Social Economic Costs, Health-Related Quality of Life and Disability in Patients with Cri Du Chat Syndrome

From phenotype to phonotype: a comprehensive description of voice features of Cri du chat syndrome

Genetic syndromes have been studied by extensive research allowing a better definition of their clinical manifestations, natural history, and etiopathogenetic mechanisms. Nevertheless, some relevant, but still unexplored aspects of these multisystemic conditions need to be clarified. One of these aspects is the characterization of the vocal production, especially in some genetic syndromes in which the distinctive voice is the hallmark of the syndrome (e.g., Cri du chat syndrome, CdCS). The aim of this study is to provide a detailed description of phonotype of patients affected by CdCS. We prospectively recorded and analysed acoustical features of three corner vowels [a], [i], and [u] and number listing from 1 to 10 of 29 patients with molecularly confirmed CdCS (age range 4-21 years; mean 11 ± 6; median 10 years). For perceptual analysis, the GIRBAS scale was completed. The acoustical analysis was performed through BioVoice software. When stratified by age and gender, in the older men subgroup the grade, roughness, and asthenia mean values are the highest for each vowel, when compared with values of the same parameters obtained in the other subgroups. Statistical analysis highlighted 26 significant differences: 38% (10) concern the sustained phonation of /a/, 27% (7) are related to /i/ whereas 19% (5) to /u/. Ratio1, Ratio2, VSA, and FCR were also significant. Conclusion: The voice production not only conveys linguistic and paralinguistic information but also can give information regarding the speaker's biological and clinical characteristics.

[Neonatal cri-du-chat syndrome revelead by facial dysmorphism and weak suction: a case report]

Cri-du-chat syndrome is a rare genetic disorder, due to a deletion of the short arm of chromosome 5 (5p-). Its incidence is ranging from 1/15000 to 1/50000 live births. This was a one-day-old male newborn from a non-consanguineous marriage, the first pregnancy uncomplicated and carried to term with a birth weight of 2295g. Clinical examination revealed: craniofacial dysmorphism with hypertelorism and microcephaly, hypotonia, poor suction and clubfoot more marked on the right, the rest of the examination was unremarkable. During hospitalization, a high-pitched monochromatic cry mimicking a cat's meow was observed. The clinical diagnosis was confirmed by fluorescence in situ hybridization, showing a deletion of the short arm of chromosome 5 (5p15.2). The basic malformative work-up came back without any other abnormalities. The association of a high-pitched monochromatic cry with craniofacial dysmorphism in a newborn should indicate the need for cytogenetic study, in particular fluorescence in siti hybridization.

Neonatal Cri du chat syndrome with atypical facial appearance: A case report

BACKGROUND

Cri du chat syndrome (CdCS), also known as 5p deletion syndrome (5p-) is a syndrome caused by partial deletion of the 5p chromosome in human beings. The incidence accounts for 1/50000 and the cause of CdCS is related to partial deletion of chromosome 5 short arm (p). CdCS is a sporadic event. Only one case of CdCS was detected by chromosome screening in 125 and 170 pregnant Iranian women[1]. The most prominent clinical manifestations of CdCS are typical high-pitched cat calls, severe mental retardation or mental retardation and is most harmful to both language and growth retardation[2]. CdCS is a chromosome mutation disease which occurs during embryonic development and the symptoms of some cases are extremely atypical. It is difficult to make an early diagnosis and screening in clinic. We can suspect the disease from its atypical manifestations in the weak crying of cats, and chromosome karyotype analysis can find some questionable gene deletion fragments to assist the clinical diagnosis and prognosis of CdCS.

CASE SUMMARY

A 2-d-old male child who was admitted to our hospital with a poor postnatal reaction and poor milk intake. The baby's crying and sucking is weak, reaction and feeding time is poor and the baby has nausea and vomiting. Karyotype analysis showed that the chromosomes were 46, XY, deletion (5) p15. Whole genome microarray analysis (named ISCN2013) showed that the chromosomes of the child were male karyotypes and contained three chromosomal abnormalities. Among them, loss of 5p15.2pter (113576-13464559) was associated with cat call syndrome. After 3 mo of follow-up, the child still vomited repeatedly, had poor milk intake, did not return to normal growth, had developmental retardation and a poor directional response.

CONCLUSION

Therefore, when cat crying and laryngeal sounds occur in the neonatal period, it should be considered that they are related to CdCS. Chromosome karyotype and genome analysis are helpful for the diagnosis of CdCS.

The impact of fibrodysplasia ossificans progressiva (FOP) on patients and their family members: results from an international burden of illness survey

BACKGROUND

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare, genetic disorder of heterotopic ossification, which transforms soft, connective tissues into bone, resulting in limited joint function and severe disability. We present results from an international burden of illness survey (NCT04665323) assessing physical, quality of life (QoL), and economic impacts of FOP on patients and family members.

METHODS

Patient associations in 15 countries invited their members to participate; individuals with FOP and their family members were eligible. The survey was available online, in 11 languages, from January 18-April 30, 2021. Participants responded to assessments measuring joint function, QoL, healthcare service and living adaptation utilization, out-of-pocket costs, employment, and travel.

RESULTS

The survey received 463 responses (patients, n=219; family members, n=244). For patients, decreased joint function was associated with reduced QoL and greater reliance on living adaptations. Nearly half of primary caregivers experienced a mild to moderate impact on their health/psychological wellbeing. Most primary caregivers and patients (≥18 years) reported that FOP impacted their career decisions.

CONCLUSIONS

Data from this survey will improve understanding of the impact of FOP on patients and family members, which is important for identifying unmet needs, optimizing care, and improving support for the FOP community.

Valuing the "Burden" and Impact of Rare Diseases: A Scoping Review

Introduction: Rare diseases (RDs) are a severe, chronic, degenerative and often life-threatening group of conditions affecting more than 30 million people in Europe. Their impact is often underreported and ranges from psychological and physical symptoms seriously compromising quality of life. There is then a need to consolidate knowledge on the economic, social, and quality of life impacts of rare diseases. Methods: This scoping review is the result of 9 qualitative interviews with experts and a literature search on Cost-of-Illness (COI) studies and quality of life (QoL) studies following the PRISMA methodology. Grey literature was also included to complement findings. Results. 63 COI studies were retrieved, covering 42 diseases and a vast majority of them using a prevalence-based approach (94%). All studies included medical costs, while 60% included non-medical costs, 68% productivity losses and 43% informal care costs. 56 studies on QoL were retrieved, mostly from Europe, with 30 different measurement tools. Grey literature included surveys from the pharmaceutical industry and patient organisations. Discussion: The majority of studies evaluating the impact of RDs on the individual and society use the COI approach, mostly from a societal perspective. Studies often vary in scope, making them difficult to consolidate or compare results. While medical costs and productivity losses are consistently included, QoL aspects are rarely considered in COI and are usually measured through generic tools. Conclusion: A comprehensive study on impact of rare disease across countries in Europe is lacking. Existing studies are heterogeneous in their scope and methodology and often lack a holistic picture of the impact of rare. Consensus on standards and methodology across countries and diseases is then needed. Studies that consider a holistic approach are often conducted by pharmaceutical companies and patient organisations exploring a specific disease area but are not necessarily visible in the literature and could benefit from the sharing of standards and best practices.

Towards a Comprehensive Strategy for the Management of Rare Diseases in Slovenia: Outlining an IT-Enabled Ecosystemic Approach

Rare diseases (RDs), with distinctive and complex features, pose a serious public health concern and represent a considerable challenge for the Slovenian healthcare system. One of the potential approaches to tackling this problem and treating patients with RDs in a quality and effective manner is to form an RD ecosystem. This represents a functional environment that integrates all stakeholders, procedures, and relationships required for the coordinated and effective treatment of patients. This paper explores the current situation in the field of RDs, especially in light of the proposed ecosystemic arrangement, and provides an outline for the design of an RD ecosystem in Slovenia. The research applies a case-study design, where focus groups are used to collect evidence from the field, assess the state of affairs, and generate ideas. Structured focus group discussions were conducted with preeminent experts affiliated with the leading institutions in the field of RDs in Slovenia. Analyses and interpretations of the obtained data were carried out by means of conventional content analysis. Setting up an RD ecosystem in Slovenia would lead to significant benefits for patients, as it could promote the coordination of healthcare treatment and facilitate extensive monitoring of the treatment parameters and outcomes. A well-organized RD ecosystem could garner considerable systemic benefits for evidence-informed policymaking, a better utilization of resources, and technological innovation. Delivering quality healthcare in this complex field is largely reliant on the effective integration and collaboration of all entities within the RD ecosystem, the alignment of related systemic factors, and the direction of healthcare services to support the needs and well-being of patients with RDs.

Associations of Cognitive Complaints and Depressive Symptoms with Health-Related Quality of Life and Perceived Overall Health in Japanese Adult Volunteers

Cognitive complaints, defined as perceived cognitive dysfunction in daily living, are associated with depressive symptoms. The associations of cognitive complaints and depressive symptoms with health-related quality of life (HRQoL) and perceived overall health in Japanese adults remains unknown. To investigate these relationships, we evaluated a convenience sample of 525 Japanese adult volunteers (Mage: 41.3 ± 11.7; 238 male and 287 female). We used the Cognitive Complaints in Bipolar Disorder Rating Assessment (evaluating cognitive complaints), Patient Health Questionnaire-9 (evaluating depressive symptoms), EuroQol-5 Dimension-5 Level (EQ-5D-5L; evaluating HRQoL), and EuroQol-Visual Analogue Scale (EQ-VAS; evaluating perceived overall health). Our path analyses suggested that both cognitive complaints and depressive symptoms had significant total effects on HRQoL and perceived overall health. Furthermore, cognitive complaints were not significantly associated directly with HRQoL and perceived overall health, whereas cognitive complaints were significantly associated with HRQoL and perceived overall health indirectly via depressive symptoms. Depressive symptoms were significantly associated directly with HRQoL and perceived overall health. This study suggests that depressive symptoms may mediate the associations of cognitive complaints with HRQoL and perceived overall health. Thus, to address the HRQoL and perceived overall health associated with cognitive complaints, evaluation and intervention for depressive symptoms may be useful in public health.