Noonan syndrome and neuroblastoma

Article Abstract:

Noonan syndrome may be associated with neuroblastoma. Noonan's syndrome is a cluster of congenital anomalies, including short stature, characteristic appearance, heart abnormalities, undescended testes, and mild mental retardation. Neuroblastoma is a cancer of the embryonic nerve cells that is known to be associated with congenital heart anomalies. A female infant was born at 32 weeks gestation. She had the characteristics of Noonan syndrome, and ultrasound imaging revealed heart anomalies and constriction of the aorta and pulmonary artery. She was discharged 8 weeks after birth and readmitted at 10 weeks for poor color, cough, and rapid breathing. Heart surgery was performed, but she continued to have congestive heart failure. At 10 months she was admitted for respiratory distress. X-ray and magnetic resonance imaging revealed tumors in the tissue wall separating the lungs and in the liver. A biopsy was diagnostic for neuroblastoma. The tumors were not amenable to surgery. She died several days later.

Case studies, Congenital heart disease, Neuroblastoma, Liver tumors

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Hemolytic anemia: an unusual presentation of congenital heart disease

Article Abstract:

Hemolytic anemia may be caused by a congenital heart defect. Hemolytic anemia occurs when a high velocity flow of a small volume of blood destroys red blood cells. Artificial heart valves and patches are known to occasionally cause this complication. In this case report, a 5-week-old baby boy with heart failure and anemia was found to have a defect in the wall between the lower two heart chambers and a damaged heart valve. He also had an open ductus arteriosis, a fetal blood vessel that bypasses the lung and should close after birth. Analysis of a blood sample showed red blood cell fragments. He underwent successful surgical repair at 8 weeks old, and two months later, all blood values were normal. This suggests that abnormal blood flow through the heart chamber defect caused hemolytic anemia.

Causes of, Congenital heart disease in children, Hemolytic anemia

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Does employee involvement work? Yes, sometimes

Article Abstract:

Employee participation and involvement in healthcare is touted as being valuable, but it is not always effective for improving performance or employee attitudes. Some kinds are better than others from the point of view of managers. Seven kinds can be identified: quality of work life programs, quality circles, gainsharing, worker councils and employee representatives, job enrichment, self-directed work teams, employee ownership. The most effective approaches are self-directed work teams and gainsharing programs according to a study based on the literature of the area.

Evaluation, Officials and employees, Participatory management, Hospitals, Public, Public hospitals

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