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myelomalacia

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(mī″ĕ-lō-mă-lā′shē-ă) [Gr. myelos, marrow, + malakia, softening] Abnormal softening of the spinal cord.

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myelomeningocele

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(mī″ĕ-lō-mening′ŏ-sēl″, -mĕ-nin′jŏ-) [myelo- + meningo- + -cele] A hernia of the spinal cord and meninges through the posterior vertebral column that results from failure of the neural tube to close during embryonic development (about 28 days after conception). The defect usually is found in the lumbosacral spine and often results in significant impairment in urination, defecation, and walking (spastic or flaccid paralysis).

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PREVENTION: Folic acid supplementation is recommended for all women of childbearing age because maternal dietary folate deficiency is a known risk factor. It reduces but does not eliminate the risk of severe neural tube defects (NTDs) like myelomeningocele.

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PATIENT CARE: When an NTD has been diagnosed by amniocentesis, the parents should be referred for genetic counseling, information, and support regarding decisions to terminate or continue the pregnancy. Myelomeningoceles are common, occurring in about 1 in 2000 live births. After birth, the defect is cleansed gently, and foam or sheepskin support provided to prevent pressure, skin breakdown, and infection. Parental bonding is encouraged: the infant needs cuddling and loving, and should be held facedown held on the parent's lap. Fluid balance is monitored and adequate nutrition provided. Passive range of motion exercises help minimize contractures. Surgical repair of the defect is followed by careful monitoring for hydrocephalus, infection, shock, and increased intracranial pressure (bulging fontanels are the most common indicator in infants). The wound is inspected and redressed according to protocol. Leg casts may be needed to treat hip and knee deformities. Close assessment of the child's growth and development, and ongoing physical and occupational therapy will be needed throughout the child's life, along with psychological support for the child and parents who may feel guilt, anger, or helplessness. Mental stimulation helps to ensure maximum development. Bladder and bowel training are taught, with management dependent on the severity of the deficit. Social services may be able to assist parents with financial needs. Counseling and careful follow-up are needed to optimize outcomes and the adaptation of the child and parents to the illness. Parents may acquire additional support and information from the Spina Bifida Association of America (800-621-3141; www.sbaa.org). SYN: meningomyelocele.

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myelopathy

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(mī″ĕ-lop′ă-thē) [myelo- + -pathy] Any disease or condition affecting the spinal cord.

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focal m. Myelopathy of small areas.

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HTLV-1–associated m. Tropical spastic paraparesis.

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transverse m. Myelopathy extending across the spinal cord.

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traumatic m. Myelopathy due to trauma to the spinal cord.

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myeloperoxidase

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(mī-ĕl″ō-pĕr-ŏks′ĭ-dās″) [″ + peroxidase] ABBR: MPO. An enzyme found principally in neutrophils and monocytes that generates hypochlorous acid from hydrogen peroxide and chloride ions. The enzyme is released into plasma in ...

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