Abstract
BackgroundThere is a multitude of protocols of treatment of cleft lip and palate (CLP) worldwide differing in number of operations, surgical techniques, and timings of surgeries. Despite, facial appearance in subjects with CLP is rarely ideal and residual stigmata are easy to notice in many patients irrespective of the protocol. The prospective controlled investigations are optimal for comparing effectiveness of treatment protocols. Because prospective studies are very challenging to perform in CLP field, it is reasonable to retrospectively assess different surgical protocols to identify the promising ones and then to test them in a prospective way.MethodsOur objective was to assess the nasolabial appearance in a preadolescent Slavic population with unilateral cleft lip and palate (UCLP) by using the 0–200 numeric scale with reference photographs. Patients treated in Warsaw, Poland (n = 32), Prague, Czech Republic (n = 26) and Bratislava, Slovakia (n = 17) were included in this retrospective study. Each cleft center used a unique surgical protocol. Two panels of professional raters (n = 7) and laypeople (n = 10) scored blindly the nasolabial esthetics on cropped frontal and profile images with cropped reference photograph present on the same slide. Intra- and inter-rater agreement was assessed with Cronbach’s alpha, intraclass correlation coefficients, t-tests, and Bland–Altman plots. Inter-group differences were evaluated with one-way ANOVA and regression analysis.ResultsThe agreement within and between raters was acceptable. We found that patients treated in Warsaw, Prague, and Bratislava showed comparable nasolabial appearance on frontal and profile photographs when judged by both professional raters (p > 0.05) and laypeople (p > 0.05). Regression analysis did not identify influence of gender, group (i.e., Warsaw, Prague, and Bratislava), age at lip repair, surgeon, and age at photographic assessment on esthetic outcome (p > 0.05).ConclusionThis study showed that none of the surgical protocols showed superiority to produce good nasolabial appearance.
Highlights
American College of Sports Medicine states energy availability (EA) by means of the amount of energy left over and available for proper organism functions after the energy used for exercise is subtracted from the calories from the meals
As the Female Athlete Triad (FAT) and Relative Energy Deficiency in Sports (Red-S) are very common in athletes and to the authors’ knowledge, no research has yet assessed the prevalence of FAT and Red-S in youth female football players in Poland, the aim of this study was to assess the prevalence of FAT and Red-S using the Low Energy Availability in Females questionnaire (LEAF-Q) in youth female football players
LEAF-Q scores Almost the two thirds (64.7%) of participants are classified as being at risk for the FAT/Red-S according to the LEAF-Q scores
Summary
American College of Sports Medicine states energy availability (EA) by means of the amount of energy left over and available for proper organism functions after the energy used for exercise is subtracted from the calories from the meals. Low energy availability (LEA) in endurance athletes could be affected by eating disorders This all together could have health consequences related to the Female Athlete Triad (FAT) (Loucks, 2004; Marcason, 2016). It has been noticed that Female Athlete Triad (Fat) and Relative Energy Deficiency (Red-S) in Sport are characterized by the symptoms of impaired endocrinemetabolic function and bone health in female athletes. It may be evaluated with a qualitative tool, such as Low Energy Availability in Females questionnaire (LEAF-Q) and quantitative measurements: bone mineral density (BMD), resting energy expenditure (REE), body composition, 24-hour dietary recall. Identification of Fat/Red-S symptoms by screening tools such as the LEAF questionnaire is important in protecting young athletes from long-term damage due to the progression of the risk factors associated with the Fat/Red-S
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