Risk factors and demographics for microtia in South America: a case-control analysis

BACKGROUND: The etiopathogenesis of microtia is still unknown in the majority of the cases, particularly for individuals presenting with isolated microtia. Our aim was to evaluate potential risk factors for this condition using a case–control approach. METHODS: We analyzed data from 1,194 live births with isolated microtia enrolled in the ECLAMC study (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) from 1982 to 2011 and their respective controls. Odds ratios (ORs) were estimated with logistic regression models along with 95% confidence intervals for the resulting OR estimates controlling for the effects of potential confounders (sex, maternal age, hospital, and year of birth) for an adjusted OR (aOR). RESULTS: Multiparity was associated with a higher risk of microtia compared with primiparity (aOR, 1.5; 95% confidence interval [CI], 1.2–1.8), with women who had eight or more prior pregnancies having the highest risk (aOR, 2.8; 95% CI, 1.6–5.2). Women who presented with cold-like symptoms were at higher risk for microtia (aOR, 2.2; 95% CI, 1.2–3.9) as well as those that used tobacco or alcohol during pregnancy (aOR, 1.7; 95% CI, 1.1–2.6 and aOR, 1.4; 95% CI, 0.9–2.1, respectively). The association with alcohol use appeared to be limited to those women who reported binge drinking during pregnancy (aOR, 1.4; 95% CI, 0.7–3.1). Cases from hospitals at low altitude (<2500 m) tended to have more severe types of microtia than those from hospitals at high altitude. CONCLUSION: These results support the hypothesis that, in addition to teratogens, other nongenetic risk factors contribute to the occurrence of isolated microtia.Fil: Luquetti, Daniela. University of Washington; Estados Unidos. Seattle Children; Estados UnidosFil: Saltzman, Babette S.. Seattle Children; Estados UnidosFil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; ArgentinaFil: Dutra, Maria da Graça. Instituto Oswaldo Cruz; BrasilFil: Castilla, Eduardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; Argentina. Instituto Nacional de Genética Médica Populacional; Brasi

Preferential associated anomalies in 818 cases of microtia in South america

The etiology of microtia remains unknown in most cases. The identification of patterns of associated anomalies (i.e., other anomalies that occur with a given congenital anomaly in a higher than expected frequency), is a methodology that has been used for research into the etiology of birth defects. We conducted a study based on cases of microtia that were diagnosed from more than 5 million live (LB)- and stillbirths (SB) examined in hospitals participating in ECLAMC (Latin American Collaborative Study of Congenital Malformations) between 1967 and 2009. We identified 818 LB and SB with microtia and at least one additional non-related major congenital anomaly (cases) and 15,969 LB and SB with two or more unrelated major congenital anomalies except microtia (controls). A logistic regression analysis was performed to identify the congenital anomalies preferentially associated with microtia. Preferential associations were observed for 10 congenital anomalies, most of them in the craniofacial region, including facial asymmetry, choanal atresia, and eyelid colobomata. The analysis by type of microtia showed that for anomalies such as cleft lip and palate, macrostomia, and limb reduction defects, the frequency increased with the severity of the microtia. In contrast, for other anomalies the frequency tended to be the same across all types of microtia. Based on these results we will integrate data on the developmental pathways related to preferentially associated congenital anomalies for future studies investigating the etiology of microtia.Fil: Luquetti, Daniela V.. University of Washington; Estados Unidos. Seattle Children’s Research Institute; Estados UnidosFil: Cox, Thimoty C.. Monash University; Australia. University of Washington; Estados UnidosFil: López Camelo, Jorge Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; ArgentinaFil: Dutra, Maria da Graça. Instituto Oswaldo Cruz; BrasilFil: Cunningham, Michael L.. University of Washington; Estados Unidos. Seattle Children’s Research Institute; Estados UnidosFil: Castilla, Eduardo Enrique. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina. Instituto Oswaldo Cruz; Brasil. Instituto Nacional de Genética Médica Populacional; Brasi

Preferential associated anomalies in 818 cases of microtia in South America

The etiology of microtia remains unknown in most cases. The identification of patterns of associated anomalies (i.e., other anomalies that occur with a given congenital anomaly in a higher than expected frequency), is a methodology that has been used for research into the etiology of birth defects. We conducted a study based on cases of microtia that were diagnosed from more than 5 million live (LB)- and stillbirths (SB) examined in hospitals participating in ECLAMC (Latin American Collaborative Study of Congenital Malformations) between 1967 and 2009. We identified 818 LB and SB with microtia and at least one additional non-related major congenital anomaly (cases) and 15,969 LB and SB with two or more unrelated major congenital anomalies except microtia (controls). A logistic regression analysis was performed to identify the congenital anomalies preferentially associated with microtia. Preferential associations were observed for 10 congenital anomalies, most of them in the craniofacial region, including facial asymmetry, choanal atresia, and eyelid colobomata. The analysis by type of microtia showed that for anomalies such as cleft lip and palate, macrostomia, and limb reduction defects, the frequency increased with the severity of the microtia. In contrast, for other anomalies the frequency tended to be the same across all types of microtia. Based on these results we will integrate data on the developmental pathways related to preferentially associated congenital anomalies for future studies investigating the etiology of microtia.Instituto Multidisciplinario de Biología Celula

Economic and financial model to the mass‐rearing of Macrolophus pygmaeus (Rambur) (Heteroptera: Miridae), a biological control agent against the tomato moth Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) in protected culture

ABSTRACT: BACKGROUND - Tuta absoluta (Meyrick) is a major pest of tomato produced in glasshouses and open field, causing severe damages to crops, reducing the quality of tomato fruits. The current maintenance of the pest populations below the economic threshold is not achieved by natural and classical control, thus requiring the continuous application of biological control agents (BCAs), under an augmentative or inoculative approach. The present study aims to develop an economic and financial model to evaluate the commercial viability of a continuous mass production of Macrolophus pygmaeus (Rambur), a BCA commonly used against the tomato moth, Tuta absoluta, in protected culture. The estimations for our model were based on two approaches: the farm-level impact analysis and the benefit–cost analysis. RESULTS - The results of the farm-level analysis show that the adoption of a more sustainable biological control approach is profitable for farmers and the benefit–cost analysis provides evidence that the investment on a new factory dedicated to the mass rearing of M. pygmaeus to control tomato moth populations generates a positive net present value (NPV) of 7.2 million euros, corresponding to an internal rate of return (IRR) of 28.4% per year. CONCLUSION - Our results are in line with (i) the more recent European Commission proposals for a new Regulation on sustainable use of plant protection products, which includes the reduction of 50% the use and risk of chemical pesticides by 2030 and (ii) most of the existing literature which conclude that new projects on BCA production are worth investments.info:eu-repo/semantics/publishedVersio

Epidemiological surveillance of birth defects compatible with thalidomide embryopathy in Brazil

The thalidomide tragedy of the 1960s resulted in thousands of children being born with severe limb reduction defects (LRD), among other malformations. In Brazil, there are still babies born with thalidomide embryopathy (TE) because of leprosy prevalence, availability of thalidomide, and deficiencies in the control of drug dispensation. Our objective was to implement a system of proactive surveillance to identify birth defects compatible with TE. Along one year, newborns with LRD were assessed in the Brazilian hospitals participating in the Latin-American Collaborative Study of Congenital Malformations (ECLAMC). A phenotype of LRD called thalidomide embryopathy phenotype (TEP) was established for surveillance. Children with TEP born between the years 2000-2008 were monitored, and during the 2007-2008 period we clinically investigated in greater detail all cases with TEP (proactive period). The period from 1982 to 1999 was defined as the baseline period for the cumulative sum statistics. The frequency of TEP during the surveillance period, at 3.10/10,000 births (CI 95%: 2.50-3.70), was significantly higher than that observed in the baseline period (1.92/10,000 births; CI 95%: 1.60-2.20), and not uniformly distributed across different Brazilian regions. During the proactive surveillance (2007-2008), two cases of suspected TE were identified, although the two mothers had denied the use of the drug during pregnancy. Our results suggest that TEP has probably increased in recent years, which coincides with the period of greater thalidomide availability. Our proactive surveillance identified two newborns with suspected TE, proving to be a sensitive tool to detect TE. The high frequency of leprosy and the large use of thalidomide reinforce the need for a continuous monitoring of TEP across Brazil.Instituto Multidisciplinario de Biología Celula

REVISITANDO O CUIDADO EM SAÚDE: REVISÃO DE LITERATURA / NEW LOOK AT THE HEALTH CARE: LITERATURE REVIEW

Introdução: O cuidado é atitude, característica e necessidade própria do ser humano. Cuidadores em saúde (profissional ou não), estão suscetíveis a adoecer e sofrerem suas implicações biopsicossociais. Muitos trabalhos enfatizam a importância do cuidado com a saúde do cuidador familiar, entretanto, poucos são direcionados para o profissional de saúde enquanto pessoa que cuida e demanda cuidados. Objetivo: Realizar levantamento bibliográfico sobre o cuidar e as conseqüências para aquele que cuida, enfocando sobre saúde e estresse profissional. Métodos: Estudo descritivo e bibliográfico em revistas e artigos científicos, sites especializados e livros técnicos sobre o tema. Resultados: O cuidado como profissão requer atenção quanto às experiências, muitas vezes antagônicas, vivenciadas. Os profissionais de saúde convivem com dor e sofrimento humano, doença e morte em suas rotinas laborais. Além disso, a nível hospitalar, possuem carga horária de trabalho excessiva e tem contato constante com situações limites de tensão e perigo de vida para si e para os outros. Assim, associando-se o comprometimento laboral e estresse crônico, o cuidador profissional pode desenvolver a Síndrome de Burnout, caracterizada por sinais e sintomas de ordem física e emocional, identificada por três elementos: Exaustão, Despersonalização e Baixo rendimento profissional. Esta síndrome tem implicações na saúde dos cuidadores em si e naquele que é cuidado. Conclusão: Pesquisas sobre a saúde dos cuidadores em saúde precisam ser estimuladas a fim de que se direcionem as políticas assistências à saúde destes profissionais.Palavras-chave: Cuidados em saúde. Cuidadores. Estresse profissional.AbstractIntroduction: Care is attitude, character and need as a human being. Health caregivers (professional or otherwise), characters - key health - disease process, are likely to suffer illness and biopsychosocial implications. Many studies stress the importance of health care of the family caregiver, however, few are directed to health professionals as a person who cares and demands care. Objective: literature on caring and the consequences for those who care, focusing on health and professional stress. Methods: This descriptive study and bibliographical and scientific articles in magazines, websites and specialized technical books on the subject. Results: The profession requires careful attention as to the experiences, often antagonistic, experienced. Health professionals live with pain and human suffering, disease and death in their daily work. In addition, the hospital level, have excessive workload and has constant contact with extreme situations of tension and danger of life for themselves and others. So, associating the work and commitment chronic stress, the caregiver can develop the professional Burnout Syndrome, characterized by signs and symptoms of physical and emotional, identified by three elements: exhaust you, depersonalization and low employment income. This syndrome has implications for the health of caregivers themselves and the one which is taken care of. Conclusion: Research on the health of caregivers in healthcare need to be encouraged to ensure that policies are to target assistance to the health of these professionals.Keywords: health care. Caregivers. Professional stress

Epidemiological surveillance of birth defects compatible with thalidomide embryopathy in Brazil

The thalidomide tragedy of the 1960s resulted in thousands of children being born with severe limb reduction defects (LRD), among other malformations. In Brazil, there are still babies born with thalidomide embryopathy (TE) because of leprosy prevalence, availability of thalidomide, and deficiencies in the control of drug dispensation. Our objective was to implement a system of proactive surveillance to identify birth defects compatible with TE. Along one year, newborns with LRD were assessed in the Brazilian hospitals participating in the Latin-American Collaborative Study of Congenital Malformations (ECLAMC). A phenotype of LRD called thalidomide embryopathy phenotype (TEP) was established for surveillance. Children with TEP born between the years 2000-2008 were monitored, and during the 2007-2008 period we clinically investigated in greater detail all cases with TEP (proactive period). The period from 1982 to 1999 was defined as the baseline period for the cumulative sum statistics. The frequency of TEP during the surveillance period, at 3.10/10,000 births (CI 95%: 2.50-3.70), was significantly higher than that observed in the baseline period (1.92/10,000 births; CI 95%: 1.60-2.20), and not uniformly distributed across different Brazilian regions. During the proactive surveillance (2007-2008), two cases of suspected TE were identified, although the two mothers had denied the use of the drug during pregnancy. Our results suggest that TEP has probably increased in recent years, which coincides with the period of greater thalidomide availability. Our proactive surveillance identified two newborns with suspected TE, proving to be a sensitive tool to detect TE. The high frequency of leprosy and the large use of thalidomide reinforce the need for a continuous monitoring of TEP across Brazil.Instituto Multidisciplinario de Biología Celula

Epidemiological Surveillance of Birth Defects Compatible with Thalidomide Embryopathy in Brazil

The thalidomide tragedy of the 1960s resulted in thousands of children being born with severe limb reduction defects (LRD), among other malformations. In Brazil, there are still babies born with thalidomide embryopathy (TE) because of leprosy prevalence, availability of thalidomide, and deficiencies in the control of drug dispensation. Our objective was to implement a system of proactive surveillance to identify birth defects compatible with TE. Along one year, newborns with LRD were assessed in the Brazilian hospitals participating in the Latin-American Collaborative Study of Congenital Malformations (ECLAMC). A phenotype of LRD called thalidomide embryopathy phenotype (TEP) was established for surveillance. Children with TEP born between the years 2000–2008 were monitored, and during the 2007–2008 period we clinically investigated in greater detail all cases with TEP (proactive period). The period from 1982 to 1999 was defined as the baseline period for the cumulative sum statistics. The frequency of TEP during the surveillance period, at 3.10/10,000 births (CI 95%: 2.50–3.70), was significantly higher than that observed in the baseline period (1.92/10,000 births; CI 95%: 1.60–2.20), and not uniformly distributed across different Brazilian regions. During the proactive surveillance (2007–2008), two cases of suspected TE were identified, although the two mothers had denied the use of the drug during pregnancy. Our results suggest that TEP has probably increased in recent years, which coincides with the period of greater thalidomide availability. Our proactive surveillance identified two newborns with suspected TE, proving to be a sensitive tool to detect TE. The high frequency of leprosy and the large use of thalidomide reinforce the need for a continuous monitoring of TEP across Brazil

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio