea greater fall off in length centile than of head circumference centile.muscle hypotonia.loss of turgor.hyperkalaemia.iron deficiency anaemia.
Examination C
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, The New DRCOG Examination, 2017
Aalia Khan, Ramsey Jabbour, Almas Rehman
Muscle hypotonia is characteristic. A round head with a flat facial profile, dysplastic ears, blunt inner eye angles, broad hands with a single palmar crease and an incurving 5th digit are other features of Down’s syndrome. Brushfield’s spots are on the periphery of the iris.
Can Individuals with Down Syndrome Benefit from Hippotherapy? An Exploratory Study on Gait and Balance
Published in Developmental Neurorehabilitation, 2020
Simona Portaro, Alberto Cacciola, Antonino Naro, Filippo Cavallaro, Gaetano Gemelli, Barbara Aliberti, Rosaria De Luca, Rocco Salvatore Calabrò, Demetrio Milardi
DS is characterized by altered psychomotor development, resulting in gait and balance impairments with aging, associated to an increased risk of concomitant congenital defects and organic disorders, such as heart and gastrointestinal defects, immune disorders and leukemia, as well as disorders of the endocrine/metabolic systems or Alzheimer’s disease.567–8 Decreased fronto-parietal gray matter and frontostriatal white matter tracts have been proposed as one of the main causes of gait and balance impairments in aging adults with DS.9 Children affected by DS learn to walk and acquire many other fundamental skills later than children with a normal development.10 Taking into account the anatomical and functional features of DS (i.e., muscle hypotonia, joint laxity, and gait instability), these individuals present with several motor deficits, including general clumsiness and slowness of movements, persisting through adulthood.11,12 The delays in achieving motor development milestones may imply that patients with DS usually have balance and postural deficits13, longer movement and reaction times14, and altered motor synergies.15 Furthermore, the delayed motor development of infants and children with DS usually presents with ligament laxity and generalized muscle hypotonia.11
Construct Validity of the Early Clinical Assessment of Balance in Toddlers with Cerebral Palsy: Brief Report
Published in Developmental Neurorehabilitation, 2020
Samuel R. Pierce, Tracy Kornafel, Julie Skorup, Athylia C. Paremski, Laura A. Prosser
Data from children with CP were collected in conjunction with a randomized controlled clinical trial comparing a motor learning based physical therapy program using a dynamic weight assistance technology to conventional physical therapy (ClinicalTrials.gov Identifier: NCT02340026).9 Subjects with CP met the following criteria: 1) 12–36 months of age, 2) diagnosis of CP or suspected CP (suspected CP was identified as a motor percentile rank less than the 10th percentile on the Bayley Scales of Infant Development10, and a neurological sign associated with CP such as spasticity) 3) ability to initiate pulling to stand at a surface (Score of 1 on GMFM Item 52), 4) cognitive ability to follow one-step commands. Subjects were excluded if they met the following criteria: 1) secondary orthopedic, neuromuscular or cardiovascular condition unrelated to CP, 2) general muscle hypotonia, without other neurological signs associated with CP, 3) independent walking ability (Score of 3 on GMFM Item 69 – Walks forward 10 steps), 4) history of surgery or injury to the lower extremities in the past 6 months. GMFCS Level was determined by the same physical therapist who completed the screening visit for the clinical trial.
The pharmacotherapeutic management of obstructive sleep apnea
Published in Expert Opinion on Pharmacotherapy, 2019
Stefano Marra, Dario Arnaldi, Lino Nobili
During sleep there is a physiological muscle hypotonia. The reduction of dilatory muscle activity increases the risk of airway collapse. Normally, this risk is counteracted by arousals and increased central respiratory drive induced by mild hypercapnia. The upper airway muscles have complex patterns of neuronal activation. The genioglossus, which is the most important pharyngeal dilatory muscle, receives up to six different patterns of drive [25]. The genioglossus receives inputs by the central nervous system from the brainstem and reflex inputs from pharyngeal mechanoreceptors and chemoreceptors. This eventually leads to a phasic pattern of muscle activation, being more evident during inspiration and less during expiration. Muscle activities are reduced at sleep onset [26] and vary between sleep stages [27]. In OSA patients, the combination of a loss in central drive and poor reflex input to the muscles, causes a poor and ineffective response of the genioglossus to the reduced width of the airway, eventually leading to OSA events.