Fifth Year Of Life Research Articles

The influence of environmental factors related to Juvenile Dermatomyositis (JDM), its course and refractoriness to treatment

ObjectiveTo evaluate the influence of environmental factors and prematurity relating to juvenile dermatomyositis (JDM), its course and refractoriness to treatment.MethodsA case-control study with 35 patients followed up at a tertiary hospital and 124 healthy controls, all residents of São Paulo. Patients were classified according to monocyclic, polycyclic or chronic disease courses and refractoriness to treatment. The daily concentrations of pollutants (inhalable particulate matter-PM10, sulfur dioxide-SO2, nitrogen dioxide-NO2, ozone-O3 and carbon monoxide-CO) were provided by the Environmental Company of São Paulo. Data from the population were obtained through a questionnaire.ResultsFifteen patients had monocyclic courses, and 19 polycyclic/chronic courses. Eighteen patients were refractory to treatment. Maternal occupational exposure to inhalable agents (OR = 17.88; IC 95% 2.15–148.16, p = 0.01) and exposure to O3 in the fifth year of life (third tertile > 86.28µg/m3; OR = 6.53, IC95% 1.60–26.77, p = 0.01) were risk factors for JDM in the multivariate logistic regression model. The presence of a factory/quarry at a distance farther than 200 meters from daycare/school (OR = 0.22; IC 95% 0.06–0.77; p = 0.02) was a protective factor in the same analysis. Prematurity, exposure to air pollutants/cigarette smoke/sources of inhalable pollutants in the mother’s places of residence and work during the gestational period were not associated with JDM. Prematurity, maternal exposure to occupational pollutants during pregnancy as well as patient’s exposure to ground-level pollutants up to the fifth year of life were not associated with disease course and treatment refractoriness.ConclusionRisk factors for JDM were maternal occupational exposure and exposure to O3 in the fifth year of life.

THE STATE OF THE ORGANIZATION OF COMMUNICATIVE ACTIVITIES AS A MEANS OF PEDAGOGICAL CORRECTION OF SPEECH ERRORS IN CHILDREN OF THE FIFTH YEAR OF LIFE

The formation of state education and its significant modernization is a consequence of Ukraine’s entry into the European and world educational space. One of the priority tasks of the education system is the upbringing and development of a Ukrainian-speaking personality with a national outlook. Such an individual must possess a single language system of spoken and written Ukrainian texts, must be fluent in various communicative situations, comprehensively contribute to the popularization of the language, ensuring its social prestige. The article is devoted to the study of the state of the organization of communicative activity, which can become an effective means of pedagogical correction of speech errors in children of the fifth year of life both in the conditions of a preschool education institution and in the family, provided that it is properly and managed. The purpose of the research is the analysis of the Basic Component of Preschool Education, current educational programs for preschool institutions for the presence of speech development tasks, as well as a survey of educators and parents of pupils regarding awareness of the concepts of “speech errors”, “speech correction” and ownership of tools for correcting speech mistakes and practicing correct speech.

Short-term duration of diabetic retinopathy as a predictor for development of diabetic kidney disease.

Diabetic retinopathy (DR) is a risk factor for diabetic kidney disease (DKD). Whether the duration, especially the short-term duration, of DR is associated with the development and progression of DKD remains unclear. A retrospective study and two-sample Mendelian randomization (MR) analysis were conducted. Kidney disease was defined by the urinary albumin-to-creatinine ratio (ACR) and the estimated glomerular filtration rate (eGFR). DR was diagnosed by an expert ophthalmologist by using a digital fundus camera. Binary and ordinal logistic regression analyses were performed. A restricted cubic spline was utilized to detect nonlinear associations. Summary statistics for DR- and DKD-associated single-nuclear polymorphisms (SNPs) were extracted from the FinnGen and the UK Biobank consortia. A total of 2674 patients with type 2 diabetes mellitus (T2DM) and type 2 diabetic kidney disease (T2DKD) were included. The prevalence and mean duration of DR increased with elevation of ACR and decline in eGFR. Renal function was significantly reduced in patients with DR in the fifth year of life. Binary and ordinal logistic regression showed that each 1-year increase in DR duration was associated with a 19% risk increase in the development of DKD, 16% in the elevation of ACR, and 21% in the decline of renal function. MR estimates indicated that DR was causally associated with DKD development, with an odds ratio of 2.89. DR and the duration of DR were independent risk factors for the development and progression of DKD. The short-term duration of DR may be associated with DKD development. DR had a statistically significant effect on DKD.

“Tooth fairy" educational strategy for infants in the fifth year of life

Introduction: caries in early childhood is one of the most frequent diseases and can influence the development of the infant. Childhood is a stage characterized by intense learning processes and fundamental in the formation of habits and behaviors in the process of education and human development. It depends on the joint action of teachers, health personnel and legal guardians that infants have access and opportunity to transform health information into knowledge, attitudes and adequate practices that allow them to take care of and protect their health. Objective: to implement the educational strategy "The Tooth Fairy" in infants in the fifth year of life. Methods: a quasi-experimental before-and-after study with a control group was carried out. The sample consisted of 34 infants in the fifth year of life in the Juan Delio Chacón neighborhood, obtained by simple random sampling. Results: before the intervention, a poor level of knowledge about oral health predominated in the infants, representing 70,6 % of the experimental group, as well as in the legal guardians and educators for 56,7 %, raising it to good after the intervention in 88,2 % and 86,66 % respectively.Conclusions: the implementation of the strategy in the educational context, involving families, educators and community proved to be effective since it modified lifestyles and lifestyles, also increasing the level of knowledge about oral health of infants, educators and legal guardians

Playing hide and seek: Contextual regularity learning develops between 3 and 5 years of age

The ability to acquire contextual regularities is fundamental in everyday life because it helps us to navigate the environment, directing our attention where relevant events are more likely to occur. Sensitivity to spatial regularities has been largely reported from infancy. Nevertheless, it is currently unclear when children can use this rapidly acquired contextual knowledge to guide their behavior. Evidence of this ability is indeed mixed in school-aged children and, to date, it has never been explored in younger children and toddlers. The current study investigated the development of contextual regularity learning in children aged 3 to 5 years. To this aim, we designed a new contextual learning paradigm in which young children were presented with recurring configurations of bushes and were asked to guess behind which bush a cartoon monkey was hiding. In a series of two experiments, we manipulated the relevance of color and visuospatial cues for the underlying task goal and tested how this affected young children’s behavior. Our results bridge the gap between the infant and adult literatures, showing that sensitivity to spatial configurations persists from infancy to childhood, but it is only around the fifth year of life that children naturally start to integrate multiple cues to guide their behavior.

Health Services Use Among Children With Prenatal Substance Exposure or Neonatal Abstinence Syndrome.

Infants with prenatal substance exposure or neonatal abstinence syndrome (NAS) use health services more often than other children; however, little is known about their use of mental health services and psychotropic medication. The sample (N=1,004,085) consisted of infants born in 2016 in 38 states who were followed through the fifth year of life and enrolled each year in Medicaid or the Children's Health Insurance Program. Infants with prenatal substance exposure or NAS were identified with ICD-10 diagnosis codes; procedure and revenue codes documented their service use. Rates of any mental health visit and of psychotropic medication use were higher among infants with prenatal substance exposure or NAS compared with infants without either condition; these patterns persisted during most years of the 5-year study. Infants' elevated mental health services use through their first 5 years of life highlights the importance of early screening and subsequent engagement in school-based mental health interventions.

Epidemiological Profile and Associated Allergic Conditions of Atopic Dermatitis: Data from a Referral Service in Southeastern Brazil

Background: Atopic dermatitis is a chronic, inflammatory, and pruritic dermatosis of high prevalence, especially in childhood. a relevant public health issue. Atopic dermatitis is associated with several factors, including genetic, psychological, infectious, food, and environmental, and may be associated with other manifestations of atopy, such as asthma and rhinitis. Objective: To determine the epidemiological profile and the prevalence of personal and family history of allergy in children with atopic dermatitis at a referral service, comparing it to existing literature. Methods: We conducted a cross-sectional and descriptive hospital-based study involving children of both genders under 18 years with clinical diagnosis of atopic dermatitis (Hanifin and Rajka criteria) seen at the Pediatric Dermatology Outpatient Clinic of Hospital Municipal Universitário de Taubaté (HMUT), SP-Brazil, from October 2018 to April 2019. Epidemiological data and data related to personal and family history of allergies were collected from the medical records. Microsoft Excel 2019 was used for compilation and data analysis. Results: Of the 440 consultations in that period, 35 (7.9%) were for atopic dermatitis, of which 23 of them were females (65.7%) and 15 were phototype IV (42.9%); their mean age was 7.7 (standard deviation = 4.3), and the duration of disease ranged from 2 months to 14 years (mean 5.3 years; standard deviation = 4.3). Among the 35 patients, 31 (88.6%) manifested the condition by the fifth year of life. Personal history of allergies was observed in 27 individuals (77.1%), with a predominance of allergic rhinitis and in older age groups. Conclusion: This study, as a pioneer in the region, contributes to the epidemiological profile of patients with atopic dermatitis from the Pediatric Dermatology Outpatient Clinic of HMUT, revealing an early onset and a higher prevalence in females and individuals with higher phototypes. In addition, this study also demonstrated the prevalence of personal and family history of allergies in these patients, consistent with literature.

Agrotechnics of sorghum in grass-field crop rotation for the conditions of the West Kazakhstan region

Sorghum can be sown after any crop in a field rotation, but in fields that are free of weeds. Sorghum is easy to grow in a wide variety of soil and climate conditions. Most often, it is cultivated in arid conditions, which is its clear advantage over other crops. These studies were conducted from 2019-2021. at the station in LLP “Ural Agricultural Experimental Station”, deployed in time and space, grass-field crop rotation, where the predecessors for sorghum were a mixture of perennial grasses of the fifth year of life. Before sowing sorghum, a background agrochemical characterization of the soil was carried out at 20 and 40 cm. In the studies, appropriate agrotechnics for sorghum cultivation were applied. The use of crops of perennial grasses consisting of cereal-legume phytocenoses (wheat grass, sainfoin, alfalfa) in grass-field crop rotations is promising from the point of view of further application of chemical means of protection against weeds, but also increasing soil fertility due to the organic matter of crop rotation crops.

Uloga gena modifikatora na klinički tok Dišenove mišićne distrofije

Duchenne muscular dystrophy is the most common inherited muscle disease in childhood, which has a progressive clinical course with a fatal outcome that most often occurs between the second and fourth decade of life. The disease is inherited X-linked, recessively, and in two-thirds of patients, it is transmitted from the mother, while in the remaining third of patients, it is a de novo mutation. Mutations in the dystrophin gene (DMD gene) such as deletions, duplications and small mutations can be found throughout the entire length of the gene. The disease begins between the third and fifth year of life, and the initial muscle weaknesses are clinically manifested as slower running, difficulty climbing stairs or difficulty getting up from squats. Sometimes, accidentally discovered, elevated keratin kinase values or delayed early psychomotor development milestones in a child with hypertrophic calves can initiate a diagnostic procedure in the direction of Duchenne muscular dystrophy. The disease usually has a uniform clinical course and implies a clear time sequence of events. Muscle weakness leads to loss of ambulation, then the function of the upper extremities, to complete immobility, with the evolution of dilated cardiomyopathy and respiratory insufficiency, which are the main causes of death. Certain patients show deviations from the above in terms of longer functionality and later loss of independent ambulation, later cardiomyopathy and respiratory insufficiency and vice versa. It is believed that in addition to the application of modern standards of care and treatment of patients, the clinical course is influenced by genes independent of the causal DMD gene, which affects processes in dystrophic muscle, primarily inflammation, fibrosis and fatty infiltration, through specific signaling pathways. So far, six genes have been described whose variants modify the course of Duchenne muscular dystrophy. The secreted phosphoprotein 1 (SPP1) is the first described gene whose G allele in the variant rs28357094 is associated with an earlier age of gait loss. In addition, variants in the genes described are LTBP4 (latent transforming growth factor-b binding protein 4), CD40, ACTN3 (actinin 3), THBS1 (thrombospondin 1) and TCTEX1D1 (Tctex1 domain containing 1). The aim of this paper is to present already-known genes that modify Duchenne muscular dystrophy and their influence on the clinical course of the disease.

The predictive value of the cognitive scale of the Bayley Scales of Infant and Toddler Development-III

The measurement of cognitive development is of major importance within developmental psychology research. However, empirical findings from longitudinal studies using the Bayley Scales of Infant and Toddler Development-III (BSID-III) are scarce. Moreover, few studies have assessed the predictive relationship between the BSID-III and later IQ measurements using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III). The aims of the current study were to investigate (1) the predictive relationship within the first, second, and third year of life using the Cognitive Scale of the BSID-III, (2) the predictive relationship between the Cognitive Scale of the BSID-III and the WPPSI-III Verbal IQ, Performance IQ and Full Scale IQ scores in the fifth year of life, and (3) the relationship of habituation speed and novelty preference with BSID-III and WPPSI-III scores. Therefore, 110 children were tested with the BSID-III at the ages of 6, 9, 18, and 26 months, with a habituation and novelty preference task at 9 months, and with the WPPSI-III at 50 months. Structural equation modeling revealed that BSID-III at all ages predicted the children’s IQ obtained using the WPPSI-III at 50 months. Furthermore, all BSID-III scores predicted subsequent BSID-III scores. These findings highlight the predictive value of the Cognitive Scale of the BSID-III. Habituation speed and novelty preference were not related to the BSID-III or WPPSI-III scores. Explanations for these findings, limitations, and ideas for future studies are discussed.

Whole-exome sequencing uncovered genetic diagnosis of severe inherited haemolytic anaemia: Correlation with clinical phenotypes.

Next-generation sequencing has shed light on the diagnosis of previously unsolved cases of inherited haemolytic anaemia (IHA). We employed whole-exome sequencing to explore the molecular diagnostic spectrum of 21 unrelated Thai paediatric patients with non-thalassemic IHA, presenting hydrops fetalis and/or becoming transfusion-dependent for 1year or more or throughout their lifespan. Anaemia was detected prenatally, within the first month and the fifth year of life in three, 12 and six patients respectively. Molecular diagnosis obtained from all patients revealed SPTB as the most frequently mutated gene (four reported, three novel), found in 31 of 42 studied alleles. The other two mutated genes identified were ANK1 (three novel) and KLF1 (two reported). Four recurring mutations within exon 29/30 (NM_001024858.2) accounted for the vast majority (90%) of mutated SPTB alleles, biallelic inheritance of which resulted in the most severe phenotypes: hydrops fetalis and life-long transfusion dependency. Dominant ANK1 (n= 3) and SPTB (n= 2) mutations and biallelic class 2 KLF1 mutations (n= 1) led to a shorter period of transfusion dependency. Our study demonstrated that mutated SPTB causing red-cell membranopathy is likely the most common cause of severe non-thalassemic IHA among Thai patients. This urges carrier screening in the population to prevent subsequent, severely affected births.

Risk factors for intussusception in childhood gastroenteritis: a nationwide cross-sectional study in Italy


 
 
 
 Background. The aetiology of intussusception is unknown for most of the cases studied, although some associated conditions have been identified. We aimed to clarify the role played by enteric pathogens as potential risk factors for intussusception.
 
 Methods. A retrospective review of the records relating to hospitalizations for gastroenteritis with or without concurrent intussusception in Italian children was conducted among children aged <6 years old during the period 2005-2012. Through a multivariate logistic regression model, the associations, expressed as odds ratios with 95% confidence intervals, were estimated between the presence of gastroenteritis with intussusception and the explanatory variables, such as sex, age, the aetiology of gastroenteritis and whether the subjects lived in the North, South and Islands or Centre Italy.
 Results. A total of 174 records related to admissions due to the concomitant manifestation of gastroenteritis and intussusception were extracted and analyzed. The estimate of the adjusted odds ratio confirmed the significant contribution that sex and geographical location made to hospitalizations both for gastroenteritis with concurrent intussusception, and in the associated secondary diagnosis of gastroenteritis, with the exception of the rotavirus, where a different seasonality and a bucking trend were observed. The probability of intussusception became statistically significant lower from 12 months of age to ≤23 months and for age 48-59 months, respect to the first year of life.
 Conclusions. Our observational study highlighted males, affected by enteric infections, other than rotavirus and parasitic, living in North and Centre of Italy have an increased risk of developing intussusceptions. In the second and fifth year of life the probability of intussusceptions becomes lower than in the first year. Additional research is needed to confirm these findings and evaluate the pathogenesis which may link such infections with intussusception. 
 
 
 

ПРИЖИВАЕМОСТЬ И РОСТ СОСНЫ ОБЫКНОВЕННОЙ В УСЛОВИЯХ ПРИМЕНЕНИЯ ПОЛИМЕРОВ ДЛЯ УСЛОВИЙ СТЕПИ И ЛЕСОСТЕПИ

The article presents the results of a study of the survival, growth and condition of forest crops of scots pine with the use of polyacrylamide polymer "AQUASORB". The object of research was the forest cultures of scots pine in the conditions of the steppe on sand and sandy soils, in the conditions of the forest-steppe - on loam. The polymer was used as a gel in doses of 125 ml and 250 ml, and also in dry form was introduced into the root system of seedlings before planting. The ability of the polymer to absorb water and give it to plants with its subsequent shortage in the soil caused its effectiveness, which is confirmed by an increase in the survival rate of pine crops by 16-20% in steppe conditions on sand and sandy soils and by 9-13% on loam in forest-steppe conditions. The intensity of pine growth in variants with different doses of polymer increased by 48-78% in steppe conditions and by 36-60% in forest-steppe conditions in the first year of pine crops' life. In the third and fifth years of the life of pine crops, the intensity of pine growth in (150) variants with polymer decreases, which indicates the leveling of the polymer's action in the soil over time. Positively affecting the survival rate and growth rate of pine crops, AQUASORB polymer contributes to an increase in the preservation of pine forest crops in the fifth year of life by 1.2-1.3 times. The effectiveness of the polymer decreases with sufficient water reserves in the soil.

Nephro-urological outcomes of a proactive management of children with spina bifida in their first 5 Years of life

The proactive management of spina bifida (SB), especially of its severe form, myelomeningocele (MMC), has contributed to decreasing chronic kidney disease (CKD). The objective of this study is to present the evolution of 5-year-old patient with MMC followed from birth with a proactive approach. This retrospective study included 55 cases with MMC of up to 5 years of age. All of them were admitted at birth and followed by a multidisciplinary group, with a proactive approach: CIC and anticholinergics. In the same group, the variables were compared within the first year and the within the fifth year of life. Chronic kidney disease (CKD) was defined by: alterations on renal DMSA scintigraphy; alterations in microalbuminuria/creatininuria ratio, proteinuria 24 hs and decrease in glomerular filtration rate (GFR) calculated with Schwartz bedside equation. Although overactivity, UTI and VUR decreased throughout the first 5 years (49, 9 and 12%), reduced cystometric capacity, DLPP >40 cm of water and end-filling pressure (Pdet) >20 cm of water increased (41, 27 and 61%). All patients at 5 years of age required CIC. Reduced cystometric capacity and VUR were more significant with abnormal DMSA (36%) at 5 years old ( p: 0.03). Proteinuria and CKD increased to 25% and 49%. Similarly, the need for enalapril increased from 10% to 27%. The microalbuminuria/creatininuria ratio was pathological in 27.3%. 48 patients (87%) remained unchanged on DMSA scan and the other 7 underwent modifications (4 new cases with altered DMSA) over time. Of the 32 normal DMSA cases without changes, 81% did not present proteinuria and 88% continued to respond favorably to oxybutynin. GFR <90 ml/min/1.72m 2 was found in only 3 cases with abnormal DMSA. There was a RR 1.91 (IC95% 1.15-3.16) greater of renal compromise in cases that were anticholinergic-resistant compared to non-refractory cases. Over time, some patients suffered loss of bladder wall compliance, despite the proactive approach. There is an association between abnormal renal DMSA, reduced bladder capacity, and VUR at 5 years of age. Although proteinuria, CKD and enalapril requirement increased over 5 years, almost 90% did not show changes in renal DMSA status. Over time, some patients suffered loss of bladder wall compliance. Hence, even if a proactive approach is followed since birth, it is essential to continue with the ongoing monitoring of the renal status and thus avoid greater renal deterioration.

Pedagogical Conditions for the Development of Artistic Perception in Children of the Fifth Year of Life in the Process of Familiarization with Works of Fine Art

The article considers the problem of the development of artistic perception in children of the fifth year of life. The paper substantiates the possibility and necessity of developing artistic perception in preschool age, the features of using works of fine art in the development of artistic perception of preschool children, the willingness of a teacher to develop artistic perception of pupils, as well as the relationship of directly educational activities with the independent creativity of children.

ENERGY AND ECONOMIC EFFICIENCY OF MUSCLE GROWTH GROWING IN THE SOUTHERN STEPPE OF UKRAINE UNDER DROP IRRIGATION

In the article technological methods energy and economic evaluation of growing sage in southern steppe of Ukraine conditions have been analysed. The economists’ views on the raw medicinal herbs under drip irrigation formation of efficient production have been considered. The analysis of previous agronomic studies on the cultivation of crops under drip irrigation has allowed us to conclude that there are no such results on the plantations of Salvia sclarea. The yield level of Salvia sclarea inflorescences was stable during the first three years of using, on the average in the first year it was 9.51 t/ha, in the second year it was 9.38 t/ha, in the third year it was 9.69 t/ha. Only in the fourth year of crops using (the fifth year of life) the yield was decreasing sharply. On the basis of yield data, the calculation and analysis of such indicators as energy efficiency, energy intensity of growing 1 kg of inflorescences and the conditional net profit when growing sage in drip irrigation in southern Ukraine. The maximum values of energy efficiency ratio were obtained in the first year of using and sowing in the first decade of December against the background of N60P90 - 3,25 application. When the crops sowing was postponed to the first decade of April, this indicator decreased twice to 1.59. In our experiment the minimum values of energy ratio of Salvia sclarea growing technology were obtained in the fourth year of plantation using. The classical indicators which reflect the economic and energy efficiency level of inflorescences of nutmeg production at long-term use of a culture plantation culture have been analysed. The analysis of the factors which influence for efficiency change of cultivation of culture was carried out. The mechanism of efficiency increase of cultivation of sage nutmeg in the conditions of the southern Steppe of Ukraine has been offered.

К вопросу о понимании дошкольниками эмоциональных состояний другого человека

The article presents the results of studies during which the authors studied the dynamics of the development of the emotional and social spheres of preschool children. Based on the results, a number of issues related to the diagnosis and various psychological practices aimed at the development of these areas are considered. Also given are the results of a study that identifies the age-related potential of preschool children associated with the ability to focus on the emotional states of another person. The results presented in the article demonstrate that only in the fifth year of life, most children on their own (without the help of an adult) begin to highlight the emotional state of a person as an essential sign. But they do not use their skill when they try to orient in the sense of what is happening. Only at the end of preschool age do some children begin to determine the meaning of what is happening on the basis of the emotional states of another person. Based on the data obtained, an admission is made about the need for developmental (not diagnostic) work with children. The methodology of the forming experiment described in the article allows one to determine the directions of psychological and pedagogical support of the emotional development of preschool children.

Natal Dispersal Distance of Golden Eagles in the Southwestern United States

Abstract Data on natal dispersal distances (NDDs) of golden eagle Aquila chrysaetos in North America are needed to define local area populations and inform decisions authorizing take (i.e., injury, death, or disturbance) of the species via federal permit. Sixteen golden eagles (6 males, 10 females) tagged with satellite transmitters as ∼8-wk-old nestlings in the southwestern United States during 2010–2013 dispersed a mean of 55.3 km (SD = 29.7, median = 64.5), either 1) between their natal nest sites and nests where they first bred (n = 3 females, all subadults, i.e., in their fourth year of life), or 2) between natal sites and where they permanently settled as adults at least in their fifth year of life, but did not necessarily breed (i.e., exhibiting only gross natal dispersal). On average, females dispersed about 50% farther than males; mean NDD of males and females was 41.2 km (90% credible interval = 11.1–75.2) and 63.8 km (44.8–82.6), respectively. Median NDD of males and females was 41.5 and 65.8 km, respectively; in a Bayesian framework, the estimated difference in posterior median distributions of male and female NDDs was 22.2 km (−15.7 to 57.3; P ≠ 0 = 0.89), tentatively indicating that NDD of golden eagles in our study area may be female biased. Although our findings are based on a relatively small data set including both effective and gross natal dispersal records, they represent the first comparison of NDD between sexes of golden eagle in North America and the first published records on the continent of the species' NDD based on telemetry methods. More work is needed to validate whether golden eagle NDD in at least some regions of North America is female biased, which could have important implications for authorizing take of the species.

The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study.

Background:Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry.Methods:We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls. The children were evaluated in their fifth year of life. Three midline and 3 bilateral orthopometric midface landmarks were programmed using a custom software (OnyxCeph3, Image Instruments GmbH, Germany), and corresponding linear measurements from the midline were obtained and compared between the groups using 1-way analysis of variance and Scheffe’s post hoc test.Results:Significant differences were observed between the control and CUCLP groups for the measurements of the proanasale, subnasale, and zygion. However, there were no significant differences between the PNAM and no nasoalveolar molding groups for the 6 midface landmarks.Conclusions:PNAM does not seem to significantly impact the long-term midface symmetry in children with CUCLP.

Childhood nephroblastoma in Southern and Eastern Europe and the US: Incidence variations and temporal trends by human development index

BackgroundDespite advances in the management of nephroblastoma (Wilms’ tumor, WT), the etiology of the tumor remains obscure. We aimed to compare nephroblastoma incidence rates and time trends among children (0–14 years) in 12 Southern and Eastern European (SEE) countries and the Surveillance, Epidemiology, and End Results Program (SEER), USA, in relation to the human development index (HDI). MethodsIn total 1776 WT cases were recorded in 13 SEE collaborating registries (circa 1990–2016), whereas data on 2260 cases (1990–2012) were extracted from the SEER database. Age-standardized incidence rates (AIRs) were calculated and correlated with HDI, whereas temporal trends were evaluated using Poisson regression and Joinpoint analyses. ResultsThe overall SEE AIR (9.2/106) was marginally higher than that of the SEER (8.3/106), whereas significant differences were noted among the 13 SEE registries which comprised mainly Caucasian populations. A statistically significant temporal increase in incidence was noted only in Belarus. Most cases (∼75%) were diagnosed before the fifth year of life, with rates steadily declining thereafter; median age at diagnosis was similar in SEE countries and SEER. A slight male preponderance in the first year of life (male:female = 1.1) was followed by a female preponderance in the older age groups (male:female = 0.7). Lastly, a statistically significant positive association between higher HDI and increasing nephroblastoma incidence was noted (regression coefficient: +3.25, 95%CI: +1.35, +5.15). ConclusionsVariations in incidence and time trends across the examined registries, changing male-to-female patterns with advancement in age, and positive associations with the HDI imply a plausible role for environmental and genetic factors in disease etiology, and these need to be explored further.