scholarly journals Pregnancy Termination in the Case of an Orofacial Cleft: An Investigation of the Concept of Reproductive Autonomy

2020 ◽  
Vol 57 (9) ◽  
pp. 1134-1139
Author(s):  
Kristien Hens ◽  
Greet Hens
Keyword(s):  
Pregnant Woman ◽  
Cleft Lip ◽  
Pregnancy Termination ◽  
Clinical Information ◽  
Orofacial Cleft ◽  
Reproductive Autonomy ◽  
Ethical Theories ◽  
Cleft Lip Palate ◽  
Ethical Approaches ◽  
The Right

Objective: To describe ethical approaches to the issue of pregnancy termination after prenatal detection of cleft lip ± palate. Results: Gynecologists and cleft surgeons are sometimes confronted with the demand for a pregnancy termination after ultrasound detection of an isolated cleft lip/cleft palate. In this article, we discuss different ethical theories and principles that can be applied to the dilemma at hand. We formulate recommendations that will respect the right to autonomy of the pregnant woman and at the same time acknowledge that a termination of pregnancy for a cleft lip may in most cases not be the best option. Conclusion: The recognition of each person’s right to reproductive autonomy also entails that clinicians should make sure that prospective parents are provided with up-to-date and relevant clinical information.

scholarly journals Prenatal Diagnosis of EEC Syndrome with “Lobster Claw” Anomaly by 3D Ultrasound

2012 ◽  
Vol 2 ◽  
pp. 40 ◽  
Author(s):  
Livia T. Rios ◽  
Edward Araujo ◽  
Ana C. R. Caetano ◽  
Luciano M. Nardozza ◽  
Antonio F. Moron ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Cleft Lip ◽  
Three Dimensional ◽  
3D Ultrasound ◽  
Eec Syndrome ◽  
Cleft Lip Palate ◽  
The Right ◽  
Hands And Feet ◽  
Genetic Anomaly ◽  
Better Than

The EEC syndrome is a genetic anomaly characterized by the triad: ectodermal dysplasia (development of anomalies of the structures derived from the embryonic ectodermal layer), ectrodactyly (extremities, hands and feet malformations) and cleft lip and/or palate; these malformations can be seen together or in isolation. The prenatal diagnosis can be made by two-dimensional ultrasonography (2DUS) that identifies the facial and/or limb anomalies, most characteristic being the “lobster-claw” hands. The three-dimensional ultrasonography (3DUS) provides a better analysis of the malformations than the 2DUS. A 25-year-old primigravida, had her first transvaginal ultrasonography that showed an unique fetus with crow-rump length of 47 mm with poorly defined hands and feet,. She was suspected of having sporadic form of EEC syndrome. The 2DUS performed at 19 weeks confirmed the EEC syndrome, showing a fetus with lobster-claw hands (absence of the 2nd and 3rd fingers), left foot with the absence of the 3rd toe and the right foot with syndactyly, and presence of cleft lip/palate. The 3DUS defined the anomalies much better than 2DUS including the lobster-claw hands.

scholarly journals Clinical and epidemiological profile of cleft lip/ palate deformities in Tamil Nadu, India

2019 ◽  
Vol 6 (6) ◽  
pp. 2428
Author(s):  
S. Prabakaran
Keyword(s):  
Tamil Nadu ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Parental History ◽  
Speech Pathologist ◽  
Cleft Lip Palate ◽  
Epidemiological Profile ◽  
The Right

Background: Cleft lip and palate deformities are commonly detected at the time of birth in most of the developing countries like India. The surgical management of cleft lip/ palate deformities involve multi-disciplinary approach with corrective measures from dental surgeon, plastic surgeon, speech pathologist and audiologist. The role of pediatricians in clinical management of cleft lip is often missed. This study was done to evaluate the clinical profile of cleft lip and palate deformities.Methods: This cross sectional study was carried out among 1077 patients diagnosed with cleft lip or cleft palate deformity for a period of 5 years between 2014 and 2019. A structured patient information schedule was prepared and data regarding the age, gender, antenatal details and parental history were recorded. A detailed clinical examination was carried out to evaluate the presence of complete and incomplete deformity in the lip, alveolus, hard palate and soft palate.Results: Complete cleft lip was present in 47.8% of the participants on the left side while on the right, complete cleft lip was present in 29.4% of the participants. Complete deformity of the alveolus on the left side was present in 45.4% of the participants while complete deformity on the right side of alveolus was present in 27.4% of the participants.Conclusions: It is important the pediatricians sensitize the parents regarding the clinical and supportive management and also initiate the surgical correction of this deformity with help of a multidisciplinary team.

scholarly journals An Evaluation of Muscle Repair Techniques: Implications in Musculoskeletal Healing and Corollaries in Oral-Facial Clefting

2020 ◽  
Author(s):  
Jaehoon Kim ◽  
Jaehoon Choi ◽  
Junhyung Kim ◽  
Taehee Jo ◽  
Il Sun Hwang ◽  
...  
Keyword(s):  
Western Blotting ◽  
Muscle Fiber ◽  
Cleft Lip ◽  
The Other ◽  
Sprague Dawley ◽  
Gait Symmetry ◽  
Tnf Α ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
The Right

Abstract We performed an animal study to identify the techniques associated with the best muscle healing outcomes in cleft lip/palate surgery. The right triceps of thirty adult male Sprague-Dawley rats were cut and repaired by three different suture techniques: simple (n=10), overlapping (n=10), and splitting sutures (n=10). Muscle tissues were isolated from 5 rats per group 1 and 8 weeks postoperation. The inflammatory response and muscle fiber healing were evaluated by hematoxylin and eosin (H&E) staining, western blotting, immunohistochemistry for TNF-α and IL-1β, and immunofluorescence for laminin and MyoD. Grip strength (N/100 g) and spatial gait symmetry were evaluated before surgery and 1, 2, 4 and 8 weeks postoperation. Eight weeks postoperation, grip force per weight was significantly higher in the simple suture (median, 3.49; IQR, 3.28-3.66) and overlapping groups (median, 3.3; IQR, 3.17-3.47) than the splitting group (median, 2.91; IQR, 2.76-3.05). There was no significant difference in range of motion between groups. The simple group exhibited significant remission of inflammation by H&E staining and lower expression of TNF-α and IL-1β than the other groups by western blotting and immunohistochemistry. Immunofluorescence revealed stronger expression of MyoD and weaker expression of laminin in the splitting group than in the other groups at week 8, indicating prolonged inflammation and healing followed by poor muscle fiber remodeling. Simple interrupted sutures and overlapping sutures showed similar muscle healing in this study. Therefore, there was some limitation to reconstructing the philtral column using overlapping sutures alone, and additional procedures could be needed.

1. Ethical theories

Legal Ethics ◽  
2017 ◽  
Author(s):  
Jonathan Herring
Keyword(s):  
Ethical Dilemmas ◽  
Legal Practice ◽  
Ethical Theories ◽  
Ethical Approaches ◽  
The Right ◽  
Ethical Obligations ◽  
Legal Training

This chapter sets out some general theories about ethics. How do we judge what is the right thing to do? What makes a decision morally justifiable? What makes a person good? It considers some ethical disagreements and describes some of the general ethical approaches that are taken to ethical dilemmas. It then addresses the question of whether lawyers’ ethics are any different from others. Finally, it looks at how legal training and legal practice has taken the ethical obligations of lawyers more seriously.

Maternal Drug Use and Infant Cleft Lip/Palate with Special Reference to Corticoids

2003 ◽  
Vol 40 (6) ◽  
pp. 624-628 ◽  
Author(s):  
Bengt Källén
Keyword(s):  
Drug Use ◽  
Cleft Palate ◽  
Early Pregnancy ◽  
Cleft Lip ◽  
First Trimester ◽  
Orofacial Cleft ◽  
Orofacial Clefts ◽  
Maternal Drug Use ◽  
Median Cleft ◽  
Cleft Lip Palate

Objective To study the association between maternal drug use in early pregnancy and orofacial cleft in the infant. Design Register analysis based on prospectively collected information. Patients All delivered women in Sweden July 1, 1995, through December 31, 2001. Main outcome measure Presence of orofacial cleft in infant. Results Prospective information on maternal drug use during the first trimester, as reported in early pregnancy, was studied in 1142 infants with orofacial clefts, isolated or with other malformations, excluding chromosome anomalies. Any drug use was not associated with clefts (odds ratio [OR] = 0.98, 95% confidence interval [95% CI] = 0.85 to 1.13), with isolated clefts (OR = 0.92) with isolated median cleft palate (OR = 1.03, 95% CI = 0.79 to 1.36) or with isolated cleft lip with or without cleft palate (OR = 0.86, 95% CI = 0.71 to 1.05). Reported use of multivitamins, folic acid, or B12 was not associated with a decrease in orofacial cleft risk (OR = 1.00, 95% CI = 0.63 to 1.52). ORs above 2 were seen for some drugs: sulfasalazine, naproxen, and anticonvulsants, but only a few exposed cases occurred. An association between glucocorticoid use and infant cleft was indicated and seemed to be strongest for median cleft palate. Conclusion Maternal drug use seems to play only a small role for the origin of orofacial clefts, at least in Sweden.

scholarly journals Dysregulation of Rho GTPases in orofacial cleft patients-derived primary cells leads to impaired cell migration, a potential cause of cleft/lip palate development

2021 ◽  
Vol 165 ◽  
pp. 203656
Author(s):  
Mirvat El-Sibai ◽  
Joelle El Hajj ◽  
Maria Al Haddad ◽  
Nada El Baba ◽  
Mounir Al Saneh ◽  
...  
Keyword(s):  
Cell Migration ◽  
Rho Gtpases ◽  
Cleft Lip ◽  
Orofacial Cleft ◽  
Primary Cells ◽  
Palate Development ◽  
Cleft Lip Palate

scholarly journals Effects of anesthesia and oral cleft types on academic achievement

2020 ◽  
Author(s):  
Saskia Gladys Nadal
Keyword(s):  
Academic Achievement ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Orofacial Cleft ◽  
Oral Cleft ◽  
Percentage Point Increase ◽  
School Year ◽  
Point Increase ◽  
Different Types ◽  
Cleft Lip Palate

ObjectiveResearch looking simultaneously at the effects of anesthesia and oral cleft types on academic achievement is scarce. Available results are contradictory: some studies suggest that anesthesia exposure is responsible for underachievement, and others that responsibility falls instead on the type of orofacial cleft. This study investigates the potential compound effects of exposure to anesthesia and orofacial cleft types on the risk of academic underachievement.DesignCentre Labio Palatin Albert Coninck, Cliniques universitaires Saint-Luc, Brussels, Belgium, nationwide register-based study.SettingBirth cohort 1995-2007.PatientsTwenty-nine children with isolated orofacial clefts exposed to anesthesia.InterventionsAverage duration of exposure to anesthesia before the Certificat d Etudes de Base (CEB) exam was 382 minutes.Main Outcome Measure(s)Scores obtained by patients at the CEB exam were compared with the scores of the 6th grade Belgian general population who passed the same exam controlling for gender, school year, year they passed the exam, medical illnesses, duration of exposure to anesthesia in minutes and socioeconomic confounders.ResultsDoubling the time of anesthesia exposure produces a 17 percentage point increase in the probability that patients will underachieve. Cleft lip reduces while cleft right-left increases the duration of anesthesia exposure relative to cleft lip palate. Results do not change when anesthesia exposure only up to 4 years and socioeconomic factors are considered.ConclusionsBoth exposure to anesthesia and different types of orofacial cleft may result in underachievement at the CEB exam.

scholarly journals Ocular coloboma combined with cleft lip and palate: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yung Ju Yoo ◽  
Sang Beom Han ◽  
Hee Kyung Yang ◽  
Jeong-Min Hwang
Keyword(s):  
Visual Acuity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anterior Segment ◽  
Case Presentation ◽  
Corrected Visual Acuity ◽  
Cleft Lip Palate ◽  
Part Time ◽  
The Right ◽  
Best Corrected Visual Acuity

Abstract Background Ocular coloboma is an excavation of ocular structures that occurs due to abnormal fusion of the embryonic optic fissure. Further, cleft lip/palate (CL/P), a congenital midline abnormality, is caused by a defect in the fusion of the frontonasal, maxillary, and mandibular prominences. No study has reported the association between these two phenotypes in the absence of other systemic abnormalities. We present a case of ocular coloboma along with CL/P and without other neurological abnormalities. Case presentation A 5-year-old Asian boy presented with decreased visual acuity in his right eye. Physical examination revealed no abnormal findings except CL/P, which was surgically corrected at the age of 9 months. Best-corrected visual acuity was 20/60 in the right eye and 20/25 in the left eye. Anterior segment examination revealed iris coloboma in the inferior quadrant of his right eye as well as a large inferonasal optic disc and chorioretinal coloboma in the same eye. He was prescribed glasses based on his cycloplegic refractive errors and part-time occlusion of the left eye was recommended. After 3 months, best-corrected visual acuity improved to 20/30 in the right eye. Conclusion The association of ocular coloboma should be kept in mind when encountering a patient with CL/P without other neurological or systemic abnormalities.

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