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Se presenta un caso clínico de un paciente masculino con 12 años de edad diagnosticado con labio paladar fisurado unilateral no sindrómico, maloclusión clase III, resalte de -5 mm y mordida cruzada posterior bilateral, el que recibió tratamiento ortopédico mediante el uso de disyuntor en abanico y máscara facial. Luego de 7 meses de terapéutica, se obtuvo una evolución favorable relativa a la protrusión del maxilar y un resalte de 0 mm. El resultado del tratamiento pudo verse afectado debido a la edad del paciente, el que se encontraba en etapa de crecimiento puberal.

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Copyright of Enfermería Neonatal is the property of Fundacion para la Salud Materno Infantil (FUNDASAMIN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Palate formation occurs between the fifth and eleventh week of intrauterine life as a result of the union of the primary and secondary palate. On the other hand, the formation of the upper lip occurs between the fifth and sixth week of development, and is configured in its middle part by the fusion of the medial and lateral nasal processes, at the expense of the maxillary processes. The prevalence of cleft lips and / or cleft palate varies according to the different ethnic groups, with figures ranging from 0.7 to 1.1 cases per 1000 live births. The aim of this work was to carry out a literature review on epidemiological aspects, molecular and environmental genetic mechanisms that influence the occurrence of cleft lip, cleft palate and its embriology. The literature search was carried out in the databases PUBMED, SCOPUS, SPRINGER, SCIENCEDIRECT using the English terms "cleft lip and palate", "cleft lip", "cleft palate" and "embryology". Inclusion criteria included studies carried out in humans and animals, published between 2015 and 2021. The search yielded a total of 407 works, of which after a filter by title and abstract, a total of 38 articles remained, in which a text analysis was carried out complete to finally select 26 articles that cover genetic-molecular, environmental, epidemiological and syndromic topics. In addition, 6 documents associated with textbooks and scientific articles were incorporated by manual search, without considering the inclusion criterion of time. This review describes the strong association between oral fissures and mutations of genes Msx1, sonic hedgehog, bone morphogenetic proteins and fibroblast growth factor during migration of neural crest cells and palate shaping and formation. Lack of folic acid during palae development dar and the presence of hypoxia due to exposure to smoke, are the environmental factors most frequently observed in orofacial malformations. [ABSTRACT FROM AUTHOR]

Introducción: la ortopedia prequirúrgica en el tratamiento de la fisura labiopalatina constituye una pauta terapéutica controversial. Los investigadores que están a favor plantean que favorece el cierre de la fisura lo cual facilita la cirugía, y otros apoyan el criterio de limitar el crecimiento maxilar y provocar su colapso.Objetivo: determinar los efectos morfológicos en el crecimiento transversal del maxilar durante el período de uso de la placa ortopédica prequirúrgica en niños con fisura labiopalatina atendidos en el Hospital Provincial Universitario «José Luis Miranda» de Villa Clara, en el período de marzo de 2015 a junio de 2019.Métodos: se realizó un estudio de intervención longitudinal. La muestra estuvo conformada por 34 niños previo consentimiento de sus padres o tutores. La información se obtuvo a través de: la entrevista, el examen clínico y mediciones; se aplicaron pruebas estadísticas como el test de Wilcoxon y el estadístico exacto de Fisher.Resultados: en la muestra estudiada predominaron los pacientes del sexo masculino y la fisura transforamen. Con el uso de la placa ortopédica prequirúrgica el maxilar mostró un crecimiento uniforme con un incremento de 5,6 mm de la distancia intercanina y de 5,2 mm de la distancia postgingival desde el nacimiento hasta la cirugía del paladar. La media de crecimiento entre el nacimiento y la cirugía del labio fue de 2,7 y 2,6 mm para la distancia intercanina y postgingival, respectivamente.Conclusiones: la ortopedia prequirúrgica favorece el crecimiento transversal del maxilar con un incremento uniforme de su ancho anterior y posterior.

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Background: Congenital malformations are anomalies, structural or functional, that occur during the embryonic or fetal phase. There are several causes, one of which is the ingestion of toxic plants. Considering the importance of native toxic plants in the Central Backlands of Ceará state - Brazil, this paper reports cases of congenital malformations in sheep due to ingestion of Mimosa tenuiflora. Cases: Cases of abortion and malformations in sheep, were monitored in a rural property in the municipality of Piquet Carneiro with 20 ruminants (15 sheep and 5 cows) raised on a semi-intensive regime. The animals grazed during the day and were supplemented with corn, having unrestricted access to dam water. On its margins, there was a large amount of jurema preta (Mimosa tenuiflora), which the owner reported that the sheep consumed daily. The owner was unaware of the toxicity of M. tenuiflora but reported that cases of malformations had already occurred on his property some time ago. In an interval of approximately 12 days, 3 sheep miscarriage fetuses with multiple malformations. Malformed fetuses were referred for anatomopathological examination at the Animal Pathology Laboratory of the Veterinary Hospital of Federal University of Campina Grande (UFCG), Campus Patos, Paraíba, Brazil. The fetuses were necropsied and tissue samples of the nervous system and organs from the thoracic and abdominal cavities were collected, fixed in 10% neutral buffered formalin, routinely processed for histopathology, included in paraffin, cut into 3 µm sections and stained with hematoxylin and eosin (HE). At necropsies were observed permanent contracture of the thoracic limb joints (arthrogryposis), particularly at the radio-carpal joints; incomplete medial fusion of the palatal bone, with communication between the oral and nasal cavities (palatoschisis); hypoplasia of the mandibular bone (micrognathia); unilateral hypoplasia of the incisive bone with discontinuity of the upper lip (cheiloschisis); unilateral hypoplasia of the eyeball (microphthalmia); lateral curvature of the cervical spine (scoliosis); and chest deformity characterized by ventral protrusion of the sternum and ribs (Pectus carinatum). At the histopathological evaluation of the tissues, no alterations were observed. Discussion: The diagnosis was based on the epidemiological, clinical, and anatomopathological findings. The semi-intensive management system applied on the property predisposed the sheep to ingestion of M. tenuiflora, which grows abundantly on the property and throughout the Central Backlands of Ceará, Brazil, with a high rate of geographical coverage. Despite that, most rural producers, especially subsistence farmers, are unaware of the toxic and teratogenic properties of the plant. In the northeastern, where there are long periods of drought coupled with forage shortages, poisoning by M. tenuiflora is a common cause of malformation and mortality in lambs. Therefore, it is necessary to adopt preventive measures in herds, such as raising awareness among producers about the toxic potential of some native plants and the practice of producing and supplying silage to animals, so that native toxic plants are not the only food source during the scarcity period. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a disorder that affects women's health and the quality of the mother-baby relationship. This study compared the PPD of mothers of babies without and with cleft lip and/or palate, and identified the predictor variables of PPD considering the sample as a whole. 120 mothers participated, 60 of babies with clefts and 60 of babies without risk condition. For data collection, were used the interview protocol and the Edinburgh Postnatal Depression Scale (EPDS). Results showed a higher incidence of PPD in mothers of babies without cleft (30%) than in mothers of babies with clefts (20%). However, there were no statistically significant differences between groups. The variables that explained the occurrence of PPD were: lower maternal education, fewer children, absence of cleft in the baby, older age of the baby, and lower socioeconomic status. [ABSTRACT FROM AUTHOR]

Introducción: El labio y paladar hendido son malformaciones craneofaciales que se presentan en 1:1000 nacidos vivos en Colombia. Realizar un moldeado nasoalveolar previo a la cirugía favorece el reposicionamiento de los cartílagos nasales deformados y de los procesos alveolares. Objetivo: Dar a conocer a los profesionales la importancia de realizar moldeado nasoalveolar en un paciente con labio y paladar hendido antes de la intervención quirúrgica. Materiales y métodos: En la clínica odontológica de la Universidad del Sinú de Montería (Córdoba, Colombia), se atendió una paciente de 17 días de nacida que presentaba labio y paladar hendido completo unilateral izquierdo severo. Luego de diligenciar la historia clínica odontológica, se realizó placa de órtesis, que se cambió cada 15 días y se hizo el retoque del “tutor” cada 8 días. Resultados: La placa de órtesis permitió un moldeado naso alveolar, con el progreso en la alimentación y mejoras en el contorneado de los tejidos nasales, que mejoró la preparación para la operación de la hendidura a los 8 meses de edad. Conclusiones: La importancia del moldeado nasoalveolar en casos como el presentado, es propiciar mejores condiciones físicas, favoreciendo la ingesta de alimentos y beneficiando la apariencia física.

cleft lip and palate are congenital malformations of the stomatognathic system; they occur due to an alteration of the anatomical structures of the skull, face and oral cavity, due to a failure in the fusion of tissues in embryogenesis; malformations can be of the lip, hard palate, soft palate, palatal mucosa, and in some cases of the nasal cavity; moreover, they affect the structures involved in the functions of language, speech, and hearing. Objective: To identify the genetic and environmental factors associated with cleft lip and palate. Methodology: the bibliographic review was carried out in PubMed, LILACS, OVID-MEDLINE academic databases using standardized language with DECS-LILACS terms: exposure to environmental risks, cleft palate, cleft lip, genetics, precision medicine and syndrome; Search filters of the databases, types of scientific texts and information relevant to the research were applied. According to the results of the bibliographic search, it was found that the etiology of the fissures is multifactorial and is associated with genetic and environmental factors. The identification of various genes related to these malformations has made it possible to timely recognize when a cleft is syndromic or non-syndromic, which leads to understanding gene-by-gene interaction, identifying functional variants and understanding their etiological importance. Conclusions: the study and knowledge regarding the molecular mechanisms that are involved in the formation of cleft lip and palate has gained strength thanks to the understanding of the human genome and the development of modern molecular biology tools that allow the identification of large amounts of sequence data, causing the candidate genes to increase constantly. [ABSTRACT FROM AUTHOR]

El origen de una clasificación para las fisuras labiopalatinas se remonta desde comienzos del siglo XX. Muchos de los sistemas propuestos por diversos autores no han prosperado, principalmente debido a su complejidad para memorizar y registrar. Esta nota científica resume las clasificaciones de fisuras labiopalatinas más populares entre los profesionales de la salud y además propone una nueva, basada en aspectos anatómicos y morfológicos de las fisuras en los pacientes, la Clasificación Anatómica. Esta clasificación, diseñada y utilizada por la Unidad de Malformaciones Craneofaciales de la Universidad de Chile, busca entregar una solución a esta problemática, categorizando las fisuras, de manera simple y descriptiva, según los tejidos comprometidos (labio, paladar, labiopalatinas), si su manifestación clínica es poco prevalente (atípicas) o si se encuentran asociadas a algún síndrome (sindrómicas).

La fisura labio-palatina es la malformación congénita más común entre las anomalías craneofaciales y causa una serie de alteraciones a nivel funcional, fisiológico, estético y social. Una de las características comúnmente asociada a estos pacientes, es la hipoplasia maxilar severa producto de la gran resistencia opuesta por los tejidos cicatrizales de labio y paladar, como consecuencia de la cirugía primaria. Tradicionalmente, el tratamiento ha sido la cirugía ortognática convencional al término del crecimiento, sin embargo, este enfoque ha demostrado tener ciertas limitaciones. La distracción osteogénica mediante un distractor rígido externo ha resultado ser una buena alternativa para el manejo de estos pacientes, ya que permite la distracción gradual del maxilar y de los tejidos asociados, mejorando los resultados a corto y largo plazo. Se realizó una revisión de la literatura actual disponible con el objetivo de describir el alcance del tratamiento de la distracción osteogénica maxilar con distractor rígido externo en los pacientes con fisura labio-palatina e hipoplasia maxilar severa. Se concluye que la distracción osteogénica maxilar con distractor rígido externo es un procedimiento efectivo, confiable y relativamente estable, con mínimas complicaciones asociadas y que podría superar a la cirugía convencional en el manejo de pacientes que requieran un avance maxilar severo.

El labio y paladar fisurado (FLAP) se consideran como defectos anatómicos de profundo impacto estético como funcional lo cual lleva una serie de secuelas físicas, funcionales y psicológicas. Dentro del amplio tratamiento multidisciplinario que son sometidos los pacientes, el injerto alveolar secundario es fundamental para resolver diferentes secuelas como el defecto anatómico, la función y buscar continuar con el desarrollo adecuado del paciente. El objetivo del presente trabajo de investigación es hacer una revisión de la amplia literatura que existe entre los parámetros y consideraciones de esta técnica quirúrgica, ya que existe gran controversia entre los diversos estudios. El injerto alveolar secundario se realiza comúnmente entre los 9 y 12 años de edad durante la dentición mixta y antes de la erupción del canino permanente. Según la literatura el hueso esponjoso autólogo presenta los mejores resultados para este tipo de procedimientos, por sus diferentes mecanismos biológicos para la integración ósea. La zona dadora más utilizada sigue siendo la cresta ilíaca debido a su gran disponibilidad de tejido esponjoso y cortical, junto a su baja morbilidad. Actualmente los injertos óseos secundarios presentan una gran tasa de éxito y una reabsorción razonable, siendo el tratamiento más efectivo para las fisuras alveolares.

Introducción: Los niños que padecen enfermedades genéticas son una población vulnerable para desarrollar problemas de salud mental. La fisura labiopalatina (FLAP) es una anomalía congénita de tipo estructural. Objetivo: Estudiar el impacto a nivel familiar del diagnóstico de FLAP. Métodos: Alcance descriptivo, de diseño mixto y corte transversal. Se construyó un cuestionario autoadministrado compuesto por un consentimiento informado, un cuestionario de datos sociodemográficos, el Child Behavior Checklist y preguntas abiertas. El muestreo fue intencional y la muestra fue de 50 casos. Resultados: El CBCL 1.5-5 indicó una media de M=53.60 (DE 23,53) en la escala general de problemas comportamentales y emocionales, M=14,86 para la escala internalizante, y de M=19.04 para la externalizante. Conclusión: El diagnóstico de una fisura labio palatina es una experiencia difícil en los padres, quienes viven este momento de manera negativa, con tristeza y miedo. Los niños en edad preescolar con diagnóstico de fisura labiopalatina son una población en riesgo de desarrollar trastornos psicopatológicos, mayormente de tipo externalizantes.

Se presentó un recién nacido del sexo femenino, hijo de madre de 31 años con antecedentes patológicos referidos de hipertensión arterial y abuela materna con diabetes mellitus. En el examen físico realizado se comprobó la base de labio y paladar hendidos unilaterales izquierdo completos. Fue atendida en el Hospital Provincial Ginecobstétrico “Fe del Valle Ramos”, provincia Granma, por un equipo de salud multidisciplinario. Es importante una vez diagnosticada la patología, desarrollar a través de un equipo multidisciplinario acciones que permitan restaurar la adecuada funcionalidad de la vía digestiva, así como todas las problemáticas estéticas y fonética, mejorando de esta manera la calidad de vida del niño, de sus padres y familiares, lo que permitirá al paciente una mejor integración a la sociedad.

Objetivo: identificar y describir, desde la perspectiva del derecho fundamental a la salud, la garantía de la atención sanitaria en menores dominicanos afectados con labio y/o paladar hendido (LPH) y sus madres. Métodos: en tanto este es un estudio descriptivo, se realizaron encuestas semiestructuradas y se aplicó la observación no participante en los territorios de residencia de familias con menores afectados por LPH, atendidos en una fundación de República Dominicana. Resultados: la mayoría de familias afectadas por LPH pertenecen a clases sociales vulnerables con limitada capacidad de pago para adquirir seguros de salud. De las 39 familias abordadas, 26 madres no contaron con seguro de salud durante la gestación, pero los 39 pacientes con LPH sí contaban con algún tipo de aseguramiento. Se evidenció negación sistemática en la prestación de servicios sanitarios, barreras administrativas, invisibilización de la problemática del LPH en los servicios de salud y en definitiva, un sistema de salud excluyente en la práctica. Conclusión: pese a que la atención sanitaria a gestantes y menores de 18 años se reconoce constitucionalmente como un derecho fundamental a cargo del Estado, la forma en que opera el sistema de salud dominicano supedita la atención a la capacidad de pago de las familias, lo que genera inequidades sociales y sanitarias que vulneran el goce efectivo del derecho a la salud de las madres y los menores que nacen con LPH.

El trabajo investigativo buscó determinar las diferencias de tipo esqueletal y de inclinación dental que se exhibe comparando medidas cefalométricas de personas con labio y paladar hendido (LPH) y personas con ausencia de cualquier trastorno bucofacial. El estudio fue de tipo observacional, descriptivo y transversal utilizando radiografías laterales de cráneo archivadas en historias clínicas de 20 individuos con labio y paladar hendido frente a 20 individuos sin fisuras bucofaciales de entre 6 y 16 años de edad. Manualmente, se realizaron los análisis cefalométricos donde el 100% de los pacientes con labio y paladar hendido presentaron clase III esqueletal, en tanto que, los individuos sin fisuras abarcan el 50% en clase I, 35% clase II y 15% clase III. La inclinación dental preponderante para los individuos con labio y paladar hendido fue de proinclinación para el incisivo inferior y retroinclinación para el incisivo superior, en tanto, el grupo de control presenta mayor proinclinación en el incisivo superior y normo inclinación para el incisivo inferior. Se logró establecer diferencias estadísticamente significativas en la inclinación del incisivo superior del grupo de control y del grupo de estudio (p=0,002; t=3,25; gl=38), además, diferencias estadísticamente significativas entre la discrepancia ósea del grupo de control y del grupo de estudio (p=0,00; U=9).

Introdução: Relato de caso de uma criança que nasceu com fenda labiopalatal. Uma alteração que atinge cerca de 1 a cada 800 crianças, podendo ocorrer por diversos fatores incluindo fatores genéticos e o uso de álcool e drogas feito pela mãe durante o período gestacional. Objetivo: Descrever a trajetória de uma criança que nasceu no Distrito Federal com a má formação no lábio e palato, tendo grande parte do seu tratamento realizado no Hospital Regional da Asa Norte. Este estudo mostra as dificuldades encontradas pela criança portadora da malformação, os cuidados necessários no pré e pós-operatório, na realização das cirurgias e os problemas futuros relatados pelos pais da criança. Método: O estudo trata-se de um relato de caso qualitativo e para obter as informações foram utilizados exames, fotos, entrevistas feitas com o pai e a mãe da criança e uma revisão de literatura como forma de complemento. Resultado: O caso relatado mostra que quanto antes a criança for submetida aos cuidados necessários, melhor será o resultado final dos tratamentos, evitando assim, que essa condição possa causar transtornos maiores para a vida da paciente conforme for crescendo. Conclusão: O trabalho realizado pela equipe multiprofissional em conjunto com a família da criança, são fundamentais para a superação de dificuldades.

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Copyright of Dental Press Journal of Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to analyze the epidemiological profile of labiopalatine clefts in children cared for at a care and research center on craniofacial anomalies. Method: this is an epidemiological, documentary and cross-sectional study that assessed 116 children, aged from 0 to 12 incomplete years, with labial and/or palatine cleft cared for at a reference center in western Paraná from February 2013 to February 2017 Results: there was a predominance of male patients (n=67; 57.8%), living in Cascavel (n=58; 50%) and over five years old at the time of the first consultation (n=41; 35.3%). The most frequent clefts were typified as: complete extension (n=56; 50.9%), labiopalatine (n=50; 43.1%) and left-sided unilateral (n=35; 44.3%). Conclusions: the acquired data are in accordance with the findings of the pertinent literature and show the need for measures that enable the early access of cleft children to this specialized service. [ABSTRACT FROM AUTHOR]

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Las malformaciones congénitas son defectos estructurales presentes en el nacimiento. Las fisuras labio-alvéolo palatinas tienen una alta incidencia que se presenta en uno de cada 750 recién nacidos vivos, por lo que están entre las malformaciones más frecuentes y mejor conocidas. El labio y paladar hendido son anomalías que comúnmente están asociadas y constituyen las malformaciones congénitas más frecuentes de la cabeza y el cuello. Se define como labio leporino o hendido, fisura labial o queilosquisis al defecto facial que involucra el cierre incompleto del labio, unilateral, bilateral o medial, generalmente lateral a la línea media. Se define como paladar hendido, palatosquisis, o fisura palatina al defecto palatino en la línea media que comunica con fosas nasales y cavidad oral.

RESUMEN Introducción: la fisura labial es una malformación congénita que puede estar asociada a fisura velo-palatina como consecuencias de disrupciones en los distintos mecanismos embriológicos que ocurren durante el desarrollo fetal en la región maxilofacial. Presentación de casos: catorce pacientes con diagnóstico clínico de fisura labio-palatina en el hospital general de Malange Angola en el periodo comprendido entre mayo del 2014 a julio del 2015, con el objetivo de demostrar los resultados mediante el tratamiento quirúrgico de esta deformidad. Según la edad, el grupo con más morbilidad fue de 0 a 5 años (35.8 %), ambos sexos fueron afectados por igual (50%), según la clasificación de la OMS encontramos 8 pacientes con fisura labial unilateral (57.2 %), 4 pacientes con fisura labial unilateral asociada a fisura palatina completa (28,6 %) y un paciente con fisura labial bilateral asociada a fisura palatina completa (7.2 %). La técnica quirúrgica de Millard se utilizó en 12 pacientes (85.7 %) y solo dos por la técnica de Tennyson-Randall (14.3 %). Conclusiones: resultaron rehabilitados estética, funcional y psicosocialmente el 57,2% y solo parcialmente el 35.8 % por no disponer del instrumental adecuado para la corrección de la fisura palatina. ABSTRACT Introduction: the cleft lip is a congenital malformation that may be associated with cleft soft palate as a consequence of disruptions in the different embryological mechanisms that occur during fetal development in the maxillofacial region. Case presentation: 14 patients with clinical diagnosis of cleft lip and palate at the Malange Angola general hospital from May 2014 to July 2015 were evaluated, in order to demonstrate the results by surgical treatment of this deformity. According to age, the group with the highest morbidity was 0 to 5 years old (35.8 %), both sexes were affected equally (50 %), according to the WHO classification we found 8 patients with unilateral lip fissure (57.2 %), 4 patients with unilateral cleft lip associated with complete cleft palate (28.6 %) and one patient with bilateral cleft lip associated with complete cleft palate (7.2 %). Millard's surgical technique was used in 12 patients (85.7 %) and only two patients by the Tennyson-Randall surgical technique (14.3 %). Conclusions: aesthetic, functional and psychosocially rehabilitated 57.2% and only partially 35.8 % because they did not have adequate instruments for the correction of the cleft palate.

El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales (2,3).

El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales.

Individuals with these anomalies have anatomical deformities that commonly involve the lip, alveolar ridge and palate.Consequently, both aesthetics and function are impairedin the vast majority of cases(1). In view of this, the treatment of people with CL/P often requires multiple surgeries and other therapies throughout childhood, adolescence and adulthood(4-6). In addition, these craniofacial malformations can influence, among other things, the self-perception and social functioning of affected individuals, even after surgical repair(7).Therefore, multidisciplinary care isnecessary for successful treatment of these individuals(1,8).

Cleft lip -with or without cleft palate- is the most frequently reported facial congenital malformation in the world that requires surgery -cheiloplasty- to be corrected. Unfortunately, the hypertrophic scar after cheiloplasty is a common result that negatively affects the patient, their social environment and even the specialists, because to date there is no specific treatment. In order to know the current status of the treatment of this problem, a literature review was conducted since 2000 in the different databases. It was found that the treatment and prevention options are similar: primary closure of the wound without tension, adhesive tape of microporous paper, injection of intralesional corticoid, silicone sheet or gel, flavonoid gel, and laser. It was concluded that the treatment of the hypertrophic scar after cheiloplasty is still unsatisfactory and the research is limited since it is not a replicable pathology in animal models. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Antropología Biológica is the property of Revista Argentina de Antropologia Biologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract OBJECTIVE To assesses the quality of life and the impact of oral health conditions in the pre- and post-surgical correction of dentofacial deformity of individuals with cleft lip and palate. METHOD Quantitative and prospective study in a referral hospital in the period from June 2011 to May 2013. A total of 50 participants responded the questionnaires World Health Organization Quality of Life - Bref (WHOQOL-Bref) and Oral Health Impact Profile - 14 (OHIP-14), approximately 3 days before and 3 to 12 months after surgery. The "t" test for paired samples and Wilcoxon test were used for statistical analysis with a significance level of 5%. RESULTS After surgery, differences were found in the domains: Physical, Psychological, Environmental and General Questions of the WHOQOL-Bref and domains: Psychological Discomfort, Psychological Disability, Social Disability, Handicap and Overall Score of OHIP-14. CONCLUSION Surgical correction of dentofacial deformity improved quality of life and had positive impact of oral health condition.

El objetivo de este artículo es dar a conocer el trabajo que, desde hace 8 años, está realizando un grupo de cirujanos plásticos perteneciente a la Fundación Operación Sonrisa República Dominicana a favor de los pacientes con malformaciones congénitas faciales, especialmente labio leporino y fisura palatina.

Abstract OBJECTIVE To assess the nursing workload (NW) in Semi-intensive Therapy Unit, specialized in the care of children with Craniofacial anomalies and associated syndromes; to compare the amount of workforce required according to the Nursing Activities Score (NAS) and the COFEN Resolution 293/04. METHOD Cross-sectional study, whose sample was composed of 72 patients. Nursing workload was assessed through retrospective application of the NAS. RESULTS the NAS mean was 49.5%. Nursing workload for the last day of hospitalization was lower in patients being discharged to home (p

La fisura labio-palatina es una de las malformaciones congénitas más comunes de la región orofacial, y puede incidir significativamente en la calidad de vida de los afectados. El tratamiento integral de estos pacientes es complejo e incluye el uso de injerto óseo alveolar, para restaurar la morfología y función normal de los arcos. El objetivo de este trabajo fue describir las características de las diversas técnicas de injerto alveolar que aún son objeto de controversia. La osteoplastía secundaria es el enfoque más ampliamente aceptado, y consiste en la realización del injerto alveolar durante la dentición mixta, entre los 9 y 12 años, antes de la erupción del canino permanente, pues la disponibilidad de hueso es más predecible en este período, a la vez que proporcionaría el apoyo periodontal adecuado para la erupción y la preservación de los dientes adyacentes a la hendidura. La literatura señala que el hueso esponjoso autólogo fresco es el estándar de oro para este procedimiento, ya que proporciona las células óseas inmunocompatibles necesarias; pero estudios más recientes han señalado una superioridad del injerto córtico-medular, además del uso complementario de rhBMP-2. De la misma manera, se señala que la cresta iliaca corresponde al sitio dador más promovido, aunque la calota craneal puede representar una opción igual o aún más efectiva y con un menor nivel de morbilidad postoperatoria. Es necesario continuar explorando las alternativas mencionadas y promover la investigación en búsqueda de nuevas opciones, incluyendo avances en la ingeniería tisular.

Objective To identify the main doubts of caregivers of children with cleft lip and palate on postoperative care after cheiloplasty and palatoplasty. Method Cross-sectional study carried out in a reference hospital, between September and November 2012. The sample was composed of 50 individuals divided in two groups, of which 25 caregivers of children submitted to cheiloplasty, and 25 of children submitted to palatoplasty. The doubts were identified by an interview applied during the preoperative nursing consultation and were then categorized by similarity. Descriptive statistics was used for analysis of the outcomes. Results Concerning cheiloplasty, the doubts were related to feeding (36%), hygiene and healing (24% each), pain and infection (8% each). With regard to palatoplasty, the doubts were related to feeding (48%), hygiene (24%), pain (16%), bleeding (8%) and infection (4%). Conclusion The study evidenced the concern of caregivers in relation to feeding and care of the postoperative wound.

Resumo Objetivos Realizamos este estudo para avaliar a segurança e eficácia da analgesia com a adição de cetamina à bupivacaína em bloqueio do nervo infraorbitário, bilateral e extraoral, em crianças submetidas à cirurgia de lábio leporino. Métodos Foram randomicamente alocados 60 pacientes em dois grupos ( n = 30): o Grupo B recebeu bloqueio do nervo infraorbitário com bupivacaína a 0,25% (2 mL) e o Grupo BC recebeu bloqueio com cetamina (0,5 mg.kg ‐1 ) em cada lado, mais a adição de 1 mL de solução de bupivacaína a 0,5% diluída até 2 mL da concentração a 0,25%. Os parâmetros de avaliação incluíram: hemodinâmica, tempo de recuperação, tempo até a primeira ingestão oral, escores da escala FLACC (que avalia a expressão facial [ Face ], os movimentos das pernas [ Legs ], a atividade [ Activity ], o choro [ Cry ] e a consolabilidade [ Consolability ]), escores de agitação em escala de quatro pontos, consumo de analgésicos e efeitos adversos no pós‐operatório. Resultados Os pacientes do Grupo BC apresentaram escores FLACC mais baixos em todos os momentos mensurados no pós‐operatório ( p < 0,0001). Dois pacientes do Grupo BC versus 12 do Grupo B solicitaram analgesia de resgate no pós‐operatório ( p < 0,001). Não houve diferenças entre os grupos em relação ao tempo até a primeira solicitação de analgesia de resgate. Os pacientes do Grupo BC relataram consumo menor de analgésicos (366,67 ± 45,67 vs. 240,0 ± 0,0 mg, p < 0,04). O tempo em minutos (min) até a primeira ingestão oral foi significativamente reduzido no Grupo BC (87,67 ± 15,41 vs. 27,33 ± 8,68 min, p < 0,001). Escores mais baixos de agitação no pós‐operatório foram registrados para os pacientes do Grupo BC, com significância estatística no tempo de 45 min (0,86 ± 0,11 vs. 0,46 ± 0,16; p < 0,04) e na primeira hora de pós‐operatório (1,40 ± 0,17 vs. 0,67 ± 0,14; p < 0,003). Índices mais altos de satisfação dos pais foram registrados no Grupo BC ( p < 0,04), sem efeitos adversos significativos. Conclusões A adição de cetamina à bupivacaína acentuou a eficácia analgésica do bloqueio do nervo infraorbitário em crianças submetidas à cirurgia de correção de lábio leporino. Objectives We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra‐oral infra‐orbital nerve block in children undergoing cleft lip surgeries. Methods Sixty patients were randomly allocated into two groups ( n = 30), Group B received infra‐orbital nerve block with 2 mL of 0.25% Bupivacaine and Group BK received 0.5 mg.kg −1 Ketamine for each side added to 1 mL of 0.5% Bupivacaine solution diluted up to 2 mL solution to 0.25% Bupivacaine concentration. Assessment parameters included; hemodynamics, recovery time, time to first oral intake, postoperative Faces Legs Activity Cry Consolability (FLACC) scores, Four‐point Agitation scores, analgesic consumption and adverse effects. Results Patients in Group BK showed lower postoperative FLACC scores during all recorded time points ( p < 0.0001). Two patients in Group BK versus 12 in Group B requested for postoperative rescue analgesia ( p < 0.001). There were no differences between groups in time, minutes (min), to first request for rescue analgesia. Patients in Group BK reported lower analgesic consumption (366.67 ± 45.67 vs. 240.0 ± 0.0 mg, p < 0.04). The time to first oral intake was significantly reduced in Group BK (87.67 ± 15.41 vs. 27.33 ± 8.68 min, p < 0.001). Lower postoperative Agitation scores were recorded in Group BK patients that reached a statistical significance at 45 min (0.86 ± 0.11 vs. 0.46 ± 0.16, p < 0.04) and in the first hour (h) postoperatively (1.40 ± 0.17 vs. 0.67 ± 0.14, p < 0.003). Higher parent satisfaction scores were recorded in Group BK ( p < 0.04) without significant adverse effects. Conclusions The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra‐orbital nerve block in children undergoing cleft lip repair surgeries. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. The aim of this study was to analyze the effects of individual low socioeconomic status (SES) and deprived geographical area (GA) on the occurrence of isolated cleft lip with or without cleft palate (CL±P) in Argentina. Methods. This case-control study included 577 newborns with isolated CL±P and 13 344 healthy controls, born between 1992 and 2001, from a total population of 546 129 births in 39 hospitals in Argentina. Census data on unsatisfied basic needs were used to establish the degree of geographical area deprivation. An SES index for each individual was established, using maternal age, gravidity, low paternal and maternal education, and low-level paternal occupation. Logistic regression was used to assess the effects of low SES and of deprived GA on CL±P. Results. A slightly increased risk of CL±P was observed in mothers with a low SES, while a deprived GA showed no effect. Native ancestry, acute maternal illnesses, and poor prenatal care were significant risk factors for CL±P for the mothers with low SES, after using propensity scores to adjust for the demographic characteristics in cases and controls. Conclusions. Low individual SES slightly increased the risk for CL±P, but a deprived GA did not have that effect. There was no interaction between individual SES and deprived GA. Factors related to low individual SES--including poor prenatal care, low parental education, lack of information, and lifestyle factors--should be primarily targeted as risk factors for CL±P rather than factors related to a deprived place of residence. [ABSTRACT FROM AUTHOR]