Twenty-Five Years of Fetal Echocardiography in Conjoined Twins: Lessons Learned

2013 ◽  
Vol 26 (5) ◽  
pp. 530-538 ◽  
Author(s):  
Lilian M. Lopes ◽  
Maria L. Brizot ◽  
Regina Schultz ◽  
Adolfo W. Liao ◽  
Vera L.J. Krebs ◽  
...  
Keyword(s):  
Fetal Echocardiography ◽  
Conjoined Twins ◽  
Lessons Learned

scholarly journals Conjoined twins with a single heart with complex disease

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Julia Simões Pabis ◽  
Paulo Victor Zattar Ribeiro ◽  
Milena Luisa Schulze ◽  
Júlia de Novaes Benvinuti ◽  
Paulo André Ribeiro ◽  
...  
Keyword(s):  
Complex Disease ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Conjoined Twins ◽  
Lessons Learned ◽  
Red Cross ◽  
Right To Die ◽  
Rare Presentation ◽  
Transthoracic Doppler Echocardiography ◽  
Ian Mcewan

Conjoined twins are a rare presentation with an estimated incidence of 1: 50000 pregnancies. They occur due to a random event, not related to heredity, maternal age or delivery conditions. This article is a case-report of a pair of female thoraco-omphalopagus conjoined twins, who were diagnosed during prenatal period through a morphological ultrasound. After a 24-week gestation period, the female newborns had a total weight of 1100g, and were born of a cesarean section. Both fetuses scored 3 in the Apgar scale in the first minute, getting down to a score of 1 in the fifth minute. Soon after birth, the newborns were referred to the Intensive Care Unit, where supportive measures were taken and transthoracic Doppler echocardiography was performed for diagnostic confirmation. The echocardiogram showed that there was only one heart for both newborns with a complex heart disease. In 75% of the cases of thoraco-omphalopagus conjoined twins, structural heart disfigurements are found in at least one of the fetuses. Besides, in approximately 80-90% of the cases, the cardiac abnormalities in the heart junction are far too complex, making it impossible to surgically separate the fetuses. This way, a structural and functional analysis of the heart is considerably more efficient post-birth, and it’s shown to be more accurately done through an echocardiography. This reveals that cardiac changes are a crucial factor in the fetal and postnatal evaluations of conjoined twins. Such procedures are a way of providing adequate medical recommendations, which may always be honest and based on scientific evidence.Descriptors: Diseases in Twins; Twins, Conjoined; Heart Diseases.ReferencesMcMahon CJ, Spencer R. Congenital heart defects in conjoined twins: outcome after surgical separation of thoracopagus. Pediatr Cardiol. 2006;27(1):1-12Rode H, Fieggen AG, Brown RA, Cywes S, Davies MRQ, Hewitson JP et al. Four decades of conjoined twins at Red Cross Children's Hospital--lessons learned. S Afr Med J. 2006; 96(9Pt2):931-40.Barth RA, Filly RA, Goldberg JD, Moore P, Silverman NH. Conjoined twins: prenatal diagnosis and assessment of associated malformations [published correction appears in Radiology 1991 Jan;178(1):287]. Radiology. 1990;177(1):201-7.Spencer R. Anatomic description of conjoined twins: a plea for standardized terminology. J Pediatr Surg. 1996;31(7):941-944.Andrews RE, Yates RW, Sullivan ID. The management of conjoined twins: Cardiology assessment. Semin Pediatr Surg. 2015;24(5):217-20.Andrews RE, McMahon CJ, Yates RW, et al. Echocardiographic assessment of conjoined twins. Heart. 2006;92(3):382-87.Lopes LM, Brizot ML, Schultz R, Liao AW, Krebs VLJ, Francisco RPV et al. Twenty-five years of fetal echocardiography in conjoined twins: lessons learned. J Am Soc Echocardiogr. 2013;26(5):530-538.Brooks R. Ian McEwan attacks church over right to die. Sunday may 18 2014. The Sunday Times  https://www.thetimes.co.uk/article/mcewan-attacks-church-over-right-to-die-gq8nwtbhqjb.Sih DA, Bimerew M, Modeste RRM. Coping strategies of mothers with preterm babies admitted in a public hospital in Cape Town. Curationis. 2019;42(1):e1-8.Albuquerque S, Pereira M, Fonseca A, Canavarro MC. Impacto familiar e ajustamento de pais de crianças com diagnóstico de anomalia congênita: influência dos determinantes da criança. Rev psiquiatr clín.  2012;39(4):136-41.Pereira PK, Lima LA, Legay LF, Santos JFC, Lovisi GM. Congenital malformation of the baby and risk of maternal mental disorders during the pregnancy-puerperal period: a systematic review. Cad Saúde Colet (Rio de Janeiro). 2011;19(1):2-10.

scholarly journals Conjoined Twins Separation Leading to the Death of One Twin: An Expanded Ethical Analysis of Issues Facing the ICU Team

2018 ◽  
Vol 34 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Brian M. Cummings ◽  
John J. Paris
Keyword(s):  
Systematic Approach ◽  
Pediatric Intensive Care ◽  
Conjoined Twins ◽  
Ethics Committee ◽  
Ethical Analysis ◽  
Lessons Learned ◽  
Difficult Situation ◽  
Medical Standards ◽  
Hospital Ethics ◽  
Legal Frameworks

A recent case of conjoined twins required multiple hospitalizations in the pediatric intensive care unit and led to a difficult situation confronting staff regarding the potential separation where surgery would result in the death of one twin. The hospital ethics committee was consulted. A systematic approach was utilized to examine medical standards, historical precedents, and various ethical and legal frameworks. The ethics committee believed that either proceeding with or forgoing attempted separation surgery would be ethically acceptable. We share our reasoning and lessons learned for others facing this situation in the future.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting

2020 ◽  
Vol 29 (3S) ◽  
pp. 638-647 ◽  
Author(s):  
Janine F. J. Meijerink ◽  
Marieke Pronk ◽  
Sophia E. Kramer
Keyword(s):  
Large Scale ◽  
Hearing Aid ◽  
Critical Discussion ◽  
Lessons Learned ◽  
Research Note ◽  
Support Program ◽  
Large Sample Size ◽  
Long Term Effects ◽  
Communication Program ◽  
Communication Partners

Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).

Maximizing Outcomes in Group Treatment of Aphasia: Lessons Learned From a Community-Based Center

2014 ◽  
Vol 24 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Darlene Williamson
Keyword(s):  
Group Treatment ◽  
Treatment Protocol ◽  
Lessons Learned ◽  
Group Program ◽  
Community Based ◽  
Multiple Treatment ◽  
Use Of Technology ◽  
Communication Impairments ◽  
Treatment Settings

Given the potential of long term intervention to positively influence speech/language and psychosocial domains, a treatment protocol was developed at the Stroke Comeback Center which addresses communication impairments arising from chronic aphasia. This article presents the details of this program including the group purposes and principles, the use of technology in groups, and the applicability of a group program across multiple treatment settings.

Experience With Grant Writing: Where Do I Even Begin?

2010 ◽  
Vol 11 (1) ◽  
pp. 21-24
Author(s):  
Nicole M. Mancini
Keyword(s):  
Lessons Learned ◽  
Economic Situation ◽  
Grant Writing ◽  
Personal Journey ◽  
Know How ◽  
Daunting Task

Abstract At first, grant writing may look like a daunting task. You may ask yourself, “Is it really worth the time and effort?” With today's economic situation, teachers and therapists need ways to supplement their programs and grants provide such an opportunity. However, many of us do not know how to get started. After a few experiences and many lessons learned, I have come to enjoy researching and writing grants to supplement my students' learning. It is well worth the time and effort. This article provides information about a personal journey, lessons learned, and resources to get you started.

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