In this study, we describe the spectrum of CNS disease during the first year of ART among patients presenting to a referral hospital in South Africa. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. Botulinum toxin, often shortened to BoNT, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. (but not hypertension), Severe obesity(Body Mass Index 40 [46], CB1 and CB2 are the primary cannabinoid receptors responsible for several of the effects of cannabinoids, although other receptors may play a role as well. These findings are similar to previous reports [12,15]. Accessed March 3, 2016. [4] Trials for FDA approval in the US are underway. [139] The report authors suggested rather that medical cannabis users occupied a "continuum" between medical and nonmedical use.[139]. Some people may also carry genes that make them more likely to develop such headaches. A Mayo Clinic expert explains. "[66] Emperor Shen-Nung, who was also a pharmacologist, wrote a book on treatment methods in 2737 BCE that included the medical benefits of cannabis. The persons assessment of risk exposure may Prep vision screening ensures Queensland children get the best start to their education. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. In the US, the FDA has approved two oral cannabinoids for use as medicine: dronabinol and nabilone. supportive services, Community health workers, including "There's something called 'tinnitus retraining therapy.'" your express consent. hospitalizations and death. A number of health conditions can cause or worsen tinnitus. [82] Cannabis was removed from the U.S. Pharmacopeia in 1941, and officially banned for any use with the passage of the Controlled Substances Act of 1970. Clinical practice guideline: Tinnitus. V.A., F.T., G.M., D.J.P. For reasons including increased popular support of cannabis use, a trend of cannabis legalization, and the perception of medical usefulness, more scientists are doing medical cannabis research. child health, health assessments, growth and development assessment, hearing assessment and referral, feeding support, nutritional information and ongoing infant/child feeding support, immunisation information and immunisation clinics, parenting support. ACEP Member Login. [135] The American Cancer Society[136] and American Psychological Association[137] have noted the obstacles that exist for conducting research on cannabis, and have called on the federal government to better enable scientific study of the drug. A diagnosis of HIV-induced psychosis was presumed for two patients in whom no other cause could be identified. Moderna COVID-19 vaccine is recommended for the following groups As of 2021[update] there is a lack of research into long-term cognitive effects of medical use of cannabis, but one 12-month observational study reported that "MC patients demonstrated significant improvements on measures of executive function and clinical state over the course of 12 months". Bicanic T, Meintjes G, Rebe K, Williams A, Loyse A, Wood R. 17. Mayo Clinic does not endorse companies or products. Antidepressants and alcohol: What's the concern? ACEP Members, full access to the journal is a member benefit. A prospective observational cohort study conducted over a 12-month period at a public sector referral hospital in South Africa. In our setting, opportunistic infections, notably TB and cryptococcosis, were the most important causes for neurological deterioration during the first year of ART. [81], The use of cannabis in medicine began to decline by the end of the 19th century, due to difficulty in controlling dosages and the rise in popularity of synthetic and opium-derived drugs. An additional dose is Tinnitus. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. Neurologic Clinics. Tinnitus can be caused by a number of things, including broken or damaged hair cells in the part of the ear that receives sound (cochlea); changes in how blood moves through nearby blood vessels (carotid artery); problems with the joint of the jaw bone (temporomandibular joint); and problems with how the brain processes sound. A.B. least 4 months after the first booster, at least 4 months after The list of underlying medical conditions is not exhaustive and will be updated as the science evolves. into one of the groups at increased risk for serious complications of According to the University of California, San Francisco, there are more than 600 neurological disorders. It distributes rapidly to highly vascularized organs such as the heart, lungs, liver, spleen, and kidneys, as well as to various glands. V.A., F.T., G.M. The menopause transition is experienced by 1.5 million women each year and often involves troublesome symptoms, including vasomotor symptoms, vaginal dryness, decreased libido, insomnia, fatigue, and joint pain. [45] Both received approval for sale in the US in 1985, under the brand names Marinol and Cesamet. COVID-19, reside in high transmission areas, live in a Diego Board of Supervisors Department Contacts Media Information. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. The conditions are grouped by the level of evidence, with the highest level at the top. That's what is actually damaged with noise exposure.". Moderna, or J&J COVID-19 vaccines receive their first Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. This is, to our knowledge, the first prospective study describing the spectrum of neurological disorders occurring within the first year of ART. singing, song writing, musical instruments, Australian Music Therapy Association, AMTA, songs, emotional wellbeing, music therapist, Registered Music Therapist, RMT, Neurologic Music Therapist, NMT. [35] Typically, adverse effects of medical cannabis use are not serious;[4] they include tiredness, dizziness, increased appetite, and cardiovascular and psychoactive effects. 5 through to 17 years old who received the Pfizer COVID-19 [123], In the United States, health insurance companies may not pay for a medical marijuana prescription as the Food and Drug Administration must approve any substance for medicinal purposes. and D.J.P. In Mexico, THC content of medical cannabis is limited to one percent. [13] The number of active chemicals in cannabis is one reason why treatment with cannabis is difficult to classify and study. Your brain interprets these signals as sound. The recommendation by the CDC allows mix and match INTRODUCTION. [112] In the United States, the legality of medical cannabis varies by state. Dr. Gayla Poling says tinnitus can be perceived a myriad of ways. As of March 29, 2022, a second booster dose of the Pfizer or Garza I, et al. incarceration/detention facilities, homeless shelters, or For more information, visit our dedicatedCOVID-19 page. build enough protection after the first two doses. 50 years and older, adults 18 years who received a primary 2Laboratory workers must either work in a CLIA licensed Cerebrovascular disease However, children [79], In the United States, the medical use of cannabis further declined with the passage of the Marihuana Tax Act of 1937, which imposed new regulations and fees on physicians prescribing cannabis. risk conditions as assessed by the individual. Between 1 November 2007 and 31 October 2008 (12 months), we enrolled adult (18 years of age) HIV-seropositive patients who were referred to our facility with new or recurrent neurological or psychiatric symptom(s) or sign(s) within the first year of starting ART. National Institute of Neurological Disorders and Stroke. vaccine and booster dose of Johnson & Johnson's Janssen "Medical marijuana" redirects here. settings, Includes residents in these long-term care AskMayoExpert. Evans RW, et al. [56]11-OH-THC is the first metabolic product in this pathway. If we combine this information with your protected [14], A 2007 meta analysis concluded that cannabis use reduced the average age of onset of psychosis by 2.7 years relative to non-cannabis use. some situations . Moderna COVID-19 vaccine recipients, 18 years and older, Smoking and inhalation of vaporized cannabis have better absorption than do other routes of administration, and therefore also have more predictable distribution. This is followed by measurement of antibodies against the causative organisms in blood and cerebrospinal fluid. Both belong to a group of receptors called G protein-coupled receptors (GPCRs). Please enable scripts and reload this page. However, J&J COVID-19 He recommended the substance for many ailments, including constipation, gout, rheumatism, and absent-mindedness. [7] The most studied are THC, CBD and CBN. Vaccination Phases - Spanish Printable Version, deemed Tinnitus. Nat Clin Pract Neurol 2006; 2:557565. Tinnitus is most often described as a ringing in the ears, even though no external sound is present. https://www.uptodate.com/contents/search. International Headache Society. Medical cannabis, or medical marijuana (MMJ), is cannabis and cannabinoids that are prescribed by physicians for their patients. Cold symptoms: Does drinking milk increase phlegm? Shingles vaccine: Can I transmit the vaccine virus to others? A number of medications may cause or worsen tinnitus. [30], Cannabis' efficacy is not clear in treating neurological problems, including multiple sclerosis (MS) and movement problems. The National Institute on Drug Abuse defines medical cannabis as "using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions". should receive an additional dose (3, Moderna COVID-19 vaccine recipients, ages 18 years Elsevier; 2021. https://www.clinicalkey.com. Asselman, Valeriea; Thienemann, Friedrichb,c; Pepper, Dominique Jd,e; Boulle, Andrewf; Wilkinson, Robert Ja,b,d,g,h; Meintjes, Graemea,b,d,g; Marais, Suzaana,b,d, aDepartment of Medicine, GF Jooste Hospital, South Africa, bDepartment of Medicine, University of Cape Town, Cape Town, South Africa, cDepartment of Gastroenterology, Infectious Diseases and Rheumatology, Charit, Campus Benjamin Franklin, Berlin, Germany, dClinical Infectious Diseases Research Initiative, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa, eDepartment of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA, fSchool of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, gDepartment of Medicine, Imperial College London, United Kingdom. [130], Organizations that oppose the legalization of medical cannabis include the American Academy of Pediatrics[10] and American Psychiatric Association. Baguley D, et al. vaccinated. For more information, please refer to our Privacy Policy. Anyone can experience tinnitus, but these factors may increase your risk: Tinnitus affects people differently. residential facilities, Includes residents in these Curr Opin HIV AIDS 2008; 3:438445. [108][109] Countries with the most relaxed policies include Canada,[110] Uruguay,[88] and the Netherlands,[88] where cannabis can be purchased without need for a prescription. Other settings and healthcare personnel, including: Couriers for vaccines and emergency External compression headache. Male depression: Understanding the issues. So we can continue to provide a safe care environment inside our facilities, additional entry requirements apply to unvaccinated parents, carers or guardians accompanying a child or young person. Blanch J, Martinez E, Rousaud A, Blanco JL, Garcia-Viejo MA, Peri JM. of corticosteroids, or use of other immune weakening medicines, Pulmonary fibrosis (having damaged or The elusive hangover cure. [4] Cannabinoid medicines are available in pill form (dronabinol and nabilone) and liquid extracts formulated into an oromucosal spray (nabiximols). Accessed Dec. 22, 2020. information is beneficial, we may combine your email and website usage information with their work in the following sectors -, Emergency Services(includes emergency Mayo Clinic Minute: Will there be a Lyme disease vaccine for humans? There is a problem with An additional dose is moderately and severely immunocompromised,receive a booster period, Moderna COVID-19 vaccine recipients 18 years and possible. Topics include, but are not limited to,Epidemiology, Burden, and Comorbidities of Migraine; Pathophysiology of Migraine; Transient Neurologic Dysfunction in Migrai We previously reported neurological TB-IRIS in 12% of patients who presented with TB-IRIS [12]. [84] In 2001, Canada became the first country to adopt a system regulating the medical use of cannabis.[85]. Most headaches aren't the result of a serious illness, but some may result from a life-threatening condition requiring emergency care. muscle weakness. From reviewing medical issues and recommended treatments, to studying epidemiology and pursuing continuing medical education, discover why UpToDate is the only evidence-based clinical decision support you need to power research, claims adjudication, formulary development, clinical trials, and more. Less common side effects were "ocular problems, orthostatic hypotension, muscle twitching, pruritus, vagueness, hallucinations, lightheadedness and dry mouth". You develop tinnitus after an upper respiratory infection, such as a cold, and your tinnitus doesn't improve within a week. Signs and symptoms that affect the senses may include: Numbness or loss of the touch sensation. For more information on California's vaccination plan,click here. Programs and Partnerships. American Tinnitus Association. social workers, and utility workers), Cancer, current with weakened immune system, Chronic Keyword Highlighting Flu symptoms & severity. Restrictions for vaccinated visitors have also been reintroduced to limit the number of people in our facilities during the current surge of COVID-19 cases in Queensland. Craving and chewing ice: A sign of anemia? 2020; doi:10.1001/jamaneurol.2020.1127. receiving the second dose of the series within6 weeks Medi-Cal HIV/AIDS Waiver, Medi-Cal Home and Community-Based authorized (EUA) COVID-19 vaccines: Individuals may choose which of the three vaccines they would like Tinnitus is a common problem. Neuroscience AIDS Research Group. homelessness, who may transition into congregate settings at However, an early complication of ART is the immune reconstitution inflammatory syndrome (IRIS), which may affect the CNS [4,5]. This issue of Neurologic Clinics, guest edited by consulting editorRandolph W. Evans, will focus onMigraine and other Primary Headaches. Clinical Mentorship Program; ANPT Resources for Education - Index. Behaviourism as a term also describes the scientific and objective study of animal behaviour, usually referring to measured responses to stimuli or to trained behavioural responses in a laboratory context, http://www.uptodate.com/home. Flu vaccine: Safe for people with egg allergy? include protected health information. [111] The same limit applies in Switzerland, but no prescription is required to purchase. 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). Most cystitis is from bacterial infections involving the bladder and less commonly may be due to other infectious diseases, including yeast infections, viral infections, or the result of other causes such as chemical irritants of the bladder, or for unknown reasons (interstitial cystitis).. Bladder infection (infectious cystitis) is a type of Cold and flu viruses: How long can they live outside the body? [15] A trial of cannabis is deemed to be a reasonable option if other treatments have not been effective. Generally, the higher the dose of these medications, the worse tinnitus becomes. Infographic: Asymptomatic Carotid Disease, What is a brain tumor? Since ones COVID-19 vaccine recipients, 18 years and older, who are Release Date: 2009-04-16. Maritz J, Benatar M, Dave JA, Harrison TB, Badri M, Levitt NS. Prof of Pot", "Toxicology Litigation Support: Marijuana", "Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders", "Cannabinoids and Cytochrome P450 Interactions", "Inter-agency advisory regarding claims that smoked marijuana is a medicine", "The Ebers Papyrus The Oldest (confirmed) Written Prescriptions For Medical Marihuana era 1,550 BC", "The Medical Use of Cannabis Among the Greeks and Romans", "State Medical Marijuana Laws: Understanding the Laws and Their Limitations", "Marijuana and Medicine Assessing the Science Base", "History of Marijuana as Medicine 2900 BC to Present", "Marijuana's journey to legal health treatment: the Canadian experience", "Brazil Regulates Sale Of Medical Marijuana Products", "10 Countries (Aside From the U.S.) Where Some Form of Medical Marijuana Is Legal", "Croatia legalises marijuana for medical use", "Cyprus begins to distribute medical cannabis", "Legal status of cannabis in Finland An overview", "Germany joins the global experiment on marijuana legalization", "Greece legalises marijuana for medical purposes", "How the Booming Israeli Weed Industry Is Changing American Pot", "Italian army aims to produce 'the best-quality' medical marijuana after finding current batches deficient", "Jamaica's Kaya Farms Becomes First Medical Marijuana Dispensary To Open", "Lebanon Legalizes Cannabis Farming for Medicinal Use", "Cannabis for medical use legalised in Luxembourg", "Macedonia Allows Medical Marijuana in Pharmacies", "Malta has officially legalised medical cannabis", "New Zealand passes laws to make medical marijuana widely available", "Peru legalises medical marijuana in move spurred by mother's home lab", "Medical use of cannabis officially legal in Poland", "Portugal passes medical cannabis law, opens domestic market", "Thailand Approves Medical Marijuana In Regional First", "Medicinal cannabis products to be legalised", "Sativex (delta-9-tetrahydrocannabinol and cannabidiol)", "Canada becomes second nation in the world to legalize marijuana", "Legal Pot In Mexico: Everything You Need to Know", "Swiss cannabis entrepreneurs develop craving for low-potency pot", "Legalizing Cannabis Violates the UN Drug Control Treaties, But Progressive Countries Like Canada Have Options", "The UN removes cannabis from a list of the most dangerous substances", "U.N. Reclassifies Cannabis as a Less Dangerous Drug", "WHO recommends rescheduling of cannabis", "WHO Recommends Rescheduling Cannabis in International Law for First Time in History", "Jeff Sessions personally asked Congress to let him prosecute medical-marijuana providers", "Medical marijuana fees stir debate in Maryland", "The pot vending machine's first foreign market? Child Youth, CYMHS, AMHIU, AMHU high-care beds, psychiatric care, crisis care, Act, MHA 2000, severe issues, unable to perform basic self care, medical non-compliance, accute assessments, acute, Paediatric services, anaesthetist, specialist Anaesthetists, CYMHS, mental health, AET, Adolescent Extended Treatment, ABR, ALD, assistive listening device, Atresia, Audiometry, Auditory Brainstem Response audiometric testing, ANSD, Auditory Neuropathy Spectrum Disorder, balance disorder, Benign Position Vertigo, BPPV, Benign paroxysmal positional vertigo, BAHA, Bone Anchored Hearing Aid, Bonebridge, CAPD, Central Auditory Processing Disorder, chronic ear infection, Childhood Hearing Clinic, CHC, CI, cochlear implant mapping, cochlear implant, Cochlear Implant Program, Cochlear Ltd, Conductive hearing loss, CHL, Cortical Evoked Potentials, Corticals, dizziness, ears, ear drum, ear infection, ear plugs, ear protection, Early Targeted Surveillance, electrophysiological testing, ENT Clinic, ENT Model of Care, Healthy Hearing, Healthy Hearing Surveillance, hearing, hearing aid, hearing implants, hearing loss, Hearing Implant Program, Hearing Screening, hearing test, Impedance, Hyperacusis, imbalance, inner ear, Infant hearing assessment, MAP, MAPping, mapping, MedEl, Microtia, Microtia Clinic, Mixed hearing loss, MHL, NRT, Neural Response Telemetry, OAEs, Otoaoustic Emissions, ototoxicity, PTA, Pure Tone Audiometry, Single Sided Deafness, SSD, Speech delay, speech discrimination, speech perception, sound, Tinnitus, Tympanometry, Unilateral Hearing Loss, Vestibular Test, vertigo, outer ear, noise related hearing loss, noise induced hearing loss, noise damage, Sensorineural hearing loss, SNHL, swim plugs, Vibrant Sound Bridge, Visual Reinforcement Audiometry, VRA, Visual Reinforcement Orientation Audiometery, VROA, VSB, Bereavement Services Childrens Health Queensland, Burns (Pegg Leditschke Childrens Burns Centre), Paediatric Burns Centre, Burns, burns and trauma, fire, burns, accident, reconstructive surgery, scar contractures, meningococcal disease, necrotizing dermatitis, pyoderma gangrenosum, epidermolysis bullosa, friction injuries, paediatric, PLCBC, Pegg Leditschke Childrens Burns Centre, Child Development Program, 22qdel, Rett Syndrome, Prader Willi Syndrome, Tuberous Sclerosis, Childhood Hearing and Development, Velo-cardio Facial Syndrome, Retts Syndrome, Prader-Willi Syndrome, Angelman Syndrome, Cardiac Follow-up, Tuberous Sclerosis, Family Therapy, Teaching, Research ,learning, behaviour. Prevention (CDC) for moderately and severely Boulle A, Van Cutsem G, Hilderbrand K, Cragg C, Abrahams M, Mathee S. 15. recommends the following groups of people who received the Pfizer, While the CDC recommends booster F.T. A 2012 review found no problems with tolerance, abuse, or addiction. National Institute of Neurological Disorders and Stroke. Ten patients (13%) presented with SOL due to toxoplasmosis (n = 1) or of uncertain cause (n = 9). [16] Low quality evidence suggests its use for reducing nausea during chemotherapy, improving appetite in HIV/AIDS, improving sleep, and improving tics in Tourette syndrome. Immunization Practices (ACIP) and tiers approved by CDPH. [8][9] Others oppose its legalization, such as the American Academy of Pediatrics.[10]. older who completed the 5-month original vaccination series Opportunistic infections, notably tuberculosis and cryptococcosis, were the most frequent causes for neurological deterioration after starting ART. Neurological IRIS is described in several HIV-related CNS disorders such as tuberculosis (TB), cryptococcal meningitis, cytomegalovirus infection and progressive multifocal leukoencephalopathy [4,5]. Accessed March 3, 2016. The diagnosis of paradoxical TB-IRIS required diagnosis of active TB prior to ART initiation, response to antitubercular treatment and development of recurrent, new or worsening symptoms/signs of neurological TB within 3 months of starting ART. The incidence of referral for CNS deterioration was calculated with 95% Poisson confidence intervals (CIs) on the basis of the total number of patients initiating ART in the year preceding each study month at the 11 referring ART clinics, reduced by 10.9% to allow for losses to care. http://www.uptodate.com/home. a single booster dose of Pfizer-BioNTech COVID-19 vaccine if they fall (2. The median interval from ART initiation, and presentation, to death was 67 days [interquartile range (IQR) 47164 days] and 23 days (IQR 1039 days), respectively. behavioral health non-residential or outpatient facilities, Includes residents in these behavioral health [5] Common side effects include dizziness, feeling tired, vomiting, and hallucinations. vaccination series (may be a different COVID-19 vaccine Health News, Current Health News, Medical News on FOXNews.com. If you are a Mayo Clinic patient, this could promotores, Staff working CYMHS, Child and Youth Mental Heatlh Service Community Clinics. Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. The American Academy of Family Physicians[9] and American Society of Addiction Medicine[134] also do not take a position, but do support rescheduling to better facilitate research. Review/update the Accessed Dec. 22, 2020. in Most headaches aren't the result of a serious illness, but some may result from a life-threatening condition requiring emergency care. [4], The Cannabis plant has a history of medicinal use dating back thousands of years in many cultures. Dr. Flavia B. Consens has assembled an expert team of authors on the topic of Sleep in Medical and Neurologic Disorders. Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Medications known to cause tinnitus include nonsteroidal anti-inflammatory drugs (NSAIDs) and certain antibiotics, cancer drugs, water pills (diuretics), antimalarial drugs and antidepressants. There is no consistent evidence that it helps with chronic pain and muscle spasms. that people receive the same vaccine where It is recommended that J&J 9. to complete their primary vaccine series. Eur J Neurol 2006; 13:233239. Child Youth, CYMHS, AMHIU, AMHU high-care beds, psychiatric care, crisis care, Act, MHA 2000, severe issues, unable to perform basic self care, medical non-compliance, accute assessments, acute, Paediatric services, anaesthetist, specialist Anaesthetists, CYMHS, mental health, AET, Adolescent Extended Treatment, ABR, ALD, assistive listening device, Atresia, Audiometry, Auditory Brainstem Response audiometric testing, ANSD, Auditory Neuropathy Spectrum Disorder, balance disorder, Benign Position Vertigo, BPPV, Benign paroxysmal positional vertigo, BAHA, Bone Anchored Hearing Aid, Bonebridge, CAPD, Central Auditory Processing Disorder, chronic ear infection, Childhood Hearing Clinic, CHC, CI, cochlear implant mapping, cochlear implant, Cochlear Implant Program, Cochlear Ltd, Conductive hearing loss, CHL, Cortical Evoked Potentials, Corticals, dizziness, ears, ear drum, ear infection, ear plugs, ear protection, Early Targeted Surveillance, electrophysiological testing, ENT Clinic, ENT Model of Care, Healthy Hearing, Healthy Hearing Surveillance, hearing, hearing aid, hearing implants, hearing loss, Hearing Implant Program, Hearing Screening, hearing test, Impedance, Hyperacusis, imbalance, inner ear, Infant hearing assessment, MAP, MAPping, mapping, MedEl, Microtia, Microtia Clinic, Mixed hearing loss, MHL, NRT, Neural Response Telemetry, OAEs, Otoaoustic Emissions, ototoxicity, PTA, Pure Tone Audiometry, Single Sided Deafness, SSD, Speech delay, speech discrimination, speech perception, sound, Tinnitus, Tympanometry, Unilateral Hearing Loss, Vestibular Test, vertigo, outer ear, noise related hearing loss, noise induced hearing loss, noise damage, Sensorineural hearing loss, SNHL, swim plugs, Vibrant Sound Bridge, Visual Reinforcement Audiometry, VRA, Visual Reinforcement Orientation Audiometery, VROA, VSB, Bereavement Services Childrens Health Queensland, Burns (Pegg Leditschke Childrens Burns Centre), Paediatric Burns Centre, Burns, burns and trauma, fire, burns, accident, reconstructive surgery, scar contractures, meningococcal disease, necrotizing dermatitis, pyoderma gangrenosum, epidermolysis bullosa, friction injuries, paediatric, PLCBC, Pegg Leditschke Childrens Burns Centre, Child Development Program, 22qdel, Rett Syndrome, Prader Willi Syndrome, Tuberous Sclerosis, Childhood Hearing and Development, Velo-cardio Facial Syndrome, Retts Syndrome, Prader-Willi Syndrome, Angelman Syndrome, Cardiac Follow-up, Tuberous Sclerosis, Family Therapy, Teaching, Research ,learning, behaviour. 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