BACKGROUND. Limited information is available on the incidence of major congenital abnormalities (MCAs) in low- and middle-income countries (LMICs). OBJECTIVE. To determine the incidence and types of MCA and associated all-cause mortality from a facility with a large delivery service in an LMIC. METHODS. Births and neonatal admission registers of live inborn births between 1 January 2012 and 31 December 2013 at the Chris Hani Baragwanath Academic Hospital, South Africa, were reviewed for diagnosis of MCA. RESULTS. A total of 201 infants were admitted with a diagnosis of MCA, of which 114 were inborn. This translated to an incidence of 2.60 per 1 000 live births. The cardiovascular (43.9%), gastrointestinal (21%), musculoskeletal (13.2%) and central nervous system (12.3%) were commonly affected systems. Most MCAs were single defects (75.4%), followed by trisomies (19.3%). A significant number of infants with trisomies were born to multigravid women older than 35 years (p<0.001). A significant number of infants with single defects were preterm (p<0.002) and of low birth weight (p<0.002). One third (34%) required surgical intervention before hospital discharge. All-cause mortality at hospital discharge was 20.2%, with more deaths among patients with trisomy 13 (50%) and trisomy 18 (40%) compared with patients with single defects (19.8%) or trisomy 21 (7.8%) (p<0.05). CONCLUSION. The incidence of MCAs found in this study is much lower than what has been reported from HICs but similar to findings from other LMICs. MCAs in LMIC settings are associated with high mortality rates.

O ácido úsnico, um metabólito de liquens, é conhecido por sua atividade antimitótica e antiproliferativa em células humanas normais e malignas. Muitos quimioterápicos exercem suas atividades bloqueando a progressão do ciclo celular e induzindo morte celular por apoptose. Os microtúbulos, estruturas protéicas envolvidas na segregação dos cromossomos durante a mitose, servem como alvo quimioterapêutico devido ao seu importante papel tanto na divisão celular quanto nos mecanismos de morte celular por apoptose. O objetivo deste trabalho foi investigar se o ácido úsnico afeta a formação e/ou estabilização dos microtúbulos, a partir da visualização de microtúbulos e determinação de índices mitóticos após o tratamento. Células de câncer de mama MCF7 e de câncer de pulmão H1299 foram tratadas por 24 horas com 29 µM de ácido úsnico e dois controles positivos: vincristina (que impede a formação de microtúbulos) e taxol (que estabiliza microtúbulos). O tratamento das células MCF7 e H1299 com o ácido úsnico não resultou em aumento do índice mitótico. Os resultados sugerem que a atividade antineoplásica do ácido úsnico não está relacionada a alterações na formação e/ou estabilização de microtúbulos.

Usnic acid, a lichen metabolite, is known to exert antimitotic and antiproliferative activities against normal and malignant human cells. Many chemotherapy agents exert their activities by blocking cell cycle progression, inducing cell death through apoptosis. Microtubules, protein structure involved in the segregation of chromosomes during mitosis, serve as chemotherapeutical targets due to their key role in cellular division as well as apoptosis. The aim of this work was to investigate whether usnic acid affects the formation and/or stabilisation of microtubules by visualising microtubules and determining mitotic indices after treatment. The breast cancer cell line MCF7 and the lung cancer cell line H1299 were treated with usnic acid 29 µM for 24 hours and two positive controls: vincristine (which prevents the formation of microtubules) or taxol (which stabilizes microtubules). Treatment of MCF7 and H1299 cells with usnic acid did not result in any morphological changes in microtubules or increase in the mitotic index. These results suggest that the antineoplastic activity of usnic acid is not related to alterations in the formation and/or stabilisation of microtubules.