Malformation of the oral cavity of the foetus, what support is available for parents?

One of the many questions which parents ask with regard to the malformation of the oral cavity of their child at birth concerns feeding. By answering all the couple's questions, the antenatal consultation aims to prepare the baby's birth and its admission into its family and society.     

Evaluation of the Malnourished Children's Recuperation Program in the town of Embu, located in the Metropolitan Area of São Paulo

The objective of this study is to assess the anthropometric evolution of children who had been assisted by the Malnourished Children's Recuperation Program in the town of Embu, as well as to analyze some variables that interfered in this evaluation. The study included 233 children aged under five, enrolled in the program from January 1984 to December 1985. 201 (86,3%) were undernourished grade II and 32 (13,7%) grade III, according to Gomez. The percentage increase of Weight in relation to Age (W/A) and Height in relation to Age (H/A) - outcome variables, in the first and last examinations in the program - were analyzed, using the multiple linear regression. Younger children and in worse nutritional conditions showed higher W/A and H/A increases. Low birth weight, more frequent examinations, and longer stay in the program were associated to lower W/A increases. The presence of chronical pathologies jeopardized the H/A rate increases. This result strengthens the importance of developing programs for the assistance of undernourished children, due to higher risk of morbi-mortality in this group, mainly in younger children and with worse nutritional conditions.     

The Pre-Sports Cardiovascular Evaluation: Should It Depend on the Level of Competition,the Sport,or the State?

Sudden cardiac death (SCD) in an athlete is a rare but tragic event, and significant controversy exists regarding the most effective method to define those at highest risk. Recommendations of the American Heart Association require that a history and physical examination be used for preparticipation screening with an abnormal cardiac finding expected to prompt further evaluation. Given the lack of data documenting that electrocardiogram (ECG) screening in all competitive athletes is either feasible or appropriate, these same guidelines state that such screening is optional but not mandatory. The extremely low incidence of SCD events, in conjunction with the low sensitivity and specificity of ECG as a screening tool in athletes, contributes to this recommendation. Although these guidelines target all competitive athletes, however, there may be subgroups of athletes, based on age, level of competition, individual sport, or state of residence, for which mandatory ECG screening may be both appropriate and sensible. Given the lack of resolution of the ongoing ECG debate, it is perhaps reasonable to consider screening specific high-risk subgroups of athletes rather than continuing to dispute whether to screen all competitive athletes or none at all. Recent data suggest that such a program may be feasible and may provide a rationale basis for subsequent expansion of cardiovascular screening programs.     

Given the benefits of breastfeeding, what contraindications exist?

Breastfeeding is not contraindicated in association with environmental hazards in the United States under ordinary circumstances. Unusual massive exposure should be assessed on an individual basis. In the face of any possible contraindication to breastfeeding, the tremendous benefits of being breastfed should be compared with the theoretic risk for the hazard involved and a decision made on an individual basis.     

Bone measurements of infants in the first 3 months of life by quantitative ultrasound: the influence of gestational age, season, and postnatal age

Background: There are a few quantitative ultrasound (QUS) studies of bone status for Chinese children. Objective: To evaluate the clinical application and to investigate the bone status of neonates and young infants with QUS. Materials and methods: An ultrasound bone sonometer was used to measure the bone speed of sound (SOS) of the tibia in 542 neonates within 3 months of birth. Results: At birth, no significant difference of SOS was found between boys and girls, but there was a significant difference of SOS between premature infants and full-term infants. The SOS in neonates born during spring and summer was significantly lower than those born during autumn and winter. There were significant correlations between SOS and gestational age, and between bone SOS and birth weight in appropriate for gestational age (AGA) infants. Multiple regression analysis found that gestational age and infant birth season were two important factors influencing SOS. During the first 3 months, there was no significant difference in SOS between sexes. The SOS of infants showed an inverse correlation with postnatal age, and the decrease of bone SOS with age in premature infants was more marked than in full-term infants. Conclusions: QUS is suitable for evaluating bone status in infants with high precision. The study offers some basic data for neonates and young infants.     

What is the role of the prevention of allergy in the first period of life?

The widespread increase in the prevalence of allergic disease, which has occurred over the last 20 y, has created general concern in Europe and in the rest of the world. The reason for this increase is still partially unknown. In this period, despite a greater understanding of the pathogenesis and risk factors of allergies plus the greater efficacy of drugs to control the symptoms, the cost of intervention and the socio-economic impact are still very high. For these reasons, prevention in the first period of life represents a goal for both developed and developing countries in order to reduce this upward trend.     

Radiological diagnosis of the constitutional disorders of bone. As easy as A,B, C?

Although many constitutional disorders of bone are individually rare, collectively they make up a large group of disorders. They are broadly classified into osteochondrodysplasias and dysostoses. Because of the rarity of some of these conditions, they can be difficult to diagnose. Members of the International Dysplasia Group meet regularly to update and clarify the nomenclature. The last meeting was in Oxford in 2001. This article attempts to highlight the differences between the osteochondrodysplasias and the dysostoses, and provides a systematic approach to their radiological diagnosis.