[Dysphagia] (no subject)

[Drirenect at aol.com (Drirenect@aol.com)]

Quite apart from the questionable validity of  e-stim, these unfortunate 
children have a multiplicity of severe impairments.  The whole list is available 
at OMIM 
_http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=180849_ 
(http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=180849)  
In terms of the feeding problems it is, of course,  essential first to 
identify the cause. Some are due to collapsible larynges,  many to esophageal 
problems as follows: 
Vascular ring leading to  tracheoesophageal compression in a patient with 
Rubinstein-Taybi  syndrome. _Clin  Genet._ 
(javascript:AL_get(this,%20'jour',%20'Clin%20Genet.');) 
1995  Dec;48(6):324-7
_Shashi  V_ 
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&itool=PubMed_Abstract&term="Shashi+V"[Author]) , _Fryburg  JS_ 
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&itool=PubMed_Abstract&t
erm="Fryburg+JS"[Author]) .
Mediastinal  vascular rings cause tracheoesophageal obstruction, resulting in 
respiratory  symptoms and dysphagia in children. Although a large number of 
children with  Rubinstein-Taybi syndrome have frequent respiratory infections 
and feeding  difficulties, there has been no firmly established association 
between this  syndrome and the occurrence of vascular rings. We report on a 
patient with  Rubinstein-Taybi syndrome who had a vascular ring. Since there was a 
previous  report of a similar ring in a child with Rubinstein-Taybi syndrome, 
we suggest  there may be an association between Rubinstein-Taybi syndrome and 
vascular  rings. The patient had a remarkable improvement in swallowing 
ability after  surgery and some decrease in the frequency of respiratory infections 
Obviously, in the above cases, e-stim would serve  no purpose. 
The following is the accepted resource for medical  treatment: 
Wiley, S.; Swayne, S.; Rubinstein, J. H.; Lanphear, N.  E.; Stevens, C. A. :  
Rubinstein-Taybi syndrome medical guidelines. Am. J.  Med. Genet. 119A: 
101-110, 2003.