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多个神经管缺陷可能并非十分罕见。

Multiple neural tube defects may not be very rare.

作者信息

Mahalik Santosh Kumar, Vaze Dhananjay, Kanojia Ravi Prakash, Narasimhan Kannan L, Rao K L N

机构信息

Department of Pediatric Surgery, PGIMER Chandigarh, Chandigarh 160012, India.

出版信息

Childs Nerv Syst. 2013 Apr;29(4):609-19. doi: 10.1007/s00381-012-1976-5. Epub 2012 Dec 4.

Abstract

BACKGROUND

Multiple neural tube defects (MNTDs) are a rare occurrence. Although the clinical incidence is small, MNTDs raise some interesting embryological queries.

AIM

This study aims to investigate the morphological and clinical variations observed in neonates presenting with multiple neural tube defects and associated central nervous system anomalies.

MATERIALS AND METHODS

This is a prospective study carried out at our institute to assess clinical and morphological variation in patients presenting with multiple neural tube defects.

RESULTS

Among the 263 patients with a neural tube defect, who presented to our outpatient department and emergency departments, only 10 cases of MNTDs were identified. Thus, incidence of MNTDs in the cohort of patients affected with NTD was 0.038 %. Among the 10 patients, 9 had double neural tube defects and 1 patient had three neural tube defects.

CONCLUSIONS

Multiple neural tube defects may not be very rare in the general population, especially the populations with high incidence of neural tube defects. Multisite closure theory has the versatility to explain various combinations of neural tube defects, but better insights into the molecular pathways governing this tightly regulated process can provide us the missing link in establishing the pathogenesis of multiple NTDs. It can also provide us with an opportunity to prevent NTDs or treat them in utero by pharmacological modulation of these signaling pathways.

摘要

背景

多发性神经管缺陷(MNTDs)较为罕见。尽管临床发病率较低,但MNTDs引发了一些有趣的胚胎学问题。

目的

本研究旨在调查患有多发性神经管缺陷及相关中枢神经系统异常的新生儿中观察到的形态学和临床变异。

材料与方法

这是一项在我们研究所进行的前瞻性研究,以评估患有多发性神经管缺陷患者的临床和形态学变异。

结果

在前来我们门诊部和急诊科就诊的263例神经管缺陷患者中,仅发现10例MNTDs。因此,在受神经管缺陷影响的患者队列中,MNTDs的发病率为0.038%。在这10例患者中,9例有双神经管缺陷,1例有三个神经管缺陷。

结论

多发性神经管缺陷在普通人群中可能并不十分罕见,尤其是在神经管缺陷发病率高的人群中。多部位闭合理论具有解释神经管缺陷各种组合的通用性,但对控制这一严格调控过程的分子途径有更深入的了解,可以为我们提供建立多发性神经管缺陷发病机制中缺失的环节。它还可以为我们提供一个机会,通过对这些信号通路进行药理学调节来预防神经管缺陷或在子宫内进行治疗。

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