Cleft Palate

The anti-epilepsy drug topiramate triples the risk of cleft palate and other birth defects of the oral cavity when taken during the first trimester of pregnancy compared with other anti-epilepsy drugs, the Food and Drug Administration warned Friday. In addition to being used to control epileptic seizures, the drug, sold under the brand name Topamax, is FDA-approved for preventing migraine headaches and is used off-label for some other purposes, including appetite control. For those uses, the risk is much higher.

If you worry that our culture's reliance on GPS and mobile maps is ruining our ability to explore the hidden nooks and crannies -- the unexpected -- in our world, this story is for you. It's the tale of former Marine Sgt. Winston Fiore, 27, who just completed a 408-day, 5,000-mile walk through nine countries in Southeast Asia to raise funds for the International Children's Surgical Foundation--an organization that provides free plastic surgeries to...

Folic acid, already recommended as a nutritional supplement during pregnancy to prevent spina bifida, also reduces the risk of cleft lips and cleft palates by 25% to 50%, according to researchers at the California Birth Defects Monitoring Program. Dr. Gary Shaw and his colleagues at the monitoring program report Saturday in the international medical journal the Lancet that they compared the diets of 731 women who delivered a baby with a cleft lip or palate to 734 who did not.

Smoking during pregnancy increases the risk of a wide range of birth defects, including skull defects, missing or deformed limbs, clubfoot, cleft palate, protrusion of the gastrointestinal system through the skin and heart problems, according to the first major study to examine the incidence of such risks. Smoking during pregnancy is already well known for increasing the risk of miscarriage, low birth weight and premature birth, said Dr. Allan Hackshaw of the University College London Cancer Institute, who led the study, published in the journal Human Reproduction Update.

For Dr. Libby Wilson, a surgeon at White Memorial Medical Center in East Los Angeles, a trip to Nepal 10 years ago turned into an odyssey of mercy to save lives in that remote part of the world. An avid hiker, Wilson joined a group that was trekking along the trails of the Himalayas to a Hindu shrine.

In 1977, two young women--Julee Rosso and Sheila Lukins--opened a takeout food shop on New York's Columbus Avenue. It was supposed to be called Seaboard Deluxe, which is coffee-shop slang for an order to go, but then food journalist Florence Fabricant suggested another name, which stuck: The Silver Palate. The Silver Palate became a success literally almost overnight and soon grew into a culinary mini-empire. Rosso and Lukins developed a thriving catering operation and a line of packaged food products sold nationwide, even a series of spin-off shops in Japan.

Smoking during pregnancy increases the risk of a wide range of birth defects, including skull defects, missing or deformed limbs, clubfoot, cleft palate, protrusion of the gastrointestinal system through the skin and heart problems, according to the first major study to examine the incidence of such risks. Smoking during pregnancy is already well known for increasing the risk of miscarriage, low birth weight and premature birth, said Dr. Allan Hackshaw of the University College London Cancer Institute, who led the study, published in the journal Human Reproduction Update.

Benjamin Ponce is a personable, affable young man with a ready smile. He is always neatly dressed and a diligent, hard-working employee--just about everything a person needs to be to get ahead in the world. But until recently, Ponce's future was not at all promising. Life can be hard when practically no one understands a thing you say. Twenty-one years ago, Ponce was born with a cleft palate and cleft lip, deformities that left gaping holes in the roof of his mouth and on his upper lip.

Sandy and David Peckinpah were in the delivery room of Westlake Hospital, video camera rolling, thrilled at the imminent birth of their daughter. Suddenly came the baby's loud cry, a concerned look on the physician's face and Sandy knew something was wrong. David turned to her and said, "Sandy, she really is . . . beautiful . . . and we'll take care of her," and then Sandy saw that her daughter was born with a cleft lip. About one in 600 babies is born with a cleft lip or a cleft palate.

Re: "Anesthesia: A Medical Mainstay Re-examined" [May 14], thank you for publishing this article. In general, this report was accurate, emphasizing our continuing commitment to advancing the science of anesthesiology and the comfort and well-being of those for whom we care. It is imperative to point out several caveats to the research in the article. The exposure of laboratory animals to anesthetic agents is very different than the administration of surgical anesthesia to patients.

The anti-epilepsy drug topiramate triples the risk of cleft palate and other birth defects of the oral cavity when taken during the first trimester of pregnancy compared with other anti-epilepsy drugs, the Food and Drug Administration warned Friday. In addition to being used to control epileptic seizures, the drug, sold under the brand name Topamax, is FDA-approved for preventing migraine headaches and is used off-label for some other purposes, including appetite control. For those uses, the risk is much higher.

On a rainy afternoon in a cramped trailer, the five homemakers listened as state officials with clipboards asked personal questions: Did they or their husbands smoke, drink or take illicit drugs? Had they been exposed to pesticides or other toxic substances in the United States or Mexico? Do their families have histories of birth defects? Each had miscarried a fetus or given birth to a child with severe birth defects within the last three years. Each suspected it had something to do with a nearby toxic waste facility.

Archaeologists have weaved elaborate tales of intrigue and deceit about the death at age 19 of Egypt's fabled boy king Tutankhamen, with theories that include poisoning by his regent, Aye, and a blow to the head by thugs hired by Aye, but new research indicates his cause of death was probably more mundane -- complications from a broken leg and malaria. Using a new approach for analyzing mummies called molecular Egyptology, an international team of researchers found DNA traces of malaria parasites in the boy-king's brain, suggesting an infection was a major factor in his death.

Re: "Anesthesia: A Medical Mainstay Re-examined" [May 14], thank you for publishing this article. In general, this report was accurate, emphasizing our continuing commitment to advancing the science of anesthesiology and the comfort and well-being of those for whom we care. It is imperative to point out several caveats to the research in the article. The exposure of laboratory animals to anesthetic agents is very different than the administration of surgical anesthesia to patients.

Dr. Janusz Bardach, 83, a Polish immigrant who spent five years in a Siberian prison camp and later became one of the most respected plastic surgeons in the world, died Aug. 16 in Iowa City, Iowa, of pancreatic cancer. He pioneered the Bardach palatoplasty, a surgical technique for repairing cleft lips and palates that reduced the number of required surgeries, improved speech and reduced scarring.

You'd think a baby born with only one ear would be entitled to surgery that fixes the problem. Forget about it. In the confusing world of what some doctors call "mangled care," the outer ear is often considered irrelevant. Listen to Barbara Scarlett, office manager for Berkeley plastic surgeon Michael Cedars: "I tell the insurer that this little guy was born minus an ear and we're going to fix it. The insurer says he can hear without the ear, so why bother?

If you worry that our culture's reliance on GPS and mobile maps is ruining our ability to explore the hidden nooks and crannies -- the unexpected -- in our world, this story is for you. It's the tale of former Marine Sgt. Winston Fiore, 27, who just completed a 408-day, 5,000-mile walk through nine countries in Southeast Asia to raise funds for the International Children's Surgical Foundation--an organization that provides free plastic surgeries to...

On a rainy afternoon in a cramped trailer, the five homemakers listened as state officials with clipboards asked personal questions: Did they or their husbands smoke, drink or take illicit drugs? Had they been exposed to pesticides or other toxic substances in the United States or Mexico? Do their families have histories of birth defects? Each had miscarried a fetus or given birth to a child with severe birth defects within the last three years. Each suspected it had something to do with a nearby toxic waste facility.

For Dr. Libby Wilson, a surgeon at White Memorial Medical Center in East Los Angeles, a trip to Nepal 10 years ago turned into an odyssey of mercy to save lives in that remote part of the world. An avid hiker, Wilson joined a group that was trekking along the trails of the Himalayas to a Hindu shrine.