Disability
Theory and models Disability theory Ableism / Disablism Medical model Social model
Education Mainstreaming Individualized Education Program (IEP) Special needs Special school Special education Learning disability
Therapy Physical therapy Occupational therapy Speech therapy
Societal implications Disability rights movement inclusion People-first language Pejorative terms
Personal / physical assistance Personal care assistant Activities of daily living Orthotics and braces Prosthetics Assistive technology Mobility aid Physical accessibility Universal design Web accessibility
Socioeconomic assistance Social Security Disability Insurance (SSDI) Supplemental Security Income (SSI) Ticket to Work Disability Living Allowance (DLA) Disabled students allowance Disabled Persons Railcard Freedom Pass
Groups and organizations Society for Disability Studies Disabled Peoples' International (DPI) Visitability
Disabled sports Special Olympics Paralympics Deaflympics Extremity Games
Culture Disability in the arts Disability Art Disability in the media
Disability portal category lists
v t e

A congenital disorder, or congenital disease, is a condition existing at birth and often before birth, or that develops during the first month of life (neonatal disease), regardless of causation. Of these diseases, those characterized by structural deformities are termed "congenital anomalies"; that is a different concept (MeSH) which involves defects in or damage to a developing fetus.

A congenital disorder may be the result of genetic abnormalities, the intrauterine (uterus) environment, errors of morphogenesis, infection, or a chromosomal abnormality. The outcome of the disorder will depend on complex interactions between the pre-natal deficit and the post-natal environment.^[1] Animal studies indicate that the mother's (and possibly the father's) diet, vitamin intake, and glucose levels prior to ovulation and conception have long-term effects on fetal growth and adolescent and adult disease.^[2] Congenital disorders vary widely in causation and abnormalities. Any substance that causes birth defects is known as a teratogen.

The older term congenital^[3] disorder does not necessarily refer to a genetic disorder despite the similarity of the words. Some disorders can be detected before birth through prenatal diagnosis (screening).

Classification[link]

Much of the language used for describing congenital conditions predates genomic mapping, and structural conditions are often considered separately from other congenital conditions. It is now known that many metabolic conditions may have subtle structural expression, and structural conditions often have genetic links. Still, congenital conditions are often classified in a structural basis, organized when possible by primary organ system affected.

Primarily structural[link]

Several terms are used to describe congenital abnormalities. (Some of these are also used to describe noncongenital conditions, and more than one term may apply in an individual condition.)

• A congenital physical anomaly is an abnormality of the structure of a body part. An anomaly may or may not be perceived as a problem condition. Many, if not most, people have one or more minor physical anomalies if examined carefully. Examples of minor anomalies can include curvature of the 5th finger (clinodactyly), a third nipple, tiny indentations of the skin near the ears (preauricular pits), shortness of the 4th metacarpal or metatarsal bones, or dimples over the lower spine (sacral dimples). Some minor anomalies may be clues to more significant internal abnormalities.
• Birth defect is a widely used term for a congenital malformation, i.e. a congenital, physical anomaly which is recognizable at birth, and which is significant enough to be considered a problem. According to the CDC, most birth defects are believed to be caused by a complex mix of factors including genetics, environment, and behaviors,^[1] though many birth defects have no known cause. An example of a birth defect is cleft palate.
• A congenital malformation is a congenital physical anomaly that is deleterious, i.e. a structural defect perceived as a problem. A typical combination of malformations affecting more than one body part is referred to as a malformation syndrome.
• Some conditions are due to abnormal tissue development:
  • A malformation is associated with a disorder of tissue development.^[4] Malformations often occur in the first trimester.
  • A dysplasia is a disorder at the organ level that is due to problems with tissue development.^[4]
• It is also possible for conditions to arise after tissue is formed:
  • A deformation is a condition arising from mechanical stress to normal tissue.^[4] Deformations often occur in the second or third semester, and can be due to oligohydramnios.
• A disruption involves breakdown of normal tissues.^[4]
• When multiple effects occur in a specified order, it is known as a sequence. When the order is not known, it is a syndrome.

Other[link]

• Genetic disorders or diseases are all congenital, though they may not be expressed or recognized until later in life. Genetic diseases may be divided into single-gene defects, multiple-gene disorders, or chromosomal defects. Single-gene defects may arise from abnormalities of both copies of an autosomal gene (a recessive disorder) or of only one of the two copies (a dominant disorder). Some conditions result from deletions or abnormalities of a few genes located contiguously on a chromosome. Chromosomal disorders involve the loss or duplication of larger portions of a chromosome (or an entire chromosome) containing hundreds of genes. Large chromosomal abnormalities always produce effects on many different body parts and organ systems.
• A congenital metabolic disease is also referred to as an inborn error of metabolism. Most of these are single gene defects, usually heritable. Many affect the structure of body parts but some simply affect the function.
• Other well defined genetic conditions may affect the production of hormones, receptors, structural proteins, and ion channels.

Causes[link]

This section requires expansion.

Antibiotics[link]

Use of antibiotics around the time of conception, particularly sulfonamides and nitrofurantoin are associated with major birth defects. Whether or not this association is causal has not been determined.^[5]

Petroleum[link]

Petroleum oil and distillates cause birth defects.^[6]

Epidemiology[link]

Disability-adjusted life year for congenital anomalies per 100,000 inhabitants in 2004.^[7]

  no data

  less than 160

  160-240

  240-320

  320-400

  400-480

  480-560

  560-640

  640-720

  720-800

  800-900

  900-950

  more than 950

Cell division errors can be due to a lack of nutrients or availability of atomic building blocks, or the presence of toxins that impede normal growth. Division errors which occur very early in the development of a multicellular organism can result in large scale structural and functional differences in the organism's final shape. For example it is now understood that a lack of folic acid in the diet of a mother can cause cellular neural tube deformities that result in Spina Bifida.

External physical shocks or constrainment due to growth in a restricted space, may result in unintended deformation or separation of cellular structures resulting in an abnormal final shape or damaged structures unable to function as expected.

For multicellular organisms that develop in a womb, the physical interference or presence of other similarly developing organisms such as twins can result in the two cellular masses being integrated into a larger whole, with the combined cells attempting to continue to develop in a matter that satisfies the intended growth patterns of both cell masses. The two cellular masses can compete with each other, and may either duplicate or merge various structures. This results in conditions such as conjoined twins, and the resulting merged organism may die at birth when it must leave the life-sustaining environment of the womb and must attempt to sustain its biological processes independently.

Fossil record[link]

Evidence for congenital deformities found in the fossil record is studied by paleopathologists, specialists in ancient disease and injury. Fossils bearing evidence of congenital deformity are scientifically significant because they can help scientists infer the evolutionary history of life's developmental processes. For instance, because a Tyrannosaurus rex specimen has been discovered with a block vertebra, it means that vertebrae have been developing the same basic way since at least the most recent common ancestor of dinosaurs and mammals. Other notable fossil deformities include a hatchling specimen of the bird-like dinosaur, Troodon, the tip of whose jaw was twisted.^[8] Another notably deformed fossil was a specimen of the choristodere Hyphalosaurus, which had two heads- the oldest known example of polycephaly.^[9]

See also[link]

• Congenital abnormality
• Malformative syndrome
• ICD-10 Chapter Q: Congenital malformations, deformations and chromosomal abnormalities
• List of congenital disorders
• List of ICD-9 codes 740-759: Congenital anomalies
• March of Dimes
• Mitochondrial disease

References[link]

External links[link]

• CDC’s National Center on Birth Defects and Developmental Disabilities
• Birth Defects- Types and Causes

This article is about the U.S. sociopolitical commentator. For other people with a similar name, see Brian Fisher (disambiguation).

Bryan J. Fischer is the Director of Issues Analysis for the American Family Association (AFA). He hosts the talk radio program Focal Point on American Family Radio and posts on the AFA-run blog Rightly Concerned.

Fischer opposes abortion, national health care, gay adoption,^[2] and same-sex marriage.^[3] Fischer's controversial comments on racial and ethnic minorities were cited by Southern Poverty Law Center (SPLC) in explaining the hate group designation they gave to the AFA in November 2010.^[4]

Biography[link]

Fischer has an undergraduate degree in philosophy from Stanford University, and holds a graduate degree in theology from Dallas Theological Seminary. Fischer served at the Cole Community Church in Boise, Idaho and founded the Cole Center for Biblical Studies and was the church's director for thirteen years. Fischer then founded Community Church of the Valley and was senior pastor for twelve years. Before joining the board of directors of American Family Association, Fischer was also executive director of Idaho Values Alliance.^[3]

In 2004, he co-founded the Keep the Commandments Coalition, a group dedicated to keeping a Ten Commandments monument in Julia Davis Park in Boise, Idaho. From 2000 to 2005, he served as a commissioner for the city's Park and Recreation Department.^[3]

In November 2010, the SPLC changed their listing of the AFA from a group that used hate speech to the more serious one of being designated a hate group.^{[5][6][7][8][9]} The SPLC's Mark Potok said that the AFA's "propagation of known falsehoods and demonizing propaganda" was the basis for the change.^[10][11] Fischer's anti-gay comments were given as an example by SPLC in support of the hate group designation.^[4]

Recently, Fischer has become a supporter of the AIDS denial movement. His guest on the January 3, 2012 edition of Focal Point was prominent AIDS denialist Peter Duesberg. On that show, Fischer strongly supported Duesberg's contention that AIDS is not caused by HIV, but by recreational drug use.^[12][13] Fischer expanded on this further in a post on Rightly Concerned, saying that it isn't possible for a virus to remain dormant for a long period of time. He cited as an example Magic Johnson, who was diagnosed with HIV in 1991 and has remained healthy for over 20 years. This is despite overwhelming scientific consensus that HIV can stay dormant for several years before the onset of AIDS. In Fischer's view, HIV is a hoax that was concocted by cancer researchers who needed an excuse to keep their grants.^[14] He has also expressed support for tax protester theory; on the April 17, 2012 edition of Focal Point he made the common tax protester argument that the 16th Amendment does not count wages and salaries as income.^[15]

MormonVoices, a group associated with Foundation for Apologetic Information & Research, included Fischer on its Top Ten Anti-Mormon Statements of 2011 list for saying "Mormonism is not an orthodox Christian faith. It just is not ... It's very clear that the Founding Fathers did not intend to preserve automatically religious liberty for non-Christian faiths."^[16]

References[link]

1. ^ Adler, Ben (January 18, 2011). "The Liberal Media's Conservative of the Month". Newsweek.
2. ^ Fischer, Bryan (June 15, 2011). "Homosexual adoptions victimize children". http://afa.net/Blogs/BlogPost.aspx?id=2147508635. 
3. ^ ^{a b c} Biography at American Family Association. Retrieved November 18, 2010.
4. ^ ^{a b} Potok, Mark (December 15, 2010). "SPLC Responds to Attack by FRC, Conservative Republicans". Hatewatch. Southern Poverty Law Center. http://www.splcenter.org/blog/2010/12/15/splc-responds-to-attack-by-frc-conservative-republicans/. Retrieved April 26, 2011. 
5. ^ Schlatter, Evelyn (Winter 2010). "18 Anti-Gay Groups and Their Propaganda | Southern Poverty Law Center". Splcenter.org. http://www.splcenter.org/get-informed/intelligence-report/browse-all-issues/2010/winter/the-hard-liners. Retrieved December 17, 2010. 
6. ^ Waddington, Lynda (November 23, 2010). "Groups that Helped Oust Iowa Judges Earn 'Hate Group' Designation; SPLC Adds American Family Association, Family Research Council to List". Iowa Independent. http://iowaindependent.com/47947/groups-that-helped-oust-iowa-judges-earn-hate-group-designation. Retrieved November 25, 2010. 
7. ^ "SPLC's Anti-Gay Hate List Compiled With Diligence and Clear Standards | Southern Poverty Law Center". Splcenter.org. December 23, 2010. http://www.splcenter.org/get-informed/news/splc-s-anti-gay-hate-list-compiled-with-diligence-and-clear-standards. Retrieved March 19, 2011. 
8. ^ Eichler, Alex (November 23, 2010). "13 New Organizations Added to Anti-Gay 'Hate Groups' List". The Atlantic Wire. The Atlantic Monthly Group. http://www.theatlanticwire.com/national/2010/11/13-new-organizations-added-to-anti-gay-hate-groups-list/22153/. Retrieved April 22, 2011. 
9. ^ Benen, Steve (December 18, 2010). "This Week in God". Political Animal. Washington Monthly. http://www.washingtonmonthly.com/archives/individual/2010_12/027153.php. Retrieved April 22, 2011. 
10. ^ Banks, Adele M. (November 29, 2010). "Religion News Service: Hate group watchdog adds Family Research Council to its list". The Pew Forum. The Pew Forum on Religion & Public Life. http://pewforum.org/Religion-News/RNS-Hate-group-watchdog-adds-Family-Research-Council-to-its-list.aspx. Retrieved April 22, 2011. 
11. ^ Nelson, Josh (November 29, 2010). "Judge-ouster supporters blast 'hate' label". WCFCourier.com. http://wcfcourier.com/news/local/article_0d224deb-9ca4-5f17-9ae0-cdd5c98e47f5.html. Retrieved April 22, 2011. 
12. ^ Part 1 of Fischer interview with Duesberg from AFA YouTube channel
13. ^ Part 2 of Fischer interview with Duesberg from AFA YouTube channel
14. ^ Fischer, Bryan. "Why is Magic Johnson healthy as a horse? HIV does NOT cause AIDS". American Family Association, January 5, 2012.
15. ^ "16th Amendment exempts wages and salaries from taxation" (video). American Family Association. 2012-04-17. http://www.youtube.com/watch?v=58YvmJHCZ10. 
16. ^ Walker, Joshua (January 8, 2012). "Group lists Top Ten Anti-Mormon Statements of 2011". Deseret News. http://www.deseretnews.com/article/print/700213557/Group-lists-Top-Ten-Anti-Mormon-Statements-of-2011.html. 

External links[link]

• American Family Association