Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.561
Filtrar
1.
Niger J Clin Pract ; 23(1): 59-64, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929208

RESUMO

Background: Clefts are common birth defects, usually accompanied by various malformations that include malocclusions, and may be associated with tooth decay. The aim of this study was to assess the malocclusion and caries status of the patients with unrepaired clefts who presented at the National Orthopaedic Hospital Enugu. Subjects and Methods: A cross-sectional, descriptive study was conducted among patients with unrepaired cleft lip and/or palate that presented at the National Orthopaedic Hospital, Enugu between January 2009 and December 2011. Detailed records of 140 patients with cleft deformities who presented to the hospital within the study period were analyzed for the cleft pattern, whereas those patients above 6 years of age (52 patients) were analyzed for malocclusion using the Angle's classification of malocclusion. Assessment for dental caries according to WHO guidelines was made for all the patients. Result: There were 74 males and 66 females. Cleft lip with or without alveolus involvement had equal prevalence (47.1%) (66 patients) with combined cleft lip and palate; eight patients had isolated cleft palate (4.71%). Angle's class 1 malocclusion was statistically significantly higher than other classes (P = 0.000). Class I malocclusion was seen in 38 patients (73.1%), whereas class 111 was seen in 8 patients (15.4%) and class 11 in 6 patients (11.5%). Eight patients (100%) who developed class 111 malocclusion all had a hard palatal defect. Proclining of maxillary anterior teeth (increased overjet) was the most common orthodontic anomalies, reported in 25 patients (48.1%) (P = 0.002). Caries prevalence of 12.9% was observed in this study. Caries experience was statistically significantly higher in deciduous than permanent teeth (P = 0.002). Conclusion: The high prevalence of malocclusion in these cleft patients emphasizes the need for an interdisciplinary team approach and early inclusion of dental care especially oral hygiene to prevent tooth decays.


Assuntos
Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Cárie Dentária/epidemiologia , Má Oclusão/epidemiologia , Adolescente , Criança , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Estudos Transversais , Dentição Permanente , Feminino , Humanos , Masculino , Má Oclusão/etiologia , Má Oclusão de Angle Classe II , Nigéria/epidemiologia , Prevalência
2.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 947-956, Sept.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1057128

RESUMO

Abstract Objectives: to analyze the trend and the associated factors with the presence of cleft lip and/or cleft palate in Brazilian newborns, in order to verify possible associations with maternal care and newborn factors. Methods: a cross-sectional and ecological study, involving all live births in Brazil, recorded in the Information System on Live Births from 2005 to 2016. Maternal and infant information were evaluated using trend analysis and odds ratio, with a 95% confidence interval. The analyses were performed using SPSS software. Results: we analyzed 17,800 live births with presence of cleft lip and/or cleft palate. The Brazilian prevalence rate was 0.51 / 1000 live births, with South and Southeast Regions registering higher rates than the national rate. There was an association with maternal age above 35 years old, with no partner, less than seven prenatal consultations, premature birth and cesarean section. About the factors of the newborn, being male, Apgar less than seven in the 1st and 5th minutes of life, low birth weight and white color were associated. Conclusions: Brazil has an increasing tendency for cleft lip and/or cleft palate (p=0.019), reinforcing the need to strengthen health care networks, providing adequate support for newborn with cleft lip and/or cleft palate and their families.


Resumo Objetivos: analisar a tendência e os fatores associados à presença de fissura labial e/ou fenda palatina em recém-nascidos brasileiros, a fim de verificar possíveis associações da mesma com fatores maternos, assistenciais e do recém-nascido. Métodos: estudo transversal, ecológico, envolvendo todos os nascimentos vivos do Brasil, registrados no Sistema de Informação sobre Nascidos Vivos de 2005 a 2016. Foram avaliadas informações maternas e infantis, utilizando-se análise de tendência e razão de chances, com intervalo de confiança de 95%. As análises foram realizadas através do software SPSS. Resultados: foram analisados 17.800 nascidos vivos com presença de fissura labial e/ou fenda palatina. A taxa de prevalência brasileira foi de 0,51/1000 nascidos vivos, sendo que as Regiões Sul e Sudeste registraram taxas maiores do que a nacional. Houve associação com idade materna superior a 35 anos, sem companheiro, menos de sete consultas de pré-natal, nascimento prematuro e cesariana. Sobre os fatores do recém-nascido, o sexo masculino, Apgar menor que sete no 1º e 5º minutos de vida, baixo peso ao nascer e raça/cor branca apresentaram associação. Conclusões: o Brasil apresenta tendência crescente das taxas de fissura labial e/ou fenda palatina (p=0,019), reforçando a necessidade de fortalecimento das redes de atenção à saúde, prevendo o amparo adequado aos bebês com fissura labial e/ou fenda palatina e suas famílias.


Assuntos
Humanos , Recém-Nascido , Brasil/epidemiologia , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Nascimento Vivo/epidemiologia , Sistemas de Informação em Saúde/estatística & dados numéricos , Anormalidades Congênitas , Recém-Nascido de Baixo Peso , Cesárea , Estudos Transversais , Idade Materna , Nascimento Prematuro
3.
BMC Oral Health ; 19(1): 290, 2019 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870360

RESUMO

BACKGROUND: To evaluate the relationship between gender, ethnicity/citizenship, clinical phenotype, total prevalence, and the various congenital malformations associated with oral clefts (OC) in Italy across the period 2001-2014. METHODS: A retrospective analysis (2001-2014) was conducted based on the National Congenital Malformation Registries network of Italy (Emilia-Romagna Registry of Birth Defects [IMER] and Registro Toscano Difetti Congeniti [RTDC]), which were analyzed to investigate time trends, geographical/ethnic clusters, topography, sex ratio, and associated congenital anomalies of OC phenotypes. RESULTS: Among 739 registered cases, 29.8% were syndromic or had multi-malformed associated anomalies, compared with 70.2% having isolated orofacial cleft. Cleft lip (CL) was observed in 22%, cleft palate (CP) in 40%, and cleft lip and palate (CLP) in 38% of live births, stillbirths, and terminations of pregnancy for fetal anomaly cases. Other associated conditions were major anomalies of cardiovascular defects (39%), followed by defects of the limbs (28%), neuroectodermal defects (23%), and urogenital malformations (10%). Male-to-female sex ratio was 1:1.14 in CP, 1.22:1 in CL, and 1.9:1 in CLP. Foreigners were represented by 29% from Southeast Asia, 25% from Balkans, 25% from North-Central Africa, 9% from the East, 7% from Western Europe, and 5% from South America. Total prevalence of OC cases ranged from 0.9 (RTDC) to 1.1 (IMER) of 1000 births. CONCLUSIONS: This retrospective study provides a population-based, clinical-epidemiological description of the orofacial cleft phenomenon. As a relatively frequent congenital malformation, its social and economic impact is worthy of further study. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Gravidez , Prevalência , Estudos Retrospectivos
4.
Mymensingh Med J ; 28(4): 833-838, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599248

RESUMO

Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes Cleft lip (CL), Cleft palate (CP) and both together (CLP). Cleft lip with/or palate are the major human orofacial congenital malformations seen in live birth as well as in still birth. This descriptive cross sectional study was done to determine how the different types of Cleft lip (CL), Cleft lip with palate (CLP) and Cleft palate (CP) are distributed among Bangladeshi Children. This study was performed at a health screening camp for patients with cleft lip with/or palate at Dhaka Shishu Hospital, Dhaka. A total 30 patients irrespective of their age and gender, presenting with cleft lip with/or palate deformities were included in the study. A questionnaire was constructed to be filled out by the present researcher through a face-to-face interview with the respondent preferably the mother. The data were organized and analyzed through Statistical Package for Social Sciences (SPSS, Version 20). Looking frequencies of different types of cleft lip with/or palate some trends can be noted regarding the laterality, completeness, extent, side involved and involvement of the alveolus. Out of the 14 CL cases, only 1 (7.14%) showed bilateral cleft. This cleft was complete but simple. All the others were unilateral cleft. A vast majority 9(about 65%) of the cleft lips belonged to the unilateral incomplete left sided simple type. One (7.14%) showed unilateral incomplete right sided simple type of CL. Only 2(14.28%) cases involved the alveolus. Out of the 11 CLP cases, unilateral cleft lip was present in 8 (more than 70% cases). Among them 6 cases showed complete cleft lip and 2 cases showed incomplete cleft lip. Out of all CLP cases 1 but all showed complete cleft palate. The most common type of CLP was "unilateral complete left sided compound cleft lip with unilateral complete left sided cleft palate" present in 5 of the children (i.e. more than 45% of the CLP cases and more than 16% of all cleft cases). Out of the 5 CP cases, only 1(20%) had involvement of the uvula plus posterior part of the soft palate. The rest 4(80%) had involvement of soft palate. Cleft lip with/or palate commonly occurred in Bangladeshi children. Genetic and environmental factors cause this birth defect. Therefore, integrated research among those factors is essential to prevent this birth defect.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Bangladesh/epidemiologia , Criança , Estudos Transversais , Humanos
5.
BMC Res Notes ; 12(1): 495, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399144

RESUMO

OBJECTIVE: Although infant mortality because of birth defect has increased in both developed and developing countries, had not got attention like other health issues at national, regional, or local levels. Documenting the risk factors that influence the occurrence of birth defects and its seasonality will help to inform the community and to develop preventive strategies for the country. RESULTS: Factors associated with higher likelihood of a major structural birth defects included maternal age; neonates born from women living in urban; and in Dega; history of fever during pregnancy; intake of herbal medicine; and drinking alcohol. Counselling for pregnancy preparation and folic acid supplementation was found protective for the likelihood of birth defect.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Anormalidades Congênitas/epidemiologia , Anormalidades Musculoesqueléticas/epidemiologia , Defeitos do Tubo Neural/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos de Casos e Controles , Fenda Labial/etiologia , Fenda Labial/prevenção & controle , Fissura Palatina/etiologia , Fissura Palatina/prevenção & controle , Anormalidades Congênitas/etiologia , Anormalidades Congênitas/prevenção & controle , Países em Desenvolvimento , Suplementos Nutricionais , Etiópia/epidemiologia , Feminino , Febre/complicações , Ácido Fólico/administração & dosagem , Humanos , Lactente , Recém-Nascido , Masculino , Idade Materna , Anormalidades Musculoesqueléticas/etiologia , Anormalidades Musculoesqueléticas/prevenção & controle , Defeitos do Tubo Neural/etiologia , Defeitos do Tubo Neural/prevenção & controle , Parto , Gravidez , Encaminhamento e Consulta , Fatores de Risco , Estações do Ano , População Urbana
6.
Anesth Analg ; 129(2): 515-519, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31314746

RESUMO

BACKGROUND: Malaria is a common problem throughout the world, particularly in sub-Saharan Africa, where 90% of all deaths in the world from malaria occur. While many studies on malaria are available in the medical literature, few publications have addressed the problems of managing malaria during surgery and anesthesia. At a newly opened hospital in Niger, we initiated further studies to evaluate our process of managing malaria when we had a number of problems in our first group of pediatric patients having elective cleft lip and palate repairs. Many patients had fevers during and soon after surgery and were found to have clinical malaria, despite recent treatment. METHODS: In our first group of 16 patients (group A), 4 initially tested positive for malaria by light microscopy and were treated before arrival at our hospital. On arrival at our hospital, we retested all the patients for malaria. Three of the original 4 were still positive. Six additional patients also tested positive, for a total of 9 of 16 in group A. Despite treatment, 6 of these 16 patients still had fevers in the operating rooms and postoperative period requiring further treatment for clinical malaria (6/16 or 38% incidence of perioperative malaria; 95% CI, 15%-65%).We then changed our diagnostic and management strategies for subsequent patients: all patients were tested for malaria 3-7 days before surgery at our hospital rather than before arrival. We decided to universally treat all patients coming for surgery for presumed malaria due to the number of problems encountered in the first group and the high prevalence of malaria in our population. We changed the source of the malaria medications used for all subsequent patients. We included rapid diagnostic tests for falciparum and nonfalciparum malaria species. RESULTS: After the change in protocols, no children in the second group of patients (group B, n = 53) developed clinical malaria or fever during or after surgery (P < .0001, comparing 6/16 vs 0/53, using Fisher exact test). During the first 4 months after the implementation of rapid diagnostic tests for malaria testing, we tested 283 patients, of whom 73 were found to be positive for malaria by light microscopy and/or rapid diagnostic test. Of the 73 malarias, 24.6% were nonfalciparum malarias (95% CI, 14.7%-34.5%), much higher than the 1%-5% incidence that international and local health officials told us to expect. CONCLUSIONS: Pediatric patients in many areas of the world often present with a high risk for malaria in the perioperative time frame. Treatment with artemisinin-based therapy 3-7 days before elective surgeries may be an effective method to reduce the risks of febrile episodes and clinical malaria during and after surgery in areas of high transmission. However, these results may be limited by (1) the presence of nonfalciparum malarias, some of which may require prolonged treatment for hepatic cryptogenic malaria; (2) the potential for complications related to counterfeit medications; and (3) international efforts at malaria eradication, especially when considering the use of malaria medications that have the potential to develop drug resistance.


Assuntos
Antimaláricos/administração & dosagem , Artemisininas/administração & dosagem , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Países em Desenvolvimento , Recursos em Saúde , Malária/tratamento farmacológico , Procedimentos Cirúrgicos Bucais , Adolescente , Fatores Etários , Antimaláricos/efeitos adversos , Artemisininas/efeitos adversos , Criança , Pré-Escolar , Fenda Labial/diagnóstico , Fenda Labial/epidemiologia , Fissura Palatina/diagnóstico , Fissura Palatina/epidemiologia , Protocolos Clínicos , Esquema de Medicação , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Incidência , Lactente , Malária/diagnóstico , Malária/epidemiologia , Malária/transmissão , Masculino , Nigéria/epidemiologia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Assistência Perioperatória , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-31336885

RESUMO

This study examines the spatial structure of children with cleft lip and palate (CLP) and its association with polluted areas in the Monterrey Metropolitan Area (MMA). The Nearest Neighbor Index (NNI) and the Spatial Statistical Scan (SaTScan) determined that the CLP cases are agglomerated in spatial clusters distributed in different areas of the city, some of them grouping up to 12 cases of CLP in a radius of 1.2 km. The application of the interpolation by empirical Bayesian kriging (EBK) and the inverse distance weighted (IDW) method showed that 95% of the cases have a spatial interaction with values of particulate matter (PM10) of more than 50 points. The study also shows that 83% of the cases interacted with around 2000 annual tons of greenhouse gases. This study may contribute to other investigations applying techniques for the identification of environmental and genetic factors possibly associated with congenital malformations and for determining the influence of contaminating substances in the incidence of these diseases, particularly CLP.


Assuntos
Fenda Labial/epidemiologia , Fenda Labial/etiologia , Fissura Palatina/epidemiologia , Fissura Palatina/etiologia , Poluentes Ambientais/toxicidade , Poluição Ambiental , Teorema de Bayes , Criança , Pré-Escolar , Fissura Palatina/etnologia , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Material Particulado
8.
Early Hum Dev ; 135: 23-26, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31226652

RESUMO

BACKGROUND: The cleft lip with or without palate is the most common congenital craniofacial anomaly, presenting prevalence that varies between different ethnicities. It presents a complex and multifactorial etiology which involves genetic and environmental factors. Regarding family history, some studies have observed a significant association among parental consanguinity and orofacial clefts. AIMS: To investigate if there is an association between parental consanguinity and the occurrence of oral cleft in the offspring. STUDY DESIGN: Retrospective, cross-sectional, quantitative case-control study. SUBJECTS: Case group - parents of subjects with nonsyndromic oral cleft (n = 746). Oral cleft was classified in the following group: cleft lip only - CLO (complete or incomplete, unilateral or bilateral); complete cleft lip and palate - CLP (unilateral or bilateral); and, cleft palate only - CPO (complete or incomplete). Control group - parents of subjects without clefts or other anomalies (n = 502), totaling 1248 subjects. OUTCOME MEASURES: Fisher's exact test was used to compare the consanguinity rates observed between the two groups (p < 0.05 for statistically significant differences). RESULTS: A positive consanguinity rate of 2.68% was observed in the case group and 0.79% in the control group. This difference found between the groups was statistically significant (p = 0.02). The most frequent degree of kinship in cases of consanguineous marriages, in both groups, was between first cousins. The most frequent types of clefts in the offspring were also the cleft palate only and the cleft lip only. CONCLUSION: In the study population, parental consanguinity was associated with the occurrence of nonsyndromic oral cleft, and may be considered an isolated risk factor in this population.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Consanguinidade , Pais , Fenda Labial/genética , Fissura Palatina/genética , Humanos , Linhagem
9.
J Pak Med Assoc ; 69(5): 632-639, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105281

RESUMO

OBJECTIVE: To compare the occurrence, distribution and management of clefts of lip and palate in local patients with the available data from India and China. METHODS: The retrospective study was conducted at the Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, and comprised data related to a three-month period from January to March 2015 at two medical centres in Lahore. Data from Pakistani centres was analysed based on province, gender, age and clefts of lip and palate conditions and Spearman's correlation matrix. RESULTS: Of the 1574 cases, 1061(67.4%) were from Punjab, 361(23%) Khyber Pakhtunkhwa, 85(5%) Sindh and 67(4.2%) were from Azad Jammu and Kashmir. The incidence of clefts of lip and palate was higher in males than females. There was higher awareness of the need for timely management in new borns with clefts of lip and palate. Some patients seeking secondary treatment were also being surgically corrected. There is no national registry of children born with cleft defect, making it difficult to assess the full scale of the problem.. CONCLUSIONS: Based on available data, it is likely that there are many adults who have not been treated when younger..


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Adolescente , Adulto , Enxerto de Osso Alveolar , Criança , Pré-Escolar , China/epidemiologia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Intervenção Médica Precoce , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Masculino , Paquistão/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Reoperação , Estudos Retrospectivos , Distribuição por Sexo , Adulto Jovem
10.
Sci Total Environ ; 678: 123-132, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31075579

RESUMO

Polycyclic aromatic hydrocarbons (PAHs), which are ubiquitous in the environment, have been found to cause orofacial clefts (OFCs) in mouse model. However, evidence from the human study with markers of intrauterine exposure is absent. We explored the associations between the levels of sixteen PAHs in umbilical cord tissue and risk for OFCs using multivariable logistic models and Bayesian Kernel Machine Regression (BKMR). This case-control study included 89 OFC cases and 129 controls without congenital malformations. Concentrations of PAHs in umbilical cord tissue were detected using gas chromatography coupled to triple quadrupole tandem mass spectrometry. The median levels of ΣPAHs, Σlow molecular weight polycyclic aromatic hydrocarbons, and Σhigh molecular weight polycyclic aromatic hydrocarbons were all higher in cases of total OFCs and its subtypes than in controls, although the differences were not statistically significant. No statistical associations between levels of PAHs in umbilical cord tissue and risk for OFCs were observed in either multivariable logistic models or BKMR models. Maternal using a stove for heating and lower frequency of ventilation in the bedroom/living room, and consumptions of fresh green vegetables were positively correlated with levels of PAHs in umbilical cord. In conclusion, our results did not suggest that in utero exposure to PAHs were associated with the risk for OFCs, in estimating whether single effect of PAHs or joint effects of multiple PAHs.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Exposição Ambiental/análise , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Cordão Umbilical/metabolismo , Animais , Fenda Labial/veterinária , Fissura Palatina/veterinária , Camundongos , Modelos Animais
11.
Int J Mol Sci ; 20(9)2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31052503

RESUMO

Craniofacial bone defect anomalies affect both soft and hard tissues and can be caused by trauma, bone recessions from tumors and cysts, or even from congenital disorders. On this note, cleft/lip palate is the most prevalent congenital craniofacial defect caused by disturbed embryonic development of soft and hard tissues around the oral cavity and face area, resulting in most cases, of severe limitations with chewing, swallowing, and talking as well as problems of insufficient space for teeth, proper breathing, and self-esteem problems as a consequence of facial appearance. Spectacular advances in regenerative medicine have arrived, giving new hope to patients that can benefit from new tissue engineering therapies based on the supportive action of 3D biomaterials together with the synergic action of osteo-inductive molecules and recruited stem cells that can be driven to the process of bone regeneration. However, few studies have focused on the application of tissue engineering to the regeneration of the cleft/lip and only a few have reported significant advances to offer real clinical solutions. This review provides an updated and deep analysis of the studies that have reported on the use of advanced biomaterials and cell therapies for the regeneration of cleft lip and palate regeneration.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Fenda Labial/terapia , Fissura Palatina/terapia , Medicina Regenerativa/métodos , Animais , Fenda Labial/epidemiologia , Fenda Labial/patologia , Fenda Labial/fisiopatologia , Fissura Palatina/epidemiologia , Fissura Palatina/patologia , Fissura Palatina/fisiopatologia , Ácido Fólico/análogos & derivados , Ácido Fólico/uso terapêutico , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Osteogênese/efeitos dos fármacos , Transplante de Células-Tronco/métodos , Engenharia Tecidual/métodos
12.
PLoS One ; 14(5): e0215931, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071123

RESUMO

OBJECTIVE: The study was conducted to determine the epidemiology and clinical profile of individuals with cleft lip and/or palate (CLP) utilizing specialized academic treatment centres in South Africa's public health sector. MATERIALS AND METHODS: The Human Research Ethics Committee of the University of the Witwatersrand in Johannesburg provided ethical approval for the study. We conducted a retrospective record review of all cases of CLP treated at the specialised academic centres for the two-year period from 1 January 2013 until 31 December 2014. We used a structured, pre-tested record review form to obtain demographic, clinical and treatment information on each CLP case. We used Stata 13 to analyse the data and conducted statistical tests at 5% significance level. RESULTS: We analysed 699 records of individuals with CLP. The estimated prevalence of CLP in the South African public health sector was 0.3 per 1000 live births, with provincial variation of 0.1/1000 to 1.2/1000. The distribution of clefts was: 35.3% cleft palate; 34.6% cleft lip and palate; 19.0% cleft lip and other cleft anomalies at 2%. Of the total number of CLP, 47.5% were male and 52.5% female, and this difference was statistically significant (p<0.001). The majority of clefts occurred on the left for males (35.5%) and palate for females (43.4%), with a male predominance of unilateral cleft lip and palate (53.3%). CONCLUSION: The study findings should inform the implementation of South Africa's planned birth defect surveillance system and health service planning for individuals with CLP.


Assuntos
Fenda Labial/epidemiologia , Fenda Labial/terapia , Fissura Palatina/epidemiologia , Fissura Palatina/terapia , Universidades , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , África do Sul/epidemiologia , Adulto Jovem
13.
J Environ Radioact ; 204: 125-131, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31029986

RESUMO

Uranium and thorium are common radioactive elements that exist in the environment. However, few environmental epidemiological studies have focused on their possible effects on congenital malformations. Here, we explored the association between uranium and thorium concentrations in maternal scalp hair grown from 3 months before to 3 months after conception, namely during the periconceptional period and the risk of orofacial clefts (OFCs) in offspring. Our study included 153 women whose pregnancies were affected by OFCs (cases) and 601 women who delivered infants without birth defects (controls) from four provinces in China. Face-to-face interviews were used to collect sociodemographic characteristics with a structured questionnaire. Concentrations of uranium and thorium in maternal scalp hair grown during the periconceptional period were detected using inductively coupled plasma-mass spectrometry. The risk of OFCs in association with higher concentrations of the two radioactive elements was estimated using odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for potential confounding factors. The levels of uranium and thorium in maternal hair were in agreement with the published literature. After adjusting for several confounders, the ORs of thorium in the highest, upper, and lower quartile versus the lowest quartile were 2.63 (95% CI, 1.41-4.92), 1.98 (95% CI, 1.03-3.79), and 2.73 (95% CI, 1.46-5.12), respectively. No association was found between levels of uranium and the risk of OFCs. Maternal periconceptional exposure to thorium may be a risk factor for OFCs in offspring.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Cabelo/química , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Tório/análise , Urânio/análise , Adulto , China/epidemiologia , Fenda Labial/induzido quimicamente , Fissura Palatina/induzido quimicamente , Feminino , Humanos , Recém-Nascido , Masculino , Razão de Chances , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Fatores de Risco , Couro Cabeludo/química , Adulto Jovem
14.
Sci Total Environ ; 661: 196-202, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30669052

RESUMO

A deficiency or excess of zinc (Zn), selenium (Se), cobalt (Co), molybdenum (Mo), or manganese (Mn) may interfere with fetal organogenesis. However, the impact of these essential trace elements on the occurrence of cleft lip with or without cleft palate (CL ±â€¯P) remains to be elucidated. We aimed to investigate the associations between the amounts of Zn, Se, Co, Mo, and Mn in umbilical cord tissue and risk for CL ±â€¯P. This case-control study included 200 controls without congenital malformations and 88 CL ±â€¯P cases. Zn, Se, Co, Mo, and Mn concentrations in the umbilical cord were determined using inductively coupled plasma mass spectrometry. Information was collected on demographics, lifestyle behaviors, and dietary intake. The median concentrations of Zn in cases of CL ±â€¯P and cleft lip with cleft palate (CLP), of Se in cases of CL ±â€¯P and cleft lip only (CLO), and of Co in cases of CLO were lower than in the controls. In utero exposure to higher levels of Zn was associated with reduced risk for CL ±â€¯P (OR = 0.44, 95% CI, 0.20-0.93) and for CLP (OR = 0.35, 95% CI, 0.14-0.86), and a higher level of Se was associated with reduced risk for CL ±â€¯P and CLO, with ORs of 0.47 (95% CI, 0.23-0.95) and 0.22 (95% CI, 0.08-0.67), respectively. By contrast, higher levels of Mo in the umbilical cord were associated with 2.52-fold (95% CI, 1.23-5.20) and 2.59-fold (95% CI, 1.12-5.95) higher risk for CL ±â€¯P and CLP, respectively. No association was found between Co or Mn and risk for CL ±â€¯P. In conclusion, in utero exposure to higher levels of Zn and Se was associated with reduced risk for CL ±â€¯P, but higher levels of Mo were associated with increased risk for CL ±â€¯P.


Assuntos
Fissura Palatina/epidemiologia , Oligoelementos/análise , Cordão Umbilical/química , Adulto , Estudos de Casos e Controles , China/epidemiologia , Fenda Labial/induzido quimicamente , Fenda Labial/epidemiologia , Fissura Palatina/induzido quimicamente , Feminino , Humanos , Recém-Nascido , Masculino , Fatores de Risco , Oligoelementos/deficiência , Adulto Jovem
15.
Birth Defects Res ; 111(3): 142-150, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30516876

RESUMO

BACKGROUND: Children with nonsyndromic orofacial clefts (NS OFCs) may require exceptional children's (EC) services for academic delays. We examined EC service use of children with and without NS OFCs in NC in elementary school. METHODS: We included 559 children with NS OFCs and 6,822 children without birth defects who had NC educational records. We estimated prevalence ratios, trends in enrollment, and characteristics of eligibility classification using descriptive statistics and logistic regression by cleft subtype and race/ethnicity. We estimated the odds of third grade retention by EC enrollment using logistic regression with inverse probability of treatment weights. RESULTS: Children with NS OFCs were 3.02 (95% CI: 2.50, 3.64) times as likely to receive third grade special education (SE) services compared to unaffected peers. The prevalence odds was highest among children with CL+P (OR: 4.61, 95% CI: 3.49, 6.09) declining by 54% by fifth grade. The prevalence odds of SE for white children was approximately 1.50 times that for African American children in fourth and fifth grades. Approximately 33% of children with NS OFCs within each racial/ethnic group received SE in third grade. African American children were twice as likely to receive services under specific learning disability. Children with NS OFCs receiving EC services were 44% (OR: 0.56; 95% CI: 0.13, 2.38) less likely to be retained in third grade compared to children with NS OFCs who were not receiving services. CONCLUSIONS: Children with NS OFCs are more likely to receive SE services in elementary school compared to their unaffected peers. The eligibility category differed by racial/ethnic group.


Assuntos
Educação Especial/tendências , Utilização de Instalações e Serviços/tendências , Afro-Americanos/educação , Criança , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Educação Especial/métodos , Grupo com Ancestrais do Continente Europeu/educação , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Prevalência , Instituições Acadêmicas
16.
Int Heart J ; 60(1): 12-18, 2019 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-30518714

RESUMO

Emery-Dreifuss muscular dystrophy (EDMD) is a group of hereditary muscular dystrophy syndrome caused by deficiency of genes encoding nuclear envelope proteins. Patients having EDMD show the triad of muscle dystrophy, joint contracture, and cardiac disease. In almost all patients, cardiac involvement is prevalent and is the most severe aspect of EDMD. Cardiac disease is predominantly shown by conduction defects, atrial fibrillation/flutter, and atrial standstill. Sudden death and heart failure because of left ventricular dysfunction are important causes of mortality, particularly in those patients that have the LMNA mutation. Medical treatment of EDMD is limited to addressing symptoms and ambulation support; moreover, pacemaker implantation is necessary when there are severe conduction defects and bradycardia occurs. Note that automated defibrillation devices may be considered for those patients who have a high risk of sudden death, rate, or rhythm control. Also, anticoagulation should be initiated in those patients who have atrial fibrillation/flutter. Thus, for optimal management, a multidisciplinary approach is required.


Assuntos
Fibrilação Atrial/terapia , Distrofia Muscular de Emery-Dreifuss/genética , Disfunção Ventricular Esquerda/mortalidade , Anormalidades Múltiplas/epidemiologia , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Cardiomiopatias/fisiopatologia , Fissura Palatina/complicações , Fissura Palatina/epidemiologia , Contratura/complicações , Contratura/epidemiologia , Morte Súbita/epidemiologia , Feminino , Doenças Genéticas Inatas/fisiopatologia , Átrios do Coração/anormalidades , Átrios do Coração/fisiopatologia , Bloqueio Cardíaco/fisiopatologia , Cardiopatias/complicações , Cardiopatias/epidemiologia , Humanos , Hidrocefalia/complicações , Hidrocefalia/epidemiologia , Comunicação Interdisciplinar , Deformidades Congênitas dos Membros/complicações , Deformidades Congênitas dos Membros/epidemiologia , Masculino , Distrofias Musculares/complicações , Distrofias Musculares/epidemiologia , Distrofia Muscular de Emery-Dreifuss/complicações , Distrofia Muscular de Emery-Dreifuss/diagnóstico , Distrofia Muscular de Emery-Dreifuss/terapia , Marca-Passo Artificial/normas , Disfunção Ventricular Esquerda/epidemiologia
17.
Plast Reconstr Surg ; 143(1): 140e-151e, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30431540

RESUMO

BACKGROUND: It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae. METHODS: Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed. RESULTS: Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. CONCLUSION: The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.


Assuntos
Fissura Palatina/classificação , Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos/transplante , Insuficiência Velofaríngea/cirurgia , Adolescente , Adulto , Fatores Etários , Algoritmos , Criança , Pré-Escolar , Fissura Palatina/diagnóstico , Fissura Palatina/epidemiologia , Estudos de Coortes , Países em Desenvolvimento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Qualidade de Vida , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento , Insuficiência Velofaríngea/diagnóstico , Insuficiência Velofaríngea/epidemiologia , Adulto Jovem
18.
Sci Total Environ ; 652: 406-412, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30366340

RESUMO

Natural exposure to and increasing use of barium and aluminum in various products, such as plastics, rubber, and food additives, raise concerns for their potential health impacts on pregnant women and vulnerable fetuses. We investigated whether there are associations between barium and aluminum concentrations in placental tissues and the risk for orofacial clefts (OFCs) in offspring. In this case-control study, we recruited 103 women with OFC-affected pregnancies and 206 women who delivered healthy newborns. Concentrations of barium and aluminum in placental tissues were measured using inductively coupled plasma-mass spectrometry. Information on maternal sociodemographic characteristics and diet was collected via face-to-face interviews using a structured questionnaire. Aluminum concentrations in placental tissues were not associated with OFC risk. However, a higher concentration of barium in placental tissues was associated with an increased risk for OFCs, with an adjusted odds ratio (OR) of 2.42 (95% confidence interval [95% CI] 1.34-4.40) for total cleft lip with or without cleft palate (CL ±â€¯P), and 1.90 (95% CI 1.03-3.50) for isolated CL ±â€¯P. There was a positive dose-response relationship between placental barium concentrations and OFC risk. Maternal exposure to barium may increase the risk for OFCs in offspring.


Assuntos
Alumínio/metabolismo , Bário/metabolismo , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/metabolismo , Placenta/metabolismo , Feminino , Humanos , Exposição Materna/estatística & dados numéricos , Gravidez
19.
Acta Otorrinolaringol Esp ; 70(1): 36-46, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29033123

RESUMO

The incidence and the prevalence rates of otitis media with effusion (OME) are high. However, there is evidence that only a minority of professionals follow the recommendations provided in clinical practice guidelines. For the purpose of improving diagnosis and treatment of OME in children to prevent and/or reduce its impact on children's development, the Commission for the Early Detection of Deafness (CODEPEH) has deeply reviewed the scientific literature on this field and has drafted a document of recommendations for a correct clinical reaction to of OME, including diagnosis and medical and surgical treatment methodology. Among others, medication, in particular antibiotics and corticoids, should not be prescribed and 3 months of watchful waiting should be the first adopted measure. If OME persists, an ENT doctor should assess the possibility of sugical treatment. The impact of OME in cases of children with a comorbidity is higher, so it requires immediate reaction, without watchful waiting.


Assuntos
Otite Média com Derrame/diagnóstico , Otite Média com Derrame/terapia , Testes de Impedância Acústica , Adenoidectomia/estatística & dados numéricos , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Audiometria , Criança , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Fissura Palatina/epidemiologia , Comorbidade , Contraindicações de Medicamentos , Anormalidades Craniofaciais/epidemiologia , Deficiências do Desenvolvimento/etiologia , Síndrome de Down/epidemiologia , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Perda Auditiva/prevenção & controle , Humanos , Lactente , Recém-Nascido , Transtornos da Linguagem/etiologia , Ventilação da Orelha Média/estatística & dados numéricos , Triagem Neonatal , Otite Média com Derrame/epidemiologia , Otoscopia/métodos , Fatores de Risco , Conduta Expectante
20.
Int J Pediatr Otorhinolaryngol ; 116: 88-91, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30554716

RESUMO

BACKGROUND: A bifid uvula is an anatomic variation that can be predictive of sub-mucous cleft palate, which may cause velopharyngeal insufficiency (VPI). Bifid uvula prevalence in the literature ranges from 0.18% to 10.3%, depending on the population studied. The aim of this study is to determine the prevalence of bifid uvula in the Geneva's school children population. METHODS: A cross-sectional study was conducted in Geneva's primary school children, from September 2014 to June 2015. An examination of the uvula was performed by dentists working for the Scholastic Dental Service, after a specific training in diagnosing bifid uvulas. The dentists recorded their findings on a standardized form. RESULTS: The total number of school children in Geneva in the school year 2014-2015 was 30,375. 23,961 children had their uvula examined, representing 79% of the total population of school children. Among them, a hundred school children had a cleft uvula. One schoolgirl had no uvula. The prevalence of bifid uvula is 0.42%. Sex ratio (M/F) is 0.96. DISCUSSION: This large study, the second in literature for number of patients examined, identified a prevalence of bifid uvula of 0.42%. This result is in agreement with previous studies.


Assuntos
Fissura Palatina/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Suíça/epidemiologia , Úvula/anormalidades
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA