Abnormalities of corpus callosum are one of the most common brain anomalies. Fetuses with isolated corpus callosum agenesis (CCA) have a better prognosis than those with additional anomalies. However, unpredictable neurodevelopmental outcomes of truly isolated CCA make prenatal counseling a challenge. The aim of this review is to evaluate neurodevelopmental outcomes in children with prenatal diagnosis of isolated CCA. Controlled clinical trials published between May 23, 2009, and May 23, 2019, using the MeSH term “agenesis of corpus callosum” were reviewed. A total of 942 articles were identified, and 8 studies were included in the systematic review depending on the inclusion criteria. These studies included 217 fetuses with isolated CCA and no other anomalies at prenatal assessment. Neurodevelopmental outcome was reported to be normal in 83 children with a prenatal diagnosis of isolated CCA confirmed at birth within 128 completed assessments. About 45 children presented borderline, moderate, or severe neurodevelopmental outcome. In this review, neurodevelopment was favorable in two-thirds of the cases, but mild disabilities emerged in older children. Despite this, disabilities can occur later beyond school age and a low risk of severe cognitive impairment exists. Our study highlights the essential early diagnosis and proper supportive therapy.
The tubercle of Carabelli is an important morphological characteristic in the studies of dentalmorphology and forensic medicine. This trait has been used as an anthropological measure. The purpose of thiswork is to make a review of the information available about this dental characteristic. Its morphology, geneticcharacteristics and frequency are discussed in this article.
Manchester Triage System is a reliable system of triage in the emergency department of a hospital. This system when applied to a specific patients' condition such the pregnancy has several limitations. To overcome those limitations an alternative triage IDSS was developed in the MJD. In this approach the knowledge was obtained directly from the doctors' empirical and scientific experience to make the first version of decision models. Due to the particular gynecological and/or obstetrics requests other characteristics had been developed, namely a system that can increase patient safety for women in need of immediate care and help low-risk women avoid high-risk care, maximizing the use of resources. This paper presents the arrival flowchart, the associated decisions and the knowledge acquisition cycle. Results showed that this new approach enhances the efficiency and the safety through the appropriate use of resources and by assisting the right patient in the right place.
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