Craniofacial morphology in complete unilateral cleft lip and palate patients consecutively treated with 1-stage repair of the cleft.

OBJECTIVE: To retrospectively evaluate the craniofacial morphology of children with a complete unilateral cleft lip and palate treated with a 1-stage simultaneous cleft repair performed in the first year of life. METHODS: Cephalograms and extraoral profile photographs of 61 consecutively treated patients (42 boys, 19 girls) who had been operated on at 9.2 (SD, 2.0) months by a single experienced surgeon were analyzed at 11.4 (SD, 1.5) years. The noncleft control group comprised 81 children (43 boys and 38 girls) of the same ethnicity at the age of 10.4 (SD, 0.5) years. RESULTS: In children with cleft, the maxilla and mandible were retrusive; the palatal and mandibular planes were more open, and sagittal maxillomandibular relationship was less favorable in comparison to noncleft control subjects. Soft tissues in patients with cleft reflected retrusive morphology of hard tissues--subnasal and supramental regions were less convex, profile was flatter, and nasolabial angle was more acute relative to those of the control subjects. CONCLUSIONS: Craniofacial morphology after 1-stage repair was deviated in comparison with noncleft control subjects. However, the degree of deviation was comparable with that found after treatment with alternative surgical protocols.

[Preconceptional cigarette smoking and other risk factors for giving birth to a child with orofacial cleft]. / Palenie tytoniu przez matkie przed zajsciem w ciaze i wystepowanie innych czynników ryzyka urodzenia dziecka zrozszczepem twarzoczaszki.

Evidence suggests an association between orofacial clefts and maternal smoking, common cold, and stressful life events. 247 mothers of children with an orofacial cleft completed a self-administered survey with questions concerning obstetric history. Of these, 29.6% were smokers in pre-conceptional period. 6.3%, 5.2% and 25.2% of participants reported working exposure to solvents, stressful life events, and common cold in the early pregnancy, respectively. Differences were seen between smokers and non-smokers for preconceptional folic acid supplementation (5.6% vs. 19.9%), multivitamin use (2.8% vs. 6.4%), pre-conceptional health care utilization (15.3% vs. 30.4%), and late enrollment for prenatal care (> 12 weeks of gestation; 6.2% vs. 1.9%). Improved lifestyles of women of childbearing age is required.

Nucleotide variants of the cancer predisposing gene CDH1 and the risk of non-syndromic cleft lip with or without cleft palate.

The CDH1 gene plays an important role during carcinogenesis and craniofacial morphogenesis. Germline mutations in this gene have been described in families presenting syndromic diffuse gastric cancer and orofacial clefts. The aim of this study was to evaluate the association between nucleotide variants of CDH1 and the risk of non-syndromic cleft lip with or without cleft palate (NSCL/P). Six single nucleotide polymorphisms (SNPs) of the CDH1 gene (rs16260, rs9929218, rs7186053, rs4783573, rs16958383, and rs1801552) were genotyped using the TaqMan SNP genotyping assays in 250 patients with NSCL/P and 540 controls from the Polish population. Comparison between patient and control groups showed that the CDH1 rs1801552 variant, under the assumption of recessive model, was associated with a two-fold decrease in the risk of NSCL/P (ORTT vs CT + CC = 0.481, 95 % CI 0.281-0.824, p = 0.007). This association remained statistically significant even after the multiple testing correction. No significant associations with NSCL/P risk were found for the other five tested SNPs. We found a strong association between the cancer predisposing gene CDH1 and the risk of NSCL/P in the Polish population. This result, together with previous observations of co-occurrence of orofacial clefts and a variety of cancer types, suggests the need for replication studies testing rs1801552 in NSCL/P cohorts with a known cancer history.

Lack of association of polymorphic variants of genes encoding zinc transporters with the risk of orofacial cleft-affected pregnancies.

Maternal zinc deficiency seems to be a risk factor for orofacial clefts in offspring. This study was undertaken to investigate the involvement of polymorphic variants of genes for zinc transporters in the susceptibility of clefting. PCRRFLP analysis was used to analyze single nucleotide polymorphisms of SLC30A1 (rs7526700, rs2278651, rs611386), SLC30A4 (rs2453531, rs8029246), SLC30A5 (rs351444, rs164393, rs6886492), SLC39A1 (rs10127484, rs11264736), and SLC39A3 (rs759071, rs4806874, rs10415622) in mothers of children with non-syndromic cleft lip with or without cleft palate (CL/P) and control mothers. The allele, genotype, and haplotype distribution was found to be similar among case and control mothers. Also, the gene-by-gene interaction analysis conducted using the Multifactor Dimensionality Reduction approach revealed no significant interactive genetic effect on having a child with a cleft. In conclusion, our results demonstrated that the analyzed polymorphic variants of genes for zinc transporters are not implicated in abnormal palatogenesis in the investigated group of women from the Polish population.

[Risk factors of surgical site infection in newborn infants]. / Czynniki ryzyka zakazenia pooperacyjnego u noworodków.

AIM OF THE STUDY: Was to estimate the risk factors for surgical site infections (SSJ) in the newborn infants. MATERIALS AND METHODS: We retrospectively analyzed medical records of 381 operated newborn infants in order to estimate the rate of SSI and risk factors. All types of operations were divided according to contamination of surgical wound /CDC classification: clean, clean-contaminated, contaminated and dirty infected/. Additionally we evaluated risk factors such as: birth weight, gestational age, congenital infection, additional surgery, other congenital defect and invasive procedures like: mechanical ventilation and presence of central venous line. Descriptive statistics and odds ratios with 95% confidence intervals were applied in univariate statistical analysis. RESULTS: The mean incidence of SSI was 37%. According to CDC classification SSI rate were 27%, 35%, 46%, 71% respectively. The most important risk factors of SSI were: mechanical ventilation (IS:10.80), central line (IS:8.20), birth weight below 1500 g (IS:5.03) and congenital infection (IS:4.74). The risk of SSI depended on the type of surgery. The incidence of infections was significantly higher for contaminated and dirty-infected wounds than for clean and clean-contaminated. Risk factors for SSI were similar for clean and clean-contaminated wounds as for all study group. CONCLUSIONS: The premature newborns who underwent surgery, were mechanically ventilated, with venous access had the highest risk of SSI. The significance of risk factors was the same for the total study group for every type of surgery wound.