Defects In Relation Research Articles

Clinical evaluation of porous hydroxyapatite bone graft (Periobone G) with and without collagen membrane (Periocol) in the treatment of bilateral grade II furcation defects in mandibular first permanent molars.

Background:Furcation invasions represent one of the most demanding therapeutic challenges in periodontics. This investigation assessed and compared the clinical efficacy of hydroxyapatite bone graft material when used alone and with collagen membrane in the treatment of grade II furcation defects.Materials and Methods:Ten patients with comparable bilateral furcation defects in relation to mandibular first molars were selected and treated in a split-mouth design. After the hygiene phase of therapy was completed, the groups were selected randomly either for treatment with hydroxyapatite bone graft (Periobone G) alone or with a combination of bone graft and guided tissue regeneration (GTR) membrane (Periocol). Clinical parameters like plaque index, gingival index, vertical probing depth, horizontal probing depth, clinical attachment level, position of marginal gingiva, and the amount of bone fill were used at baseline and at 3 and 6 months postoperatively.Results:At 6 months, both surgical procedures resulted in statistically significant reduction in vertical and horizontal probing depths and gain in the clinical attachment level.Conclusion:The use of combination technique yielded superior results compared to sites treated with bone graft alone. However, the difference was not statistically significant.

Evaluation of a porous hydroxyapatite alloplast in the management of grade II furcation defects in molars. A case series

Introduction: The present case series evaluates the efficacy of a hydroxyapatite graft material in the management of grade II furcation involvement in first molars. Material and methods: Eight patients presenting with a total of 9 grade II furcation defects in relation to the facial aspect of either maxillary or mandibular first molars were treated with a porous hydroxyapatite alloplast. The clinical outcomes were measured in terms of change in probing pocket depth and clinical attachment level (vertical and horizontal) at 6 months post-operatively. Radiographs were used as supplements. Results: At 6 months, there was a mean pocket depth reduction of 3.12±1.25 mm, a mean vertical attachment gain of 2.75±1.17 mm, and a mean horizontal attachment gain of 3.25±1.28 mm. Radiographs showed bone fill at all treated sites. The outcomes were better in mandibular teeth compared to maxillary teeth. The use of hydroxyapatite graft is effective in reducing pocket depth and bringing out gain in attachment levels when used in grade II furcation defects. Key words:Grade II furcation, bone grafts, hydroxyapatite.

Lack of periconceptional vitamins or supplements that contain folic acid and diabetes mellitus–associated birth defects

The purpose of this study was to examine the risk of birth defects in relation to diabetes mellitus and the lack of use of periconceptional vitamins or supplements that contain folic acid. The National Birth Defects Prevention Study (1997-2004) is a multicenter, population-based case-control study of birth defects (14,721 cases and 5437 control infants). Cases were categorized into 18 types of heart defects and 26 noncardiac birth defects. We estimated odds ratios for independent and joint effects of preexisting diabetes mellitus and a lack of periconceptional use of vitamins or supplements that contain folic acid. The pattern of odds ratios suggested an increased risk of defects that are associated with diabetes mellitus in the absence vs the presence of the periconceptional use of vitamins or supplements that contain folic acid. The lack of periconceptional use of vitamins or supplements that contain folic acid may be associated with an excess risk for birth defects due to diabetes mellitus.

A Population-Based Evaluation of the Specific Risks for Five Major Congenital Heart Defects in Relation to Assisted Reproductive Technologies

A Population-Based Evaluation of the Specific Risks for Five Major Congenital Heart Defects in Relation to Assisted Reproductive Technologies

Emotional reactivity in infants with congenital heart defects and maternal symptoms of postnatal depression

The object of this study was to examine the role of emotional reactivity in infants with congenital heart defects (CHD) in relation to their mothers' symptoms of postnatal depression. The study population was drawn from the Norwegian country-wide CHD registry from the Department of Pediatric Cardiology at Oslo University Hospital and the Norwegian Mother and Child Cohort Study. Mother-infant dyads with mild/moderate or severe CHD (n=242) were assessed with a 6-item short version (EPDS-6) of the Edinburgh Postnatal Depression Scale and the Infant Characteristic Questionnaire's fussy/difficult subscale (ICQ-D/F-7) at 6 months postpartum. When adjusting for infant emotional reactivity, mothers of infants with severe CHD showed significantly elevated symptoms of postnatal depression 6 months postpartum (odds ratio=2.22) compared to the mothers of infants with mild/moderate CHD. The results identify severe CHD in infants as a predictor of heightened symptoms of postnatal depression in mothers, independent of the infant's emotional reactivity. Although a causal direction underlying the association could not be determined, the possible, negative reciprocal relationships between severe CHD in infants, high levels of emotional reactivity in infants, and symptoms of maternal postnatal depression are considered.

The relationship of enamel defects and caries: a cohort study

Is there a relationship between enamel defects and early childhood caries? A total of 275 children participated in a cohort study from birth to 54 months of age. Enamel defects were determined by the development defects enamel index and dental caries was registered according to the WHO criteria. Data were analyzed using descriptive, analytical techniques, multivariate analysis, and evidence-based tools as number needed to harm (NNH). In the follow up, 224 children were still in the study, 81.3% presented at least one tooth with enamel defect and 44.2% had dental caries. An association was found between enamel defects and dental caries (P = 0.0091). Multivariate analysis showed that night bottle-feeding, absence of fluoride and enamel defects were predictors of dental caries at 18 months (P < 0.05). Enamel defect was the only statistically significant variable to influence the development of caries at 24, 30, 36, and 42 months. At 48 months, the use of fluoride toothpaste had effect on the decrease of caries (P < 0.05). The NNH for enamel defects in relation to dental caries was 3.0, at 24 months and 5.0 at 54 months. Enamel defect is a predisposing factor for ECC.

Developmental Defects of Enamel in Children of Davangere District and Their Relationship to Fluoride Levels in Drinking Water

To assess the prevalence and severity of developmental defects and their relationship to fluoride levels in drinking water. 739 (406 male and 333 female) schoolchildren aged 13 years formed the study population. We used the ion selective electrode method to estimate the fluoride concentration in drinking water. A modified developmental defects of enamel index was used for recording the developmental defects. The Karl Pearson coefficient for correlation and the chi-square test were used for statistical estimation. The fluoride concentration ranged from 0.64 to 2.64 ppm. The prevalence of developmental defects was 88.5%. The most common type of defect was diffuse opacity in 61.2% of the children. There was a significant positive correlation between the type (r=0.85; P<.001) and extent (r=0.92; P<.001) of developmental defects in relation to fluoride levels in drinking water. The observed prevalence demonstrates the need to ascertain factors other than fluoride levels in drinking water that could contribute to its occurrence.

Risk of limb birth defects and mother's home proximity to cornfields

Background Although previous studies have linked proximity to crops and birth defects, they lacked individual-level exposure data and none was based on using planted area instead of linear proximity to crops as the exposure metric. We studied birth defects in relation to the area of corn or soybeans within 500 m of the mother's residence. Methods We selected all singleton births from rural areas conceived during the 2000–2004 spring-summer months ( n = 48,216). We determined whether the area with corn or soybeans around the home was associated with birth defects using multiple unconditional logistic regression. Results We found that limb birth defects (ICD-9-CM 754.5, 755) increased in relation to cornfields (Adjusted OR = 1.22; 95 % CI = 1.01, 1.47 per additional 10 ha planted with corn within 500 m). None of the birth defect types studied was associated with soybeans. Conclusions In the Midwest, a significant and expanding proportion of the population is now living in close proximity to cornfields. Our results suggest that additional studies should be conducted to identify which factor(s) associated with cornfields are behind the observed increase in limb birth defects.

Frecuencia y tendencia temporal de los defectos congénitos en Asturias. La necesidad de la vigilancia clinicoepidemiológica

Objective Congenital defects remain the second cause of perinatal and infant death and the third cause between the second and fifth years of life in Asturias. These anomalies generate substantial morbidity. The aim of the present study was to describe the population-based frequency of congenital defects in Asturias and their forms of presentation. Methods Data from the population-based Registry of Congenital Defects of Asturias for 1990–2004 were analyzed. The data related to live births, stillbirths and induced abortions after prenatal diagnosis and are presented as birth prevalence and total prevalence (including induced abortions). Results The total number of births was 103,452 and there were 3,035 cases of congenital defects, representing a total prevalence of 2.9 cases per 100 births and a birth prevalence of 2.5%. These figures showed a tendency to increase throughout the study period. A total of 2,516 (82.9%) cases were live births, 46 (1.5%) were stillbirths and 473 (15.6%) were induced abortions. Prenatal diagnosis increased throughout the period. Sixtythree percent of total cases showed an isolated defect, 17% a recognized syndrome and the remaining 20% had multiple malformations without a syndromic pattern. The most frequent and severe defects registered were neural tube defects (12.2 per 10,000 births), chromosomal abnormalities (34.4 per 10,000), and cardiac defects (75.2 per 10,000). Conclusions The 15-year experience of the Registry of Congenital Defects of Asturias reveals the utility of this type of database to evaluate prenatal screening programs, plan the resources needed in affected pregnant women and infants, and perform epidemiological surveillance of congenital defects in relation to environmental risks, drug exposure and assisted reproduction techniques.

PRESCRIPTION MEDICATION SHARING

In their survey of prescription medication sharing, Goldsworthy et al.1 appropriately noted the paucity of information on this important behavior. Given concerns about potentially harmful effects on the fetus from in utero exposures to medication, it is particularly important to understand medication-sharing behaviors among a broad sample of pregnant women. We examined this question some time ago. A performer participates in the second Walk Against Children's Malnutrition and Hunger in El Salvador, organized by the World Food Programme of the United Nations in the face of the global food crisis. Photograph by Jose Cabezas/AFP/Getty Images. Printed with permission. In the early days of our current case–control surveillance study of birth defects in relation to medication use in pregnancy,2 we evaluated the effect of questionnaire design on recall of medication use. As part of that analysis, we summarized data from interviews conducted between 1976 and 1984 involving 5435 mothers who delivered malformed or nonmalformed infants in geographic areas surrounding Boston, Massachusetts; Philadelphia, Pennsylvania; Toronto, Ontario; and in part of Iowa. Interviews were conducted within 6 months of delivery, and included questions about use in pregnancy of 9 specifically named prescription medications. Women who answered affirmatively to any of those drugs were asked whether these medications were obtained from physicians or from other sources, such as friends, neighbors, or relatives.3 Among users of Bendectin, Fiorinal, Hydrodiuril, Clomid, and Seconal, less than 5% reported a source other than a physician; however, higher proportions reported nonphysician sources for Compazine (9%), Diuril (11%), Valium (18%), and Darvon (22%). Goldsworthy et al.1 correctly noted a number of consequences of medication-sharing behaviors, to which we would add an additional consequence: pharmacoepidemiology studies of drug safety increasingly rely on exposure information drawn from computerized prescription or pharmacy records (often as part of HMO or claims data). Our earlier conclusion, now supported by the work of Goldsworthy et al., is therefore even more relevant today: [I]n addition to concern that [information from such sources] includes false positive ‘exposures’—prescriptions issued or filled but not consumed—our findings suggest that these data sources may also include appreciable numbers of false negative exposures—drugs consumed but obtained from nonidentified sources.3(p675) Appreciable exposure misclassification would have very serious consequences when it comes to using prescription data sources to identify adverse effects of medication exposures; any such efforts must take into consideration the extent to which studied medications are shared.

Classifying internal defects in forgings based on flaw-detection patterns obtained by ultrasound

A method has been proposed for classifying internal defects in forgings based on the flaw-detection patterns obtained in ultrasonic testing. The reliability of the method is greater than 75%. Also, a program has been developed to classify internal defects in relation to their length and their location through the thickness and width of forgings. The method is valid for flaw-detection patterns in groups I and III. The method is now being used at the Chelyabinsk affiliate of the Ural Forging Company. The method of classification can also be used to identify internal defects in cylindrical specimens obtained by free forging on presses.

Maternal hypertension, antihypertensive medication use, and the risk of severe hypospadias

Hypertensive disorders occur in an estimated 5-10% of pregnancies, but few studies have examined birth defects in relation to high blood pressure and antihypertensive medication use. The objective of this study was to investigate the relationship between high blood pressure, antihypertensive medication use, and severe hypospadias. We used data from the National Birth Defects Prevention Study, a population-based, multicenter, case-control study of birth defects to assess risks for severe hypospadias in relation to self-reported high blood pressure and prenatal exposures to antihypertensive drugs in 758 male infants with severe hypospadias and 2,058 male controls born between 1997 and 2002. Logistic regression analyses estimated ORs and 95% CIs, adjusted for potential confounders. We observed slight to moderate elevations in the risk of severe hypospadias for maternal untreated hypertension (adjusted OR 2.1; 95% CI: 1.6-2.9) and antihypertensive medication use during 1 month preconception through pregnancy month 4 (adjusted OR 1.4; 95% CI: 0.7-2.9). The association was strongest for subjects initiating medications after the fourth month (adjusted OR 5.0; 95% CI: 1.9-12.9). We observed an association between hypertension, antihypertensive medication use, and the risk of severe hypospadias, particularly when medication use began late in pregnancy. Because hypospadias occurs in early pregnancy, the data suggest that hypertension and its morphologic/physiologic precursors play an etiologic role, perhaps via compromised uteroplacental perfusion. Birth Defects Research (Part A) 2008.

Extended defects in crystals: examples in powder processing for ancient cosmetics

The article presents briefly the nature and the properties of extended defects in relation to the light they shed on the history of ancient objects and their conservation. Chemical reactions, phase transitions and plastic deformation of materials, which take place during the fabrication of objects, leave their imprints under the form of specific crystalline imperfections such as grain boundaries, twins and dislocations. Observations of the microstructure of objects from the cultural heritage can reveal many details about ancient civilisations and technologies. Besides optical microscopy, these observations rely on various dedicated techniques based on X-rays and electron microscopy to identify extended defects, viz. grain boundaries, twins, and dislocations. Defects due to powder processing of lead compounds have been studied recently. Such compounds have been used for centuries in the fabrication of cosmetics.

Role of geographic information systems in birth defects surveillance and research

With the significant advancement of geographic information systems (GIS), mapping and evaluating the spatial distribution of health events has become easier. We examine the role of GIS in birth defects surveillance and research. We briefly describe the geocoding process and potential problems in accuracy of the obtained geocodes, and some of the capabilities and limitations of GIS. We illustrate how GIS has been applied using the Metropolitan Atlanta Congenital Defects Program geocoded dataset. We provide some comments on potential data quality and confidentiality issues with birth defects in relation to GIS. It is desirable to geocode addresses using a multistrategy approach to achieve a high-quality and accurate GIS dataset. Beyond the basic but important function of mapping, sophisticated statistical approaches and software are available to analyze the spatial or spatial-temporal occurrence of birth defects, alone or in association with environmental hazards, and to present this information without compromising the confidentiality of the subjects. We recommend a broad and systematic use of GIS in birth defects spatial surveillance and research.

TheDrosophilaphosphatidylinositol transfer protein encoded byvibratoris essential to maintain cleavage-furrow ingression in cytokinesis

Cytokinesis requires the coordination of cytoskeletal and plasma membrane dynamics. A role for phosphatidylinositol lipids has been proposed for the successful completion of cytokinesis but this is still poorly characterised. Here, we show mutants of the gene vibrator, previously found to encode the Drosophila phosphatidylinositol transfer protein, produce multinucleate cells indicative of cytokinesis failure in male meiosis. Examination of fixed preparations of mutant spermatocytes showed contractile rings of anillin and actin that were of normal appearance at early stages but were larger and less well organised at later stages of cytokinesis than in wild-type cells. Time-lapse imaging revealed sequential defects in cytokinesis of vibrator spermatocytes. In cells that fail cytokinesis, central spindle formation occurred correctly, but furrow ingression was delayed and the central spindle did not become compressed to the extent seen in wild-type cells. Cells then stalled at this point before the apparent connection between the constricted cytoskeleton and the plasma membrane was lost; the furrow then underwent elastic regression. We discuss these defects in relation to multiple functions of phosphoinositol lipids in regulating actin dynamics and membrane synthesis.

International Retrospective Cohort Study of Neural Tube Defects in Relation to Folic Acid Recommendations: Are the Recommendations Working?

This retrospective cohort study was planned to determine whether recommendations to take folic acid have in fact lessened the risk of neural tube defects. Recommendations typically include eating a healthy diet and takingfolic acid supplements when planning pregnancy or throughout the childbearing years. In a few countries, including the United States, flour is fortified so that much of the population will receive at least a small supplemental amount of folic acid. Many governments promote the use of supplements because folic acid is inexpensive, safe, and easy to use. The authors acquired information on more than 13 million births from 13 birth defects registries in Norway that monitored rates of neural tube defects from 1988 to 1998. Cases of anencephaly and spina bifida totaled 8636. Rates of defects were stable during the 10-year monitoring interval in most areas. There were no evident changes in rates of defects after local recommendations were issued. Comparable findings were obtained when analyzing anencephaly and spina bifida separately and combined. Folic acid use in Europe is, in general, low; in Norway, it is approximately 10%. In China, intensive educational efforts and a high rate of planned pregnancies probably are responsible for the effectiveness of a public health campaign to promote the use of folic acid supplements. Rates of folic acid use generally follow economic and educational trends. Fortifying flour with folic acid holds promise for delivering some folic acid to a large part of the population, crossing social and economic barriers. Blood folate levels have increased rapidly where this practice is followed. It is estimated that thousands of neural tube defects occurring since 1992 could have been prevented.

Regional over-representations on chromosomes 1q, 3q and 7q in the progression of hepatitis B virus-related hepatocellular carcinoma

Hepatocellular carcinoma is a highly malignant tumor that is prevalent in Southeast Asia and China, where hepatitis B viral infection is the main etiologic factor. Despite a high incidence of hepatocellular carcinoma developing in patients with viral hepatitis B-induced liver cirrhosis, the molecular events underlying the malignant liver progression remain largely unclear. In an effort to characterize the genetic abnormalities involved in the hepatitis B-related liver carcinogenesis, we performed genome-wide explorations by the technique of comparative genomic hybridization (CGH) on 100 hepatocellular carcinoma tumors that arose from hepatitis B-induced liver cirrhosis. According to the American Joint Committee on Cancer staging, four cases were classified as stage I, 69 as stage II, 23 as stage III and four as stage IV. CGH analysis indicated chromosomal instability in both early (stages I/II) and advanced (stages III/IV) stage tumors, with common gains on 1q, 8q and 17q23–q25, and losses on 4q22–q35, 8p21–p22, 13q14–q21, 16q and 17p identified in both groups (P>0.05). Nevertheless, preferential sites of chromosomal defects in relation to hepatocellular carcinoma progression were also identified. Statistical correlations suggested a higher incidence of regional 1q21–q22, 3q22–q28, 7q21–q22 and 7q34–q36 over-representations in association with the advanced stage tumors (P<0.05). In this study, our novel identification of specific chromosomal aberrations in relation to the advanced stage tumors may represent a first step towards mapping genes linked to the progression of hepatocellular carcinoma.

International retrospective cohort study of neural tube defects in relation to folic acid recommendations: are the recommendations working?

Objectives To evaluate the effectiveness of policies and recommendations on folic acid aimed at reducing the occurrence of neural tube defects.Design Retrospective cohort study of births monitored by birth defect...

The Australian registry of anti-epileptic drugs in pregnancy: experience after 30 months.

Most women with epilepsy need to take antiepileptic drugs (AEDs) in pregnancy to prevent the potentially harmful effects of seizures. Retrospective studies have demonstrated an increased chance of having a child with a birth defect (BD) in women with epilepsy taking AEDs. It is uncertain how much of this risk is directly caused by the AEDs and whether certain drugs or combinations are associated with a greater risk. To establish a register to evaluate prospectively the incidence of adverse pregnancy outcomes in women exposed to specific AEDs; to determine whether certain AEDs or combinations were associated with a greater risk; and to determine whether other factors influenced the risk. An Australia-wide, prospective, voluntary, telephone-interview based, observational register. Three groups of pregnant women were enrolled: those with epilepsy taking AEDs, those with epilepsy not taking AEDs, and those taking AEDs for a non-epileptic indication. The pregnancy outcomes were evaluated by follow-up interviews and by reference to hospital and treating doctors' records. Over the first 30 months of the study (till December 2001) 334 eligible women were enrolled, with all states and territories being represented. Two hundred and ninety two pregnancies had been completed, of which 256 (88%) resulted in a healthy live birth, 19 (6.5%) a live birth with a birth defect, four an induced abortion because of a detected malformation on ultrasound, one premature labour with a stillbirth and 12 (4%) spontaneous abortions. Of the completed pregnancies, 269 were exposed to at least one AED during the first trimester. The incidence of birth defects in relation to specific AEDs was: valproate (16.7%), phenytoin (10.5%), lamotrigine (7.7%) and carbamazepine (3.3%), none of which was significantly different from that in women with epilepsy not taking an AED (4.3%, n.s.). The dose of valproate taken was higher in pregnancies with BD compared to those without (mean 2081 mg vs. 1149 mg, p<0.0001). The incidence of folate supplementation being taken prior to conception did not differ for pregnancy outcomes with or without BD (70% vs. 66%, n.s.). The model for the Australian Pregnancy Register appears to be successful, with strong enrolment from all regions over the first 30 months. The study is prospective and includes reference to all new AEDs approved in Australia over the past decade. Analysis of the pregnancy outcomes to date may reveal early trends, but numbers are still to small for any definitive conclusions to be made regarding the relative risk in pregnancy of individual AEDs.

Short-term outcome of isolated and associated congenital heart defects in relation to antenatal ultrasound screening.

To investigate the outcome of fetuses affected by congenital heart defects (CHD), either detected or undetected at ultrasound screening, according to their complexity and severity. The study group comprised 3633 malformed fetuses entered into the Eurofetus database of which 798 had CHD. We compared the short-term outcome in cases where a CHD was detected by ultrasound screening with that in cases where a CHD was not detected. Isolated and associated CHD (ICHD and ACHD) and the degree of severity of defects were considered separately. Outcome data included termination of pregnancy (TOP), intrauterine fetal death, neonatal death (< 6 days after birth), gestational age at diagnosis and at delivery, mode of delivery and birth weight. Of the 798 fetuses with CHD, 595 had ICHD and 203 had ACHD. The diagnosis of an anomaly was made significantly earlier in ACHD cases. TOP was chosen in 28% of cases with a prenatal diagnosis of CHD, 20% for ICHD and 37% for ACHD (P < 0.001). The survival rate of antenatally diagnosed fetuses was lower in those with ACHD than in those with ICHD (P < 0.001) and lower for fetuses with antenatal diagnosis than with postnatal diagnosis (P < 0.001); this was due to significant differences in the complexity and severity of the defect. Premature delivery (< 32 weeks) was more frequent in fetuses in which an antenatal diagnosis of CHD had been made. Severe CHD were diagnosed earlier and were associated with a higher rate of TOP and spontaneous loss. The severity of CHD has a positive influence on the sensitivity of screening but a negative influence on the outcome. CHD that are not diagnosed antenatally include a high proportion of benign malformations. This explains the apparent paradox of a poorer outcome in fetuses in which a CHD was detected prenatally compared to those fetuses in which the defect was undetected prenatally. However, prenatal diagnosis provides parents with the option of TOP or of preventive care in specialized centers.