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Atton G, Baralle D. Epidemiology of Robin sequence: geographical variation in the UK/Ireland. Arch Dis Child 2024; 109:177-178. [PMID: 38199816 DOI: 10.1136/archdischild-2023-326079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Giles Atton
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Diana Baralle
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
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Malarbi S, Chisholm AK, Gunn-Charlton JK, Burnett AC, Tan TY, Cheng SSW, Pellicano A, Shand J, Heggie A, Hunt RW. Intellectual Functioning of Children With Isolated PRS, PRS-Plus, and Syndromic PRS. Cleft Palate Craniofac J 2024; 61:33-39. [PMID: 35898178 DOI: 10.1177/10556656221115596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Describe the intelligence quotient (IQ) of children with Pierre Robin sequence (PRS). DESIGN Prospective cohort study. SETTING Neurodevelopmental follow-up clinic within a hospital. PATIENTS Children with PRS (n = 45) who had been in the Neonatal Intensive Care Unit (NICU) were classified by a geneticist into 3 subgroups of isolated PRS (n = 20), PRS-plus additional medical features (n = 8), and syndromic PRS (n = 17) based on medical record review and genetic testing. MAIN OUTCOME MEASURE Children with PRS completed IQ testing at 5 or 8 years of age with the Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) or Fourth Edition (WPPSI-IV) or the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) or Fifth Edition (WISC-V). RESULTS IQ scores were more than 1 to 2 standard deviations below the mean for 36% of the overall sample, which was significantly greater compared to test norms (binomial test P = .001). There was a significant association between PRS subtype and IQ (Fisher's exact P = .026). While only 20% of children with isolated PRS were within 1 standard deviation below average and 35% of children with syndromic PRS were below 1 to 2 standard deviations, 75% of PRS-plus children scored lower than 1 to 2 standard deviations below the mean. CONCLUSION PRS subgroups can help identify children at risk for cognitive delay. The majority of children with PRS-plus had low intellectual functioning, in contrast to the third of children with syndromic PRS who had low IQ and the majority of children with isolated PRS who had average or higher IQ.
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Affiliation(s)
- Stephanie Malarbi
- The Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Dr Malarbi and Ms Chisholm are co-first authors and have contributed equally to this work
| | - Anita K Chisholm
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Dr Malarbi and Ms Chisholm are co-first authors and have contributed equally to this work
| | - Julia K Gunn-Charlton
- The Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Alice C Burnett
- The Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Tiong Yang Tan
- University of Melbourne, Melbourne, Australia
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia
| | - Shirley S W Cheng
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Jocelyn Shand
- Plastic and Maxillofacial Surgery Section, The Royal Children's Hospital, Melbourne, Australia
| | - Andrew Heggie
- Plastic and Maxillofacial Surgery Section, The Royal Children's Hospital, Melbourne, Australia
| | - Rod W Hunt
- The Royal Children's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Monash University, Melbourne, Australia
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3
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Kumar K, Katarmal J, Pandey D. A Case of Pierre Robinson Sequence in an Adult. J Assoc Physicians India 2022; 69:11-12. [PMID: 35057600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Kanishka Kumar
- Assistant Professor, Department of General Medicine, Grant Government Medical College and Sir JJ Hospital, Mumbai, Maharashtra
| | - Jayesh Katarmal
- Resident, Department of General Medicine, Grant Government Medical College and Sir JJ Hospital, Mumbai, Maharashtra
| | - Deepika Pandey
- Resident, Department of General Medicine, Grant Government Medical College and Sir JJ Hospital, Mumbai, Maharashtra
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Owczarek-Lipska M, Markus F, Bültmann E, Korenke GC, Neidhardt J. A TARP Syndrome Phenotype Is Associated with a Novel Splicing Variant in RBM10. Genes (Basel) 2022; 13:genes13112154. [PMID: 36421828 PMCID: PMC9691016 DOI: 10.3390/genes13112154] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
TARP syndrome (Talipes equinovarus, Atrial septal defect, Robin sequence, and Persistence of the left superior vena cava) is a rare genetic condition, caused by developmental defects during embryogenesis. The phenotypic spectrum of TARP shows high clinical variability with patients either missing cardinal features or having additional clinical traits. Initially, TARP was considered a lethal syndrome, but patients with milder symptoms were recently described. The TARP-locus was mapped to the gene RNA-binding motif protein 10 (RBM10) on the human X-chromosome. We clinically and genetically described a six-year-old boy with a TARP-phenotype. Clinical heterogeneity of symptoms prompted us to sequence the entire exome of this patient. We identified a novel splice variant (NM_005676: c.17+1G>C, p.?) in RBM10. A patient-derived cell line was used to verify the pathogenicity of the RBM10 splice variant by RNA analyses, Western blotting, and immunofluorescence staining. Our molecular genetic findings together with the analyses of progressing clinical symptoms confirmed the diagnosis of TARP. It seems essential to analyze correlations between genotype, phenotype, and molecular/cellular data to better understand RBM10-associated pathomechanisms, assist genetic counseling, and support development of therapeutic approaches.
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Affiliation(s)
- Marta Owczarek-Lipska
- Junior Research Group, Genetics of Childhood Brain Malformations, School of Medicine and Health Sciences, Faculty VI, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
- Human Genetics, Faculty of Medicine and Health Sciences, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
- Research Center Neurosensory Science, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
| | - Fenja Markus
- Junior Research Group, Genetics of Childhood Brain Malformations, School of Medicine and Health Sciences, Faculty VI, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
- Human Genetics, Faculty of Medicine and Health Sciences, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
| | - Eva Bültmann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - G. Christoph Korenke
- Department of Neuropediatrics, University Children’s Hospital, Klinikum Oldenburg, Rahel-Straus-Straße 10, 26133 Oldenburg, Germany
| | - John Neidhardt
- Human Genetics, Faculty of Medicine and Health Sciences, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
- Research Center Neurosensory Science, University of Oldenburg, Ammerländer Heerstr. 114-118, 26129 Oldenburg, Germany
- Correspondence: ; Tel.:+49-(0)-441-798-3800
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Zhang X, Fan A, Liu Y, Wei L. Humidified versus nonhumidified low-flow oxygen therapy in children with Pierre-Robin syndrome: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e30329. [PMID: 36197167 PMCID: PMC9509148 DOI: 10.1097/md.0000000000030329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Humidification is an important process in clinical oxygen therapy. We aimed to evaluate the effects and safety of humidified versus nonhumidified low-flow oxygen therapy in children with Pierre-Robin syndrome. METHODS This study was an open-label, single-centered randomized controlled trial (RCT) with a parallel group design. The study protocol has been registered in Chinese Clinical Trial Registry (ChiCTR1900021584). The children were randomized to the humidified versus nonhumidified groups. Average arterial oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2), incidence of ventilator-associated pneumonia (VAP), nasal cavity dryness, nasal mucosal bleeding and bacterial contamination of the humidified bottle, the cost of nasal oxygen therapy and duration of intensive care unit (ICU) stay were analyzed. RESULTS A total of 213 children with Pierre-Robin syndrome were included. There were no significant differences in the gender, age, weight, prematurity, duration of anesthesia and surgery duration of mandibular traction between humidified group and nonhumidified group (all P > .05). No significant differences in the average arterial PaO2 and PaCO2 level on the postoperative day 1, 2, and ICU discharge between humidified group and nonhumidified group were found (all P > .05). There were no significant differences in the incidence of nasal cavity dryness, nasal mucosal bleeding, bacterial contamination and VAP, the duration of ICU stay between humidified group and nonhumidified group (all P > .05). The cost of nasal oxygen therapy in the humidified group was significantly less than that of nonhumidified group (P = .013). CONCLUSIONS Humidifying the oxygen with cold sterile water in the low-flow oxygen therapy in children may be not necessary. Future RCTs with lager sample size and rigorous design are warranted to further elucidate the effects and safety of humidified versus nonhumidified low-flow oxygen therapy.
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Affiliation(s)
- Xin Zhang
- Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Aijuan Fan
- Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Yingfei Liu
- Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Li Wei
- Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China
- * Correspondence: Li Wei, Surgical Intensive Care Unit, Children’s Hospital of Nanjing Medical University, No. 72 Guangzhou Road, Gulou District, Nanjing City, Jiangsu Province, China (e-mail: )
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Ramirez-Martinez A, Zhang Y, van den Boogaard MJ, McAnally JR, Rodriguez-Caycedo C, Chai AC, Chemello F, Massink MP, Cuppen I, Elferink MG, van Es RJ, Janssen NG, Walraven-van Oijen LP, Liu N, Bassel-Duby R, van Jaarsveld RH, Olson EN. Impaired activity of the fusogenic micropeptide Myomixer causes myopathy resembling Carey-Fineman-Ziter syndrome. J Clin Invest 2022; 132:e159002. [PMID: 35642635 PMCID: PMC9151691 DOI: 10.1172/jci159002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/21/2022] [Indexed: 01/19/2023] Open
Abstract
Skeletal muscle fibers contain hundreds of nuclei, which increase the overall transcriptional activity of the tissue and perform specialized functions. Multinucleation occurs through myoblast fusion, mediated by the muscle fusogens Myomaker (MYMK) and Myomixer (MYMX). We describe a human pedigree harboring a recessive truncating variant of the MYMX gene that eliminates an evolutionarily conserved extracellular hydrophobic domain of MYMX, thereby impairing fusogenic activity. Homozygosity of this human variant resulted in a spectrum of abnormalities that mimicked the clinical presentation of Carey-Fineman-Ziter syndrome (CFZS), caused by hypomorphic MYMK variants. Myoblasts generated from patient-derived induced pluripotent stem cells displayed defective fusion, and mice bearing the human MYMX variant died perinatally due to muscle abnormalities. In vitro assays showed that the human MYMX variant conferred minimal cell-cell fusogenicity, which could be restored with CRISPR/Cas9-mediated base editing, thus providing therapeutic potential for this disorder. Our findings identify MYMX as a recessive, monogenic human disease gene involved in CFZS, and provide new insights into the contribution of myoblast fusion to neuromuscular diseases.
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Affiliation(s)
- Andres Ramirez-Martinez
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yichi Zhang
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - John R. McAnally
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Cristina Rodriguez-Caycedo
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Andreas C. Chai
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Francesco Chemello
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | - Robert J.J. van Es
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nard G. Janssen
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Ning Liu
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rhonda Bassel-Duby
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Eric N. Olson
- Department of Molecular Biology and Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Perrino MA. Neonatal Mandibular Distraction. Atlas Oral Maxillofac Surg Clin North Am 2022; 30:57-62. [PMID: 35256110 DOI: 10.1016/j.cxom.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Abstract
Facial clefts and Robin sequence (RS) share the timing of the diagnosis during the course of pregnancy, their association with genetic diseases and the subsequent management following the initial diagnosis. If a suspicion of a facial cleft or RS is made, a detailed anatomical examination of the fetus should be carried out to identify further anomalies. This may also involve genetic testing including a microarray or an exome analysis. Interdisciplinary counseling, including pre- and postnatal experts with sufficient experience in the management of such neonates, should be involved in this counseling. Parents should be informed about disease-specific therapeutic options and postnatal outcome. Delivery should take place in a center with experience in craniofacial malformations where clinicians are prepared for potentially life-threatening airway obstruction immediately after birth.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Hospital, Eberhard Karls University, Calwerstraße 7, Tübingen, 72076, Germany; Interdisciplinary Center for Craniofacial Malformations, University Hospital, Eberhard Karls University, Tübingen, Germany.
| | - Karl Oliver Kagan
- Department of Gynecology and Obstetrics, University Hospital, Eberhard Karls University, Calwerstraße 7, Tübingen, 72076, Germany.
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9
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Dhakal R, Makaju R, Karki S, Dhakal B. Respiratory Failure in a Neonate with Pierre Robin Syndrome -A Challenging Proposition. Kathmandu Univ Med J (KUMJ) 2021; 19:80-84. [PMID: 34812163] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Fine needle aspiration (FNA) with radiological assisted tools such as ultrasonography (USG) and computed tomography (CT) are effective in obtaining high yield aspiration of tissues located in technically difficult places such as deep-seated. It is a simple outpatient procedure with low cost as compared to surgical biopsies. Objective To study the cytomorphological features of deep-seated lesions according to the site of occurrence, and to categorize them with respect to age, sex and behavior of lesions. Method This was a descriptive cross-sectional study of 125 patients who underwent imageguided fine needle aspiration cytology of deep-seated lesions. The study was conducted in the Department of Pathology and Department of Radiodiagnosis, Dhulikhel Hospital- Kathmandu University Hospital, between January 2017 and December 2018. Under radiological guidance, aspiration was performed under negative pressure, and adequate material was obtained. Smears were stained with Giemsa and Papanicolaou stain. The prepared slides were examined under a microscope. Result Of the 125 patients who underwent USG and CT-guided fine needle aspiration cytology (FNAC), 68(54.4%) were female and 57(45.6%) were male. The age of the patients ranged from 13 to 84 years. The maximum number of patients was above 50 years. The nature of lesions was categorized as malignant 78(62.4%), followed by 23(18.4%) inflammatory and benign 1(0.8%). Conclusion Image-guided fine needle aspiration cytology is a safe diagnostic procedure, as it provides real-time visualization of tip insertion in anatomical structures. It provides high yield and a better representation of the samples.
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Affiliation(s)
- R Dhakal
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R Makaju
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Karki
- Department of Radiology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Dhakal
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Long HK, Osterwalder M, Welsh IC, Hansen K, Davies JOJ, Liu YE, Koska M, Adams AT, Aho R, Arora N, Ikeda K, Williams RM, Sauka-Spengler T, Porteus MH, Mohun T, Dickel DE, Swigut T, Hughes JR, Higgs DR, Visel A, Selleri L, Wysocka J. Loss of Extreme Long-Range Enhancers in Human Neural Crest Drives a Craniofacial Disorder. Cell Stem Cell 2020; 27:765-783.e14. [PMID: 32991838 PMCID: PMC7655526 DOI: 10.1016/j.stem.2020.09.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/09/2020] [Accepted: 09/02/2020] [Indexed: 01/09/2023]
Abstract
Non-coding mutations at the far end of a large gene desert surrounding the SOX9 gene result in a human craniofacial disorder called Pierre Robin sequence (PRS). Leveraging a human stem cell differentiation model, we identify two clusters of enhancers within the PRS-associated region that regulate SOX9 expression during a restricted window of facial progenitor development at distances up to 1.45 Mb. Enhancers within the 1.45 Mb cluster exhibit highly synergistic activity that is dependent on the Coordinator motif. Using mouse models, we demonstrate that PRS phenotypic specificity arises from the convergence of two mechanisms: confinement of Sox9 dosage perturbation to developing facial structures through context-specific enhancer activity and heightened sensitivity of the lower jaw to Sox9 expression reduction. Overall, we characterize the longest-range human enhancers involved in congenital malformations, directly demonstrate that PRS is an enhanceropathy, and illustrate how small changes in gene expression can lead to morphological variation.
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Affiliation(s)
- Hannah K Long
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Marco Osterwalder
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Ian C Welsh
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Karissa Hansen
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - James O J Davies
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Yiran E Liu
- Cancer Biology Program, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mervenaz Koska
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alexander T Adams
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Robert Aho
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Neha Arora
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kazuya Ikeda
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Ruth M Williams
- MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Tatjana Sauka-Spengler
- MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthew H Porteus
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Tim Mohun
- The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Diane E Dickel
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Tomek Swigut
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jim R Hughes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Douglas R Higgs
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Laboratory of Gene Regulation, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Axel Visel
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; US Department of Energy Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
| | - Licia Selleri
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Wysocka
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA 94305, USA.
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11
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钟 建, 罗 向, 黄 振, 仇 书, 程 超, 杨 李, 易 新, 曾 锦, 刘 大. [The significance of evaluation of sleep respiration in infants with Pierre Robin sequence]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 34:496-498. [PMID: 32842177 PMCID: PMC10128329 DOI: 10.13201/j.issn.2096-7993.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Objective:This study aimed to evaluate the sleep disorders of infants with Pierre Robin sequence by PSG, and to understand the sleep breathing characteristics of them. Method:Seventeen patients with Pierre Robin sequence underwent polysomnography lasting over 7 hours. Sleep apnea and oxygen index was recorded and analyzed. Result:14(82.35%) patients with Pierre Robin sequence presented with apnea, hypopnea and hypoxemia with varying degree. The apnea-hypopnea index(12.39±9.86) and lowest arterial oxygen saturation(84.12±8.12) %were not significantly different between sexes. However, age showed a negative impact with apnea-hypopnea index, which was worse in younger infants. Conclusion:Most patients with the Pierre Robin sequence have sleep apnea and hypoxemia, and appropriate management should be implemented in an early age. Polysomnography can provide objective analysis of the treatment.
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Affiliation(s)
- 建文 钟
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 向前 罗
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 振云 黄
- 广州市妇女儿童医疗中心耳鼻咽喉科Department of Oto1aryngology, Guangzhou Women and Children's Medical Center
| | - 书要 仇
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 超 程
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 李强 杨
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 新华 易
- 广州市妇女儿童医疗中心耳鼻咽喉科Department of Oto1aryngology, Guangzhou Women and Children's Medical Center
| | - 锦鸿 曾
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
| | - 大波 刘
- 南方医科大学深圳医院儿童耳鼻咽喉科(广东深圳,518000)Department of Pediatric Oto1aryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, China
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Ehmke N, Cusmano-Ozog K, Koenig R, Holtgrewe M, Nur B, Mihci E, Babcock H, Gonzaga-Jauregui C, Overton JD, Xiao J, Martinez AF, Muenke M, Balzer A, Jochim J, El Choubassi N, Fischer-Zirnsak B, Huber C, Kornak U, Elsea SH, Cormier-Daire V, Ferreira CR. Biallelic variants in KYNU cause a multisystemic syndrome with hand hyperphalangism. Bone 2020; 133:115219. [PMID: 31923704 PMCID: PMC10521254 DOI: 10.1016/j.bone.2019.115219] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Received: 11/18/2019] [Revised: 12/25/2019] [Accepted: 12/29/2019] [Indexed: 01/17/2023]
Abstract
Catel-Manzke syndrome is characterized by the combination of Pierre Robin sequence and radial deviation, shortening as well as clinodactyly of the index fingers, due to an accessory ossification center. Mutations in TGDS have been identified as one cause of Catel-Manzke syndrome, but cannot be found as causative in every patient with the clinical diagnosis. We performed a chromosome microarray and/or exome sequencing in three patients with hand hyperphalangism, heart defect, short stature, and mild to severe developmental delay, all of whom were initially given a clinical diagnosis of Catel-Manzke syndrome. In one patient, we detected a large deletion of exons 1-8 and the missense variant c.1282C > T (p.Arg428Trp) in KYNU (NM_003937.2), whereas homozygous missense variants in KYNU were found in the other two patients (c.989G > A (p.Arg330Gln) and c.326G > C (p.Trp109Ser)). Plasma and urine metabolomic analysis of two patients indicated a block along the tryptophan catabolic pathway and urine organic acid analysis showed excretion of xanthurenic acid. Biallelic loss-of-function mutations in KYNU were recently described as a cause of NAD deficiency with vertebral, cardiac, renal and limb defects; however, no hand hyperphalangism was described in those patients, and Catel-Manzke syndrome was not discussed as a differential diagnosis. In conclusion, we present unrelated patients identified with biallelic variants in KYNU leading to kynureninase deficiency and xanthurenic aciduria as a very likely cause of their hyperphalangism, heart defect, short stature, and developmental delay. We suggest performance of urine organic acid analysis in patients with suspected Catel-Manzke syndrome, particularly in those with cardiac or vertebral defects or without mutations in TGDS.
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Affiliation(s)
- Nadja Ehmke
- Charité - Universitätsmedizin Berlin, Institute of Medical Genetics and Human Genetics, Augustenburger Platz 1, 13353 Berlin, Germany; Max Planck Institute for Molecular Genetics, Development and Disease Group, Ihnestr. 63-73, 14195 Berlin, Germany.
| | - Kristina Cusmano-Ozog
- Biochemical Genetics and Metabolism Laboratory, Children's National Hospital, Washington, DC 20010, USA
| | - Rainer Koenig
- Department of Human Genetics, University of Frankfurt, 60590 Frankfurt, Germany
| | - Manuel Holtgrewe
- Core Unit Bioinformatics - CUBI, Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Banu Nur
- Department of Pediatric Genetics, Akdeniz University Medical School, 07059 Antalya, Turkey
| | - Ercan Mihci
- Department of Pediatric Genetics, Akdeniz University Medical School, 07059 Antalya, Turkey
| | - Holly Babcock
- Rare Disease Institute, Children's National Hospital, Washington, DC 20010, USA
| | | | - John D Overton
- Regeneron Genetics Center, Regeneron Pharmaceuticals Inc., Tarrytown, NY 10599, USA
| | - Jing Xiao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ariel F Martinez
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Judith Jochim
- Sana Klinikum Offenbach GmbH, Starkenburgring 66, 63069 Offenbach am Main, Germany
| | - Naji El Choubassi
- Charité - Universitätsmedizin Berlin, Institute of Medical Genetics and Human Genetics, Augustenburger Platz 1, 13353 Berlin, Germany; Max Planck Institute for Molecular Genetics, Development and Disease Group, Ihnestr. 63-73, 14195 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Föhrerstr. 15, 13353 Berlin, Germany
| | - Björn Fischer-Zirnsak
- Charité - Universitätsmedizin Berlin, Institute of Medical Genetics and Human Genetics, Augustenburger Platz 1, 13353 Berlin, Germany; Max Planck Institute for Molecular Genetics, Development and Disease Group, Ihnestr. 63-73, 14195 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Föhrerstr. 15, 13353 Berlin, Germany
| | - Céline Huber
- Department of Genetics, INSERM UMR 1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, AP-HP, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Uwe Kornak
- Charité - Universitätsmedizin Berlin, Institute of Medical Genetics and Human Genetics, Augustenburger Platz 1, 13353 Berlin, Germany; Max Planck Institute for Molecular Genetics, Development and Disease Group, Ihnestr. 63-73, 14195 Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Föhrerstr. 15, 13353 Berlin, Germany
| | - Sarah H Elsea
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Valérie Cormier-Daire
- Department of Genetics, INSERM UMR 1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, AP-HP, Hôpital Necker Enfants Malades, 75015 Paris, France
| | - Carlos R Ferreira
- Department of Pediatric Genetics, Akdeniz University Medical School, 07059 Antalya, Turkey; Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Herring ME, Lee C, Taylor J, Hajishengallis E. Macrodontia Associated with Mandibular Distraction Osteogenesis. J Dent Child (Chic) 2020; 87:48-52. [PMID: 32151311] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Infants diagnosed with Pierre Robin sequence frequently have airway obstruction. In severe cases of obstruction, mandibular distraction osteogenesis (MDO) can alleviate the airway blockage through elongation of the mandible and subsequent anterior placement of the tongue. However, there are several complications associated with MDO in the very young child. Among those are injuries to teeth that develop in the area of the MDO osteotomies. Such injuries include distalization and/or morphologic anomalies of primary and permanent molars. We describe a case of an unusual macrodontia of the primary mandibular left second molar in a six-year-old male who underwent MDO as an infant. We believe that the mesial-distal elongation of the crown of the primary second molar occurred through distraction histogenesis of the tooth structures during the distraction of the mandible. We discuss the importance of preoperative planning to minimize such damages to the developing dentition.
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Affiliation(s)
- Mark E Herring
- Dr. Herring is a pediatric dentist in private practice, Cary and Cameron, N.C., USA
| | - Catherine Lee
- Dr. Lee is a resident, Pediatric Dentistry Division, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa., USA
| | - Jesse Taylor
- Dr. Taylor is Peter Randall Endowed Chair of Plastic Surgery and chief, Division of Plastic and Reconstructive Surgery, Department of Surgery; and co-director, Cleft Lip and Palate Program and the Craniofacial Program, Children's Hospital of Philadelphia, Philadelphia, Pa., USA
| | - Evlambia Hajishengallis
- Dr. Hajishengallis is a professor, graduate program director and chief, Pediatric Dentistry Division, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa., USA;,
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Affiliation(s)
- Daan P F van Nunen
- Division of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Cichocka-Jarosz E, Stobiecki M, Brzyski P, Rogatko I, Nittner-Marszalska M, Sztefko K, Czarnobilska E, Lis G, Nowak-Węgrzyn A. Simplification of intradermal skin testing in Hymenoptera venom allergic children. Ann Allergy Asthma Immunol 2016; 118:326-332. [PMID: 27986410 DOI: 10.1016/j.anai.2016.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The direct comparison between children and adults with Hymenoptera venom anaphylaxis (HVA) has never been extensively reported. Severe HVA with IgE-documented mechanism is the recommendation for venom immunotherapy, regardless of age. OBJECTIVE To determine the differences in the basic diagnostic profile between children and adults with severe HVA and its practical implications. METHODS We reviewed the medical records of 91 children and 121 adults. RESULTS Bee venom allergy was exposure dependent, regardless of age (P < .001). Atopy was more common in children (P = .01), whereas cardiovascular comorbidities were present almost exclusively in adults (P = .001). In the bee venom allergic group, specific IgE levels were significantly higher in children (29.5 kUA/L; interquartile range, 11.30-66.30 kUA/L) compared with adults (5.10 kUA/L; interquartile range, 2.03-8.30 kUA/L) (P < .001). Specific IgE levels for culprit insect venom were higher in bee venom allergic children compared with the wasp venom allergic children (P < .001). In adults, intradermal tests revealed higher sensitivity, accompanied by larger area of skin reactions, regardless of type of venom. At concentrations lower than 0.1 μg/mL, 16% of wasp venom allergic children and 39% of bee venom allergic children had positive intradermal test results. The median tryptase level was significantly higher in adults than in children for the entire study group (P = .002), as well as in bee (P = .002) and wasp venom allergic groups (P = .049). CONCLUSION The basic diagnostic profile in severe HVA reactors is age dependent. Lower skin test reactivity to culprit venom in children may have practical application in starting the intradermal test procedure with higher venom concentrations.
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Affiliation(s)
- Ewa Cichocka-Jarosz
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Stobiecki
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland.
| | | | - Iwona Rogatko
- Department of Clinical Biochemistry, University Children's Hospital, and Faculty of Medicine, Jagiellonian University, Krakow, Poland
| | | | - Krystyna Sztefko
- Department of Clinical Biochemistry, University Children's Hospital, and Faculty of Medicine, Jagiellonian University, Krakow, Poland
| | - Ewa Czarnobilska
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland
| | - Grzegorz Lis
- Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Nowak-Węgrzyn
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, New York, New York
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Faraz A, Fareed J, Wasay HA, Siddique UN. Pierre Robin Sequence: A Rare Presentation Of Absent Femur And Inguinal Hernia. J Ayub Med Coll Abbottabad 2016; 28:407-408. [PMID: 28718574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pierre Robin Sequence is a well-recognized case of rarity which presents with a triad of glossoptosis, cleft palate. We report a rare case of Pierre robin Sequence in an Asian child, with the absence of left femur and right sided inguinal hernia.
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Affiliation(s)
- Ahmad Faraz
- SAbassi Shaheed Hospital, Karachi Medical & Dental College, Karachi, Pakistan
| | - Jaweria Fareed
- Abassi Shaheed Hospital, Karachi Medical & Dental College, Karachi, Pakistan
| | - Hafiz Abdul Wasay
- Abassi Shaheed Hospital, Karachi Medical & Dental College, Karachi, Pakistan
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Abstract
BACKGROUND The majority of patients with Pierre Robin sequence in the subdivision Fairbairn- Robin triad (FRT), are born with glossoptosis, retro-/micrognathia and cleft or agenesis of the palate leading to feeding difficulties and airway obstruction. There is limited literature on these problems, and on methods used to address them. OBJECTIVES Community nurses in the Facial Cleft Deformity Clinic evaluate associated airway obstruction and feeding problems and devise nursing interactions to address these. This retrospective study examined the incidence of airway and feeding difficulties in the neonatal, pre-surgical period, as well as the surgical and nutritional management of these infants. METHOD Retrospective records of 215 infants with FRT were examined and data on incidence, airway and feeding difficulties and surgical and nutritional management was collected. Descriptive statistics, including average and percentage values, were compiled. RESULTS The incidence of FRT amongst the cleft palate patients was 6.0%, with 37.7% of these having feeding difficulties. However, surgical interventions such as glossopexy (5.6%), distraction osteogenesis (0.9%) and tracheotomy (2.3%) for airway management were seldom required. Most of the infants who had upper airway obstruction and feeding problems were handled by means of suction and drinking plates, along with additional specific feeding aids. This reduced airway obstruction in 70.6%, and feeding problems in 62.4% of these infants. CONCLUSION Based on this study’s finding the introduction of the suction and drinking plate and the use of specific types of feeding devices and surgical management can improve growth and development in infants with FRT.
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Shi XH, Yin N, Fei J, Huang HQ, Jiang WX. [Assessment and management of difficult airways in neonates with Pierre Robin sequence]. Zhonghua Yi Xue Za Zhi 2012; 92:886-888. [PMID: 22781528] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess the difficult airways preoperatively in neonates with Pierre Robin sequence (PRS). METHODS A total of 18 newborn PRS with difficult intubation were evaluated with the assessment grade. The scores were based upon clinical observation, weight gain, airway obstruction and Cormack-Lehane classification. RESULTS A total of 14 neonates (77%) had medium (n = 8) and severe (n = 6) airway obstruction. And 89% (n = 16) failed to display glottis and unsuccessful tracheal intubation (50%). CONCLUSION The assessment practice of clinical observation, weight gain, airway obstruction and Cormack-Lehane classification may help to identify the difficult airways in neonates with PRS.
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Affiliation(s)
- Xiao-hua Shi
- Department of Anesthesiology, Affiliated Nanjing Children's Hospital, Nanjing Medical University, Nanjing 210008, China.
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Andrews P, Fenlon S. Laryngeal mask airway-aided fiberoptic intubation in infants--a modified technique, but is it new? Paediatr Anaesth 2010; 20:283. [PMID: 20470323 DOI: 10.1111/j.1460-9592.2009.03245.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stricker P, Fiadjoe JE, McGinnis S. Intubation of an infant with Pierre Robin sequence under dexmedetomidine sedation using the Shikani Optical Stylet. Acta Anaesthesiol Scand 2008; 52:866-7. [PMID: 18582313 DOI: 10.1111/j.1399-6576.2008.01631.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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LINDSTEN J, FRACCARO M, KLINGER HP, ZETTERQVIST P. Meiotic and Mitotic Studies of a Familial Reciprocal Translocation Between Two Autosomes of Group 6–12. Cytogenet Genome Res 2008; 4:45-64. [PMID: 14291491 DOI: 10.1159/000129843] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
We propose the term brainstem dysgenesis to designate patients with congenital dysfunction of the cranial nerves and muscle tone due to prenatal lesions or anomalies of the brainstem. In some patients, the dysgenesis is genetically determined and can be isolated or form part of a more extensive polymalformation syndrome (mutations of organizing or regulatory genes). In most patients with brainstem dysgenesis, however, the disorder is caused by prenatal destructive or disruptive lesions of vascular origin. Depending on the vessels involved and the magnitude of the lesion, clinical manifestations can range from intrauterine death to mild involvement of several cranial nerves. Clinical findings in some of these patients may coincide with those described in Möbius, Pierre Robin or Cogan syndromes and, if that is the case, the eponym will indicate the location of the brainstem lesion. Clinical manifestations in most patients with brainstem dysgenesis, however, do not fit into any of the aforementioned syndromes. In these circumstances the term brainstem dysgenesis should be used followed by a detailed description of each patient's clinical findings and/or the brainstem segment presumably involved. The prognosis of patients with brainstem dysgenesis due to prenatal destructive lesions depends on the magnitude of the vascular territory involved and, in most cases, is better than the initial clinical manifestations would indicate.
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Affiliation(s)
- M Roig Quilis
- Sección de Neurología Infantil y Laboratori de Recerca de Malalties Neurometabòliques, Hospital Universitari Vall d'Hebron, 08035 Barcelona, España.
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Kamitani J, Toda Y, Nakatsuka H, Sato K, Morimatsu H, Taga N, Takeuchi M, Morita K. [General anesthesia outside the operating room in patients with Pierre-Robin syndrome]. Masui 2005; 54:687-9. [PMID: 15966393] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Anesthesiologists are increasingly asked to involve in administering general anesthesia outside the operating room for such procedures as computed tomography, magnetic resonance imaging or angiography. Especially, pediatric patients require some kind of sedation or general anesthesia during these procedures. We report general anesthesia outside the operating room in patients with Pierre-Robin syndrome, who are expected to have possible difficult airway. A one-year-old girl and a 16-year-old boy were anesthetized for cardiac catheterization. General anesthesia was given at the angiography room which was located outside the operating room. Anesthesia was induced with oxygen, nitrous oxide and sevoflurane while portable storage unit for difficult airway was prepared including various types and size of laryngoscopes, laryngeal mask airway, fiberoptic intubation equipment and surgical airway access. Fortunately, tracheas were successfully intubated without using special devices, although cautious care during induction was taken. According to development of medical and surgical procedures, it is readily presumed that anesthesiologists will be more often involved in the sedation or anesthesia conducted outside the operating room in future. Anesthesiologists should always ensure enough staffing, proper monitoring and equipment when sedation or anesthesia is conducted outside the operating room, particularly if patients have anesthetic risks.
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Affiliation(s)
- Junko Kamitani
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine and Dentistry, Okayama
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Leifer D. A labour of love. Nurs Stand 2002; 16:18-9. [PMID: 12219444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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26
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Kurosawa K. [RAG syndrome]. Ryoikibetsu Shokogun Shirizu 2002:568. [PMID: 11528900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- K Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center
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Yokoyama Y. [Digito-palatal syndrome (Stevenson type)]. Ryoikibetsu Shokogun Shirizu 2001:562-3. [PMID: 11462570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- Y Yokoyama
- Department of Pediatrics, Okayama University Medical School
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28
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Kurosawa K. [Carey-Fineman-Ziter (CFZ) syndrome]. Ryoikibetsu Shokogun Shirizu 2001:335-6. [PMID: 11462462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- K Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center
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Nakayama H. [ Pierre Robin syndrome (Robin sequence)]. Ryoikibetsu Shokogun Shirizu 2001:459-60. [PMID: 11462515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- H Nakayama
- Maternity and Perinatal Care Unit, Kyushu University Hospital
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Abstract
Iatrogenic oesophageal perforation in neonates is well recognized in the medical and surgical literature with intubation injury listed as a possible contributing mechanism besides nasogastric tube placement and suctioning. Diagnosis can be difficult and sometimes confused with other entities. With early diagnosis, nonsurgical management often leads to complete resolution in neonates. We report the case of a 1-day-old premature neonate who was brought to the operating room with the preliminary diagnosis of proximal oesophageal atresia with stump perforation and distal tracheo-esophageal fistula. His intubation for respiratory distress at birth had been difficult due to Pierre-Robin sequence with micrognathia. Oesophagoscopy in the operating room revealed a patent oesophagus but perforations in the pharynx and in the proximal oesophagus with the nasogastric tube entering the pharyngeal perforation. Oesophageal perforation and the limitations of the difficult airway algorithm in small neonates are discussed.
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Affiliation(s)
- C Seefelder
- Department of Anesthesia, Children's Hospital, Boston, MA 02115, USA
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Barker I. Anaesthesia for Pierre-Robin syndrome. Hosp Med 2000; 61:72. [PMID: 10735166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Stoll C, Benoit F, Peter MO, Gasser B. Familial association of camptodactyly, mental retardation, whistling face and Pierre Robin sequence. Clin Dysmorphol 1999; 8:247-51. [PMID: 10532172] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Two sibs are reported with severe developmental retardation combined with the clinical triad of camptodactyly, whistling face and Pierre Robin sequence as clinical signs of fetal hypokinesia. In spite of tracheotomy, the first child of the family died 10 hours after birth. A sister of this child was born 1 year later. During pregnancy prenatal diagnosis of hydrocephaly was made by ultrasonographic examination. MRI scan showed holoprosencephaly. At 15 months of age psychomotor development is severely impaired, birth and length are delayed.
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Affiliation(s)
- C Stoll
- Service de Génétique Médicale, Hôpital de Hautepierre, Strasbourg, France
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Howell TK, Walker RW. To paralyze or not to paralyze? Hosp Med 1999; 60:688. [PMID: 10621804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Abstract
OBJECTIVE To determine what child restraints would accommodate infants with Pierre Robin sequence who often require special attention in motor vehicle travel since microagnathia usually requires a prone position to keep the infant's airway open. RESEARCH DESIGN Dynamic testing and clinical trial. SETTING An Indiana children's hospital providing primary and tertiary care. PATIENTS Four patients with Pierre Robin sequence are described to illustrate use of the modified infant car seat and the appropriateness of the car bed restraints for meeting requirements for prone positioning during travel. SELECTION PROCEDURES Convenience sample. INTERVENTION Selected restraints were loaned to families through a clinical setting until the patient was able to use a conventional child restraint. MEASUREMENTS AND RESULTS Three child restraint systems were determined to accommodate the prone position necessary to keep the airway open for children with Pierre Robin sequence. Dynamic crash testing demonstrated the crashworthiness of an infant car seat modified to allow for prone positioning. Through a clinical trial, two car bed restraints were also found to provide safe prone positioning of infants. CONCLUSIONS To enable safe transportation for infants with Pierre Robin sequence, health care providers can direct parents to appropriate resources for travel and can monitor the airway and oxygenation of the infant with Pierre Robin sequence before hospital discharge.
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Affiliation(s)
- M J Bull
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis
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Dulude JA, Payette F. [Synthesis of current knowledge on Pierre Robin syndrome]. J Dent Que 1991; 28:9-11. [PMID: 2056159] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
An analysis of the clinical features of Pierre Robin syndrome is presented. The main characteristics relative to the clinical aspect, diagnosis, etiopathogenicity and treatment are described. The prognosis and evolution of the syndrome are finally analyzed.
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Spyropoulos MN, Papagrigorakis MJ. [Soft tissue configuration in certain syndromes of the head and neck]. Odontostomatol Proodos 1990; 44:21-7. [PMID: 2130313] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In order to examine the relationship existing between soft tissue configuration and the underlying skeletodental framework, patients presenting severe and representative syndromes of the head and neck were studied. Grouping of these patients in three groups according to the similarities of the skeletal pattern and/or the etiology of the syndrome, provided a basis for evaluation, comparison and contradistinction of the configuration of the hard and soft tissues, in a material where genetic predetermination is dominant. By cephalometric analysis, superimposition and plotting of the soft tissues on an abstraction and relative magnification basis, the following conclusions could be formulated: a) There is a specificity in the soft tissue configuration of the face of patients with specific syndromes and, this specificity, seems to be independent of the underlying skeletodental elements in the area of the nose and the upper lip. b) A genetic predetermination of the soft tissue morphology can be deduced because, in patients with specific syndromes, the same characteristics accompany constantly the same chromosomal or gene mutations. c) Further studies along these lines might throw more light on the role of genetics in soft tissue configuration and function.
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Abstract
Infants with Pierre Robin syndrome often present the anaesthesiologist with the challenge of upper airway obstruction and difficult tracheal intubation. An unconventional method for solving this problem was used in a 2 week old 2.2 kg term male infant who presented with severe micrognathia, a widely cleft palate and extreme glossoptosis. Hyperextension of the head in the prone position distracted the epiglottis from the glottis. Blind nasotracheal intubation was then used. The curve of the nasotracheal tube made it pass behind the epiglottis into the larynx.
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39
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Abstract
Renal transplantation and peritoneal or hemodialysis are therapeutic options increasingly available to diabetic patients with uremia. We report a patient with insulin-dependent diabetes mellitus (IDDM) and advanced retinopathy and nephropathy who had three pregnancies. Her first pregnancy resulted in a living female with Pierre-Robin syndrome and arthrogryposis. The second pregnancy, 8 mo post-kidney transplantation, necessitated a therapeutic abortion for an anencephalic fetus. Her third pregnancy, 22 mo after kidney transplantation, was associated with intensive diabetes management and resulted in delivery by cesarean section of a healthy boy. Renal and retinal function remained stable during both her second and third pregnancies. As more patients with IDDM achieve fertility post-renal transplantation, aggressive principles of diabetes regulation need to be expanded to include consideration of the interaction of the post-kidney-transplant state and diabetes mellitus during pregnancy.
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Abstract
Three cases are described of the Pierre Robin Syndrome in association with femoral dysgenesis. This would appear to be a definite clinical entity.
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41
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Bolasco Sindin L. [Clinical case--early treatment (author's transl)]. Ortodoncia 1975; 39:110-2. [PMID: 1072888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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42
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Skolimowski J, Urbanski M, Stopa J, Naroznik K. Microgenia as a factor making endotracheal intubation impossible. Anaesth Resusc Intensive Ther 1975; 3:273-6. [PMID: 1217701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The authors report a case of microgenia which made endotracheal intubation impossible in a patient with pharyngeal stenosis. It is suggested that laryngological examination should precede the operation and when endotracheal intubation is impossible tracheostomy should be performed.
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43
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Ellis JD, Williamson JG. Factors influencing the pregnancy and complication rates with human menopausal gonadotrophin therapy. Br J Obstet Gynaecol 1975; 82:52-7. [PMID: 1138820 DOI: 10.1111/j.1471-0528.1975.tb00563.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We report the results obtained with a standard system of gonadotrophin therapy. Seventy-seven consecutive patients were given 322 treatment cycles. Thirty-seven patients (48 per cent) conceived, six of them on two occasions, making 43 pregnancies of which 31.6 per cent were multiple. Five per cent of all treatment cycles were complicated by mild, and 0.62 per cent by severe hyperstimulation. The factors involved in achieving a satisfactory pregnancy rate whilst avoiding complications are discussed. Most complications occurred during the first cycle in which the rise in oestrogen excretion suggested follicular development and human chorionic gonadotrophin (HCG) was given (the "first effective" treatment cycle). In such cycles the risk of hyperstimulation rose sharply when the day 6 urinary total estrogen level was above 150 mug. per 24 hours and the multiple pregnancy rate was increased by a large dose of HCG.
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44
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Breslin SJ. Case study: a baby with Pierre Robin syndrome. Midwives Chron 1974; 87:424-6. [PMID: 4498199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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45
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Muir IF. Aspects of plastic surgery. Cleft lip and palate--general. Br Med J 1974; 3:107-8. [PMID: 4850650 PMCID: PMC1611037 DOI: 10.1136/bmj.3.5923.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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46
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Berkowitz S, Krischer J, Pruzansky S. Quantitative analysis of cleft palate casts. A geometric study. Cleft Palate J 1974; 11:134-61. [PMID: 4524356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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47
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Oyama M. [Congenital abnormality: trends in therapy and research]. Kokubyo Gakkai Zasshi 1974; 41:129. [PMID: 4526890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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48
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Spriestersbach DC, Dickson DR, Fraser FC, Horowitz SL, McWilliams BJ, Paradise JL, Randall P. Clinical research in cleft lip and cleft palate: the state of the art. Cleft Palate J 1973; 10:113-65. [PMID: 4220387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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49
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Agrafiotis PC. Teaching parents about Pierre Robin Syndrome. Am J Nurs 1972; 72:2040-1. [PMID: 4488812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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