Efficacy of Feeding Team Recommendations for Infants/Children Presenting With Signs of Milk Allergy

2011 ◽  
Vol 3 (6) ◽  
pp. 365-370
Author(s):  
Janice Baunach ◽  
Jennifer Malpass ◽  
Zeenat Q. Malik ◽  
Greg Cable
Keyword(s):  
Medical Intervention ◽  
Milk Allergy ◽  
Feeding Problems ◽  
Inclusion Criteria ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Study Participants ◽  
Professional Guidance ◽  
Infants And Young Children

Caregivers have reported feeding difficulties in approximately 25% to 40% of infants/toddlers that comprise a variety of signs/symptoms, though many of these are transient and resolve without significant medical intervention. Feeding problems, however, have been reported to persist in 3% to 10% of children, resulting in the caregivers seeking professional guidance. The purpose of this study was to evaluate the effectiveness of feeding team recommendations for infants and young children presenting with signs of milk allergies. Retrospective chart reviews were conducted, with associated follow-up phone surveys. Study participants met criteria based on presenting symptoms of possible milk allergy and received recommendations of milk-free diet and/or allergy testing. A total of 85 medical records were reviewed. Of the 85, 53% (45/85) met inclusion criteria for review; however, only 46% (39/85) were available for follow-up. Of the 39 patients available for follow-up, a milk-free diet was recommended for 67% (26/39), and 69% (18/26) of these families followed through with the recommendations. Of those 18 patients who followed the recommendations, 83% (15/18) reported improvement of symptoms. Our data suggest that recommendations resulting from comprehensive feeding team evaluations of infants and children with suspected milk protein allergies can, when followed, result in improvement of patient symptoms.

scholarly journals Effect of Frenotomy on Maternal Breastfeeding Symptoms and the Relationship Between Maternal Symptoms and Problematic Infant Feeding

2022 ◽  
Vol 9 ◽  
pp. 2333794X2110728
Author(s):  
Rebecca R. Hill ◽  
Karen S. Lyons ◽  
Susan Kelly-Weeder ◽  
Britt F. Pados
Keyword(s):  
Infant Feeding ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Time Points ◽  
Dental Office ◽  
The Relationship

The relationship between maternal symptoms and problematic infant feeding in the context of tongue-tie is unknown. In a sample of infants with tongue-tie undergoing frenotomy and their mothers, the aims of this study were to: (1) describe changes in maternal symptoms pre- and post-frenotomy, and (2) evaluate the relationships between maternal symptoms and symptoms of problematic feeding pre- and post-frenotomy. Mother-infant dyads were recruited from 1 pediatric dental office between July and November 2020. The sample included 102 mother-infant dyads; 84 completed the follow-up survey. Maternal symptoms of painful and difficult latch, creased/cracked nipples, bleeding, or abraded nipples, chewing of the nipple, and feelings of depression were significantly less common after tongue-tie revision. Poor latch onto the breast was associated with feeding difficulties at both time points. Frenotomy resulted in a decrease of symptoms in breastfeeding mothers. Maternal symptoms and feeding problems persisting post-frenotomy warrant further evaluation.

Innominate Artery Compression of the Trachea in Infants

1994 ◽  
Vol 103 (5) ◽  
pp. 347-350 ◽  
Author(s):  
Dwight T. Jones ◽  
Richard A. Jonas ◽  
Gerald B. Healy
Keyword(s):  
Innominate Artery ◽  
Respiratory Arrest ◽  
Feeding Problems ◽  
Tracheal Compression ◽  
Feeding Difficulties ◽  
The Past ◽  
Proper Patient Selection ◽  
Follow Up Care ◽  
Before And After

Innominate artery compression of the trachea in infants can cause severe biphasic stridor, cyanosis, and respiratory arrest. These episodes are sometimes referred to as “dying spells.” In the past, aortopexy has been used for the treatment of this problem, but since many have questioned its success, its use has not been popularized or generally accepted. Over the past 4 years, 12 children have been successfully treated for innominate artery compression of the trachea with aortopexy. These children all initially presented with significant respiratory and/or feeding difficulties. Preoperative and postoperative videos were obtained to document the degree of tracheal compression and/or lumen size before and after surgery. Since treatment, all patients have been without further feeding problems or cyanosis. When performed in selected patients, aortopexy is successful in relieving tracheal obstruction from innominate artery compression. This article discusses proper patient selection, operative technique, and follow-up care. The management of compression in patients with less severe symptoms will also be addressed.

SUNCT/SUNA: Case series presenting in an orofacial pain clinic

Cephalalgia ◽  
2020 ◽  
pp. 033310242097729
Author(s):  
Beth R Groenke ◽  
Iryna Hryvenko Daline ◽  
Donald R Nixdorf
Keyword(s):  
Orofacial Pain ◽  
Case Series ◽  
Initial Therapy ◽  
Pain Clinic ◽  
Conjunctival Injection ◽  
Inclusion Criteria ◽  
Presenting Symptoms ◽  
Cranial Autonomic Symptoms ◽  
Age Of Diagnosis

Aim Little is known about short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). We present our experience with SUNCT/SUNA patients to aid identification and management of these disorders. Methods A retrospective review of patient records of one orofacial pain clinic was performed. Inclusion criteria was a diagnosis of SUNCT/SUNA confirmed with at least one follow-up visit. Results Six of the 2464 new patients seen between 2015–2018 met the selection criteria (SUNCT n = 2, SUNA n = 4). Gender distribution was one male to one female and average age of diagnosis was 52 years (range 26–62). Attacks were located in the V1/V2 trigeminal distributions, and five patients reported associated intraoral pain. Pain quality was sharp, shooting, and burning with two patients reporting “numbness”. Pain was moderate-severe in intensity, with daily episodes that typically lasted for seconds. Common autonomic features were lacrimation, conjunctival injection, rhinorrhea, and flushing. Frequent triggers were touching the nose or a specific intraoral area. Lamotrigine and gabapentin were commonly used as initial therapy. Conclusions Differentiating between SUNCT/SUNA does not appear to be clinically relevant. Presenting symptoms were consistent with those published, except 5/6 patients describing intraoral pain and two patients describing paresthesia.

scholarly journals Orbital Paraganglioma: A Systematic Review

2017 ◽  
Vol 79 (04) ◽  
pp. 407-412 ◽  
Author(s):  
Natalie Huang ◽  
Hani Rayess ◽  
Peter Svider ◽  
Nadim Rayess ◽  
Adam Folbe ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Clinical Presentation ◽  
Human Subjects ◽  
Meta Analysis ◽  
Adjuvant Radiation ◽  
Inclusion Criteria ◽  
Presenting Symptoms ◽  
The Mean

Purpose The purpose of this study was to perform a systematic review of the literature on orbital paragangliomas, evaluating clinical presentation, diagnosis, management patterns, and prognosis. Methods The systematic review was conducted based on the principles described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Cochrane databases, Embase, and Web of Science were searched for articles related to orbital paragangliomas. Inclusion criteria included English language articles with original reports on human subjects. Data on clinical presentation, diagnosis, treatment, and prognosis were collected. Results Twenty-seven articles met inclusion criteria (28 total patients). The mean patient age was 37.1 years (range, 3–75 years); 13 (46.4%) patients were male. The most common presenting symptoms were proptosis (89.2%), visual acuity changes (67.9%), and extraocular muscle restriction (64.2%). Lesions were most commonly intraconal (92.9%). Single modality therapy was employed in 19 patients (67.9%), including excision in 12 patients (42.9%) and exenteration in 5 patients (17.9%). Ten patients (35.7%) developed recurrence, and there was a 92.9% survival rate (mean follow-up, 29 months). Conclusion Orbital paragangliomas are rare tumors with an excellent prognosis. These lesions commonly present with proptosis, and are primarily managed surgically with simple excision, although exenteration and adjuvant radiation may be necessary for invasive tumors. This series is the largest and most comprehensive systematic review of orbital paragangliomas conducted to date.

Treatment for Younger Siblings of Participants in a Home-Based Intensive Paediatric Feeding Programme in Australia

2020 ◽  
Vol 37 (4) ◽  
pp. 206-218
Author(s):  
Tessa Taylor ◽  
Alayna Haberlin
Keyword(s):  
Food Groups ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Procedural Integrity ◽  
Critical Areas ◽  
Home Based ◽  
Actual Plate ◽  
Differential Attention ◽  
Reversal Design

AbstractEarly childhood feeding problems can be challenging. Children who limit their food consumption may significantly impact multiple critical areas of development. Effective treatment should be accessed as early as possible but has been limited to a handful of US hospital programmes. Feeding problems affect both children with and without disability, and families may struggle with multiple children having feeding difficulties. We provided short-term (less than 2 weeks), in-home, intensive, behaviour-analytic feeding intervention to two children with typical development who were younger siblings of children already in the programme. We used a withdrawal/reversal design to assess the effects of nonremoval of the spoon, re-presentation, contingent and noncontingent access to tangibles, differential attention, and response cost. This multi-component intervention was effective in increasing the consumption of a wide variety of foods at regular texture and self-feeding for both participants. Variety was increased to over 60 foods from all food groups. Admission goals were met (100%). We trained caregivers to high procedural integrity and generalised the protocol. We provided actual plate picture examples of family meals consumed where the brothers and parents ate the same meal. Caregiver satisfaction and social acceptability were high. Gains were maintained at 3-year follow-up where parents reported problems were fully resolved.

MARKERS OF COW’S MILK ALLERGY PERSISTENCE: RESULTS OF A 5-YEAR FOLLOW-UP

2020 ◽  
Vol 99 (2) ◽  
pp. 88-95
Author(s):  
S.G. Makarova ◽  
◽  
A.A. Galimova ◽  
A.P. Fisenko ◽  
O.A. Ereshko ◽  
...  
Keyword(s):  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

Obesity may be associated with adjacent-segment degeneration after single-level transforaminal lumbar interbody fusion in spinopelvic-mismatched patients with a minimum 2-year follow-up

2021 ◽  
Vol 34 (1) ◽  
pp. 83-88
Author(s):  
Ping-Guo Duan ◽  
Praveen V. Mummaneni ◽  
Minghao Wang ◽  
Andrew K. Chan ◽  
Bo Li ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Inclusion Criteria ◽  
Single Level ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Surgery Rates

OBJECTIVEIn this study, the authors’ aim was to investigate whether obesity affects surgery rates for adjacent-segment degeneration (ASD) after transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis.METHODSPatients who underwent single-level TLIF for spondylolisthesis at the University of California, San Francisco, from 2006 to 2016 were retrospectively analyzed. Inclusion criteria were a minimum 2-year follow-up, single-level TLIF, and degenerative lumbar spondylolisthesis. Exclusion criteria were trauma, tumor, infection, multilevel fusions, non-TLIF fusions, or less than a 2-year follow-up. Patient demographic data were collected, and an analysis of spinopelvic parameters was performed. The patients were divided into two groups: mismatched, or pelvic incidence (PI) minus lumbar lordosis (LL) ≥ 10°; and balanced, or PI-LL < 10°. Within the two groups, the patients were further classified by BMI (< 30 and ≥ 30 kg/m2). Patients were then evaluated for surgery for ASD, matched by BMI and PI-LL parameters.RESULTSA total of 190 patients met inclusion criteria (72 males and 118 females, mean age 59.57 ± 12.39 years). The average follow-up was 40.21 ± 20.42 months (range 24–135 months). In total, 24 patients (12.63% of 190) underwent surgery for ASD. Within the entire cohort, 82 patients were in the mismatched group, and 108 patients were in the balanced group. Within the mismatched group, adjacent-segment surgeries occurred at the following rates: BMI < 30 kg/m2, 2.1% (1/48); and BMI ≥ 30 kg/m2, 17.6% (6/34). Significant differences were seen between patients with BMI ≥ 30 and BMI < 30 (p = 0.018). A receiver operating characteristic curve for BMI as a predictor for ASD was established, with an AUC of 0.69 (95% CI 0.49–0.90). The optimal BMI cutoff value determined by the Youden index is 29.95 (sensitivity 0.857; specificity 0.627). However, in the balanced PI-LL group (108/190 patients), there was no difference in surgery rates for ASD among the patients with different BMIs (p > 0.05).CONCLUSIONSIn patients who have a PI-LL mismatch, obesity may be associated with an increased risk of surgery for ASD after TLIF, but in obese patients without PI-LL mismatch, this association was not observed.

Seven-Year Follow-Up of Screening for Hypertension and Diabetes at a Dental Clinic

2019 ◽  
Author(s):  
Göran Friman
Keyword(s):  
Antihypertensive Drugs ◽  
Study Data ◽  
Initial Screening ◽  
Pharmacological Treatments ◽  
Medical Screening ◽  
Follow Up Study ◽  
Undiagnosed Hypertension ◽  
Dental Setting ◽  
Study Participants

Objective: To describe the distribution of risk, diagnosis and pharmacological treatments for diabetes and hypertension after seven years among patients provided with opportunistic medical screening in a dental setting. Material and Methods: The initial screening’s 170 participants were asked to take part in a seven-year follow-up study. Data were collected through self-reported information in a written health declaration. Outcome measures: • Number of study participants who had passed away • Prescription of antidiabetics or antihypertensives • Changes in weight and height to calculate body mass index (BMI) Results: The follow-up study consisted of 151 participants. Twenty had passed away. The risk needs for medicating with antihypertensive drugs after seven years for those not receiving pharmacological treatment at the initial screening was 3.7 times greater (p=0.025 CI 1.2-11.3) for participants with a diastolic blood pressure (BP) ≥ 90 mm Hg (85 for diabetics) than for the others. The risk was 3.9 times greater (p=0.020 CI 1.2-12.6) for those with a systolic BP of 140-159 mm Hg and 54.2 times greater (p<0.0001 CI 9.8-300.3) for those with a systolic BP ≥ 160 mm Hg than for those with a systolic BP 140 mm Hg. There were no changes in BMI. Conclusion: At least one in ten cases of incorrect medication or undiagnosed hypertension may be identifiable through opportunistic medical screening

Skeletal and Dental Correction and Stability Following LeFort I Advancement in Patients With Cleft Lip and Palate With Mild, Moderate, and Severe Maxillary Hypoplasia

2021 ◽  
pp. 105566562199610
Author(s):  
Buddhathida Wangsrimongkol ◽  
Roberto L. Flores ◽  
David A. Staffenberg ◽  
Eduardo D. Rodriguez ◽  
Pradip. R. Shetye
Keyword(s):  
Retrospective Study ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Maxillary Hypoplasia ◽  
Main Outcome Measure ◽  
Lateral Cephalograms

Objective: This study evaluates skeletal and dental outcomes of LeFort I advancement surgery in patients with cleft lip and palate (CLP) with varying degrees of maxillary skeletal hypoplasia. Design: Retrospective study. Method: Lateral cephalograms were digitized at preoperative (T1), immediately postoperative (T2), and 1-year follow-up (T3) and compared to untreated unaffected controls. Based on the severity of cleft maxillary hypoplasia, the sample was divided into 3 groups using Wits analysis: mild: ≤0 to ≥−5 mm; moderate: <−5 to >−10 mm; and severe: ≤−10 mm. Participants: Fifty-one patients with nonsyndromic CLP with hypoplastic maxilla who met inclusion criteria. Intervention: LeFort I advancement. Main Outcome Measure: Skeletal and dental stability post-LeFort I surgery at a 1-year follow-up. Results: At T2, LeFort I surgery produced an average correction of maxillary hypoplasia by 6.4 ± 0.6, 8.1 ± 0.4, and 10.7 ± 0.8 mm in the mild, moderate, and severe groups, respectively. There was a mean relapse of 1 to 1.5 mm observed in all groups. At T3, no statistically significant differences were observed between the surgical groups and controls at angle Sella, Nasion, A point (SNA), A point, Nasion, B point (ANB), and overjet outcome measures. Conclusions: LeFort I advancement produces a stable correction in mild, moderate, and severe skeletal maxillary hypoplasia. Overcorrection is recommended in all patients with CLP to compensate for the expected postsurgical skeletal relapse.

Microvascular Transposition Without Teflon: A Single Institution's 17-Year Experience Treating Trigeminal Neuralgia

2021 ◽  
Vol 20 (4) ◽  
pp. 397-405
Author(s):  
Andrew R Pines ◽  
Richard J Butterfield ◽  
Evelyn L Turcotte ◽  
Jose O Garcia ◽  
Noel De Lucia ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Postoperative Pain ◽  
Trigeminal Neuralgia ◽  
Fibrin Glue ◽  
Microvascular Decompression ◽  
Inclusion Criteria ◽  
Kaplan Meier ◽  
Trigeminal Nerve Root

Abstract BACKGROUND Trigeminal neuralgia (TN) refractory to medical management is often treated with microvascular decompression (MVD) involving the intracranial placement of Teflon. The placement of Teflon is an effective treatment, but does apply distributed pressure to the nerve and has been associated with pain recurrence. OBJECTIVE To report the rate of postoperative pain recurrence in TN patients who underwent MVD surgery using a transposition technique with fibrin glue without Teflon. METHODS Patients were eligible for our study if they were diagnosed with TN, did not have multiple sclerosis, and had an offending vessel that was identified and transposed with fibrin glue at our institution. All eligible patients were given a follow-up survey. We used a Kaplan-Meier (KM) model to estimate overall pain recurrence. RESULTS A total of 102 patients met inclusion criteria, of which 85 (83%) responded to our survey. Overall, 76 (89.4%) participants responded as having no pain recurrence. Approximately 1-yr pain-free KM estimates were 94.1% (n = 83), 5-yr pain-free KM estimates were 94.1% (n = 53), and 10-yr pain-free KM estimates were 83.0% (n = 23). CONCLUSION Treatment for TN with an MVD transposition technique using fibrin glue may avoid some cases of pain recurrence. The percentage of patients in our cohort who remained pain free at a maximum of 17 yr follow-up is on the high end of pain-free rates reported by MVD studies using Teflon. These results indicate that a transposition technique that emphasizes removing any compression near the trigeminal nerve root provides long-term pain-free rates for patients with TN.

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