1
|
Smythe T, Rotenberg S, Lavy C. The global birth prevalence of clubfoot: a systematic review and meta-analysis. EClinicalMedicine 2023; 63:102178. [PMID: 37680947 PMCID: PMC10480528 DOI: 10.1016/j.eclinm.2023.102178] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/09/2023] Open
Abstract
Background Estimates of the birth prevalence of clubfoot in low and middle income settings range from 0.5 to 2 per 1000 births. However, there is currently no estimate of global birth prevalence of clubfoot. Methods We conducted a systematic review of studies reporting the birth prevalence of clubfoot across all countries and regions worldwide in the last 10 years. Africa Wide Information, EMBASE, CINAHL, Global Health, LILACS and Medline databases were searched for relevant studies from January 1st 2012 to February 9th 2023. Pooled prevalence estimates were calculated using the inverse variance method, and a random effects model was applied to account for heterogeneity between studies. Quality appraisal was performed using a modified Newcastle-Ottawa Quality Assessment Scale for Cohort studies. This review was registered with PROSPERO, CRD42023398410. Findings The search generated 757 studies. Thirty-five studies from 36 countries and five WHO regions were included. The pooled prevalence of clubfoot was 1.18 per 1000 births (95% CI: 1.00-1.36) based on data from 44,818,965 births. The highest prevalence rates were observed in low- and middle-income countries, particularly in the South-East Asia Region (1.80, 95% CI: 1.32-2.28) and the Africa Region (1.31, 95% CI: 0.86-1.77). We estimate that 176,476 (95% CI: 126,126-227,010) children will be born with clubfoot globally each year. Interpretation This study provides a comprehensive estimate of the global prevalence of clubfoot and highlights the significant burden of this condition, particularly in low- and middle-income countries. The findings underscore the need for improving access to effective treatment and prevention strategies in resource-limited settings. Funding SR received funds from the Global Clubfoot Initiative and the Rhodes Trust.
Collapse
Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, WC1E 7HT, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
| | - Chris Lavy
- Nuffield Department of Orthopaedics, Reumatology and Musculoskeletal Sciences University of Oxford, OX2 6GG, UK
| |
Collapse
|
2
|
Chedrawe ER, Keefe DT, Romao RLP. Diagnosis, Classification, and Contemporary Management of Undescended Testicles. Urol Clin North Am 2023; 50:477-490. [PMID: 37385709 DOI: 10.1016/j.ucl.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
This article provides a comprehensive review regarding undescended testicles and other related conditions. We have included background information summarizing variable clinical presentations, epidemiology, and the implications of undescended testis (UDT) on fertility and malignancy risk. This article has an emphasis on the approach to diagnosis and surgical management for the UDT. The purpose of this review is to provide readers with useful clinical tools for assessing and treating patients with cryptorchidism.
Collapse
Affiliation(s)
- Emily R Chedrawe
- Division of Pediatric Urology, IWK Health Centre, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K 6R8 Canada; Department of Urology, Dalhousie University, 1276 South Park Street. Room 293, 5 Victoria, Halifax, NS, B3H 2Y9, Canada
| | - Daniel T Keefe
- Division of Pediatric Urology, IWK Health Centre, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K 6R8 Canada; Department of Urology, Dalhousie University, 1276 South Park Street. Room 293, 5 Victoria, Halifax, NS, B3H 2Y9, Canada
| | - Rodrigo L P Romao
- Division of Pediatric Urology, IWK Health Centre, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K 6R8 Canada; Department of Urology, Dalhousie University, 1276 South Park Street. Room 293, 5 Victoria, Halifax, NS, B3H 2Y9, Canada; Division of Pediatric Surgery and Department of Surgery, IWK Health Centre, Dalhousie University, 5850 University Avenue, P.O. Box 9700, Halifax, NS, B3K 6R8.
| |
Collapse
|
3
|
Mahboubi K, MacDonald L, Ahrens B, Lane C, MacLellan D, Anderson P, Romao RLP. Geospatial analysis of hypospadias and cryptorchidism prevalence rates based on postal code in a Canadian province with stable population. J Pediatr Urol 2023; 19:91.e1-91.e6. [PMID: 36261304 DOI: 10.1016/j.jpurol.2022.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Hypospadias and cryptorchidism are hormone-mediated malformations that occur during male development. Prevalence rates of hypospadias and cryptorchidism are thought to be increasing worldwide. In-utero exposure to endocrine-disrupting chemicals (EDCs) may have a role in the occurrence of these malformations. Our group has reported significant clustering of hypospadias and cryptorchidism at the county level in areas of intense agricultural activity in the Canadian province of Nova Scotia (NS). Finer scale spatial analysis has shown clustering near urban centres. OBJECTIVES The objectives of the study were: 1) to perform a granular geospatial analysis of hypospadias and cryptorchidism prevalence, at the postal code level, of all babies born in NS over a 26-year period; and 2) to determine whether there is spatial correlation between these conditions and industries linked to toxic output. STUDY DESIGN Cases of hypospadias and cryptorchidism were identified based on ICD-10 codes from the Nova Scotia Atlee Perinatal Database with records of all live births in NS between 1988 and 2013. Data were geocoded and mapped based on the three first digits of the maternal postal code (Forward Sortation Area [FSA]). Regional prevalence of congenital anomalies was calculated for each of the 77 FSAs. To identify statistically significant high and low prevalence clusters for each anomaly, Local Morans I was used on the spatial data. Geospatial point data was created for industries linked to toxic output and correlation between clusters of malformations and proximity to these industries was assessed. RESULTS During the study period, there were 1045 cases of hypospadias and 993 cases of cryptorchidism. Both hypospadias and cryptorchidism demonstrated statistically significant areas of high prevalence clusters. There was no significant spatial correlation between the local clustering of the congenital malformations and proximity to toxic industries. DISCUSSION AND CONCLUSION Our study shows heterogeneity in the distribution of hypospadias and cryptorchidism, which is consistent with previously published works. In this follow-up, granular geospatial analysis of hypospadias and cryptorchidism prevalence in an area with stable population, we did not confirm the previous findings of high clustering in areas of intense agricultural activity. Furthermore, our analysis did not find high clustering of the congenital malformations in areas near toxic industries to support a clear environmental role in their development. Some of the limitations include underdiagnosis of hypospadias and cryptorchidism (as they both present with a clinical spectrum and are non-life threatening), and limited data currently available on the route of exposure to EDC industries in Nova Scotia.
Collapse
Affiliation(s)
- Kiana Mahboubi
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Landan MacDonald
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Beau Ahrens
- Interdisciplinary PhD Program, Faculty of Graduate Studies, Dalhousie University, Halifax, NS, Canada.
| | - Ciaran Lane
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Dawn MacLellan
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Peter Anderson
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Rodrigo L P Romao
- Division of Urology, Department of Surgery, IWK Health Centre, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| |
Collapse
|
4
|
Mitsui T. Effects of the prenatal environment on cryptorchidism: A narrative review. Int J Urol 2021; 28:882-889. [PMID: 34075642 DOI: 10.1111/iju.14600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/25/2021] [Indexed: 12/30/2022]
Abstract
Cryptorchidism, the absence of testes from the scrotum, is the most common genital disorder in boys and a risk factor for reduced fertility and testicular cancer. The mechanism responsible for cryptorchidism involves two discrete stages: a transabdominal and an inguinoscrotal phase. These phases of testicular descent are regulated by the prenatal sex hormone environment, including levels of testosterone, insulin-like factor 3, and calcitonin gene-related peptide. Environmental endocrine disruptors, which are unfavorable environmental factors, may also affect testicular descent through prenatal sex hormones. This review examined the effects of environmental factors, particularly environmental endocrine disruptors, such as phthalates, organochlorine pesticides, diethylstilbestrol, bisphenol A, dioxins/dioxin-like compounds, and perfluoroalkyl substances, and parental lifestyles on the risk of cryptorchidism. Although some studies have shown that environmental endocrine disruptors can affect testicular descent by changing the hormonal environment during the prenatal period, no significant association has been established between exposure to environmental endocrine disruptors and the incidence of cryptorchidism. Therefore, the role played by environmental endocrine disruptor exposure (if any) in the pathogenesis of cryptorchidism remains unknown. Further studies are needed to examine these issues.
Collapse
Affiliation(s)
- Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan
| |
Collapse
|
5
|
Sharpe RM. Location, location, location-where you are born may determine your reproductive (and more general) health. Hum Reprod 2021; 36:1171-1174. [PMID: 33728440 DOI: 10.1093/humrep/deab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard M Sharpe
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| |
Collapse
|
6
|
Ge W, Chen M, Tian W, Chen J, Zhao Y, Xian H, Chen J, Xu Y. Global 3'UTR shortening and down-regulation of repeated element related piRNA play crucial roles in boys with cryptorchidism. Genomics 2021; 113:633-645. [PMID: 33485952 DOI: 10.1016/j.ygeno.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/10/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cryptorchidism is the most common congenital defect in children's genitourinary system. Decades of research have identified both environmental and genetic factors contribute to the etiology. METHODS Small-RNA/mRNA-seq were performed on testicular tissues from cryptorchidism patients. Downstream analysis included mRNA expression, piRNA expression and miRNA expression. RESULTS We find a global downregulation of repeated element related piRNA expression as well as a global 3'UTR shortening of mRNAs in patients with cryptorchidism. We also find that genes with shortened 3'UTR which are highly enriched in vascular endothelial growth and protein ubiquitination, tend to be up-regulated in cryptorchidism. These results indicate that boys with cryptorchidism may not have normal piRNA functions to protect developmental tissues from transposon invasion. Dysregulated shortened 3'UTR genes may affect normal testicular tissue development. CONCLUSION In summary, our findings also provided the first landscape of gene regulation in cryptorchidism, especially in terms of post-transcriptional regulations.
Collapse
Affiliation(s)
- Wenliang Ge
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Minhua Chen
- Department of Pediatrics, Affiliated Hospital of Yangzhou University, Yangzhou 225001, Jiangsu, China
| | - Wei Tian
- Department of Pathology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Jianan Chen
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Yinshuang Zhao
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Hua Xian
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Jinling Chen
- Department of Pathogen Biology, School of Medicine, Nantong University, Nantong 226001, Jiangsu, China.
| | - Yunzhao Xu
- Prenatal Diagnosis Center, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China; Department of Obstetrics and Gynecology, School of Medicine, Nantong University, Nantong 226001, Jiangsu, China.
| |
Collapse
|
7
|
Stadler HS, Peters CA, Sturm RM, Baker LA, Best CJM, Bird VY, Geller F, Hoshizaki DK, Knudsen TB, Norton JM, Romao RLP, Cohn MJ. Meeting report on the NIDDK/AUA Workshop on Congenital Anomalies of External Genitalia: challenges and opportunities for translational research. J Pediatr Urol 2020; 16:791-804. [PMID: 33097421 PMCID: PMC7885182 DOI: 10.1016/j.jpurol.2020.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 01/02/2023]
Abstract
Congenital anomalies of the external genitalia (CAEG) are a prevalent and serious public health concern with lifelong impacts on the urinary function, sexual health, fertility, tumor development, and psychosocial wellbeing of affected individuals. Complications of treatment are frequent, and data reflecting long-term outcomes in adulthood are limited. To identify a path forward to improve treatments and realize the possibility of preventing CAEG, the National Institute of Diabetes and Digestive and Kidney Diseases and the American Urological Association convened researchers from a range of disciplines to coordinate research efforts to fully understand the different etiologies of these common conditions, subsequent variation in clinical phenotypes, and best practices for long term surgical success. Meeting participants concluded that a central data hub for clinical evaluations, including collection of DNA samples from patients and their parents, and short interviews to determine familial penetrance (small pedigrees), would accelerate research in this field. Such a centralized datahub will advance efforts to develop detailed multi-dimensional phenotyping and will enable access to genome sequence analyses and associated metadata to define the genetic bases for these conditions. Inclusion of tissue samples and integration of clinical studies with basic research using human cells and animal models will advance efforts to identify the developmental mechanisms that are disrupted during development and will add cellular and molecular granularity to phenotyping CAEG. While the discussion focuses heavily on hypospadias, this can be seen as a potential template for other conditions in the realm of CAEG, including cryptorchidism or the exstrophy-epispadias complex. Taken together with long-term clinical follow-up, these data could inform surgical choices and improve likelihood for long-term success.
Collapse
Affiliation(s)
- H Scott Stadler
- Department of Skeletal Biology, Shriners Hospital for Children, 3101 SW Sam Jackson Park Road, Portland, OR, Oregon Health & Science University, Department of Orthopaedics and Rehabilitation, Portland, 97239, OR, USA.
| | - Craig A Peters
- Department of Urology, University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, 75390-9110, TX, USA; Pediatric Urology, Children's Health System Texas, University of Texas Southwestern, Dallas, 75390, TX, USA.
| | - Renea M Sturm
- Department of Urology, Division of Pediatric Urology, University of California Los Angeles, 200 Medical Plaza #170, Los Angeles, 90095, CA, USA
| | - Linda A Baker
- Department of Urology, University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, 75390-9110, TX, USA
| | - Carolyn J M Best
- American Urological Association, 1000 Corporate Boulevard, Linthicum, 21090, MD, USA
| | - Victoria Y Bird
- Department of Urology, University of Florida, Gainesville, 32610, FL, USA; National Medical Association and Research Group, 5745 SW 75th Street, #507, Gainesville, 32608, FL, USA
| | - Frank Geller
- Department of Epidemiology Research, Statens Serum Institut, 5 Artillerivej, Copenhagen S, DK-2300, Denmark
| | - Deborah K Hoshizaki
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Bethesda, 20892, MD, USA
| | - Thomas B Knudsen
- US Environmental Protection Agency, Office of Research and Development, Center for Computational Toxicology and Exposure, Research Triangle Park, 27711, NC, USA
| | - Jenna M Norton
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Bethesda, 20892, MD, USA
| | - Rodrigo L P Romao
- Departments of Surgery and Urology, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin J Cohn
- Department of Molecular Genetics and Microbiology, Department of Biology, And UF Genetics Institute, University of Florida, PO Box 103610, Gainesville, 32610, FL, USA.
| |
Collapse
|
8
|
Lauriot Dit Prevost A, Genin M, Occelli F, Priso RH, Besson R, Lanier C, Sharma D. Spatial analysis of hypospadias cases in northern France: taking clinical data into account. BMC Pediatr 2020; 20:442. [PMID: 32957953 PMCID: PMC7504625 DOI: 10.1186/s12887-020-02332-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/07/2020] [Indexed: 01/16/2023] Open
Abstract
Background Strong evidence for a causal role of environmental factors in a congenital anomaly is still difficult to produce. The collection of statistical data is crucial for gaining a better understanding of the epidemiology and pathophysiology of these anomalies. We aimed to evaluate spatial variations in hypospadias within our region and it’s association to socioeconomic and ecological factors, taking clinical data into account. Methods All boys with hypospadias born in northern France and seen in Lille University Medical Center (Lille, France) between 1999 and 2012 were included in the analysis. We retrospectively collected geographic data, clinical data (especially known confounding factors associated with an elevated risk of hypospadias), and demographic, socio-economic and ecological data. We analyzed the entire study population and subsequently the subset of boys lacking confounding factors. Results The study sample of 975 cases of hypospadias over the 13-year period resulted in an incidence of 25.4/10,000 male births, and was characterized by significant spatial heterogeneity (p < 0.005) and autocorrelation (p < 0.001). We detected two high-incidence clusters that differed with regard to their land use. After the exclusion of 221 patients with confounding factors, two high-incidence clusters with significant disease risks (1.65 and 1.75, respectively; p < 0.001) and a significant difference in land use (p < 0.001) again appeared. The first cluster contained a higher median [interquartile range] proportion of artificialized land (0.40 [0.22;0.47]) than the remaining “neutral areas” (0.19 [0.08;0.53]) did (p < 0.001). Conversely, the second cluster contained a higher median proportion of rural land (0.90 [0.78;0.96]) than the “neutral areas” (0.81 [0.47;0.92]) did (p < 0.001). The median deprivation index was significantly lower in the urban cluster (0.47 [0.42;0.55]) and significantly higher in the rural cluster (0.69 [0.56;0.73]) (p < 0.001). Conclusions Our results evidenced the heterogeneous spatial distribution of cases of hypospadias in northern France. We identified two clusters with different environmental and social patterns – even after the exclusion of known confounding factors.
Collapse
Affiliation(s)
- Arthur Lauriot Dit Prevost
- CHU Lille, Clinique de Chirurgie et Orthopédie de l'Enfant, F-59000, Lille, France. .,CHU Lille, Centre de référence du développement génital DEV-GEN, F-59000, Lille, France. .,Univ. Lille, CHU Lille, ULR 2694 METRICS - Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France.
| | - Michael Genin
- Univ. Lille, CHU Lille, ULR 2694 METRICS - Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France
| | - Florent Occelli
- Univ. Lille, Laboratoire de Génie Civil et géo-Environnement, F-59000, Lille, France.,Faculté ILIS/Faculté de pharmacie de Lille - LSVF, Lille, F-59000, France
| | - René-Hilaire Priso
- CHU Lille, Clinique de Chirurgie et Orthopédie de l'Enfant, F-59000, Lille, France.,CHU Lille, Centre de référence du développement génital DEV-GEN, F-59000, Lille, France
| | - Remi Besson
- CHU Lille, Clinique de Chirurgie et Orthopédie de l'Enfant, F-59000, Lille, France.,CHU Lille, Centre de référence du développement génital DEV-GEN, F-59000, Lille, France
| | - Caroline Lanier
- Univ. Lille, Laboratoire de Génie Civil et géo-Environnement, F-59000, Lille, France.,Faculté ILIS/Faculté de pharmacie de Lille - LSVF, Lille, F-59000, France
| | - Dyuti Sharma
- CHU Lille, Clinique de Chirurgie et Orthopédie de l'Enfant, F-59000, Lille, France.,CHU Lille, Centre de référence du développement génital DEV-GEN, F-59000, Lille, France
| |
Collapse
|
9
|
Lowry RB, Bedard T, Crawford S, Grevers X, Bernier FP, Thomas MA. Prevalence rates study of selected isolated non-Mendelian congenital anomalies in the Hutterite population of Alberta, 1980-2016. Am J Med Genet A 2020; 182:2594-2604. [PMID: 32893972 DOI: 10.1002/ajmg.a.61834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 11/10/2022]
Abstract
A study of the prevalence rates for selected isolated non-Mendelian congenital anomalies in the Hutterite Brethren of Alberta, Canada was undertaken to further examine longitudinal data in this isolated community that was last reported in 1985 (Lowry et al., 1985), although there are numerous publications on recessive disorders (Boycott et al., 2008; Triggs-Raine et al., 2016). Cases were ascertained from the Alberta Congenital Anomaly Surveillance System for the years 1997-2016. Since our initial results showed some surprising findings in the Hutterite Brethren, such as zero cases of spina bifida, cleft lip and palate, gastroschisis, and omphalocele, and a significant excess of cases with hypospadias, we extended the study to prior years (1980-1996) for selected anomalies. For the extended study period (1980-2016), there was a significant increased prevalence of hypospadias, tetralogy of Fallot and tricuspid atresia in the Hutterite population, and although not statistically significant, zero cases of cleft lip with cleft palate, gastroschisis and omphalocele were confirmed. Further research is needed to determine the precise effects of rural environmental exposures, lifestyle factors, and genetic associations for selected multifactorial congenital anomalies.
Collapse
Affiliation(s)
- R Brian Lowry
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanya Bedard
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
| | - Susan Crawford
- Alberta Perinatal Health Program, Alberta Health Services, Calgary, Alberta, Canada
| | - Xin Grevers
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
| | - François P Bernier
- Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mary Ann Thomas
- Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
10
|
Zhou Y, Zhang D, Liu B, Hu D, Shen L, Long C, Yu Y, Lin T, Liu X, He D, Wei G. Bioinformatic identification of key genes and molecular pathways in the spermatogenic process of cryptorchidism. Genes Dis 2019; 6:431-440. [PMID: 31832523 PMCID: PMC6889044 DOI: 10.1016/j.gendis.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/07/2018] [Indexed: 11/16/2022] Open
Abstract
This study aims to determine key genes and pathways that could play important roles in the spermatogenic process of patients with cryptorchidism. The gene expression profile data of GSE25518 was obtained from the Gene Expression Omnibus (GEO) database. Microarray data were analyzed using BRB-Array Tools to identify differentially expressed genes (DEGs) between high azoospermia risk (HAZR) patients and controls. In addition, other analytical methods were deployed, including hierarchical clustering analysis, class comparison between patients with HAZR and the normal control group, gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, and the construction of a protein–protein interaction (PPI) network. In total, 1015 upregulated genes and 1650 downregulated genes were identified. GO and KEGG analysis revealed enrichment in terms of changes in the endoplasmic reticulum cellular component and the endoplasmic reticulum protein synthetic process in the HAZR group. Furthermore, the arachidonic acid pathway and mTOR pathway were also identified as important pathways, while RICTOR and GPX8 were indentified as key genes involved in the spermatogenic process of patients with cryptorchidism. In present study, we found that changes in the synthesis of endoplasmic reticulum proteins, arachidonic acid and the mTOR pathway are important in the incidence and spermatogenic process of cryptorchidism. GPX8 and RICTOR were also identified as key genes associated with cryptorchidism. Collectively, these data may provide novel clues with which to explore the precise etiology and mechanism underlying cryptorchidism and cryptorchidism-induced human infertility.
Collapse
Affiliation(s)
- Yu Zhou
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- Chongqing Key Laboratory of Pediatrics, China
| | - Deying Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
- Chongqing Key Laboratory of Pediatrics, China
- Corresponding author. Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
| | - Bo Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Dong Hu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
| | - Lianju Shen
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
- Chongqing Key Laboratory of Pediatrics, China
| | - Chunlan Long
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
- Chongqing Key Laboratory of Pediatrics, China
| | - Yihang Yu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Tao Lin
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Xing Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
| | - Dawei He
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
- Chongqing Key Laboratory of Pediatrics, China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
- Chongqing Key Laboratory of Pediatrics, China
- Corresponding author. Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
| |
Collapse
|
11
|
Kojima Y, Yokoya S, Kurita N, Idaka T, Ishikawa T, Tanaka H, Ezawa Y, Ohto H. Cryptorchidism after the Fukushima Daiichi Nuclear Power Plant accident:causation or coincidence? Fukushima J Med Sci 2019; 65:76-98. [PMID: 31915325 PMCID: PMC7012587 DOI: 10.5387/fms.2019-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/14/2019] [Indexed: 01/20/2023] Open
Abstract
Cryptorchidism (undescended testes) is among the most common congenital diseases in male children. Although many factors have been linked to the incidence of cryptorchidism, and testicular androgen plays a key role in its pathogenesis, the cause remains unknown in most cases. Recently, a Japanese group published a speculative paper entitled, "Nationwide increase in cryptorchidism after the Fukushima nuclear accident." Although the authors implicated radionuclides emitted from the Fukushima accident as contributing to an increased incidence of cryptorchidism, they failed to establish biological plausibility for their hypothesis, and glossed over an abundance of evidence and expert opinion to the contrary. We assessed the adequacy of their study in terms of design setting, data analysis, and its conclusion from various perspectives. Numerous factors must be considered, including genetic, environmental, maternal/fetal, and social factors associated with the reporting of cryptorchidism. Other investigators have established that the doses of external and internal radiation exposure in both Fukushima prefecture and the whole of Japan after the accident are too low to affect testicular descent during fetal periods;thus, a putative association can be theoretically and empirically rejected. Alternative explanations exist for the reported estimates of increased cryptorchidism surgeries in the years following Japan's 2011 earthquake, tsunami, and nuclear crisis. Data from independent sources cast doubt on the extent to which cryptorchidism increased, if at all. In any case, evidence that radionuclides from the Fukushima Daiichi Nuclear Power Plant could cause cryptorchidism is lacking.
Collapse
Affiliation(s)
- Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University
| | - Takayuki Idaka
- Medical Research Center, Fukushima Medical University School of Medicine
| | - Tetsuo Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University
| | - Hideaki Tanaka
- Department of Pediatric Surgery, Fukushima Medical University Hospital
| | - Yoshiko Ezawa
- Medical Affairs Division, Fukushima Medical University Hospital
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| |
Collapse
|
12
|
Chen MJ, Karaviti LP, Roth DR, Schlomer BJ. Birth prevalence of hypospadias and hypospadias risk factors in newborn males in the United States from 1997 to 2012. J Pediatr Urol 2018; 14:425.e1-425.e7. [PMID: 30322769 DOI: 10.1016/j.jpurol.2018.08.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/31/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hypospadias is a common genitourinary malformation and there are conflicting data on whether its prevalence is increasing. Previous studies have described associations with risk factors including small for gestational age (SGA), multiple gestation birth, environmental influences, and maternal factors. OBJECTIVE The objective of this study was to examine birth prevalence of hypospadias and hypospadias risk factors in a large national dataset and to evaluate for changes from 1997 to 2012. We hypothesized that any increase in the birth prevalence of hypospadias would be associated with an increase in risk factors such as SGA, prematurity, or multiple gestation birth. STUDY DESIGN The Kids' Inpatient Database was used to generate national estimates for prevalence of males born with hypospadias, SGA, prematurity, or to a multiple gestation and then prevalences were evaluated for association with time. Multivariable logistic regression was used to evaluate whether birth prevalence of hypospadias was associated with increasing year, SGA, prematurity, and multiple gestation birth. RESULTS The estimated birth prevalence of hypospadias increased from 6.1 per 1000 births (95% confidence interval [CI] 5.9 to 6.3) to 6.8 per 1000 births (95% CI 6.7 to 7.0), an 11.5% increase from 1997-2012 (P = 0.014). Among male births, the prevalence of SGA increased 74%, multiple gestation increased 25%, and prematurity increased 20% (P < 0.001 for all) (Summary Figure). A risk factor was seen in around 20% of males born with hypospadias. Hypospadias birth prevalence also increased in males without risk factors but was not statistically significant (9.1% increase, P = 0.5). On multivariable logistic regression, being born SGA (odds ratio [OR] = 3.3), to a multiple gestation (OR = 1.1), or premature (OR 1.9) were associated with increased odds of hypospadias (P < 0.01 for all), whereas increasing year was not (P = 0.3). CONCLUSIONS The estimated birth prevalence of hypospadias in the United States increased from 6.1 to 6.8 per 1000 births from 1997 to 2012. Known hypospadias risk factors of SGA birth, multiple gestation birth, and premature birth also increased over this time to a higher degree. About 20% of males born with hypospadias had one of these risk factors. The birth prevalence of hypospadias in males without any studied risk factors also increased, but this was not statistically significant. More studies are needed to evaluate whether this increase in hypospadias prevalence is due to increases in known hypospadias risk factors, new environmental exposures, improved diagnosis at birth, some combination, or unrelated causes.
Collapse
Affiliation(s)
- M J Chen
- Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin St, Suite 1020, Houston, TX 77030, USA
| | - L P Karaviti
- Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin St, Suite 1020, Houston, TX 77030, USA
| | - D R Roth
- Division of Pediatric Urology, Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin St, Suite 620, Houston, TX 77030, USA
| | - B J Schlomer
- Department of Urology, University of Texas Southwestern, 2305 Stemmons Freeway, Suite D-4300, MC F4.04, Dallas, TX 75207, USA.
| |
Collapse
|
13
|
2018 CUA Abstracts. Can Urol Assoc J 2018; 12:S51-S136. [PMID: 29877793 PMCID: PMC5991937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
14
|
Trends in the Prevalences of Selected Birth Defects in Korea (2008⁻2014). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050923. [PMID: 29734759 PMCID: PMC5981962 DOI: 10.3390/ijerph15050923] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/30/2018] [Accepted: 05/03/2018] [Indexed: 12/18/2022]
Abstract
Little information is available on the prevalences of birth defects in Korea. The aims of this study were to estimate recent prevalences of selected birth defects and to analyze the prevalence trends of these defects during the period from 2008 to 2014. Prevalences were calculated for 69 major birth defects using health insurance claim data obtained from the Korea National Health Insurance Service (NHIS). Prevalence rate ratios were calculated using Poisson regression to analyze trends over the 7-year study period. The overall prevalence of a major birth defect was 446.3 per 10,000 births (95% CI: 444.0–448.6); 470.9 per 10,000 births (95% CI: 467.6–474.2) for males and 420.2 per 10,000 births (95% CI: 417–423.4) for females. The prevalence rates of the most common birth defects over the study period were; septal defect (138.2 per 10,000; 95% CI: 136.9–139.5), congenital hip dislocation (652 per 10,000; 95% CI: 64.1–65.9), and ventricular septal defect (62.62 per 10,000; 95% CI: 61.7–63.5). During the study period, a significant increase in the prevalence of a major birth defect was observed with a prevalence rate ratio (PRR) of 1.091. The strongest trend was observed for renal dysplasia, which had a PRR of 1.275 (95% CI: 1.211–1.343), and upward trends were observed for urogenital anomalies, such as, renal agenesis (PRR 1.102, 95% CI: 1.067–1.138), undescended testis (PRR 1.082, 95% CI: 1.072–1.093) and hypospadias (PRR 1.067, 95% CI: 1.044–1.090). This study shows an overall increase in the prevalences of birth defects, including hypospadias and undescended testis, which are known to be associated with endocrine factors. In the future, standardized birth defect registries should be established to enable these trends to be monitored.
Collapse
|
15
|
Amato CM, Boyd M, Yang J, McCoy KA. Organizational effects of the antiandrogen, vinclozolin, on penis development in the mouse†. Biol Reprod 2018; 99:639-649. [DOI: 10.1093/biolre/ioy087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/12/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ciro M Amato
- Department of Biology, East Carolina University, Greenville, North Carolina, USA
| | - Morgan Boyd
- Department of Biology, East Carolina University, Greenville, North Carolina, USA
| | - Joshua Yang
- Department of Biology, East Carolina University, Greenville, North Carolina, USA
| | - Krista A McCoy
- Department of Biology, East Carolina University, Greenville, North Carolina, USA
| |
Collapse
|
16
|
McCoy KA, Amato CM, Guillette LJ, St Mary CM. Giant toads (Rhinella marina) living in agricultural areas have altered spermatogenesis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 609:1230-1237. [PMID: 28787797 PMCID: PMC5600858 DOI: 10.1016/j.scitotenv.2017.07.185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
Across diverse taxa, germ cell development is controlled by an intricate cascade of processes that are tightly controlled by the hypothalamic-pituitary-gonadal axis. Endocrine disturbances, such as those induced by endocrine disrupting chemicals (EDCs) can negatively affect spermatogenesis. Here, we investigate whether spermatogenesis is altered in the giant toad, Rhinella marina, living in agricultural areas where EDCs are used relative to suburban areas. We also ask if reductions in spermatogenesis were associated with developmental gonadal abnormalities (intersex) found in the same frogs. We found that toads in agricultural areas exhibited reduced spermatogenesis relative to non-agricultural animals, and that those reductions were not associated with gross gonadal abnormalities. All toads living in agricultural areas had reduced spermatogenesis relative to those living in non-agricultural areas regardless of whether they had gonadal abnormalities originating during development. Similarities in reproductive dysfunction among diverse taxa living in agricultural areas, including humans, suggest that many vertebrate taxa living in agricultural areas around the globe are likely experiencing some level of reproductive dysfunction.
Collapse
Affiliation(s)
- Krista A McCoy
- Department of Biology, East Carolina University, Greenville, NC 27858, USA.
| | - Ciro M Amato
- Department of Biology, East Carolina University, Greenville, NC 27858, USA
| | - Louis J Guillette
- Department of Obstetrics and Gynecology (L.J.G.), Medical University of South Carolina, and Hollings Marine Laboratory, Charleston, SC 29425, USA
| | - Colette M St Mary
- Department of Biology, University of Florida, Gainesville, FL 32611, USA
| |
Collapse
|