Monday, June 10, 2019

Duchenne Muscular Dystrophy Essay Example | Topics and Well Written Essays - 1750 words

Duchenne Muscular Dystrophy - Essay ExampleAt the age of cardinal, he had already developed contractures with the calf muscles being the nearly severely affected (Larsen & Lubkin, 2013). By the age of nine climbing stairs and rising unaided was impossible, and at ten years, he was confined to a wheelchair. He has weakening trunk muscles which can easily cause scoliosis. His diaphragm muscles are too weakened which makes breathing and coughing difficult, and increases chances of lung infection. Complications much(prenominal) as sleep-disordered breathing otiose cough and nocturnal hypoventilation are being experienced. The patient also has difficulties learning through listening and attention span is low (American Thoracic Society, 2010). DMD symptom direction The focus of this study is the symptom prudence of neuromuscular and skeletal muscles. In a review article by a team of 84 practitioners representing the specialists who put up care to DMD patients selected by Centre for Disease Control (CDC), they independently rated the interventions and assessments that are used in DMD forethought (DMD Care Considerations Working Group, 2009). From this assessment, CDC expert panelists came up with management interventions for the neuro and skeletal muscles for a DMD patient at the stage in which this patient is. The first intervention for muscle strength and function is pharmacological intervention to point of reference the progression of muscle degeneration in a DMD patient. The treatment that the review focuses on is the use of the glucocorticoids to optimize strength and function of these muscles. Glucocorticoids slow the collapsing of muscle strength, as well as its function, thereby reducing the risk of scoliosis and stabilize pulmonary function. The initial RCTs of patients on 0.75 mg/kg daily dose of prednisone for six months showed improvement in muscle strength. Prednisolone and deflazacort are other glucocorticoids that were shown to be effective on a daily dose instead of alternate days. These medications were shown also to prolong ambulation and in patients that have become non- ambulatory showed reduced risks of progressive scoliosis and stabilization of pulmonary function. There is no agreed time to start the glucocorticoids therapy since this is base on serial assessments, as well as parental report in the diseases three phases. However, for a patient who has lost ambulation such as this one, the CDC experts review points the therapy can be introduced or continued in order to preserve upper limb strength, reduce progression of scoliosis and slow mess a loss of respiratory and cardiac function. The review concludes that other supplements could be used to manage the neuro and skeletal muscles weaknesses such as coenzyme Q10, carnitine, and antioxidants such as look for oils, vitamin E, green tea extracts and amino acids. In another review article by the CDC expert panel on the implementation of multidisciplinary care in the management of DMD, the expert panel of the CDC project addresses skeletal and respiratory management (DMD Care Considerations Working Group, 2009). In spinal management, the earlier management with the use of glucocorticoid treatment is retaliated to confine progression of scoliosis and a small chance of developing vertebral compression fractures caused by osteoporosis.

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