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There are many exciting milestones that accompany growing older with Down syndrome, old age can also bring unexpected challenges for which adults with Down syndrome, their families and caregivers.
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Health disorders are part of life when you are getting older , Some problems are life-threatening, while others lower the quality of life. The good news is that these Health disorders can be managed effectively.
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Check out how Physician Coder – an online specialty solution – can help you meet your practice’s goals for error-free coding. From helping you meet all your ICD-10 coding needs from one place with code lookup, crosswalk, superbill converter, scrubber, and monthly specialty articles to helping you review CPT® 2016 changes with expert analysis for your specialty, we have you covered. Plus, you’ll also learn how to stay up-to-date on 2016 fee schedule details like RVUs, global days, and MUEs; check the latest CCI edits and view LCD policy details.

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Typically, breast reconstruction takes place during or soon after mastectomy, and in some cases, lumpectomy. Breast reconstruction also can be done many months or even years after mastectomy or lumpectomy. During reconstruction, a plastic surgeon creates a breast shape using an artificial implant (implant reconstruction), a flap of tissue from another place on your body (autologous reconstruction), or both.

Carpal tunnel surgery, also called carpal tunnel release (CTR) and carpal tunnel decompression surgery, is a surgery in which the transverse carpal ligament is divided. It is a treatment for carpal tunnel syndrome and recommended when there is static (constant, not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting no longer controls intermittent symptoms of pain in the carpal tunnel. In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and are likely to result in surgical treatment.

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Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. Shoulder dystocia is an obstetric emergency, and fetal demise can occur if the infant is not delivered, due to compression of the umbilical cord within the birth canal. It occurs in approximately 0.3-1% of vaginal births. Contemporary management of shoulder dystocia requires a calm operator and a well-thought-out plan of action. It is imperative that if not already present, help is summoned immediately after shoulder dystocia is recognized. This help may include additional nursing staff, an anesthesiologist, a pediatrician or neonatologist and an additional obstetrician or midwife. Future coordination may demonstrate that rapid response teams are best suited to attend to this emergency.

The majority of fetuses are in a breech presentation early in pregnancy. By week 38th week of gestation, however, the fetus normally turns to a cephalic presentation. Although the fetal head is the widest single diameter, the fetus’s buttocks [ breech], plus the lower extremities, actually takes up more space. The fundus, being the largest part of the uterus, probably accounts for the fact that in approximately 97% of all pregnancies, the fetus turns so that the buttocks and lower extremities are in the fundus. Vaginal delivery of a breech presentation requires great skill if the fetus is not to be damaged. With the low rate of vaginal breech deliveries in the developed world, experience is being lost. 6% of women with breech presentation still have a vaginal breech delivery as they present too late - so units need to retain a high level of preparedness. Types of breech presentation: I. Complete breech [ flexed breech]: The fetal attitude is one of complete flexion, with hips and knees both flexed and the feet tucked in beside the buttocks. The presenting part consists of two buttocks, external genitalia and two feet. It is commonly present in multiparae. II. Incomplete breech: This is due to varying degrees of extension of thighs or legs at podalic pole. Three varieties are possible; - Breech with extended legs [ frank breech ]: The breech presents with the hips flexed and legs extended on the abdomen. 70% of breech presentations are of this type and it is particularly common in primigravidae whose good uterine muscle tone inhibits flexion of the legs and free turning of the fetus. - Footling breech: This is rare. One or both feet present because neither hips nor knees are fully flexed. The feet are lower than the buttocks, which distinguishes it from the complete breech. - Knee presentation: This is very rare. Thighs are extended but the knees are flexed, bringing the knees down to present at the brim.