The methodology of the GUSTO cohort study: a novel approach in studying pediatric allergy

Growing Up in Singapore Towards healthy Outcomes (GUSTO) is Singapore's largest birth cohort study to date. The main aim of GUSTO is to evaluate the role of developmental factors in the early pathways to metabolic compromise. Detailed data is collected for a range of environmental exposures in the parents and offspring, and allergic disorders are among a number of outcomes assessed in infancy and childhood. Under the Allergy domain of GUSTO, this integrated study will describe the epidemiology of allergic manifestations and different phenotypes in the Asian context and help shed light on the association of metabolic disease to allergy. Epigenetic mechanisms and associations with other childhood disorders will also be explored. The aim of this report is to focus on methodology of GUSTO, and to suggest similar approaches (i.e., integrated cohort studies on pediatric allergy) worldwide. Recruitment commenced in 2009 with a cohort of 1,163 pregnant mothers in their first trimester. The mothers and children were followed throughout pregnancy and follow-up will continue until the child reaches 3 years of age. Preliminary results showed that 39.8% of the mothers had a personal history of having at least one allergic disease, which included asthma, eczema and allergic rhinitis. Further data collection and analyses are still ongoing. Allergy is a complex spectrum of disorders with numerous poorly-understood aspects. The ongoing GUSTO cohort study, with its longitudinal design and multi-disciplinary nature, may provide new insights into developmental influences on allergy. As a Singapore-based study, it will be the first integrated allergy cohort in Southeast Asia, of which recruitment started during pregnancy.

A Review of Presurgical Orthopedics for the Infants of Cleft Lip and Palate

 The purpose of this articles is to review the presurgical orthopedics (PSO) which is one of the important procedures of the interdisciplinary management for cleft lip and palate. The review contents included history, rationales of PSO, types of appliances and contraindications, age and timing of PSO, and appliance constructions; also provided are opinions and suggested instruction of care and baby feeding during the PSO.Key words: Cleft lip and palate, Presurgical orthopedics, Obturator, Extra-oral strapping

Investigating the Occurrences of Cleft Lip, Cleft palate and Other Related Birth Defects

Some epidemiological comparisons of congenital oral clefts, particularly relating to the Asian region, are recorded. There is need extend such studies to case control and cohort studies in order to be able to better determine etiological factors. Studies of different populations have show variability of genetic constitutions and variability of outcomes of their interactions with suspected teratogens. Examples of risks of occurrence in the development of oral clefts and other birth defects through interactions of gene and environmental factors are noted. Experiences in a few  industrialized countries, so far, indicates that obtaining information about the nature of such interactions in population groups requires the establishment of central birth registries, including surveillance of human abortuses, linked with environmental monitoring