Signos Pediatria - AP Locomotor

8/18/2019 Signos Pediatria - AP Locomotor

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SIGNOS VISUALES FRECUENTES EN PEDIATRÍA: APARATO LOCOMOTOR Y

COLUMNA VERTEBRAL

INDICE DE CONTENIDOS

INTRODUCCION 4

CAPITULO N° 1: MIEMBRO SUPERIOR 5

1. &OMBRO

1.1. PARALISIS BRA'UIAL OBSTETRICA

1.2. DE(ORMIDAD DE SPRENGEL

2. BRAZO, CODO, ANTEBRAZO, MU)ECA * MANO

2.1. CODO DE NI)ERA

2.2. DE(ICIENCIAS TRANSVERSALES.

2.3. DE(ICIENCIAS LONGITUDINALES

3. DEDOS

3.1. POLIDACTILIA

3.2. SINDACTILIA

3.3. ECTRODACTILIA

3.+. CLINDACTILIA

3.. TENOSINOVITIS ESTENOSANTE DEL PULGARCAPITULO N° 2: MIEMBRO INFERIOR 1

1. DISPLASIA DE DESARROLLO DE LA CADERA DDC

2. GENU RECURVATUM * GENU (LEXUM

3. GENU VARO * GENU VALGO

4. EL METATARSO ADUCTO

. CALC/NEOVALGO

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. PIE E'UINOVARO PIE ZAMBO

. PIE PLANO

CAPITULO N° !: COLUMNA VERTEBRAL 2

1. ESPINA B(IDA

1.1. ESPINA B(IDA OCULTA

1.2. MENINGOCELE

1.3. M*ELOMENINGOCELE

2. ESCOLISIS

3. CI(OSIS * LORDOSIS

BIBLIOGRAFIA !4

3


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INTRODUCCION

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CAPITULO N° 1: MIEMBRO SUPERIOR

1" HOMBRO

1"1" PARALISIS BRA#UIAL OBSTETRICA

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1"2" DEFORMIDAD DE SPRENGEL

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2" BRA$O% CODO% ANTEBRA$O% MUÑECA Y MANO

2"1" CODO DE NIÑERA

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• HEMIMELIA


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• MANO $AMBO CUBITAL

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!"2" SINDACTILIA

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!"5" TENOSINOVITIS ESTENOSANTE DEL PULGAR

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CAPITULO N° 2: MIEMBRO INFERIOR

1" DISPLASIA DE DESARROLLO DE LA CADERA &DDC'

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M+.(+ /0 B+6"

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1!


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2" GENU VARO Y GENU VALGO

E #4 ;#u "#4 47 r%"i44 ?ru: % ?r%, 4 5r7# "i674 "# 4 #F7r#:i"" 6#>#r> 4 4# :#"i. E #4 ;#u ?4;% 4 5r7# "i674 "# 4 #F7r#:i"" 6# 4#9"# 4 4# :#"i r%"i446 9u76.

E4 ;#u ?r% 6# >%6i"#r =i6i%4;i>% 67 4%6 "%6 5ri:#r%6 %6 "# #"","#65u6 "# #67 #"" #4 ?r% 6# >%6i"#r %r:4. A 5r7ir "# 4%6 "%6 %6 #4 #9#"# 4 #F7r#:i"" #6 #u7r%. A 4%6 7r#6 %6 "# #"" 46 r%"i446 6# >#r>5r%"u>i"%6# u ;#u ?4;%, #4 >u4 "i6:iu@# 5r%;r#6i?:#7# 67 4%6 %6"# #"", >u"% 6# "ui#r# #4 %, 4 "i67>i #7r# 4%6 >"i4%6=#:%r4#6 #6 :@%r "# 7r#6 >:., 6i #4


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:@%r "# 1 ;r"%6 "# ?r%, @ 6i 5#r6i67# :% >u"% E6 6i:7ri>%, 4 "i67>i #7r# 4%6 :4%4%6i7#r%6 "# 4%6 7%8i44%6 #6 :@%r "# >:., @ >u"% #4 #9# =%r:"% #7r# #4 =:ur @

4 7i8i #6 :@%r "# 1 ;r"%6 "# ?4;%.

Ca&bi%s $isi%l6*i"%s #) )i+%s (#qu#+%s:

La primera imagen de izquierda a derecha corresponde a un niño de dos años congenu varo y la tercera imagen representa a un niño de 5 años con genu valgo

G#)u 7ar%

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G#)u 7al*%

!" GENU RECURVATUM Y GENU FLEur?7u: #6 u "#=%r:i"" u# >%6i67# # u 6%8r##F7#6i "#4 r7i>u4>i "# 4 r%"i44, ;##r"% u i "#47#. L6%8r##F7#6i "# 4 >6i% #67"%6 "%4%r%6%6 "#irri7>i. Pu#"# >%44#?r 4 r7r%6i6 "# r%"i44.

Su6 >u66 6% LuF>i >%;i7 "# 4 r7i>u4>i "# 4 r%"i44, "#8i4i"" "#4

7#9i"% >%9u7i?%, 6%8r##F7#6i% "# 4 >i @ #F7#6i "# 4 r%"i44, 5ri", >%r7:i#7%"# 4 5i#r >%7r47#r4, 7r67%r% #5i=i6iri% "#4 >r#>i:i#7%, #7r# %7r%6.

G#)u r#"ur7au&

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E4 G#u (4#Fu: #6 u "#=%r:i"" u# >%44#? 4 i:5%6i8i4i"" "# u #F7#6i>%:54#7 "# 4 r%"i44, % u# 6u5%# u i:5%r77# =>7%r "# i#678i4i"". Su#7i%4%; #6 "i?#r6 "#6#ui4i8ri% =u>i%4 :u6>u4%-4i;:#7%6%, >%;i7%,=r>7ur6, i:%?i4i$>i # @#6%, >7i7u" 7i, 6i:#7r "# 4%6 :i#:8r%6i=#ri%r#6, 4#6i%#6 5r47i>6. E4 "#=#>7% " 4u;r 4 >4% >:ir 6#7"%Q

G#)u $l#,u&

4. EL METATARSO ADUCTO

E4 7#5i #67< # "u>7%, :i#7r6 u# #4 :#"i%5i @ #4 r#7r%5i 6% %r:4#6. E48%r"# 47#r4 #6 >%?#F% @ 4 86# "#4 ui7% :#77r6i% #6 5r%:i#7#. E>%"i>i%#6 %r:4#6 u 4# 7r$" 5%r #4 :#"i% "#4 74 @ 5r4#4 4 :i6:%"#8# >ru$r #4 2 "#"%. E4 :#77r6% "u>7% #6 =4#Fi84#, 8#i;% @ 6# r#6u#4?##65%7i"#4 5i# #ui%?r%, #4 5i# #6 =4#Fi84#.

L >u6 :u#7# #6 #4 :%"#4"% i7ru7#ri%, 4 "#=%r:i"" #6 8i47#r4 ##4 0J "# 4%6 >6%6. E7r# %7r6 "#=%r:i""#6 6%>i"6 6# #>u#7r 4 "i6546i

"#4 "#6rr%44% "# 4 >"#r 2J :#77r6% "u>7%. E6 %84i;7%ri% 8u6>r4 7#7%"% 5i# >% :#77r6% "u>7%.

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M#aars% a'u"%

5" CALC=NEOVALGO

S# >r>7#ri$ 5%r u #F>#6i? "%r6i=4#Fi @ #?#r6i # #4 r#7r%5i, #4 7#5i5u#"# #67r # 8"u>>i. E %>6i%#6 #4 "%r6% "#4 5i# #7r # >%7>7% >% 4>r 7#r%47#r4 "# 4 5i#r. Su#4# 8#r u 4i:i7>i # 4 =4#Fi 547r @ #

4 i?#r6i. O>urr# # >6% "# "#6#ui4i8ri%6 #ur%:u6>u4r >% "#8i4i"" %5r%6i;u# # =%r: 5r>i4, 4 >#r4% 56i?:#7#, @ u# 4%6 :K6>u4%6#F7#6%r#6 "#4 5i# #67%7r>7ur"%6 @ r#7r"%6. A4 =%r$r 4 #F7#6i 6# ?#4%6 7#"%#6, # #4 54i#;u# "#4 5i#, 7#6% @ 6%8r#64i#7#.

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Cal"á)#%7al*%

>" PIE E#UINOVARO &PIE $AMBO'

C%6i67# # u :4 4i#>i "#4 >%:54#9% >4>7>i "# 4%6 i%6 #4 "%84# #=r#>u#>i u# 46 i6, 6# 6%>i u >%:5%#7# ;#7i>%.

E4 5i# $:8% 5u#"# 6#r 5%67ur4 5i# %r:4 u# 6# :7#i"% # :45%6i>i i7rK7#r%, >%;i7% % 6%>i"% "i?#r66 47#r>i%#6 6u8@>#7#6>%:% #4 #i6:% "i67r=i>% % #4 6"r%:# "# (r##:-S#4"%. L r7r%;ri5%6i6,#4 6"r%:# "# 46 8ri"6 :i7i>6 @ #4 :i#4%:#i;%>#4# 6# 6%>i :u@=r#>u#7#:#7#,

E4 65#>7% >4i>%, #6 #4 6i;ui#7# C?% 4 547 "#4 5i #67< #F;#r":#7#>ur?, >>?, 4% u# 5r%?%> u# #4 #:5#i# 6# ?# 47%, A"u>7% #4 7#5i #"u>>i >% r#65#>7% "#4 r#7r%5i, Vr% 4 547 "#4 5i :ir >i "#7r%, #4

8%r"# i7#r% 6# ?# >i rri8 @ #4 #F7#r% >i 89%. Eui% #4 5i #67< #=4#Fi 547r @ 7i#"# 6#;uir 4 "ir#>>i "#4 #9# "# 4 5i#r. E4 8%r"# i7#r%"#4 5i# 6# #>u#7r ;u4"% >i :#"i4, 4 5u7 #67< "iri;i" >i "#7r% ##4 54% %ri$%74, #4 8%r"# #F7#r% #6 >%?#F%. &@ u 7%r6i i7#r "#4 #9# "#4 5i#r #4 :4%4% 5#r%#% #67< 5%r "#47# "#4 7i8i4, "# :%"% u# 7%"% #4 5i##67< "iri;i"% >i "#7r%.

2+


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Pi# #qui)%7ar% % (i# 3a&b%

" PIE PLANO

E4 5i# 54% 6# >r>7#ri$ 5%r u "i6:iu>i # #4 r>% 4%;i7u"i4 i7#r%, @ ?#>#6 6# >%:5 "# ?4;% "#4 74, 5%r 4% u# 7:8i 6# 4# >%%># >%:% 5i#54% ?4;%. S# 5r#6#7 # u 20J "# 4%6 "u47%6 @ # i%6 # u 5%r>#79#:@%r, # ui##6 6# 7r7 "# u >%"i>i =i6i%4;i> 67 4%6 7r#6 %6 "##"". L u6#>i "#4 r>% 4%;i7u"i4 i7#r% "#4 5i# # 4%6 7r#6 5ri:#r%6 %6 6#

"#8# 4 5r#6#>i "# ;r6 # 4 547 "#4 5i#, @ 4 4Fi7u" "# 4%6 4i;:#7%6,>r>7#r67i>%6 "# 4 5ri:#r i=>i. E4 r>% "#4 5i# 6# ># 5r#7# 4r#"#"%r "# 4%6 + %6 @ =i4i$ 6u "#6rr%44% >i 4%6 ! %6 "# #"".

S# r#>%%># 7r#6 7i5%6 "# 5i# 54% Pi# 54% ?4;% =4#Fi84#, r#5r#6#7 "%67#r>#r6 5r7#6 "# 4%6 >6%6 "# 5i# 54% @ 5%>6 ?#>#6 5r%"u># i>5>i"". Pi#54% ?4;% =4#Fi84# 6%>i"% >% r#7r>>i "#4 7#" "# Aui4#6, #4 >u4 5u#"#6%>ir6# >% "%4%r @ 6#6>i "# >6>i% "ur7# 4 :r>. Pi# 54% r;i"%,6# 5r%"u># 5%r 8rr6 u# u# 4%6 u#6%6 "#4 7r6%, % 67r4 >%;i7%@ >6i 6i#:5r# 5r%"u># 4i:i7>i%#6 =u>i%4#6.

2


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Pi# (la)%

2


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CAPITULO N° !: COLUMNA VERTEBRAL

1" ESPINA B?FIDA

L E65i 8=i" #6 u :4=%r:>i >%;i7 5r%5i "#4 7u8% #ur4 @ ui#r#"#>ir u 5r7i"ur # 4 #65i, % 6# u# 4 >%4u: ?#r7#8r4 % 6# >#rr"%>%:54#7:#7# @ #44% 6# "#8# =47 "# >i#rr# "# 4%6 r>%6 ?#r7#8r4#6 5%67#ri%r#6.L >u6 #F>7 "# 4 #65i 8=i" 6i;u# 6i#"% u :i67#ri%. L%6 #67u"i%6 "#i?#67i;>i i"i> u# 4 i;#67 i6u=i>i#7# "# i"% =4i>%, # 4 "i#7 "# 4:"r# #6 u =>7%r >4?# # 4 >u6 "# #65i 8=i" @ %7r%6 "#=#>7%6 "#4 7u8%#ur4. E67 %:4 =#>7 1 "# >" 1,300 r#>i >i"%6.

&@ 7r#6 7i5%6 "# #65i 8=i" ?r "# 4#?# 6#?#r% @ 6%

1.1. ESPINA B?FIDA OCULTA:

C%6i67# # u 5#r7ur # u % :%4u:?#r7#8r4, 6i i;K "% 5r#7# i "#654$:i#7% "# 46 :#i;#6 i "# 4:"u4 #65i4. Su i>i"#>i #6 "#4 1J. E 4 5i#4 5u#"# 8#r u 8u47%;r6% u 4i5%:, u :> r%9i$ ;i%:, u $% "# 5#4%6 %r:4#64r;%6 i5#r7ri>%6i6, % 8i# u %ri=i>i% >u7%6 @%r7%5"i>%6.

2


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Zona de hipertricosis y orificio cutáneo

Presencia de lipoma y hemangioma

Presencia de lipoma

1.2. MENINGOCELE:

E "%"# 46 :#i;#6 5r%7rui"% 7r?6 "# u 5#r7ur # 46?r7#8r6, # u 6>% 44:"% #4 :#i;%>#4#.Q L6 :#i;#6 6%8r#64# "#

4 5#r7ur #65i4, @ 4 :4=%r:>i 5u#"# % % #67r >u8i#r7 5%r u >5"# 5i#4. S# >r>7#ri$ 5%r 4 5r#6#>i "# :6 u67i> @ =4u>7u7#. Sui>i"#>i #6 "# 10 000 r#>i >i"%6.

2!


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Meningocele

1.3. MYELOMENINGOCELE:

E6 4 =%r: :u4 46 :#i;#6 @ u5%r>i "# 4 :"u4 #65i4 5r%7rui"% 7r?6 "# u "#=#>7% "# 4>%4u: ?#r7#8r4 @ 6%8r#64# 7r?6 "# 4 #654". E 4;u%6 >6%6, 4%66>%6 #67u8i#r7%6 "# 5i#4H # %7r%6, 4%6 7#9i"%6 @ #r?i%6 #67r>7#ri$ 5%r 4 5r#6#>i "# :6 u67i> @ =4u>7u7# @ 7i## :@%r >%:5r%:i6% #ur%4;i>% u# #4 :#i;%>#4# @ 46 :i=#67>i%#6 >u7i >i"%6.

Mielomeningocele

2" ESCOLISIS:

L #6>%4i%6i6 escoliosios, 7%r>i"%Q #6 u "#=%r:i"" "# 4 >%4u: ?#r7#8r4 u#6# >r>7#ri$ 5%r 4 #Fi67#>i "# u % ?ri6 >ur?7ur6 47#r4#6 #6 "#>ir # #454% =r%74 % >%r%4. L >ur?7ur 5u#"# 7##r =%r: "# SQ % CQ. Pr>74%;r4% >%:% #6>%4i%6i6 4 >ur?7ur 47#r4 "#8# 6#r :@%r "# 10 ;r"%6. Sui>i"#>i #6 "# 2J-+J "# 4 5%84>i.

L6 5#r6%6 5u#"# 7##r #6>%4i%6i6 >u4ui#r #"". E4 7i5% :%:K #6 4#6>%4i%6i6 i"i%5, #7r# 4%6 i%6 "# 10 12 %6 @ 4 ii>i% "# 4 "%4#6>#>i.E6 #67 #"" u# 4%6 i%6 >r#># >% r5i"#$. L6 i6 7i## u :@%r 5r#"i65%6i>i #67# 7i5% "# #6>%4i%6i6 u# 4%6 ?r%#6. U #=#r:#"" u# 6#6%>i >% #6>%4i%6i6 #6 4 7Fi "# (ri#"r#i>.

2


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Escoliosis de una curvatura y escoliosis de doble curvatura

aso severo de escoliosis en la !ta"ia de #riedrieich

• T09* /0 @0(-. /0 *., *09* /0 A/+)9: S# r#4i$ >% #4 5>i#7# "#

#654"6, i?i7u7i=i>r4%, i"i>"% 4?r7#8r, #4 4"% u# #67< :


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$est de !dams

$est de !dams normal y $est de !dams positivo en donde se observa la giba dorsal

!" CIFOSIS Y LORDOSIS

E67i=%6i6 "#%:i" 6%4:#7# >%:% >i=%6i6, i5#r4%r"%6i6 % 64% 4%r"%6i6 @,6%8r# 7%"%, 4 6%>i>i "# :86 4 ?#$ >i=%4%r"%6i6. L 5r#?4#>i #>%9u7% #6 Y10J "# 4 #"" #6>%4r. L6 >u66 5u#"# 6#r :4 5%67ur,"#8i4i"" :u6>u4r # i>4u6% 6u#4# 7##r u >%:5%#7# #r#"i7ri%.

• C(@9(9: i>r#:#7% "# 4 >ur?7ur ru"# "# 4 >%?#Fi"" 5%67#ri%r "#4

rui6 "%r64, % 5ri>i "# u >ur?7ur "# >%?#Fi"" 5%67#ri%r # 4 r#;i4u:8r % >#r?i>4. EFi67# "i67i7%6 7i5%6 "# >i=%6i6 u# 5u#"# =#>7r 4%6i%6 @ >" u 7i## 6u6 5r%5i6 >u66

o Ci=%6i6 5%67ur4 #6 #4 7i5% :%:KH @ 7i## 4u;r "#8i"% u :4

5%67ur % 5%67ur #>%r?" @ # 46 :u9#r#6 i=4u@# 4 7#4ru.G##r4:#7# 6# ># #?i"#7# "ur7# 4 "%4#6>#>i 6i#"% :%:K # #4 6#F% =#:#i% @ # i%6 47%6 5r 6u #"".

o Ci=%6i6 >%;i7 4 "#=%r:i"" %>urr# # 4 #75 5r#74. Pu#"#

%>urrir u# ?ri6 ?r7#8r6 6# =u6i%# % u# 4%6 u#6%6 6# =%r:#i>%rr#>7:#7#. E4 >r#>i:i#7% 5u#"# ;r?r 4 >i=%6i6.

31


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o E=#r:#"" "# S>#u#r:, 6u#4# 5r#>#r "ur7# 4 6#;u"

">" "# 4 ?i". E #44 46 ?r7#8r6 "%57 u =%r: "# >u #?#$ "# =%r: r#>7;u4r. E6 u 5%>% :%:K # #4 6#F% :6>u4i%.N% 6# >%%># 4 >u6 5#r% @ u >%:5%#7# #r#"i7ri%. Sui>i"#>i #6 "# !J "# 4 5%84>i.

ifosis postural y cifosis cong%nita

Enfermedad de &cheuermann

• L/9(9: i>r#:#7% "# 4 >ur?7ur ru"# "# 4 >%>?i"" 5%67#ri%r "#4

rui6 4u:8r, % 5ri>i "# u >ur?7ur "# >%>?i"" 5%67#ri%r # 4r#;i "%r64. Pu#"# 8#r u i5#r4%r"%6i6 =i6i%4;i> # 4# 5r# #6>%4r.

32


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Lordosis

•

C(@/9(9: i>r#:#7% "# 46 >ur?7ur6 "%r64 @ 4u:8r 6i:u47


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BIBLIOGRAFIA

1. A4?r#$ C., #7 4. 2000. T>i> uirKr;i> 5r 4 >%rr#>>i "# 4 :% $:8>%;i7. R#? Cu8 Or7%5 Tru:7%4 2000H 1+1-2 2 !.

2. A"r6 A4#9"r% D%;4i%77i. C%>#57%6 >7u4#6 # 4 5ri#4%.%r;.r5"=5?10+?10+11.5"=

3. Brr#" P#"r%. D%r6% Cur?% % >i=%6i6. Ar7>u4% # I7#r#7[ Di65%i84# #775.5#"i7r4"i.>4>i=%6i6.7:[

+. C


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13. 4i#;: R%8#r7 M., B#r: Ri>r" E., ^#6% &4 B., S77% B%i7 (.200. N#46% Tr7"% "# P#"i7r. 1!? #"i>i. Br>#4%, E65.ELSEVIER. 2!2 2!2 55.

1+. M#$ E., #7 4. 2012. S"r%:# "# #>7r%">7i4i, "i6546i #>7%"r:i> @ =i6ur

"# 48i%54"r, i=%r:# "# u >6% >% #F5r#6i?i"" ?ri84#. Ar> Ar;#7P#"i7rH 110 # #!.

1. M%r%?i> I.200. Ciru; "# :% # 5#"i7r. R#? Ci4 P#"i7rH 1 ! 0.

1. N7i%4 I=%r:7i% C#7#r =%r &"i>55#" Ci4"r# " *%u7. NIC&C*. LE65i B=i". (#8r#r% "# 2010. 3 55. Ar7>u4% # i7#r#7[ Di65%i84# #775i>>@.%r;5->%7#7u54%"6"%>665i6=61265.5"=[

1. N7i%4 i67i7u7# %= #ur%4%;i>4 "i6%r"#r6 " 67r%# NINDS. E65i B=i".Di>i#:8r# 200. Ar7>u4% # i7#r#7[ Di65%i84# #

775#65%4.i"6.i.;%?7r67%r%6#65i_8i=i".7:[

1!. N$#r rr#r ^.M4=%r:>i%#6 C%;i76 "# 4%6 5i#6. E"i7%ri4 Ui?#r6i7ri.E"i>i 1. 200. P.S#F7 E"i>i. 200. P# A48#r7 E., &%88i6 ^% C. 200. O867#7ri>i C4ii>. 3r #"i>i.Bu#%6 Air#6, Ar;#7i. E"i7%ri4 M"i> P:#ri>. ++0 + 55.

21. S4;"% R., #7 4. 2012. E>7r%">7i4i I=%r:# "# >6% >4i>% @ r#?i6i "# 44i7#r7ur. A M#" M#FH 2 13 1 55.

22. S%>i#"" E65%4 "# Ciru; Or7%5"i> @ Tru:7%4%; Mu4 "# Ciru;Or7%5"i> @ Tru:7%4%;. M4=%r:>i%#6 C%;i76 "#4 Mi#:8r% Su5#ri%r .E"i7%ri4 M"i> P:#ri>. V%4u:# 2. 2" E"i>i. C57u4% !. P @ ;#7i>. B%;%7

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