RESUMO
Las displasias músculo-esqueléticas o también conocidas como osteocondrodisplasias o displasias esqueléticas, constituyen un grupo heterogéneo de trastornos que afectan el crecimiento, la morfología y el desarrollo de ese sistema. El diagnóstico prenatal de una displasia esquelética específica es difícil y la Osteogénesis imperfecta tipo II es una de ellas. El objetivo del trabajo es resaltar la importancia del diagnóstico precoz de malformaciones congénitas y/o defectos estructurales del feto, por ultrasonografía, en la atención primaria de salud. Presentamos las imágenes ecográficas de un feto afectado por una displasia esquelética a las 18 semanas. Previo asesoramiento genético y dado el mal pronóstico con que cursan estos casos de displasias esqueléticas letales, la paciente decidió la terminación del embarazo. El diagnóstico de displasia esquelética fue confirmado por Anatomía Patológica e Imagenología(AU)
Skeletal dysplasias, also known as osteochondrodysplasias, refer to a group of disorders described by abnormalities in the development, growth, and maintenance of both bone and cartilage. The prenatal diagnosis of skeletal dysplasia is very difficult and the lethal osteogenesis imperfect type II is the only one that can be consistently detected in utero. To highlight the importance of early diagnosis of congenital malformations by ultrasonography in primary health care. We present the sonographic images of a fetus affected by skeletal dysplasia at 18 weeks. After genetic counseling and given the poor prognosis with cases of skeletal lethal dysplasias, the patient decided to terminate the pregnancy. The diagnosis of skeletal dysplasia was confirmed by Pathology and Imaging(AU)
Assuntos
Humanos , Feminino , Gravidez , Osteocondrodisplasias/epidemiologia , Osteocondrodisplasias/diagnóstico por imagem , Osteocondrodisplasias/patologia , Ultrassonografia Pré-Natal/métodosRESUMO
Currently accepted birth prevalence for osteochondrodysplasias (OCD) of about 2/10,000 is based on few studies from small series of cases. We conducted a study based on more than 1.5 million births. OCD cases were detected from 1,544,496 births occurring and examined in 132 hospitals of ECLAMC (Latin American Collaborative Study of Congenital Malformations) between 2000 and 2007. Cases were detected and registered according to a pre-established protocol, and then ranked in four diagnostic evidence levels (DEL), according to available documentation. For the analysis of risk factors, a healthy control sample born in the same period was used. OCD was diagnosed in 492 newborns, resulting in a prevalence per 10,000 of 3.2 (95% CI: 2.9-3.5). Perinatal lethality (stillbirths plus early neonatal deaths) occurred in 50% of cases. Prenatal ultrasound diagnosis was made in 73% of cases (n = 359). Among 211 cases from the best documented group (DEL-1) and according to international classification, 33% of cases fit into the G-25 (osteogenesis imperfecta), 29% in Group-1 (FGFR3), and 8% in Group-18 (Bent bones). The prevalence of the main OCD types were: OI-0.74 (0.61-0.89); thanatophoric dysplasia-0.47 (0.36-0.59); and achondroplasia-0.44 (0.33-0.55). Paternal age (31.2 ± 8.5), parity (2.6), and parental consanguinity rate (5.4%) were higher in cases than in controls (P < 0.001). In conclusion, the OCD overall prevalence of 3.2 per 10,000 found seems to be more realistic than previous estimates. This study also confirmed the high perinatal mortality, and the association with high paternal age, parity, and parental consanguinity rate.
Assuntos
Osteocondrodisplasias/epidemiologia , Estudos de Casos e Controles , Consanguinidade , Humanos , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/etiologia , Osteocondrodisplasias/mortalidade , Idade Paterna , Prevalência , Fatores de Risco , América do Sul/epidemiologiaRESUMO
Sodium (Na+) and chloride (Cl-) nutritional requirements, dietary electrolyte balance (DEB), and their effects on acid-base balance, litter moisture, and tibial dyschondroplasia (TD) incidence for young broiler chickens were evaluated in two trials. One-day-old Cobb broilers were distributed in a completely randomized design with six treatments, five replicates, and 50 birds per experimental unit. Treatments used in both experiments were a basal diet with 0.10% Na+ (Experiment 1) or Cl- (Experiment 2) supplemented to result in diets with Na+ or Cl- levels of 0.10, 0.15, 0.20, 0.25, 0.30, or 0.35%, respectively. In Experiment 1, results indicated an optimum Na+ requirement of 0.26%. Sodium levels caused a linear increase in arterial blood gas parameters, indicating an alkalogenic effect of Na+. The hypertrophic area of growth plate in the proximal tibiotarsi decreased with Na+ levels. The TD incidence decreased with increases in dietary Na+. Litter moisture increased linearly with sodium levels. In Experiment 2, the Cl- requirement was estimated as 0.25%. Chloride levels caused a quadratic effect (P < or = 0.01) on blood gas parameters, with an estimated equilibrium [blood base excess (BE) = 0] at 0.30% of dietary Cl-. No Cl- treatment effects (P > or = 0.05) were observed on litter moisture or TD incidence. The best DEB for maximum performance was 298 to 315 mEq/kg in Experiment 1 and 246 to 264 mEq/kg in Experiment 2. We concluded that the Na+ and Cl- requirements for optimum performance of young broiler chickens were 0.28 and 0.25%, respectively.
Assuntos
Galinhas/fisiologia , Cloretos/administração & dosagem , Osteocondrodisplasias/veterinária , Doenças das Aves Domésticas/epidemiologia , Sódio/administração & dosagem , Equilíbrio Ácido-Base , Ração Animal , Animais , Gasometria , Galinhas/crescimento & desenvolvimento , Incidência , Masculino , Necessidades Nutricionais , Osteocondrodisplasias/epidemiologia , Osteocondrodisplasias/etiologia , Doenças das Aves Domésticas/etiologia , Glycine max , Tíbia , Equilíbrio Hidroeletrolítico , Zea maysRESUMO
OBJECTIVE: To characterize a kindred of Chiloe Islanders with spondyloepiphyseal dysplasia tarda (SEDT), brachydactyly, precocious osteoarthritis (OA), and intraarticular calcification. METHODS: Sixteen family members underwent a complete physical examination, anthropometric measurements, radiographic studies of the spine and peripheral joints, and analysis of the type II procollagen gene (COL2A1). RESULTS: Seven family members presented with SEDT, brachydactyly, precocious OA, and periarticular calcification while 2 others had the same syndrome but without brachydactyly. The inheritance was autosomal dominant, and the disease cosegregated with a base substitution in the COL2A1 gene. CONCLUSION: The syndrome o SEDT, precocious OA, and brachydactyly in a kindred of Chiloe Islanders is associated with a point mutation in 1 allele of the COL2A1 gene. The relationship of this type of SEDT to familial calcium pyrophosphate dihydrate deposition disease and idiopathic hip dysplasia, both endemic in Chiloe Islanders, needs to be further investigated.
Assuntos
Deformidades Congênitas do Pé/genética , Deformidades Congênitas da Mão/genética , Osteoartrite/genética , Osteocondrodisplasias/genética , Pró-Colágeno/genética , Adulto , Arginina/genética , Chile/epidemiologia , Cisteína/genética , DNA/análise , DNA/sangue , Feminino , Deformidades Congênitas do Pé/epidemiologia , Mãos/diagnóstico por imagem , Deformidades Congênitas da Mão/epidemiologia , Quadril/diagnóstico por imagem , Humanos , Joelho/diagnóstico por imagem , Leucócitos/química , Osteoartrite/epidemiologia , Osteocondrodisplasias/epidemiologia , Linhagem , Mutação Puntual , Reação em Cadeia da Polimerase , RadiografiaRESUMO
Un programa de vigilancia epidemiológica de malformaciones congénitas en efecto en el Hospital Ruíz y Páez de Ciudad Bolívar desde Abril de 1978, nos ha permitido la detección de 25 casos de Osteocondrodisplasias (OCD) en un total de 70.152 nacimientos atendidos en dicho hospital hasta Agosto de 1990, para una prevalencia total de un caso de OCD por cada 2.806 recién nacidos. Las entidades nosológicas encontradas fueron las siguientes: Acondroplasia, Displasia Tanatofórica, Osteogénesis Imperfecta II-A, Displasia Metafisaria de Kniest, Síndrome de Conradi-Hunnerman, Displasia Metafisaria de Jansen, Acondrogénesis de Parenti-Fracaro y Displasia Tóraco-Asfixiante de Jeune. Los resultados aquí reportados indican que este tipo de enfermedades representan un grupo relativamente importante de entidades nosológicas hereditarias que suman no menos de 200 casos nuevos anuales en el país. Esta relativa alta frecuencia, sus diferentes mecanismos hereditarios, sus variables complicaciones y sus índices de morbi-mortalidad, hacen que los pacientes afectados por una OCD constituyan un grupo problemático que no recibe, en general, la atención médica adecuada a su diagnóstico, asesoramiento genético y manejo de complicaciones