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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Type IV Hereditary Sensory and Autonomic Neuropathy: Challenges and Functional Outcomes.

Ahmed Dudic1, Paul Van Schuyver2, Dane Van Tassel3

  • 1Creighton University School of Medicine.

Journal of Pediatric Orthopedics
|August 18, 2025
PubMed
Summary

Type IV Hereditary Sensory and Autonomic Neuropathy (HSAN IV) significantly impacts play and global function in affected children. Early diagnosis via whole-exome sequencing is crucial for better outcomes and preventing functional decline.

Keywords:
HSAN IVfunctional outcomesorthopaedic manifestationstype IV hereditary and sensory autonomic neuropathy

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Area of Science:

  • Genetics
  • Neurology
  • Pediatrics

Background:

  • Type IV Hereditary Sensory and Autonomic Neuropathy (HSAN IV) is a rare autosomal recessive disorder.
  • Characterized by loss of pain/temperature sensation, intellectual disability, and anhidrosis.
  • Leads to frequent orthopedic injuries and complications.

Purpose of the Study:

  • To investigate the diagnostic and treatment challenges of HSAN IV.
  • To assess the functional outcomes in HSAN IV patients.
  • To highlight the impact of delayed diagnosis on patient function.

Main Methods:

  • Retrospective case series of 4 siblings with HSAN IV.
  • Review of medical records for presentation, diagnosis, and management.
  • Functional outcomes assessed using the Pediatric Outcomes Data Collection Instrument and compared to normative data.

Main Results:

  • Average diagnostic delay of 53 months, confirmed by whole-exome sequencing.
  • Significant functional deficits observed in sports/play and global function.
  • No significant differences in upper extremity function, mobility, pain/comfort, or happiness.

Conclusions:

  • HSAN IV presents with diverse manifestations, impacting play and global function.
  • Whole-exome sequencing aids in expedited diagnosis when combined with clinical suspicion.
  • Early diagnosis and intervention are vital to prevent functional deterioration and reduce medical interventions.