Effect of a hyperbolide mastication apparatus for the treatment of severe sleep bruxism in a child with cerebral palsy: Long-term follow-up

Purpose: Sleep bruxism is common among the various oromotor alterations found in individuals with cerebral palsy (CP). Few studies have investigated the use of the mastication device denominated hyperbola (HB) and none was found describing the use of such a device for the treatment of bruxism in children with CP. The aim of the present study was to evaluate the effect of the HB on electromyographic (EMG) activity in the jaw-closing muscles and the reduction in sleep bruxism in a child with CP using surface EMG analysis before and after nine months of treatment. Methods: A seven-year-old boy with severe spastic CP and sleep bruxism was enrolled in this study. The HB was chosen as the treatment option for sleep bruxism in this case because the child did not accept an occlusal splint. The HB has a hyperbolic shape and is made of soft, non-toxic, odorless, tasteless silicone. There are five different sizes of HB manufactured based on the diversity of tooth sizes. This device produces proprioceptive excitation in the dentoalveolar nerve, spindles and Golgi tendon organs. HB has been employed for the treatment of temporomandibular disorder, abnormal oro-dental development, abnormal occlusion, xerostomy, halitosis and bruxism. HB therapy was performed for 5 min six times a day over a nine-week period. Surface EMG of the mandible at rest and during maximum contraction was performed on the masseter and temporalis muscles bilaterally to evaluate electromyographic activity before and after nine months of HB usage. Results: HB usage led to a visible tendency toward the reorganization of mastication dynamics, achieving a marked balance in electromyographic activity of the jaw-closing muscles and improving the child's quality of life. Conclusion: Based on the findings of the present study, this noninvasive therapy may be useful for individuals with cerebral palsy due to its positive effects and low cost, which allows its use in the public health realm. Further clinical studies with a larger sample size are needed to validate these results and allow the development of a new treatment protocol for patients with spastic cerebral palsy. © 2013 Elsevier Ltd. All rights reserved.

Progressive recovery of a tropical deforested stream community after a flash flood

AIM: In this study, we evaluated and compared community attributes from a tropical deforested stream, located in a pasture area, in a period before (PRED I) and three times after (POSD I, II, and III) a flash flood, in order to investigate the existence of temporal modifications in community structure that suggests return to conditions previous to the flash flood. METHODS: Biota samples included algae, macrophytes, macroinvertebrates, and fish assemblages. Changes in stream physical structure we also evaluated. Similarity of the aquatic biota between pre and post-disturbance periods was examined by exploratory ordination, known as Non-Metric Multidimensional Scaling associated with Cluster Analysis, using quantitative and presence/absence Bray-Curtis similarity coefficients. Presence and absence data were used for multivariate correlation analysis (Relate Analysis) in order to investigate taxonomic composition similarity of biota between pre and post-disturbance periods. RESULTS: Our results evidenced channel simplification and an expressive decrease in richness and abundance of all taxa right after the flood, followed by subsequent increases of these parameters in the next three samples, indicating trends towards stream community recovery. Bray-Curtis similarity coefficients evidenced a greater community structure disparity among the period right after the flood and the subsequent ones. Multivariate correlation analysis evidenced a greater correlation between macroinvertebrates and algae/macrophytes, demonstrating the narrow relation between their recolonization dynamics. CONCLUSIONS: Despite overall community structure tended to return to previous conditions, recolonization after the flood was much slower than that reported in literature. Finally, the remarkably high flood impact along with the slow recolonization could be a result of the historical presence of anthropic impacts in the region, such as siltation, riparian forest complete depletion, and habitat simplification, which magnified the effects of a natural disturbance.

Increased salivary immunoglobulin A and reduced alpha-amylase activity in whole saliva from spastic cerebral palsy individuals

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Recurrent genomic alterations in sequential progressive leukoplakia and oral cancer: drivers of oral tumorigenesis?

A significant proportion (up to 62) of oral squamous cell carcinomas (OSCCs) may arise from oral potential malignant lesions (OPMLs), such as leukoplakia. Patient outcomes may thus be improved through detection of lesions at a risk for malignant transformation, by identifying and categorizing genetic changes in sequential, progressive OPMLs. We conducted array comparative genomic hybridization analysis of 25 sequential, progressive OPMLs and same-site OSCCs from five patients. Recurrent DNA copy number gains were identified on 1p in 20/25 cases (80) with minimal, high-level amplification regions on 1p35 and 1p36. Other regions of gains were frequently observed: 11q13.4 (68), 9q34.13 (64), 21q22.3 (60), 6p21 and 6q25 (56) and 10q24, 19q13.2, 22q12, 5q31.2, 7p13, 10q24 and 14q22 (48). DNA losses were observed in 20 of samples and mainly detected on 5q31.2 (35), 16p13.2 (30), 9q33.1 and 9q33.29 (25) and 17q11.2, 3p26.2, 18q21.1, 4q34.1 and 8p23.2 (20). Such copy number alterations (CNAs) were mapped in all grades of dysplasia that progressed, and their corresponding OSCCs, in 70 of patients, indicating that these CNAs may be associated with disease progression. Amplified genes mapping within recurrent CNAs (KHDRBS1, PARP1, RAB1A, HBEGF, PAIP2, BTBD7) were selected for validation, by quantitative real-time PCR, in an independent set of 32 progressive leukoplakia, 32 OSSCs and 21 non-progressive leukoplakia samples. Amplification of BTBD7, KHDRBS1, PARP1 and RAB1A was exclusively detected in progressive leukoplakia and corresponding OSCC. BTBD7, KHDRBS1, PARP1 and RAB1A may be associated with OSCC progression. Proteinprotein interaction networks were created to identify possible pathways associated with OSCC progression.

Dysregulation of Anti-Inflammatory Annexin A1 Expression in Progressive Crohns Disease

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A phylogenetic analysis of Pseudopaludicola (Anura) providing evidence of progressive chromosome reduction

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The influence of the use of stabilizer bracelet in a child with choreoathetoid cerebral palsy

Introduction: The use of stabilizer bracelet is a frequent treatment for movement disorders to strengthen muscles and adjust coordination. Still questions remain regarding the benefi t of using loads to decrease involuntary movements and the best load and placement. Objective: To measure the infl uence of the stabilizer bracelet on the kinematics and spatiotemporal parameters in planar movements performed by the upper limb. Method: One child, who has the spastic diplegy type of cerebral palsy with choreoathetoid component, and a control child without cerebral palsy, both female and 7 years old, were subjected to analysis of movements in relation to displacement, velocity, linear acceleration, and the calculation of mean square error (MSE) with and without use of stabilizer bracelet with loads of 25, 50, and 75% of the supported maximum load. Results: After comparing data between subjects, a difference was found between patient and control in all situations and variables. An inter-individual comparison using 25% of the maximum load showed the smallest difference with the NDE. Discussion and Conclusion: This therapeutic option is low cost, easy to apply, and does not signifi cantly interfere in the aesthetic of the individual. Therefore, physiotherapists may prescribe this for activities that require greater control of the upper limb because for the case studied the upper limb movement was more effi cient with the use of the stabilizer bracelet.

Test-retest reliability of electromyographic variables of masseter and temporal muscles in patients with cerebral palsy

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Correlation between sleep and quality of life in cerebral palsy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Using Threads to Overcome Synchronization Delays in Parallel Multiple Progressive Alignment Algorithms

Sao Paulo State Research Foundation-FAPESP

Diabetes triggers the loss of tooth structure associated to radiographical and histological dental changes and its evolution to progressive pulp and periapical lesions in rats

The aim of this study was to evaluate the putative influence of diabetes without metabolic control in the loss of tooth structure as well as histological changes in dentin and pulp tissue in rats. Diabetes was induced in Wistar rats (n=25) by intravenous administration of alloxan (42mg/kg). Diabetic and non-diabetic control rats were evaluated at 1, 3, 6, 9 and 12 months of follow-up. In order to evaluate the presence and progression of dental caries and periapical lesions, hemimandibles were removed and submitted to radiographical, histological, and morphometrical procedures. Dental caries were detected after radiographical and histological evaluations in diabetic group from the third month of diabetes onset, increasing gradually in frequency and severity in periods. Diabetic rats dental pulps also presented significant reduction in volume density of collagen fibers and fibroblasts at third month, parallel with a trend towards the increase in inflammatory cells volume density. Diabetic rats presented a generalized pulp tissue necrosis after 6 months of diabetes induction. Moreover, periapical lesions were not detected in control group, while these lesions were observed in all rats after 3, 6, 9, and 12 months of diabetes induction. Uncontrolled diabetes seems to trigger the loss of tooth structure, associated to histological dental changes and mediates its evolution to progressive severe pulp and periapical lesions in rats. Therefore, diabetes may be considered a very important risk factor regarding alterations in dental pulp, development of dental caries, and periapical lesions.

Dental care for cerebral palsy patients using auxiliary resources to inhibit pathological tonic reflexes

Cerebral paralysis is a chronic illness that affects the central nervous system. In this article the author describes the techniques used at CAOE (Odontological Center for Assistance to patients with special needs) to restraint CP patients during dental treatment, because they present some pathological reflexes which interfere in their odontological assistance. Also it shows how to perform a special physical restraint and how to keep the mouth open by using simple tools including a homemade one. All the devices used during the dental treatment in cerebral palsy patients, such as the physical restraint with bands or sheet to wrap them up, cylindrical pad or cushion made of a soft material, or simple tools including a homemade one to keep the mouth open are usually and safely used in CAOE. All these simple devices are necessary, because there are no available funds for the acquisition of expensive material or equipment. Despite of a shortage of resources we can easily and efficiently assist these patients.