Suicide Pact

Objective: To determine the time of diagnosis of typical orofacial clefts in different Brazilian regions and its influence on age at surgical correction. Method: This was a prospective, descriptive, cross-sectional study conducted in medical centers in the Southeast, South, and Northeast of Brazil. Trained speech therapists and geneticists interviewed the parents of affected children using a previously validated questionnaire. Epi-Info and SPSS were used for data analysis. Significance level was set at 5% (p ≤ 0.05). Results: The sample consisted of 215 interviews conducted in the following regions: 21.9% (47) in the Southeast, 51.1% (110) in the South, and 27% (58) in the Northeast. Monthly family income was higher in the Southeast (p ≤ 0.05). Cleft lip and palate were found in 61.4% (132) of cases, cleft palate in 20.9% (45), and cleft lip in 17.7% (38). Diagnosis occurred in the maternity ward in 75.3% (162) of cases, during the prenatal period in 14% (30), and after hospital discharge in 10.2% (22). The Southeast had a higher frequency of prenatal diagnosis (27.7%), possibly related to greater purchasing power in this region and greater availability of prenatal investigation. Of all cases diagnosed in the maternity ward, 74.4% occurred in the Northeast. However, no significant difference was found when comparing time of diagnosis, region, and age at first surgery. Conclusion: Considering that diagnosis is more common in the maternity ward, local health care teams should be trained in order to effectively improve the initial care of these patients. Although time of diagnosis did not affect age at surgery, it favors the planning of neonatal care and treatment of affected infants. Copyright © 2011 by Sociedade Brasileira de Pediatria.873225230Wyszynski, D.F., (2002) Cleft Lip and Palate: From Origin to Treatment, , New York: Oxford University PressMoore, K.L., Persaud, T.V., The Pharyngeal (Branchial) Apparatus (1998) The Developing Human Clinically Oriented Embryology, pp. 215-256. , Moore KL, Persaud TV. 6th ed. Philadelphia, Pa: WB SaundersMossey, P.A., Little, J., Epidemiology of oral clefts: An international perspective (2002) Cleft Lip and Palate: from Origin to Treatment, pp. 127-158. , Wyszynski DF, editor. New York: Oxford University PressGlobal strategies to reduce the healthcare burden of craniofacial anomalies (2002) Report of WHO Meetings on International Collaborative Research on Craniofacial Anomalies, , Word Health Organization. Geneva: WHOStoll, C., Alembik, Y., Dott, B., Roth, M.P., Associated malformations in cases with oral clefts (2000) Cleft Palate-Craniofacial Journal, 37 (1), pp. 41-47Marazita, M.L., Mooney, M.P., Current concepts in the embryology and genetics of cleft lip and cleft palate (2004) Clin Plast Surg, 31, pp. 125-140Cohen Jr., M.M., Gorlin, R.J., Fraser, F.C., Craniofacial Disorders (1997) Emery and Rimoin's Principles and Practice of Medical Genetics, pp. 1121-1148. , Rimoin DL, Connor JM, Pyeritz RE, Korf BR, editors. New York: Churchill LivingstoneShprintzen, R.J., Siegel-Sadewitz, V.L., Amato, J., Goldberg, R.B., Anomalies associated with cleft lip, cleft palate, or both (1985) American Journal of Medical Genetics, 20 (4), pp. 585-595. , DOI 10.1002/ajmg.1320200404Offerdal, K., Jebens, N., Syvertsen, T., Blaas, H.G., Johansen, O.J., Eik-Nes, S.H., Prenatal ultrasound detection of facial clefts: A prospective study of 49,314 deliveries in a non-selected population in Norway (2008) Ultrasound Obstet Gynecol, 31, pp. 639-646Russell, K.A., Allen, V.M., MacDonald, M.E., Smith, K., Dodds, L., A population-based evaluation of antenatal diagnosis of orofacial clefts (2008) Cleft Palate-Craniofacial Journal, 45 (2), pp. 148-153. , DOI 10.1597/06-202.1Bunduki, V., Ruano, R., Sapienza, A.D., Hanaoka, B.Y., Zugaib, M., Diagnóstico pré-natal de fenda labial e palatina: Experiência de 40 casos (2001) RBGO, 23, pp. 561-566Grandjean, H., Larroque, D., Levi, S., The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study (1999) American Journal of Obstetrics and Gynecology, 181 (2), pp. 446-454. , DOI 10.1016/S0002-9378(99)70577-6Amstalden-Mendes, L.G., Magna, L.A., Gil-da-Silva-Lopes, V.L., Neonatal care of infants with cleft lip and/or palate: Feeding orientation and evolution of weight gain in a nonspecialized Brazilian hospital (2007) Cleft Palate-Craniofacial Journal, 44 (3), pp. 329-334. , DOI 10.1597/05-177Reid, J., A review of feeding interventions for infants with cleft palate (2004) Cleft Palate-Craniofacial Journal, 41 (3), pp. 268-278. , DOI 10.1597/02-148.1Shaw, W.C., Semb, G., Nelson, P., Brattström, V., Molsted, K., Prahl- Andersen, B., The Eurocleft Project 1996-2000: Overview (2001) J Cranio-maxillofacial Surgery, 29, pp. 131-140Chitty, L.S., Griffin, D.R., Anormalidades do lábio e do palato fetal: Diagnóstico ultra-sonográfico (2005) Tratamento de Fissura Labial e Fenda Palatina, pp. 107-116. , Watson AC, Sell DA, Grunwell P. São Paulo: Editora SantosHabel, A., O papel do pediatra (2005) Tratamento de Fissura Labial e Fenda Palatina, pp. 123-135. , Watson AC, Sell DA, Grunwell P. São Paulo: Editora SantosRibeiro-Roda, S., Gil-da-Silva-Lopes, V.L., Aspectos odontológicos das fendas labiopalatinas e orientações para cuidados básicos (2008) Rev Cienc Med, 17, pp. 95-103Monlleo, I.L., Gil-da-Silva-Lopes, V.L., Craniofacial anomalies: Description and evaluation of treatment under the Brazilian Unified Health System (2006) Cadernos de Saude Publica, 22 (5), pp. 913-922. , http://www.scielo.br/pdf/csp/v22n5/04.pdfLoffredo, L.C., Freitas, J.A., Grigolli, A.A., Prevalência das fissuras orais de 1975 a 1994 (2001) Rev Saude Publica, 35, pp. 571-575Nunes, L.M., Queluz, D.P., Pereira, A.C., Prevalência de fissuras labiopalatais no município de Campos dos Goytacazes-RJ, 1999-2004 (2007) Rev Bras Epidemiol, 10, pp. 109-116Cerqueira, M.N., Teixeira, S.C., Naressi, S.C., Ferrreira, A.P., Ocorrência de fissuras labiopalatais na cidade de São José dos Campos-SP (2005) Rev Bras Epidemiol, 8, pp. 161-166Di Ninno, C.Q., Santos, P.G., Bueno, M.G., Syrio, I.M., A influência da época do diagnóstico das fissuras labiopalatinas (2006) Rev Soc Bras Fonoaudiol, 11, pp. 75-81Jones, M.C., Prenatal diagnosis of cleft lip and palate: Detection rates, accuracy of ultrasonography, associated anomalies and strategies for counseling (2002) Cleft Palate Craniofac J, 39, pp. 169-173Johnson, N., Sandy, J.R., Prenatal diagnosis of cleft lip and palate (2003) Cleft Palate-Craniofacial Journal, 40 (2), pp. 186-189. , DOI 10.1597/1545-1569(2003)0402.0.CO;2Bradbury, E., Bannister, P., Aconselhamento pré-natal, perinatal e pós-natal (2005) Tratamento de Fissura Labial e Fenda Palatina, pp. 117-122. , Watson AC, Sell DA, Grunwell P. 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Dispersão de sementes de uruvalheira (Platypodium elegans vog.) (Fabaceae) em um cerradão, Uberlândia-MG Seeds dispersal of uruvalheira (Platypodium elegans vog.) (Fabaceae) in cerradão, Uberlandia, MG

Estudou-se a dispersão de sementes de cinco árvores-matriz de Platypodium elegans Vog. (Fabaceae) em área de cerradão, na Estação Ecológica do Panga (EEP). As amostragens foram feitas em parcelas de 0,25 m2, posicionadas em linhas partindo da base da matriz em direção aos quatro pontos cardeais (Norte, Sul, Leste e Oeste), marcadas a cada metro. No laboratório, os frutos foram abertos para análise da qualidade das sementes. Foram amostradas 1.131 sementes, das quais 18,4% estavam intactas e 81,6%, danificadas e provavelmente inviáveis para germinação. A dispersão das sementes sofreu influência da topografia do local das matrizes, das respostas fisiológicas e genéticas à pré-dispersão, bem como do possível direcionamento favorável do vento. Dessa forma, a atuação conjunta desses fatores funcionaria como facilitadores relevantes na formação do banco de sementes e moldaria a probabilidade de estabelecimento de novos indivíduos, tanto na área estudada quanto nas fisionomias adjacentes..<br>It was studied seeds dispersal of five first trees of Platypodium elegans Vog. (Fabaceae), in area of cerradão in the Estação Ecológica do Panga (EEP). The samplings had been made in 0,25 plots of m2, located in lines leaving of the base of the matrix in direction to the four points cardinals (north, south, east and west), marked to each meter. The fruits had been opened for analysis of the quality of the seeds. A total of 1.131 seeds was collected in the sampling area of the five arrays, of which 18,4% they were viable and 81,6% probably impracticable for germination. The dispersion of the seeds suffered influence from the topography of the place of the matrices, of the physiological and genetic answers daily early-dispersion, as well as of the possible favorable aiming of the wind. The joint action of these factors serves as relevant facilitators on the seed bank training as so as the probability of establishment of new individuals both in the studied area and also in adjacent vegetation