P35 Improved survival in rare recessive osteogenesis imperfecta through multidisciplinary team support and early bisphosphonate use

Abstract Background Osteogenesis imperfecta is a rare connective tissue disorder of varying phenotypic presentations. In pregnancies complicated by osteogenesis imperfecta, there is an increased risk to both the mother and fetus. Case presentation We present a case of a 34-year-old, wheelchair-bound, primigravid African (Zimbabwean) patient with short stature and skeletal deformities. Her care, requiring a multidisciplinary team approach, resulted in the delivery of a live baby girl with a birth weight of 2100 g, also with osteogenesis imperfecta. Conclusion Good outcomes are reported when a multidisciplinary team is involved in the care of patients with osteogenesis imperfecta. Pregnancies can be carried to term but require close antenatal surveillance. Prenatal diagnosis is possible with ultrasound and genetic testing. Delivery should be carefully planned by a multidisciplinary team. Decisions on delivery mode should be made on a case-by-case basis.

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Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0207 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1356-1362

Author(s):

Laurence Tan Lean Chin ◽

Yu Jun Lim ◽

Wan Ling Choo

Keyword(s):

Palliative Care ◽

End Of Life ◽

Multidisciplinary Team ◽

Biopsychosocial Model ◽

Family Members ◽

Clinical Decisions ◽

Goals Of Care ◽

Complex Needs ◽

Aspiration Risk ◽

Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

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Food for Thought

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.2.68 ◽

2012 ◽

Vol 21 (2) ◽

pp. 68-72 ◽

Cited By ~ 7

Author(s):

Caryn Easterling

Keyword(s):

Multidisciplinary Team ◽

Clinical History ◽

Team Members ◽

Speech Language Pathologist ◽

Expected Outcome

Our professional American Speech-Language-Hearing Association (ASHA) guidelines state, if a speech-language pathologist suspects on the basis of the clinical history that there may be an esophageal disorder contributing to the patient's dysphagia, then “An esophageal screening can be incorporated into most [videofluoroscopic swallowing studies, or] VFSS” (ASHA, 2004). However, the esophageal screen has not been defined by ASHA or by the American College of Radiology. This “Food for Thought” column suggests deglutologists work together to determine the procedure and expected outcome for the esophageal screen so that there is acceptance and consensus among the multidisciplinary team members who evaluate patients with dysphagia.

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