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><channel><title>Stress management &#187; Stressors</title> <atom:link href="http://www.r-e-s-i.com/topic/stressors/feed" rel="self" type="application/rss+xml" /><link>http://www.r-e-s-i.com</link> <description>Releif from everyday stress immediately</description> <lastBuildDate>Fri, 10 Feb 2012 19:22:51 +0000</lastBuildDate> <language>en</language> <sy:updatePeriod>hourly</sy:updatePeriod> <sy:updateFrequency>1</sy:updateFrequency> <generator>http://wordpress.org/?v=3.1</generator> <item><title>Freeman&#8211;Sheldon syndrome &#8211; Management</title><link>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-16</link> <comments>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-16#comments</comments> <pubDate>Wed, 01 Feb 2012 21:23:15 +0000</pubDate> <dc:creator></dc:creator> <category><![CDATA[Physiological Stress]]></category> <category><![CDATA[Anaesthesia]]></category> <category><![CDATA[Anatomical]]></category> <category><![CDATA[Attending physician]]></category> <category><![CDATA[Biopsychosocial model]]></category> <category><![CDATA[Bronchitis]]></category> <category><![CDATA[Cbt]]></category> <category><![CDATA[Cervical vertebrae]]></category> <category><![CDATA[Chronic]]></category> <category><![CDATA[Clinical Depression]]></category> <category><![CDATA[Clubfoot]]></category> <category><![CDATA[Cognitive]]></category> <category><![CDATA[Cognitive Behavioural Therapy]]></category> <category><![CDATA[Craniofacial]]></category> <category><![CDATA[Developmental Delay]]></category> <category><![CDATA[Ect]]></category> <category><![CDATA[Electroconvulsive therapy]]></category> <category><![CDATA[Family Physician]]></category> <category><![CDATA[Freeman–sheldon syndrome]]></category> <category><![CDATA[Freeman–sheldon syndrome - management]]></category> <category><![CDATA[Hyperpyrexia]]></category> <category><![CDATA[Imaging studies]]></category> <category><![CDATA[Infectious disease]]></category> <category><![CDATA[Intubation]]></category> <category><![CDATA[Kyphoscoliosis]]></category> <category><![CDATA[Limbic]]></category> <category><![CDATA[Malignant hyperthermia]]></category> <category><![CDATA[Marriage counselling]]></category> <category><![CDATA[Muscle]]></category> <category><![CDATA[Myopathy]]></category> <category><![CDATA[Neuropsychiatric]]></category> <category><![CDATA[Orthopaedic]]></category> <category><![CDATA[Paediatric]]></category> <category><![CDATA[Physiological]]></category> <category><![CDATA[Physiology]]></category> <category><![CDATA[Pneumonitis]]></category> <category><![CDATA[Posttraumatic stress disorder]]></category> <category><![CDATA[Psychiatric]]></category> <category><![CDATA[Psychodynamic psychotherapy]]></category> <category><![CDATA[Psychotherapy]]></category> <category><![CDATA[Spina bifida occulta]]></category> <category><![CDATA[stress]]></category> <category><![CDATA[Stressors]]></category> <category><![CDATA[Surgeon]]></category> <category><![CDATA[Symptoms]]></category> <category><![CDATA[Upper respiratory tract infection]]></category> <category><![CDATA[Venous]]></category><guid
isPermaLink="false">http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-16</guid> <description><![CDATA[Surgical and anaesthetic considerations Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal [...]No related posts.]]></description> <content:encoded><![CDATA[<div
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</script></div><h3>Surgical and anaesthetic considerations</h3><p> Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal outcomes, secondary to the myopathy of the syndrome.</p><p>When operative measures are to be undertaken, they should be planned for as early in life as is feasible, in consideration of the tendency for fragile health. Early interventions hold the possibility to minimise developmental delays and negate the necessity of relearning basic functions.</p><p>Due to the abnormal muscle physiology in Freeman-Sheldon syndrome, therapeutic measures may have unfavourable outcomes. Difficult endotracheal intubations and vein access complicate operative decisions in many DA2A patients, and malignant hyperthermia (MH) may affect individuals with FSS, as well. Cruickshanks et al. (1999) reports uneventful use of non-MH-triggering agents. Reports have been published about spina bifida occulta in anaesthesia management and cervical kyphoscoliosis in intubations.</p><h3>Psychiatric considerations</h3><p> Patients and their parents must receive psychotherapy, which should include marriage counselling. Mitigation of lasting psychological problems, including depression secondary to chronic illness and posttraumatic stress disorder (PTSD), can be very successfully addressed with early interventions. This care may come from the family physician, or other attending physician, whoever is more appropriate; specialist care is generally not required. Lewis and Vitulano (2003) note several studies suggesting predisposal for psychopathology in paediatric patients with chronic illness. Esch (2002) advocates preventive psychiatry supports to facilitate balance of positive and negative stressors associated with chronic physical pathology. Patients with FSS should have pre-emptive and ongoing mixed cognitive therapy-psychodynamic psychotherapy for patients with FSS and cognitive-behavioural therapy (CBT), if begun after onset of obvious pathology.</p><p>Adler (1995) cautioned the failure of modern medicine to implement the biopsychosocial model, which incorporates all aspects of a patient&rsquo;s experience in a scientific approach into the clinical picture, often results in chronically-ill patients deferring to non-traditional and alternative forms of therapy, seeking to be understood as a whole, not a part, which may be problematic among patients with FSS.</p><p>Furthermore, neuropsychiatry, physiological, and imaging studies have shown PTSD and depression to be physical syndromes, in many respects, as they are psychiatric ones in demonstrating limbic system physiological and anatomy disturbances. Attendant PTSD hyperarousal symptoms, which additionally increase physiological stress, may play a part in leading to frequent MH-like hyperpyrexia and speculate on its influence on underlying myopathology of FSS in other ways. PTSD may also bring about developmental delays or developmental stagnation, especially in paediatric patients.</p><p>With psychodynamic psychotherapy, psychopharmacotherapy may need to be considered. Electroconvulsive therapy (ECT) is advised against, in light of abnormal myophysiology, with predisposal to MH.</p><h3>Medical emphasis</h3><p> General health maintenance should be the therapeutic emphasis in Freeman-Sheldon syndrome. The focus is on limiting exposure to infectious diseases because the musculoskeletal abnormalities make recovery from routine infections much more difficult in FSS. Pneumonitis and bronchitis often follow seemingly mild upper respiratory tract infections. Though respiratory challenges and complications faced by a patient with FSS can be numerous, the syndrome&rsquo;s primary involvement is limited to the musculoskeletal systems, and satisfactory quality and length of life can be expected with proper care.</p><p>Adapted from the Wikipedia article Freeman&ndash;Sheldon syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki</p><p>No related posts.</p>]]></content:encoded> <wfw:commentRss>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-16/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item><title>Freeman&#8211;Sheldon syndrome &#8211; Management</title><link>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-15</link> <comments>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-15#comments</comments> <pubDate>Mon, 30 Jan 2012 08:22:50 +0000</pubDate> <dc:creator></dc:creator> <category><![CDATA[Physiological Stress]]></category> <category><![CDATA[Anaesthesia]]></category> <category><![CDATA[Anatomical]]></category> <category><![CDATA[Attending physician]]></category> <category><![CDATA[Biopsychosocial model]]></category> <category><![CDATA[Bronchitis]]></category> <category><![CDATA[Cbt]]></category> <category><![CDATA[Cervical vertebrae]]></category> <category><![CDATA[Chronic]]></category> <category><![CDATA[Clinical Depression]]></category> <category><![CDATA[Clubfoot]]></category> <category><![CDATA[Cognitive]]></category> <category><![CDATA[Cognitive Behavioural Therapy]]></category> <category><![CDATA[Craniofacial]]></category> <category><![CDATA[Developmental Delay]]></category> <category><![CDATA[Ect]]></category> <category><![CDATA[Electroconvulsive therapy]]></category> <category><![CDATA[Family Physician]]></category> <category><![CDATA[Freeman–sheldon syndrome]]></category> <category><![CDATA[Freeman–sheldon syndrome - management]]></category> <category><![CDATA[Hyperpyrexia]]></category> <category><![CDATA[Imaging studies]]></category> <category><![CDATA[Infectious disease]]></category> <category><![CDATA[Intubation]]></category> <category><![CDATA[Kyphoscoliosis]]></category> <category><![CDATA[Limbic]]></category> <category><![CDATA[Malignant hyperthermia]]></category> <category><![CDATA[Marriage counselling]]></category> <category><![CDATA[Muscle]]></category> <category><![CDATA[Myopathy]]></category> <category><![CDATA[Neuropsychiatric]]></category> <category><![CDATA[Orthopaedic]]></category> <category><![CDATA[Paediatric]]></category> <category><![CDATA[Physiological]]></category> <category><![CDATA[Physiology]]></category> <category><![CDATA[Pneumonitis]]></category> <category><![CDATA[Posttraumatic stress disorder]]></category> <category><![CDATA[Psychiatric]]></category> <category><![CDATA[Psychodynamic psychotherapy]]></category> <category><![CDATA[Psychotherapy]]></category> <category><![CDATA[Spina bifida occulta]]></category> <category><![CDATA[stress]]></category> <category><![CDATA[Stressors]]></category> <category><![CDATA[Surgeon]]></category> <category><![CDATA[Symptoms]]></category> <category><![CDATA[Upper respiratory tract infection]]></category> <category><![CDATA[Venous]]></category><guid
isPermaLink="false">http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-15</guid> <description><![CDATA[Surgical and anaesthetic considerations Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal [...]No related posts.]]></description> <content:encoded><![CDATA[<div
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</script></div><h3>Surgical and anaesthetic considerations</h3><p> Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal outcomes, secondary to the myopathy of the syndrome.</p><p>When operative measures are to be undertaken, they should be planned for as early in life as is feasible, in consideration of the tendency for fragile health. Early interventions hold the possibility to minimise developmental delays and negate the necessity of relearning basic functions.</p><p>Due to the abnormal muscle physiology in Freeman-Sheldon syndrome, therapeutic measures may have unfavourable outcomes. Difficult endotracheal intubations and vein access complicate operative decisions in many DA2A patients, and malignant hyperthermia (MH) may affect individuals with FSS, as well. Cruickshanks et al. (1999) reports uneventful use of non-MH-triggering agents. Reports have been published about spina bifida occulta in anaesthesia management and cervical kyphoscoliosis in intubations.</p><h3>Psychiatric considerations</h3><p> Patients and their parents must receive psychotherapy, which should include marriage counselling. Mitigation of lasting psychological problems, including depression secondary to chronic illness and posttraumatic stress disorder (PTSD), can be very successfully addressed with early interventions. This care may come from the family physician, or other attending physician, whoever is more appropriate; specialist care is generally not required. Lewis and Vitulano (2003) note several studies suggesting predisposal for psychopathology in paediatric patients with chronic illness. Esch (2002) advocates preventive psychiatry supports to facilitate balance of positive and negative stressors associated with chronic physical pathology. Patients with FSS should have pre-emptive and ongoing mixed cognitive therapy-psychodynamic psychotherapy for patients with FSS and cognitive-behavioural therapy (CBT), if begun after onset of obvious pathology.</p><p>Adler (1995) cautioned the failure of modern medicine to implement the biopsychosocial model, which incorporates all aspects of a patient&rsquo;s experience in a scientific approach into the clinical picture, often results in chronically-ill patients deferring to non-traditional and alternative forms of therapy, seeking to be understood as a whole, not a part, which may be problematic among patients with FSS.</p><p>Furthermore, neuropsychiatry, physiological, and imaging studies have shown PTSD and depression to be physical syndromes, in many respects, as they are psychiatric ones in demonstrating limbic system physiological and anatomy disturbances. Attendant PTSD hyperarousal symptoms, which additionally increase physiological stress, may play a part in leading to frequent MH-like hyperpyrexia and speculate on its influence on underlying myopathology of FSS in other ways. PTSD may also bring about developmental delays or developmental stagnation, especially in paediatric patients.</p><p>With psychodynamic psychotherapy, psychopharmacotherapy may need to be considered. Electroconvulsive therapy (ECT) is advised against, in light of abnormal myophysiology, with predisposal to MH.</p><h3>Medical emphasis</h3><p> General health maintenance should be the therapeutic emphasis in Freeman-Sheldon syndrome. The focus is on limiting exposure to infectious diseases because the musculoskeletal abnormalities make recovery from routine infections much more difficult in FSS. Pneumonitis and bronchitis often follow seemingly mild upper respiratory tract infections. Though respiratory challenges and complications faced by a patient with FSS can be numerous, the syndrome&rsquo;s primary involvement is limited to the musculoskeletal systems, and satisfactory quality and length of life can be expected with proper care.</p><p>Adapted from the Wikipedia article Freeman&ndash;Sheldon syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki</p><p>No related posts.</p>]]></content:encoded> <wfw:commentRss>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-15/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item><title>Freeman&#8211;Sheldon syndrome &#8211; Management</title><link>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-14</link> <comments>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-14#comments</comments> <pubDate>Wed, 18 Jan 2012 04:22:32 +0000</pubDate> <dc:creator></dc:creator> <category><![CDATA[Physiological Stress]]></category> <category><![CDATA[Anaesthesia]]></category> <category><![CDATA[Anatomical]]></category> <category><![CDATA[Attending physician]]></category> <category><![CDATA[Biopsychosocial model]]></category> <category><![CDATA[Bronchitis]]></category> <category><![CDATA[Cbt]]></category> <category><![CDATA[Cervical vertebrae]]></category> <category><![CDATA[Chronic]]></category> <category><![CDATA[Clinical Depression]]></category> <category><![CDATA[Clubfoot]]></category> <category><![CDATA[Cognitive]]></category> <category><![CDATA[Cognitive Behavioural Therapy]]></category> <category><![CDATA[Craniofacial]]></category> <category><![CDATA[Developmental Delay]]></category> <category><![CDATA[Ect]]></category> <category><![CDATA[Electroconvulsive therapy]]></category> <category><![CDATA[Family Physician]]></category> <category><![CDATA[Freeman–sheldon syndrome]]></category> <category><![CDATA[Freeman–sheldon syndrome - management]]></category> <category><![CDATA[Hyperpyrexia]]></category> <category><![CDATA[Imaging studies]]></category> <category><![CDATA[Infectious disease]]></category> <category><![CDATA[Intubation]]></category> <category><![CDATA[Kyphoscoliosis]]></category> <category><![CDATA[Limbic]]></category> <category><![CDATA[Malignant hyperthermia]]></category> <category><![CDATA[Marriage counselling]]></category> <category><![CDATA[Muscle]]></category> <category><![CDATA[Myopathy]]></category> <category><![CDATA[Neuropsychiatric]]></category> <category><![CDATA[Orthopaedic]]></category> <category><![CDATA[Paediatric]]></category> <category><![CDATA[Physiological]]></category> <category><![CDATA[Physiology]]></category> <category><![CDATA[Pneumonitis]]></category> <category><![CDATA[Posttraumatic stress disorder]]></category> <category><![CDATA[Psychiatric]]></category> <category><![CDATA[Psychodynamic psychotherapy]]></category> <category><![CDATA[Psychotherapy]]></category> <category><![CDATA[Spina bifida occulta]]></category> <category><![CDATA[stress]]></category> <category><![CDATA[Stressors]]></category> <category><![CDATA[Surgeon]]></category> <category><![CDATA[Symptoms]]></category> <category><![CDATA[Upper respiratory tract infection]]></category> <category><![CDATA[Venous]]></category><guid
isPermaLink="false">http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-14</guid> <description><![CDATA[Surgical and anaesthetic considerations Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal [...]No related posts.]]></description> <content:encoded><![CDATA[<div
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</script></div><h3>Surgical and anaesthetic considerations</h3><p> Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal outcomes, secondary to the myopathy of the syndrome.</p><p>When operative measures are to be undertaken, they should be planned for as early in life as is feasible, in consideration of the tendency for fragile health. Early interventions hold the possibility to minimise developmental delays and negate the necessity of relearning basic functions.</p><p>Due to the abnormal muscle physiology in Freeman-Sheldon syndrome, therapeutic measures may have unfavourable outcomes. Difficult endotracheal intubations and vein access complicate operative decisions in many DA2A patients, and malignant hyperthermia (MH) may affect individuals with FSS, as well. Cruickshanks et al. (1999) reports uneventful use of non-MH-triggering agents. Reports have been published about spina bifida occulta in anaesthesia management and cervical kyphoscoliosis in intubations.</p><h3>Psychiatric considerations</h3><p> Patients and their parents must receive psychotherapy, which should include marriage counselling. Mitigation of lasting psychological problems, including depression secondary to chronic illness and posttraumatic stress disorder (PTSD), can be very successfully addressed with early interventions. This care may come from the family physician, or other attending physician, whoever is more appropriate; specialist care is generally not required. Lewis and Vitulano (2003) note several studies suggesting predisposal for psychopathology in paediatric patients with chronic illness. Esch (2002) advocates preventive psychiatry supports to facilitate balance of positive and negative stressors associated with chronic physical pathology. Patients with FSS should have pre-emptive and ongoing mixed cognitive therapy-psychodynamic psychotherapy for patients with FSS and cognitive-behavioural therapy (CBT), if begun after onset of obvious pathology.</p><p>Adler (1995) cautioned the failure of modern medicine to implement the biopsychosocial model, which incorporates all aspects of a patient&rsquo;s experience in a scientific approach into the clinical picture, often results in chronically-ill patients deferring to non-traditional and alternative forms of therapy, seeking to be understood as a whole, not a part, which may be problematic among patients with FSS.</p><p>Furthermore, neuropsychiatry, physiological, and imaging studies have shown PTSD and depression to be physical syndromes, in many respects, as they are psychiatric ones in demonstrating limbic system physiological and anatomy disturbances. Attendant PTSD hyperarousal symptoms, which additionally increase physiological stress, may play a part in leading to frequent MH-like hyperpyrexia and speculate on its influence on underlying myopathology of FSS in other ways. PTSD may also bring about developmental delays or developmental stagnation, especially in paediatric patients.</p><p>With psychodynamic psychotherapy, psychopharmacotherapy may need to be considered. Electroconvulsive therapy (ECT) is advised against, in light of abnormal myophysiology, with predisposal to MH.</p><h3>Medical emphasis</h3><p> General health maintenance should be the therapeutic emphasis in Freeman-Sheldon syndrome. The focus is on limiting exposure to infectious diseases because the musculoskeletal abnormalities make recovery from routine infections much more difficult in FSS. Pneumonitis and bronchitis often follow seemingly mild upper respiratory tract infections. Though respiratory challenges and complications faced by a patient with FSS can be numerous, the syndrome&rsquo;s primary involvement is limited to the musculoskeletal systems, and satisfactory quality and length of life can be expected with proper care.</p><p>Adapted from the Wikipedia article Freeman&ndash;Sheldon syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki</p><p>No related posts.</p>]]></content:encoded> <wfw:commentRss>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-14/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item><title>Freeman&#8211;Sheldon syndrome &#8211; Management</title><link>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-13</link> <comments>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-13#comments</comments> <pubDate>Fri, 13 Jan 2012 14:22:52 +0000</pubDate> <dc:creator></dc:creator> <category><![CDATA[Physiological Stress]]></category> <category><![CDATA[Anaesthesia]]></category> <category><![CDATA[Anatomical]]></category> <category><![CDATA[Attending physician]]></category> <category><![CDATA[Biopsychosocial model]]></category> <category><![CDATA[Bronchitis]]></category> <category><![CDATA[Cbt]]></category> <category><![CDATA[Cervical vertebrae]]></category> <category><![CDATA[Chronic]]></category> <category><![CDATA[Clinical Depression]]></category> <category><![CDATA[Clubfoot]]></category> <category><![CDATA[Cognitive]]></category> <category><![CDATA[Cognitive Behavioural Therapy]]></category> <category><![CDATA[Craniofacial]]></category> <category><![CDATA[Developmental Delay]]></category> <category><![CDATA[Ect]]></category> <category><![CDATA[Electroconvulsive therapy]]></category> <category><![CDATA[Family Physician]]></category> <category><![CDATA[Freeman–sheldon syndrome]]></category> <category><![CDATA[Freeman–sheldon syndrome - management]]></category> <category><![CDATA[Hyperpyrexia]]></category> <category><![CDATA[Imaging studies]]></category> <category><![CDATA[Infectious disease]]></category> <category><![CDATA[Intubation]]></category> <category><![CDATA[Kyphoscoliosis]]></category> <category><![CDATA[Limbic]]></category> <category><![CDATA[Malignant hyperthermia]]></category> <category><![CDATA[Marriage counselling]]></category> <category><![CDATA[Muscle]]></category> <category><![CDATA[Myopathy]]></category> <category><![CDATA[Neuropsychiatric]]></category> <category><![CDATA[Orthopaedic]]></category> <category><![CDATA[Paediatric]]></category> <category><![CDATA[Physiological]]></category> <category><![CDATA[Physiology]]></category> <category><![CDATA[Pneumonitis]]></category> <category><![CDATA[Posttraumatic stress disorder]]></category> <category><![CDATA[Psychiatric]]></category> <category><![CDATA[Psychodynamic psychotherapy]]></category> <category><![CDATA[Psychotherapy]]></category> <category><![CDATA[Spina bifida occulta]]></category> <category><![CDATA[stress]]></category> <category><![CDATA[Stressors]]></category> <category><![CDATA[Surgeon]]></category> <category><![CDATA[Symptoms]]></category> <category><![CDATA[Upper respiratory tract infection]]></category> <category><![CDATA[Venous]]></category><guid
isPermaLink="false">http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-13</guid> <description><![CDATA[Surgical and anaesthetic considerations Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal [...]No related posts.]]></description> <content:encoded><![CDATA[<div
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</script></div><h3>Surgical and anaesthetic considerations</h3><p> Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal outcomes, secondary to the myopathy of the syndrome.</p><p>When operative measures are to be undertaken, they should be planned for as early in life as is feasible, in consideration of the tendency for fragile health. Early interventions hold the possibility to minimise developmental delays and negate the necessity of relearning basic functions.</p><p>Due to the abnormal muscle physiology in Freeman-Sheldon syndrome, therapeutic measures may have unfavourable outcomes. Difficult endotracheal intubations and vein access complicate operative decisions in many DA2A patients, and malignant hyperthermia (MH) may affect individuals with FSS, as well. Cruickshanks et al. (1999) reports uneventful use of non-MH-triggering agents. Reports have been published about spina bifida occulta in anaesthesia management and cervical kyphoscoliosis in intubations.</p><h3>Psychiatric considerations</h3><p> Patients and their parents must receive psychotherapy, which should include marriage counselling. Mitigation of lasting psychological problems, including depression secondary to chronic illness and posttraumatic stress disorder (PTSD), can be very successfully addressed with early interventions. This care may come from the family physician, or other attending physician, whoever is more appropriate; specialist care is generally not required. Lewis and Vitulano (2003) note several studies suggesting predisposal for psychopathology in paediatric patients with chronic illness. Esch (2002) advocates preventive psychiatry supports to facilitate balance of positive and negative stressors associated with chronic physical pathology. Patients with FSS should have pre-emptive and ongoing mixed cognitive therapy-psychodynamic psychotherapy for patients with FSS and cognitive-behavioural therapy (CBT), if begun after onset of obvious pathology.</p><p>Adler (1995) cautioned the failure of modern medicine to implement the biopsychosocial model, which incorporates all aspects of a patient&rsquo;s experience in a scientific approach into the clinical picture, often results in chronically-ill patients deferring to non-traditional and alternative forms of therapy, seeking to be understood as a whole, not a part, which may be problematic among patients with FSS.</p><p>Furthermore, neuropsychiatry, physiological, and imaging studies have shown PTSD and depression to be physical syndromes, in many respects, as they are psychiatric ones in demonstrating limbic system physiological and anatomy disturbances. Attendant PTSD hyperarousal symptoms, which additionally increase physiological stress, may play a part in leading to frequent MH-like hyperpyrexia and speculate on its influence on underlying myopathology of FSS in other ways. PTSD may also bring about developmental delays or developmental stagnation, especially in paediatric patients.</p><p>With psychodynamic psychotherapy, psychopharmacotherapy may need to be considered. Electroconvulsive therapy (ECT) is advised against, in light of abnormal myophysiology, with predisposal to MH.</p><h3>Medical emphasis</h3><p> General health maintenance should be the therapeutic emphasis in Freeman-Sheldon syndrome. The focus is on limiting exposure to infectious diseases because the musculoskeletal abnormalities make recovery from routine infections much more difficult in FSS. Pneumonitis and bronchitis often follow seemingly mild upper respiratory tract infections. Though respiratory challenges and complications faced by a patient with FSS can be numerous, the syndrome&rsquo;s primary involvement is limited to the musculoskeletal systems, and satisfactory quality and length of life can be expected with proper care.</p><p>Adapted from the Wikipedia article Freeman&ndash;Sheldon syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki</p><p>No related posts.</p>]]></content:encoded> <wfw:commentRss>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-13/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item><title>Freeman&#8211;Sheldon syndrome &#8211; Management</title><link>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-12</link> <comments>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-12#comments</comments> <pubDate>Sat, 31 Dec 2011 13:22:55 +0000</pubDate> <dc:creator></dc:creator> <category><![CDATA[Chronic Stress]]></category> <category><![CDATA[Anaesthesia]]></category> <category><![CDATA[Anatomical]]></category> <category><![CDATA[Attending physician]]></category> <category><![CDATA[Biopsychosocial model]]></category> <category><![CDATA[Bronchitis]]></category> <category><![CDATA[Cbt]]></category> <category><![CDATA[Cervical vertebrae]]></category> <category><![CDATA[Chronic]]></category> <category><![CDATA[Clinical Depression]]></category> <category><![CDATA[Clubfoot]]></category> <category><![CDATA[Cognitive]]></category> <category><![CDATA[Cognitive Behavioural Therapy]]></category> <category><![CDATA[Craniofacial]]></category> <category><![CDATA[Developmental Delay]]></category> <category><![CDATA[Ect]]></category> <category><![CDATA[Electroconvulsive therapy]]></category> <category><![CDATA[Family Physician]]></category> <category><![CDATA[Freeman–sheldon syndrome]]></category> <category><![CDATA[Freeman–sheldon syndrome - management]]></category> <category><![CDATA[Hyperpyrexia]]></category> <category><![CDATA[Imaging studies]]></category> <category><![CDATA[Infectious disease]]></category> <category><![CDATA[Intubation]]></category> <category><![CDATA[Kyphoscoliosis]]></category> <category><![CDATA[Limbic]]></category> <category><![CDATA[Malignant hyperthermia]]></category> <category><![CDATA[Marriage counselling]]></category> <category><![CDATA[Muscle]]></category> <category><![CDATA[Myopathy]]></category> <category><![CDATA[Neuropsychiatric]]></category> <category><![CDATA[Orthopaedic]]></category> <category><![CDATA[Paediatric]]></category> <category><![CDATA[Physiological]]></category> <category><![CDATA[Physiology]]></category> <category><![CDATA[Pneumonitis]]></category> <category><![CDATA[Posttraumatic stress disorder]]></category> <category><![CDATA[Psychiatric]]></category> <category><![CDATA[Psychodynamic psychotherapy]]></category> <category><![CDATA[Psychotherapy]]></category> <category><![CDATA[Spina bifida occulta]]></category> <category><![CDATA[stress]]></category> <category><![CDATA[Stressors]]></category> <category><![CDATA[Surgeon]]></category> <category><![CDATA[Symptoms]]></category> <category><![CDATA[Upper respiratory tract infection]]></category> <category><![CDATA[Venous]]></category><guid
isPermaLink="false">http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-12</guid> <description><![CDATA[Surgical and anaesthetic considerations Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal [...]No related posts.]]></description> <content:encoded><![CDATA[<div
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</script></div><h3>Surgical and anaesthetic considerations</h3><p> Patients must have early consultation with craniofacial and orthopaedic surgeons, when craniofacial, clubfoot, or hand correction is indicated to improve function or aesthetics. Operative measures should be pursued cautiously, with avoidance of radical measures and careful consideration of the abnormal muscle physiology in Freeman-Sheldon syndrome. Unfortunately, many surgical procedures have suboptimal outcomes, secondary to the myopathy of the syndrome.</p><p>When operative measures are to be undertaken, they should be planned for as early in life as is feasible, in consideration of the tendency for fragile health. Early interventions hold the possibility to minimise developmental delays and negate the necessity of relearning basic functions.</p><p>Due to the abnormal muscle physiology in Freeman-Sheldon syndrome, therapeutic measures may have unfavourable outcomes. Difficult endotracheal intubations and vein access complicate operative decisions in many DA2A patients, and malignant hyperthermia (MH) may affect individuals with FSS, as well. Cruickshanks et al. (1999) reports uneventful use of non-MH-triggering agents. Reports have been published about spina bifida occulta in anaesthesia management and cervical kyphoscoliosis in intubations.</p><h3>Psychiatric considerations</h3><p> Patients and their parents must receive psychotherapy, which should include marriage counselling. Mitigation of lasting psychological problems, including depression secondary to chronic illness and posttraumatic stress disorder (PTSD), can be very successfully addressed with early interventions. This care may come from the family physician, or other attending physician, whoever is more appropriate; specialist care is generally not required. Lewis and Vitulano (2003) note several studies suggesting predisposal for psychopathology in paediatric patients with chronic illness. Esch (2002) advocates preventive psychiatry supports to facilitate balance of positive and negative stressors associated with chronic physical pathology. Patients with FSS should have pre-emptive and ongoing mixed cognitive therapy-psychodynamic psychotherapy for patients with FSS and cognitive-behavioural therapy (CBT), if begun after onset of obvious pathology.</p><p>Adler (1995) cautioned the failure of modern medicine to implement the biopsychosocial model, which incorporates all aspects of a patient&rsquo;s experience in a scientific approach into the clinical picture, often results in chronically-ill patients deferring to non-traditional and alternative forms of therapy, seeking to be understood as a whole, not a part, which may be problematic among patients with FSS.</p><p>Furthermore, neuropsychiatry, physiological, and imaging studies have shown PTSD and depression to be physical syndromes, in many respects, as they are psychiatric ones in demonstrating limbic system physiological and anatomy disturbances. Attendant PTSD hyperarousal symptoms, which additionally increase physiological stress, may play a part in leading to frequent MH-like hyperpyrexia and speculate on its influence on underlying myopathology of FSS in other ways. PTSD may also bring about developmental delays or developmental stagnation, especially in paediatric patients.</p><p>With psychodynamic psychotherapy, psychopharmacotherapy may need to be considered. Electroconvulsive therapy (ECT) is advised against, in light of abnormal myophysiology, with predisposal to MH.</p><h3>Medical emphasis</h3><p> General health maintenance should be the therapeutic emphasis in Freeman-Sheldon syndrome. The focus is on limiting exposure to infectious diseases because the musculoskeletal abnormalities make recovery from routine infections much more difficult in FSS. Pneumonitis and bronchitis often follow seemingly mild upper respiratory tract infections. Though respiratory challenges and complications faced by a patient with FSS can be numerous, the syndrome&rsquo;s primary involvement is limited to the musculoskeletal systems, and satisfactory quality and length of life can be expected with proper care.</p><p>Adapted from the Wikipedia article Freeman&ndash;Sheldon syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki</p><p>No related posts.</p>]]></content:encoded> <wfw:commentRss>http://www.r-e-s-i.com/article/freemansheldon-syndrome-management-12/feed</wfw:commentRss> <slash:comments>0</slash:comments> </item> </channel> </rss>
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