Carpal tunnel syndrome - Wikipedia
A description of tropes appearing in Meet the Robinsons. Disney's 47th animated feature, Tiny: "I have a big head and little arms! I'm just not sure how well this. Poor kitty has T-rex syndrome. I have a big head and little arms im not sure how well this plan was .. T rex from Meet The Robinsons lol. Prader-Willi syndrome (PWS) is characterized by severe hypotonia and feeding difficulties Short stature is common (if not treated with growth hormone); height, increase lean body mass and mobility, and decrease fat mass. diagnostic criteria met in individuals in whom the diagnosis of PWS has been.
Dose recommendations in young children are generally similar to those for individuals with isolated growth hormone deficiency i. Therapy can be started in infancy or at the time of diagnosis. Monitoring of growth velocity, head circumference, and serum IGF-1 is important to avoid overtreatment. Controlled trials of growth hormone therapies have demonstrated significant benefit from infancy through adulthood [ Carrel et alSode-Carlsen et alWolfgram et al ].
A review of the results of one to two years of growth hormone treatment among children documented in the database of one pharmaceutical company indicated improved height velocity, particularly in prepubertal children, but no change in BMI [ Craig et al ].
Significantly greater adult height was demonstrated in 21 individuals treated long term versus 39 untreated individuals without an increase in adverse side effects [ Angulo et al ]. Although there was initial concern about growth hormone treatment contributing to scoliosis in PWS, later studies showed no difference in frequency or severity in those treated compared to those who were not treated [ Nagai et alAngulo et al ]. Decreased saliva production can be addressed with products developed for the treatment of dry mouth, including special toothpastes, gels, mouthwash, and gum.
Therapies, education and behavior management. Early intervention in children before age three years, particularly physical therapy, may improve muscle strength and encourage achievement of developmental milestones. In older individuals, daily muscle training increases physical activity and lean body mass [ Schlumpf et al ]. Initiate appropriate educational programming in children: Begin speech therapy for language delay and articulation abnormalities in infancy and childhood.
Special education, either in an inclusion setting or in a self-contained classroom setting, is usually necessary during school age. An individual aide is helpful in assuring attendance to task. Social skills training groups have been beneficial. Behavioral disturbance should be addressed with behavioral management programs, including firm limit setting.
Psychosis is reported to respond well to selective serotonin reuptake inhibitors, but not to mood stabilizers [ Soni et al ]. Cryptorchidism may resolve spontaneously, even up to adolescence, but usually requires hormonal and surgical approaches; however, preservation of fertility is not an issue. Standard treatment is appropriate. Replacement of sex hormones produces adequate secondary sexual characteristics but is somewhat controversial because of the possible role of testosterone replacement in behavior problems in males and the role of estrogen replacement in the risk of stroke as well as hygiene concerns related to menstruation in females.
Daily use of the testosterone patch or gel may avert exacerbation of behavioral problems by providing a more even blood level than use of a slow-release depo-testosterone injection every month. Also, it was shown in the non-PWS adult population that depo- testosterone injections were associated with a greater risk of cardiovascular events, hospitalizations, and deaths compared with gels and patches [ Layton et al ].
Concern about osteoporosis should be considered in deciding about hormone replacement. Disturbed sleep in children and adults should prompt a sleep study, as treatment may be available. Excessive daytime sleepiness unrelated to the degree of sleep apnea is frequently seen in individuals with PWS. Modafinil has been shown to be a safe and effective treatment for this condition [ De Cock et al ].
One study demonstrated decreased skin picking with topiramate treatment in some individuals [ Shapira et al ]; other clinicians have reported anecdotally that approximately half of individuals with PWS who skin pick benefit from low-dose mg daily topiramate.
Other Management of strabismus is as for any infant. Management of scoliosis, hip dysplasia, and complications of obesity is as in the general population. For adults with PWS, the most successful living situation for behavior and weight management is a group home specially designated for individuals with PWS, where diet and access to food are tightly restricted and exercise is included in daily activities.
Affected individuals generally require a sheltered employment environment. Issues of guardianship, wills, trusts, and advocacy should be investigated no later than adolescence. Prevention of Primary Manifestations Obesity may be prevented if the diet, exercise, and supervision program described in Treatment of Manifestations is instituted. Early diagnosis allows the clinician to begin anticipatory guidance concerning the natural history of PWS, and in particular the nutritional phases, informing the family about the risk of obesity and the need to monitor weight increase and to restrict calories beginning around months of age.
If started at a young age, growth hormone treatment, along with good dietary control, may retard obesity and the high proportion of fat mass. It may also prevent development of the typical facial appearance and improve motor milestones. Prevention of Secondary Complications Diabetes mellitus rarely occurs in the absence of obesity. Calcium and vitamin D supplementation are probably beneficial, as low-calorie diets are often low in dairy products and osteoporosis has been documented in the majority of older children and adults with PWS.
If osteoporosis develops, consider treatment with a bisphosphonate. Although no formal study exists, individuals with PWS tend to be very sensitive to medications of all kinds. Starting with lower doses is recommended. Every month in infancy; Every six months in the first decade of life; At least annually thereafter. Cryptorchidism can recur after orchidopexy; therefore, testicular position should be monitored. Evaluate for the presence of diabetes mellitus by standard methods e.
Test annually for hypothyroidism, including free T4 and TSH levels. Obtain history of any sleep disturbance; if present, obtain a sleep study. Monitor for development of scoliosis clinically or, in the presence of obesity, radiographically at least annually.
Perform bone densitometry by DEXA to evaluate for possible osteoporosis every two years in adulthood. Obtain history for behavioral and psychiatric disturbance at least annually. Evaluation of Relatives at Risk See Genetic Counseling for issues related to testing of at-risk relatives for genetic counseling purposes.
Therapies Under Investigation In the last few years there has been great interest by the pharmaceutical industry in testing treatments for the major manifestations of PWS — particularly the hyperphagia, obesity, and behavioral problems. For a detailed description of these studies, click here pdf. Genetic Counseling Genetic counseling is the process of providing individuals and families with information on the nature, inheritance, and implications of genetic disorders to help them make informed medical and personal decisions.
The following section deals with genetic risk assessment and the use of family history and genetic testing to clarify genetic status for family members. This section is not meant to address all personal, cultural, or ethical issues that individuals may face or to substitute for consultation with a genetics professional.
Risk to Family Members Parents of a proband The parents of the proband are unaffected. Recommendations for genetic testing of the parents depend on the genetic mechanism of PWS in the proband see Sibs of a proband and Table 3.
Germline mosaicism in the father is rare but has been observed in cases of 15q Lewis is down after another family refused to adopt him and believes that his own mother didn't want him.
Mildredthe director of the orphanage, tries to cheer him up by telling him that maybe his mother did want him but had no choice other than to give him up.
However, Lewis takes this in the meaning that definetly wanted him and decides that his only hope of a happy family is to track her down. In the Bad Futurewhen Bowler Hat Guy is horrified by what Doris has done, he calls her out on it but is swarmed by a cloud of hat-drones and pulled down out of view.
Then another one appears onscreen, with her very sharp claws at the ready, and that's all we get to see. The director's commentary states that jealousy of Cornelius Robinson is Bowler Hat Guy's entire motivation for his villainy. Lewis manages to find a family in the end. As the movie shows, he grows to love every weird bit of it. Goob looks well on his way to this after Lewis wakes him up in time to catch the fly ball and win the game for the Dinos. Until he meets Doris, and even then he is hopelessly incompetent at being evil.
Just after the whole Time Travel adventure has succeeded in setting right what once went wrong, Cornelius Robinson, Lewis' future self, arrives home just in time to see the time machines missing and Lewis standing with the rest of the family. Well, he's home early. Because you can totally crack the hippocampus with a TV screen, a fan, a vacuum cleaner, a bottle of Mountain Dew and a Discman.
Oh, and really comfy headphones. Parodied during a food fight between Franny and her brother, where they talk like characters in a badly dubbed Martial Arts Movie and their lip movements don't match what they're saying. The truth is a lot more sinister: Uh, what do you hope to accomplish with this? Oh, nothing of consequence, I simply wish to Uh, after that, it's You mean you haven't thought this through? Frankie the Frog, B. Now, my slave, seize the boy!
i've got this big head and these little arms! : pics
Bring him to me. Did you not hear what I said, you idiot? Grab the boy and bring him! Well, it's just that there's a million people over there, and I have little arms.
I'm just not so sure how well this plan was thought through Now, go get that boy! Why aren't you seizing the boy? I have a big head Ugh, stupid, stupid, stupid! It Runs in the Family: And it runs in about four different actual families. Averted with Goob, whose evolution into a villain is only due to his constant dwelling on a painful event and subsequent refusal to keep doing what he loves, implied to be baseball. Played somewhat straight with the gym teacher, but even he acknowledges Lewis' achievement in the end.
Played straight when Goob loses the game by missing his catch and his teammates beat him up, calling him names. Later averted by older Goob's schoolmates, who are nice to him and invite him to "hang out". Unfortunately, by that time, he has spent so much time pitying himself that he's become too bitter to notice when people are genuinely nice to him.
It's implied that Bowler Hat Guy will be Ret Gone from existence when he saves his younger self from dropping the baseball and thus turning evil. The way he leaves Wilbur without saying goodbye implies that he knows this and doesn't want to make a fuss about it.
Disorders caused by chromosome abnormalities
While "Keep Moving Forward" is clearly the moral here, it's not exactly clear if that's always a good idea. Bowler Hat Guy does this after he offers to take Lewis back to find his mom if he repairs the Memory Scanner.
Bowler Hat Guy's entire motivation for his time-traveling villainy is to ruin Lewis' life and his future as genius inventor Cornelius Robinson.
At one point, the city skyline of is match-cut to a city skyline prior to the Bowler Hat Guy's attempt to present the Memory Scanner at the InventCo offices. Discussed, where Carl, before sending Lewis back in time, asks him to invent him with a more muscular design.
And it actually comes through. As mentioned above, the writers' time travel logic makes no sense when you think about it. It'd work out a lot better if the Dinosaur didn't show up again when the family said goodbye to Lewis.
The very first scene has Lewis as an infant being left at Mildred's orphanage by his mother. Towards the end of the film, the sunny, idealistic Utopian society transforms suddenly into a bleak, polluted world controlled by evil hats. From optimistic future to zombie apocalypse in five minutes and then back again, and not all at once either -- in a sweeping movement.
Lewis meets up with his future self toward the end of the movie. Named by the Adaptation: In the book, the protagonist was unnamed. Well, it's a long and pitiful story, about a young boy with a dream, a dream of winning a Little League championship If I hadn't fallen asleep, I would have caught the ball, and we would have won!
It was then that I realized it wasn't my fault Never Trust a Trailer: This trailer made it seem like the film is about two intelligent inventors trying to create the greatest invention ever. Nice Job Breaking It, Hero! Wilbur forgets to close the garage door, and allows Bowler Hat Guy to steal one of the time machines: Wilbur, make sure you shut that door tight, or else the alarm won't engage. I went to your house, snuck in the garage, and stole the time machine.
All thanks to that pointy-haired little kid who forgot to lock the garage door. Even Carl, the robot butler, makes reference to this incident earlier in the film: What do you mean don't go to the family? How can we not go to the family is this type of family crisis? By leaving the garage door unlocked, you let the time machine get stolen and now the entire time stream could be altered!
No Celebrities Were Harmed: When Doris pulls herself down over the eyes of one of the Robinson Industries lab assistants, his face resembles Stan Laurel's. No New Fashions in the Future: We have flying cars and robot buddies and bubblevators, but all the cool kids wear T-shirts, jeans and Converse All-Stars.
Well, a few of the characters do wear Jetsons-like jumpsuits. Cousin Tallulah is a fashion designer, which explains her skyscraper hat. Nobody Here but Us Birds Lewis: Will you quit that, please? I know you're not a pigeon! Not once but three times, when Wilbur is asked a question, he replies with "That is an excellent question! On a fourth occasion he actually follows it up with an answer. Obsessed Are the Listmakers: Bowler Hat Guy loves checklists and is often seen ticking off items in his, such as "Steal time machine", "Ruin science fair", and "Get that [comic book swearing symbols] boy".
Only Known by Their Nickname: A lot of minor characters have similar character models and even a few main character models are reused with Art's appearing in Midtown University and Franny's model also serving as Lewis' mother.
Lewis props the tyrannosaur's jaws open with a shovel. It is kinda strange that his future wife almost adopted him. When she realized the truth she became pretty squicked out about it herself too. Pick Your Human Half: I think we all know what side Carl and the super-intelligent DOR are on. One of the more surprising ones of the last decade — Bowler Hat Guy is really Mike Yagoobian, the somewhat nice, low energy, short, slightly chubby kid Lewis shared a room with at the orphanage.
Bowler Hat Guy since he never let one childhood trauma go and thus kept a child-like mentality. Red Eyes, Take Warning: The first time she controlled a human, Doris' eye went from green to red.
Bizarrely, an in-universe example. Near the end, Lewis is about to be attacked by the evil robot hat Doris — who was angry at being locked up as a failed invention after she turned out to be renegade. Suddenly, Lewis glares at Doris and says, "I am never going to invent you. That's right, weaponized Retcon. Wilbur is also temporarily Ret Goned. It's implied that this will happen to Bowler Hat Guy, as by stopping his younger self from dropping the fateful baseball, the evil version of himself will be erased from existence.
There are Insta-Buildings in the future, skyscrapers that go from ground level to completion in literally a few seconds. Ridiculously Successful Future Self: Founder of the future, inventor extraordinaire Cornelius Robinson Wilbur's father Cornelius Robinson is a brilliant inventor and industrialist who practically built the entire Utopian world of the future single-handedly. Both the singing frog and T. The Pooh mention is pretty Hilarious in Hindsightas the directors of this went on to do the Pooh film.
Goob's baseball team is called the Dinos, a Shout-Out to William Joyce's book Dinosaur Bob, which is about a dinosaur who plays baseball.
In the ballpark where Goob's game is being held, there is a poster of Disney's "The Jungle Book" in the background. Art reminisces about an adventure to "the black moon of Qward". Apparently all you need to calm down Sinestro is some good meatball pizza.
When Bowler Hat Guy uses the time machine to fetch a dinosaur, it's a Tyrannosaurus rex. The Story That Never Was: Lewis Robinson discovers the far future is an ugly dystopia where humanity is a Slave Race to mechanized overlords.
Strange Minds Think Alike: Happens to Bowler Hat Guy. If the CEO of a large company, a talking frog, and a T-Rex all ask you if your plan was well thought outmaybe you need to improve on your villain skills.
Bowler Hat Guy doesn't shower, doesn't even bother to think his evil plans through, and initially couldn't think of any way of revenge more effective than throwing eggs and toilet paper at the Robinson Industries sign. One of the "to do" items on Bowler Hat Guy's list is literally "Get that [grawlixes] boy".
Look at that, boys! We're almost home fr— harpoon through the chest Time Machine: There are two fully functional time machines in the whole of the film. Specifically, the Time Continuum Task Force. It's probably best not to even start on this one, not the least of which is the main character apparently has Ripple Effect-Proof Memoryand is generally ripple effect proof entirely. Could be justified in that he built it, and could have included fail-safes to ensure that he could restore the natural order if his machines got in the wrong hands.
Little Doris' last sight before being rubbed out by the frogs. Ugly Guy, Hot Wife: Morbidly obese Joe and Billie. It isn't until the start of the third act that Lewis discovers that Wilbur Robinson will be his son. When Bowler Hat Guy is recounting his backstory. Two in quick succession in the scene where the Bowler Hat Guy kidnaps Lewis: I think you mean our old room. What Happened to the Mouse? The second time machine seems to have been left in the present day.
Nobody brings it up again, even after Cornelius notices that the time machines are missing from the garage. After the plot is sorted out and Lewis convinces Wilbur to take in an emotionally drained Bowler Hat Guy in the good future, Goob decides to refuse their offer out of shame and wanders off.
He leaves behind only his diary where his revenge schemes are crossed out and now replaced with a question mark, showing that now that his lifelong goals have been rendered null, he becomes lost and confused, sulks off, and that's the last we see of him his adult self, anyway.
Although, given that Lewis undoes his Start of Darkness soon after this in the present time, it's implied that he won't be sulking for long.
What Measure Is a Non-Human? Carl's death would be cause for an R-rating if he had been a human! It's small and easy to miss, but Lizzy can be seen smiling evilly as she watches the chaos that ensues when Lewis' invention malfunctions.
You Have Outlived Your Usefulness: In the alternate future created by Doris, Lewis views a video of how it got to be that way. Luckily Lewis reverses everything, so that never gets a chance to happen. Lampshaded by Lewis, who tells Goob that the minute Doris gets what she wants, she'll "get rid of him". Zeerust - Very fifties. Just look at the poster. Tropes used in the game include: Unlike the movie, they play a huge role in the game as one of the villains. Lizzy's giant ant robots serve as one of your primary enemies.
The "touch the lava and die" rule applies and only bursts from highly visible steam vents will kill you as well.
Disorders caused by chromosome abnormalities
Prometheus, whose destruction ends up threatening the whole city. Especially after you get the invincibility and unlimited ammo cheats. Lizzy's ants and Stanley's hoplites, as well as the basement security robots. Sets the game's main plot into motion. Like in the movie, Wilbur leaves the garage door open, allowing Bowler hat guy to steal the time machine. The plot of the game is set before the events of the film, as it shows Wilbur's adventures before he met Lewis in the past.
Near the end of the game, the future changes to Doris's apocalyptic world. This however, raises some confusing questions, such as the fact Wilbur and Carl still exists despite Lewis never marrying and never becoming an inventor.
There also the fact that Doris somehow created enough hats to enslave the world, even though this is a prequel to the film, meaning she and Bowler hat guy didn't successfully sell the memory scanner yet.