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In addition, the authors appreciate the following individuals and their efforts: Vedhika Raghunathan and Sarah Oh from Healthy Asian Americans Project (HAAP) for data management; Jenni Hoffman and Nancy Prince for their assistance during STMM training; Filipino American Community Council of Michigan (FILAMCCO), Alberto Reginaldo and Ryan Rosario for their coordination; STMM operating organizations and administrators: Ang Bisaya of Michigan Foundation (ABM), Gina Robles-Solon and Nelly Paler-Jensen; Philippine Nurses Association of Michigan (PNAM), Maria Wolfinbarger, Ellen Laboga and Trinie Aair; Far Eastern and American Nurses, Allied Professionals Association (FANA), Gary Butler, Brenda Sanagustin, Dr.
In this case report we sought to introduce a rather recent approach for early management of neonates born with cleft lip palate deformity through presurgical nasoalveolar molding (PNAM) technique.
In a recent study, over one third of united states national Craniofacial centers offer NAM as a presurgical management for infants with CLP deformity7, another European study concluded that PNAM is still rather an innovative protocol of treatment, and it seems promising treatment modality.8 In the Middle East region NAM use is still not a common treatment approach, as usually surgeons undergo the primary lip repair at 5-6 months of age without any presurgical intervention.
In the present case, along with the obturator a nasal stent was added on the labial flange of feeding plate, a new approach which is called as pre-surgical nasoalveolar molding (PNAM).
PNAM technique was first described by Grayson et al in 1993.
"Pre-surgical Nasoalveolar Moulding (PNAM)" is one such therapy that moulds the tissues prior to their surgical repair.
"Pre-surgical Nasoalveolar Moulding (PNAM)" was earlier known as "Pre-surgical orthopaedics" that just aimed at reducing the distance between the cleft elements to help make surgical correction easier and reduce post-surgical breakdown.
Com a criacao do PNAM (Ministerio da Saude do Brasil, 2003), que e um conjunto de medidas e politicas de governo voltadas a concretizacao do direito humano universal a alimentacao e nutricao adequada e tambem com a adocao da Estrategia Global para a Promocao da Alimentacao Saudavel, Atividade Fisica e Saude (Ministerio da Saude do Brasil, 2005), que se mostra como uma oportunidade singular para a formulacao e implementacao de uma linha de acao efetiva para reduzir substancialmente as mortes e doencas em todo o mundo, relacionadas a alimentacao inadequada e inatividade fisica, ja mostra a necessidade de se investir mais nos profissionais envolvidos nessa "batalha", como educadores fisicos e nutricionistas.
Crystallography: Orthorhombic, Pnam, a 10.42, b 5.28, c 10.34 [Angstrom], V 568.2 [[Angstrom].sup.3], Z 4, a:b:c = 1.9735:1:1.9583.
In those patient who undergone through Pre Surgical Naso Alveolar Molding (PNAM) therapy, good collaboration between Orthodontist and Prosthodontist is required.4
91-036 Orthorhombic: Pnam a 6.31 b 9.20 c 7.10 Megascopic color unknown; luster probably dull; transparent.
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