The spectrum of orofacial clefts and treatment logistics at Universitas Academic Hospital, Bloemfontein, South Africa.

BACKGROUND: Cleft lips and/or palates should be identified early and be operated on at specific ages according to international recommendations. In African countries, however, cleft lip and palate surgeries are often delayed. METHODS: A retrospective, descriptive study was done to determine the distribution, specific time delays, demographics and loss to follow-up of patients with cleft lip and/or palates treated at Universitas Academic Hospital over a 10-year period. Data was obtained from outpatient files from the Plastic and Reconstructive Surgery Department at Universitas Academic Hospital. Two hundred and three of 318 records (63.8%) had the defined variables documented. RESULTS: The median time from first presentation to specialist consultation was 1.9 months. The median ages for first presentation was 2.2 months and for specialist consultation 5.2 months. Patients mainly had isolated cleft palates (42.4%), followed by both cleft lip and palate (31%) and isolated cleft lips (24.6%). A quarter of patients (25.6%) were lost to follow-up. More than a third (36.5%) of patients were referred from the local Motheo district and 12.8% were referred from Lesotho. CONCLUSION: In our setting, patients with cleft lip and/or palate are generally diagnosed and referred late. These patients also have delayed access to specialist consultation. Often patients are only evaluated by specialists at ages whereby they should have already undergone their first surgeries. Too many patients are lost to follow-up.

Characterization of Puumala hantavirus in bank voles from two regions in the Netherlands where human cases occurred.

Puumala hantavirus (PUUV) is the most common and widespread hantavirus in Europe and is associated with a mild form of haemorrhagic fever with renal syndrome in humans, called nephropathia epidemica. This study presents the molecular characterization of PUUV circulating in bank voles in two regions of the Netherlands. Most human cases of hantavirus infection are from these two regions. Phylogenetic analysis of the (partial) S, M and L-segments indicated that the Dutch strains belong to the CE lineage, which includes PUUV strains from France, Germany and Belgium. We have identified two distinct groups of PUUV, corresponding with their geographic origin and with adjoining regions in neighbouring countries.

The effect of selenium supplementation during the early post-mating period on embryonic survival in sheep.

The effect of selenium (Se) supplementation of ewes with blood Se concentrations ranging between 100-200 ng/ml on embryonic survival during the early post-mating period (days 15-35) was studied in 4 trials. In the 1st 2 trials 137 ewes were used in 1991 and 118 in 1992. After being mated as a single flock, these ewes were stratified randomly into 3 groups. One group served as a control, the 2nd was injected with 1 ml Deposel (containing 50 mg Se as Ba selenate) and the 3rd group injected with 1 ml containing 1 mg Se as Na selenite. During 1991, supplementation was administered immediately after the mating period. It was postponed by 14 days in 1992. Parenteral Se supplementation reduced (p < 0.10) the number of ewes that lambed by > 19% during 1991 but not during 1992. The number of ewes producing twins was unaffected. In Trials 3 and 4 there was a consistent indication that parenteral Se supplementation of pregnant ewes between 15-35 days after mating resulted in a reduced (22-40%) embryonic survival rate, although significant (p < or = 0.10) differences were only observed after the pooling of treatments receiving parenteral Se supplementation. Drenching of ewes with 50 mg Se as Na selenite resulted in a similar tendency. Biochemical appraisal of the blood, kidney and liver Se status of ewes failed to reveal toxic levels. The possible mechanisms involved in impaired embryonic survival are unclear. Supplementation of ewes during the 1st month of pregnancy with parenteral Se preparations is not recommended.

Sexual responsivity and ego defenses.

High- and low-sexual responders to a double-entendre word association test were found to differ in defensive preference on the Defense Mechanisms Inventory. Low responders preferred avoidant defenses (reversal and principalization), and high responders preferred approach defenses (turning against object and projection). Results also suggested a consistency of defensive orientation over different situations.