Rubinstein-Taybi syndrome (RSTS) is an extremely rare autosomal dominant genetic disease, with an estimated prevalence of one case per. Rubinstein-Taybi Syndrome (RTS) is a rare multiple congenital syndrome characterized by distinctive facial features, mental and growth. Rubinstein-Taybi syndrome (RTs) is a well known mental Sindrome de Rubinstein-Taybi (Estudio sobre ocho casos). Arch Neurobiol.
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PRESENTACIÓN DE CASOS. Síndrome de Rubinstein-Taybi. The Rubistein- Taybi syndrome. Lucy Pons CastroI; Teresita de J. Méndez SánchezII; Rosa María. Rubinstein-Taybi syndrome of Rubinstein-Taybi syndrome include: microdeletion of chromosome 16p, Clinical practice guidelines; Français ( , pdf). Descargar PDF. Más opciones de Síndrome de Rubinstein-Taybi, atención odontoestomatológica a pacientes especiales: reporte de caso clínico. Visitas.
Abstract Abstract The Rubinstein-Taybi syndrome RTS is a well-defined syndrome with a characteristic face, broad thumbs, broad big toes, and mental retardation as its major clinical hallmarks. RTS is generally a de novo-occurring autosomal dominant trait. The empirical recurrence risk for a couple with a previous child with RTS is as low as 0. If, however, a person with RTS is able to reproduce, the recurrence risk could be as high as 50 percent. Birth prevalence is 1 in , to , RTS has been described in populations of many different ancestries, but the number of reports on non-Caucasian patients is low.
Figure 3. The patient's hand exhibit fingers with thickened nodules joints which presented self-inflicted lesions. Dental history Patient exhibited permanent dentition, with no prior dental intervention; the mother informed she was not cooperative and exhibited an instinctual tendency to shut her mouth and bite.
Dental clinical diagnosis Generalized gingivitis, localized periodontitis, dental caries, dental crowding, anterior open bite, posterior cross-bite and impacted tooth Figures 4 and 5.
Figures 4 and 5. Opened and closed mouth, dental crowding, Cross-bite. Treatment plan Clinical approach and conditioning in a dental environment: empathy with patient and relatives, establishment of suitable communication with patient and relatives, conduct modeling. Moreover, operatory actions such as securing the patient s head with the operator's arm and forearm to preserve patient's stability require the parent's help in order to ensure patient's trust and feeling of protectiveness about having her mother nearby Active Restrictive Fixation.
Affective positive reinforcement was equally used, and effected with the behavior exhibited on the day of visit Figures 6 and 7. Figures 6 and 7.
Approach technique with active restrictive fixation family assistance. Physiotherapy, prophylaxis with ultrasound, polishing with bicarbonate and fluoridation with 1. Control of brushing and use of chlorhexidine to reinforce dental brushing Figure 8.
Figure 8. Prophylactic treatment, approach technique with restrictive fixation family assistance pneumatic ultrasound equipment. Operative dentistry. Restoration with liquid resin in teeth 14, 15, 24, 25, 34, Resin restoration in teeth number 12, 25, 37, 46, 47, 48 using self-curing ionomer base Figures 9 to Figures 9 at Operative dentistry procedure; restorations with light-curing resin, active restrictive fixation and arm supported over the patient's head in order to restrict movements.
Active familial participation. The clinical history often shows feeding problems and recurrent conjunctivitis in the neonatal period, respiratory problems in the first decade, and life-long constipation. In general, RTS patients are in good health.
Although an increased risk for different types of tumors is known, life expectancy seems to be normal. The diagnosis is based on the clinical presentation. Gross chromosomal rearrangements such as translocations and inversions are rarely found, whereas microdeletions occur in approximately 10 percent of cases.
Point mutations in the CBP gene leading to premature translation-termination are reported as well. Heterogeneity is expected, but no reports on involvement of other genes have yet been published. The CREB-binding protein functions as a transcriptional cofactor by forming a physical bridge between the different components of the transcription machinery.
It also functions as a potent histone acetyltransferase, making the DNA accessible to transcription factors. In six cases, the hybridization signal was present on only one allele on 16p CREBBP gene and its homolog, E1A binding protein p EP on chromosome 22, are involved in a number of basic cellular activities, such as DNA repair, growth, differentiation, apoptosis of cells, and tumor suppression by serving as transcriptional co-activators in different signaling pathways [ 10 ].
The results of EP sequencing in a group of six subjects revealed three mutations [ 11 ]. In this review, we discussed the clinical features and genetic studies of RSTS and we try to outline future directions for an appropriate clinical diagnosis and follow-up of this condition.
Discussion Typical features RSTS is characterized by slow development of height and weight, microcephaly, dysmorphic facial features, broad thumbs, and big toes [ 18 ]. The prenatal development is normal, with average or near-normal growth parameters at birth.
The growth charts typically approach the lower limits of normality in the first postnatal period, primarily reflecting hypo-feeding exacerbated by gastro-esophageal reflux.
Subsequently, the tendency of overweight or obesity earlier in males than females can be observed during adolescence.
Specific and recently reviewed growth charts are essential for appropriate assessment of the growth of affected individuals [ 18 ]. Particularly, high risk of cervical vertebral abnormalities instability of C1—C2, os odontoideum, hypoplasia of the dens, fusion of the cervical vertebrae has been reported [ 21 - 23 ], with possible stenosis at the craniovertebral junction, which may cause cervical myelopathy.