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Pierpont MEM, Magoulas PL, Adi S, Kavamura MI, Neri G, Noonan J, Pierpont EI, Reinker K, Roberts AE, Shankar S, Sullivan J, Wolford M, Conger B, Santa Cruz M, Rauen KA. Cardio-facio-cutaneous syndrome: clinical features, diagnosis, and management guidelines. Pediatrics 2014; 134:e1149-62. [PMID: 25180280 PMCID: PMC4179092 DOI: 10.1542/peds.2013-3189] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 12/22/2022] Open
Abstract
Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care.
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Affiliation(s)
- Mary Ella M Pierpont
- Division of Genetics and Metabolism, Department of Pediatrics and Ophthalmology, and Children's Hospitals and Clinics of Minnesota, Saint Paul, Minnesota;
| | - Pilar L Magoulas
- Department of Molecular and Human Genetics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Saleh Adi
- Madison Clinic for Pediatric Diabetes, Benioff Children's Hospital and University of California at San Francisco, San Francisco, California
| | | | - Giovanni Neri
- Institute of Medical Genetics, A Gemelli School of Medicine, Catholic University, Rome, Italy
| | - Jacqueline Noonan
- Department of Pediatrics, University of Kentucky, Lexington, Kentucky
| | - Elizabeth I Pierpont
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Kent Reinker
- Department of Orthopedics, University of Texas Health Sciences Center, San Antonio, Texas
| | - Amy E Roberts
- Department of Cardiology and Division of Genetics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Suma Shankar
- Departments of Human Genetics and Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Sullivan
- Departments of Neurology and Pediatrics, University of California at San Francisco, San Francisco, California
| | - Melinda Wolford
- Department of Counseling, Special Education and School Psychology, Youngstown State University, Youngstown, Ohio
| | | | | | - Katherine A Rauen
- Division of Genomic Medicine, Department of Pediatrics, UC Davis MIND Institute, University of California at Davis, Sacramento, California
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Kuklin A, Weaver K, Cerny T, Conger B. DNA Amplification Fingerprinting of Embryogenic and Nonembryogenic Clones of Orchardgrass (Dactylis Glomerata L.). BIOTECHNOL BIOTEC EQ 2014. [DOI: 10.1080/13102818.1994.10818753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Conger B, Nelson EC, Dietrich AJ, Blanchard C, McHugo GJ, Simmons JJ, Vernon P, Secker-Walker R, Wasson JH. Effectiveness of physician antismoking advice. Am J Prev Med 1987; 3:223-6. [PMID: 3330661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Dartmouth Primary Care Cooperative Information (COOP) Project conducted a controlled trial on the impact of antismoking advice from office-based physicians. Eighteen primary care medical practices were randomly assigned to be intervention or customary care practices. Medical personnel assigned to the intervention practices were to systematically identify cigarette smokers (among patients aged 35 to 59 years making an office visit), advise them to quit smoking, and provide educational materials. A random sample of 258 smokers was identified and followed-up four months later. Intervention-group smokers were more likely to report being advised to quit smoking (77 percent versus 47 percent) and to attempt quitting (39 percent versus 31 percent), but had success rates similar to those of the other group (6 percent versus 7 percent). We conclude that the medical office is an excellent place to identify large numbers of smokers and initiate attempts at quitting, but find that simple antismoking information and advice are not enough to improve cessation rates.
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Affiliation(s)
- B Conger
- Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire 03756
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Nelson E, Conger B, Douglass R, Gephart D, Kirk J, Page R, Clark A, Johnson K, Stone K, Wasson J, Zubkoff M. Functional health status levels of primary care patients. JAMA 1983; 249:3331-8. [PMID: 6602226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A cross-sectional study was conducted on functional status of adults visiting primary care practices. Limitations in physical and mental function were assessed independently in 28 practices by patients (N = 1,227) and physicians (N = 47) using a simple global index of disability. Results indicated 12% of patients rated their physical limitations as major and 8% rated major emotional limitations during the past month. Comparable assessments by physicians were 5% and 4%, respectively. Differences between patients and physicians were statistically significant and are demonstrated to be clinically relevant. Patients' functional limitations were associated with increased utilization of ambulatory care, older age, lower level of education, unemployment, and a primary diagnosis of a chronic condition. We conclude that functional status can be routinely recorded in medical practice to help describe severity, predict utilization, and improve the physician-patient relationship.
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