Bibliography () Jou HJ, Chow SN, Wang JF, Ouyang PC Non- J Obstet Gynecol ROC 1988;2713845. Hsieh FJ, Jou HJ, Ko TM, Chen HY Intrauterinediagnosis of short- limbed dwarfism. J Formosan Med Assoc 1989;881032-7. http://www.morida.com.tw/introduction3.html
Untitled a low ratio suggests possible dwarfism. A dateindependent predictor of intrauterinegrowth retardation Femur length / abdominal circumference ratio. AJR. http://www.medal.org/docs_ch15/doc_ch15.04.html
Extractions: Ratios of Body Parameters for Assessing Fetal Development Overview: Growth retardation may be symmetrical or assymmetrical. Ratios of biometric parameters can be useful to screen for growth retardation especially when it is assymmetrical. Ratios not involving head measurements tend to be relatively constant after 20 weeks of gestation and so can be useful in evaluating fetuses where the dates are uncertain. References: Deter RL Harrist RB. Chapter 35: Assessment of normal fetal growth. pages 361-385 (page 364) . IN: Chervenak FA Isaacson GC Campbell S. Ultrasound in Obstetrics and Gynecology. Little Brown and Company. 1993. Table of Contents, Chap. 15 Cephalic Index (Biparietal Diameter to Occipitofrontal Diameter Ratio) Overview: The cephalic index is the ratio of the biparietal diameter of the skull to the occipitofrontal diameter and can detect assymmetry in the skull during development. cephalic index = = (biparietal diameter in cm) / (occipitofrontal diameter in cm) Interpretation: normal is 0.74 to 0.83
Skeletal Reading 2 Most cases of achondroplastic dwarfism are the result of genetic defects that Intrauterinefractures of the extremities usually heal in poor alignment, causing http://www.mhhe.com/biosci/ap/seeleyap/skeletal/reading2.mhtml
Extractions: Bone Disorders Giantism is a condition of abnormally increased height that usually results from excessive cartilage and bone formation at the epiphyseal plates of long bones. The most common type of giantism, pituitary giantism, results from excess secretion of pituitary growth hormone. However, the large stature of some individuals can result from genetic factors rather than from abnormal levels of growth hormone. Acromegaly (ak'ro-meg'al-e) is also caused by excess pituitary growth hormone secretion. However, acromegaly involves growth of connective tissue, including bones, after the epiphyseal plates have ossified. The effect mainly involves increased diameter of all bones and is most strikingly apparent in the face and hands. Many pituitary giants also develop acromegaly later in life. Dwarfism, the condition in which a person is abnormally short, is the opposite of giantism. Pituitary dwarfism results when abnormally low levels of pituitary growth hormone affect the whole body, thus producing a small person who is normally proportioned. Achondroplastic (a-kon'dro-plas'tik) dwarfism, involving a disproportionate shortening of the long bones, is more common than proportionate dwarfing and produces a person with a nearly normal-sized trunk and head but shorter-than-normal limbs. Most cases of achondroplastic dwarfism are the result of genetic defects that cause deficient or improper growth of the cartilage model, especially the epiphyseal plate, and often involve deficient collagen synthesis. Often the cartilage matrix does not have its normal integrity, and the chondrocytes of the epiphysis cannot form their normal columns, even through rates of cell proliferation may be normal.
Case Based Pediatrics Chapter . . I. Constitutional Short Stature . . . . II. Primordial dwarfism (intrauterinegrowth retardation) . . . . III. Endocrine Causes . . . . . http://www.hawaii.edu/medicine/pediatrics/pedtext/s20c01.html
Extractions: This is a 15 year old boy who is seen by his primary care physician for short stature and delayed sexual development. His past medical history is unremarkable except for asthma during early childhood, which has been well controlled. He is currently on no medications. He is an average student currently in the 9th grade and is the smallest in his class. He has been harassed by older classmates because of his size. His parents are concerned because Jim is becoming withdrawn and a "loner". PMH: Pregnancy and delivery were uncomplicated. Birth weight and length were 3.86 kg (8.5 pounds) and 51 cm (20"), respectively. His HC was 35 cm. His immunizations are current. Family History: His mother is 48 years old and in good health. Her height is 167 cm (50th %tile). Her menarche began at age 13.0 years. His father is 51, also in good health. His height is 184.0 cm (75th %tile). His father's onset of puberty is not known but he was shaving regularly by age 15. There is one older male sibling age 18 who is in good health. His puberty began at age 11 years. There is no history of smoking, alcoholism, mental illness, drug abuse or learning problems in the family. Exam: VS T 37.1, P 110, R 32, BP 100/60. Ht. 158 cm (3rd %tile), Wt. 42.0 kg. (10th %tile). He is pale and anxious but cooperative. His HEENT exam is normal. His chest is clear. Heart regular, no murmurs. His pulses are symmetrical and equal. There are no masses or areas of tenderness in his abdomen. Genitalia: Normal circumcised phallus, SMR (Tanner) pubic hair stage 1, genital stage 2. His testes are firm, 2.5 cm in length and 4 ml in volume. His scrotum is reddened and stippled. The remainder of his physical exam is unremarkable.
Organizations, Links, And Personal Sites LPA Online. dwarfism Resources. For families with children who have RussellSilverintrauterine growth retardation. Association of Little People of Alberta. http://www.lpaonline.org/resources_links.html
Extractions: - Select a chapter - 1. Symptoms and Signs 2. Nutrition 3. Ethics 4. Research/Clinical Trials 5. Esophagus 6. Stomach and Duodenum 7. Small Intestine 8. Intestinal Ischemia 9. H.I.V. 10. Inflammatory Bowel 11. Colon 12. Pancreas 13. Biliary System 14. Liver 15. Paediatrics 16. Video Endoscopic Images Search 5. Growth Failure and Malnutrition / S.A. Zamora and H.G. Parsons page 583 5.1 Definitions: Failure to thrive (FTT), a widely used term in industrialized countries, is not distinct from protein-energy malnutrition encountered in children in developing countries (1). Both terms describe a spectrum of pathologic states resulting from childhood undernutrition. FTT accounts for 1-5% of tertiary hospital admissions for infants and is reported in about 10% of low-income preschool children seen in community-based settings. FTT is used to describe infants and young children whose growth is substantially less than that of their peers. Although no consensus exists on anthropometric indicators of FTT (2), most commonly used systems for selection of samples of FTT in hospital or clinic studies include children with a weight less than the 5th percentile on reference growth charts (1). The key to the identification of FTT is ascertainment of longitudinal progression of growth with serial measurements over time. A weight decrement of more than two major channels of growth (centiles) from a previously established growth channel or the loss of 10% of an infant's weight is evidence of FTT (1,3). A reduction in growth velocity is a particularly helpful indicator of abnormality in the 5% of otherwise normal children who plot out below the 5th percentile, but follow a growth channel parallel to the normal growth curves.
RANZCR - Policies foetal abnormality, a. Gestational age vital, eg microcephaly, shortlimb dwarfism. Suspectedintrauterine growth retardation, Ultrasound scan is not a screening http://www.ranzcr.edu.au/open/pol3_1.htm
Extractions: This model of best practice has been developed under the auspices of the AMA by The Royal Australian College of Obstetricians and Gynaecologists (RACOG), The Royal Australian College of General Practitioners (RACGP), The Royal Australian and New Zealand College of Radiologists (RANZCR), and The Australian Society for Ultrasound in Medicine (ASUM). It is designed to promote best clinical practice for referrers and providers of ultrasound services in pregnancy. The following lists of common indications for ultrasound examinations must be considered as guidelines only. They should not be considered as mandatory indications nor are they all inclusive. For example, patients with suspected or known foetal anomalies with Rhesus disease are not included. Such patients should have the timing of their ultrasound examinations individualised. Indications for foetal blood flow and foetal biophysical profiles are also not addressed. Clinical circumstances must be assessed by the responsible medical practitioner and a decision made about the appropriate timing and number of ultrasound examinations. Benefits of Ultrasound in Pregnancy Reduction in perinatal mortality.
References dwarfism associated with normal serum growth hormone and increased bioassayable Intrauterinegrowth retardation and postnatal growth failure associated with http://www.medscape.com/content/2000/00/41/08/410889/410889_ref.html
Extractions: References for: Pituitary Gene Mutations and the Growth Hormone Pathway Rimoin DL, Phillips JA III. Genetic disorders of the pituitary gland. In: Rimoin DL, Connor JM, Pyeritz RE, eds. Principles and Practice of Medical Genetics. 3rd ed. New York: Churchill Livingstone; 1997:1331-1364 Phillips JA III. Inherited defects in growth hormone synthesis and action. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic Basis of Inherited Disease. 6th ed. New York: McGraw-Hill; 1995:3023-3044 Carel J-C, Tresca J-P, Letrait M, et al. Growth hormone testing for the diagnosis of growth hormone deficiency in childhood: a population register-based study. J Clin Metab 1997;82:2117-2121 Cacciari E, Zucchini S, Carla G, et al. Endocrine function and morphological findings in patients with disorders of the hypothalamo-pituitary area: a study with magnetic resonance. Arch Dis Child 1990;65:1199-1202 Laron Z, Kelijman M, Pertzelan A, Keret R, Shoffner JM, Parks JS. Human growth hormone gene deletion without antibody formation or arrest during treatment: a new dis-ease entity? Isr J Med Sci 1985;21:999-1006 Matsuda I, Hata A, Jinno Y, et al. Heterogeneous phenotypes of Japanese cases with a growth hormone gene deletion. Jpn J Hum Genet 1987;32:227-235
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I Information Sites HEALTHorgs.com. Search The Largest Human Reviewed Health Databaseon Internet (Not sure of spelling? Use first letters and * such http://www.healthorgs.com/ConditionsandDiseases/I/
