Cleft Lip and Cleft Palate

Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP). A cleft lip contains an opening in the upper lip that may extend into the nose.The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disorders.

Cleft lip and palate are the result of tissues of the face not joining properly during development.As such, they are a type of birth defect. The cause is unknown in most cases.Risk factors include smoking during pregnancy, diabetes, obesity, an older mother, and certain medications (such as some used to treat seizures).Cleft lip and cleft palate can often be diagnosed during pregnancy with an ultrasound exam.

A cleft lip or palate can be successfully treated with surgery. This is often done in the first few months of life for cleft lip and before eighteen months for cleft palate. Speech therapy and dental care may also be needed. With appropriate treatment, outcomes are good.

Hydrocephalus

The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF) — a clear fluid that surrounds the brain and spinal cord. 

The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.

The ventricular system is made up of four ventricles connected by narrow passages. Normally, CSF flows through the ventricles, exits into cisterns (closed spaces that serve as reservoirs) at the base of the brain, bathes the surfaces of the brain and spinal cord, and then reabsorbs into the bloodstream.

CSF has three important life-sustaining functions: 

1) to keep the brain tissue buoyant, acting as a cushion or "shock absorber"; 

2) to act as the vehicle for delivering nutrients to the brain and removing waste; and 

3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain).

The balance between production and absorption of CSF is critically important. Because CSF is made continuously, medical conditions that block its normal flow or absorption will result in an over-accumulation of CSF. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus.

Juvenile Rheumatoid Arthritis

Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis, is the most common form of arthritis in children and adolescents. ("Juvenile" in this context refers to an onset before age 16, "idiopathic" refers to a condition with no defined cause, and "arthritis" is the inflammation of the synovium of a joint.)

JIA is an autoimmune, noninfective, inflammatory joint disease of more than 6 weeks duration in children less than 16 years of age. The disease commonly occurs in children from the ages of 1 to 6, but it may develop as late as 15 years of age. It is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. 

It differs significantly from arthritis commonly seen in adults (osteoarthritis, rheumatoid arthritis), and other types of arthritis that can present in childhood which are chronic conditions (e.g. psoriatic arthritis and ankylosing spondylitis). Aetiopathology is similar to rheumatoid arthritis, but with less marked cartilage erosion, and joint instability and absent rheumatoid factor.

Spina Bifida

Spina bifida is a birth defect where there is incomplete closing of the backbone and membranes around the spinal cord. There are three main types: spina bifida occulta, meningocele, and myelomeningocele.The most common location is the lower back, but in rare cases it may be the middle back or neck. Occulta has no or only mild signs. 

Signs of occulta may include a hairy patch, dimple, dark spot, or swelling on the back at the site of the gap in the spine. Meningocele typically causes mild problems with a sac of fluid present at the gap in the spine.Myelomeningocele, also known as open spina bifida, is the most severe form.

Associated problems include poor ability to walk, problems with bladder or bowel control, hydrocephalus, a tethered spinal cord, and latex allergy.Learning problems are relatively uncommon. Spina bifida is believed to be due to a combination of genetic and environmental factors.

SIDS

Sudden infant death syndrome (also known as SIDS or ‘cot death’) is the sudden and expected death of a baby younger than 12 months of age, which usually happens during sleep, and cannot be explained even after a thorough investigation. SIDS is a tragic event and is the subject of much ongoing research.

While SIDS can happen anytime in the first 12 months of life, the majority of deaths happen in babies aged under 6 months of age, with a peak around 3 to 4 months of age.

You may also hear the term ‘sudden unexpected death in infancy’ or SUDI – this is sometimes used to describe all cases of sudden and unexpected deaths in infancy, not just those due to SIDS. For example, other causes of SUDI may include the death of an infant due to an illness that was not thought to be life-threatening or death from an accident or trauma.

The exact cause of SIDS is unknown.The requirement of a combination of factors including a specific underlying susceptibility, a specific time in development, and an environmental stressor has been proposed.These environmental stressors may include sleeping on the stomach or side, overheating, and exposure to tobacco smoke.