Clinical and videofluoroscopic diagnosis of dysphagia in chronic encephalopathy of childhood

Objective To evaluate the contribution of deglutition videofluoroscopy in the clinical diagnosis of dysphagia in chronic encephalopathy of childhood. Materials and Methods The study sample consisted of 93 children diagnosed with chronic encephalopathy, in the age range between two and five years, selected by convenience among patients referred to the authors' institution by speech therapists, neurologists and gastroenterologists in the period from March 2010 to September 2011. The data collection was made at two different moments, by different investigators who were blind to each other. Results The method presented low sensitivity for detecting aspiration with puree consistency (p = 0.04). Specificity and negative predictive value were high for clinical diagnosis of dysphagia with puree consistency. Conclusion In the present study, the value for sensitivity in the clinical diagnosis of dysphagia demonstrates that this diagnostic procedure may not detect any change in the swallowing process regardless of the food consistency used during the investigation. Thus, the addition of the videofluoroscopic method can significantly contribute to the diagnosis of dysphagia.

Identification des mécanismes périphériques impliqués dans la douleur chronique expérimentale des muscles de la mastication

L’objectif premier de notre projet était d’établir un modèle animal de douleur chronique orofaciale, lequel pourrait imiter la sensibilité retrouvée chez les patients souffrant de douleur orofaciale myalgique. Nous avons procédé à des injections intramusculaires de saline acide (2 injections à 2 jours d’intervalle pH 4.0) pour induire une sensibilisation mécanique des mucles massétérins. La réponse nocifensive a été mesurée à l’aide de filaments de von Frey avant et après ces injections dans des rats Sprague-Dawley. Par la suite, le potentiel analgésique de différents antagonistes des récepteurs glutamatergiques fût évalué par l’injection intramusculaire de ces antagonistes à différents moments. Nos résultats suggèrent que deux injections de saline acide, produisent une hypersensibilité mécanique signalée par l’augmentation du nombre de réponses à l’application de filaments de von Frey. Cet effet dure plusieurs semaines et est bilatéral, même lorsque les injections sont unilatérales, indiquant qu’une composante centrale est forcément impliquée. Toutefois, une composante périphérique impliquant les récepteurs glutamatergiques semble présider le tout puisque les antagonistes glutamatergiques, appliqués de façon préventive empêchent le développement de l’hypersensibilité. Cependant, le maintien de cette hypersensibilité doit dépendre de mécanismes centraux puisque l’application d’antagonistes une fois la sensibilisation induite, ne diminue en rien le nombre de réponses obtenues. Ce modèle semble approprié pour reproduire une hypersensibilité musculaire durable de bas niveau. Nos données indiquent que les récepteurs glutamatergiques périphériques participent à l’induction de cette hypersensibilité de longue durée. Nous croyons que ce modèle pourra éventuellement contribuer à une meilleure compréhension des mécanismes à l’origine des myalgies faciales persistantes.

Literary meals in Canada : the Food/books of Austin Clarke, Hiromi Goto, Tessa McWatt and Fred Wah

Literary Meals in Canada étudie Pig Tails ’n Breadfruit d'Austin Clarke, Chorus of Mushrooms et The Kappa Child de Hiromi Goto, This Body de Tessa McWatt, ainsi que Diamond Grill de Fred Wah. Cette thèse entreprend d’établir la signification de la nourriture dans ces récits, ce qu'elle permet aux auteur(e)s d'exprimer par rapport à divers thématiques—les structures sociales, la culture, le langage, ou encore la subjectivité—et comment ils/elles établissent des connexions entre elles, et quelles conclusions ils/elles en tirent. En d'autres termes, cette thèse s'interroge sur les stratégies utilisées par ces auteur(e)s lorsqu'ils écrivent de la “nourritéra-ture.” Ma lecture de ces oeuvres est aussi ancrée au sein d'une conversation sur la nourriture au sens large: que ce soit dans les cercles académiques, dans les supermarchés, par l'intermédiaire des étiquettes, ou dans les médias. J'examine comment mon corpus littéraire répond, infirme, ou confirme les discours actuels sur la nourriture. Divisé en quatre chapitres—Production, Approvisionnement, Préparation, et Consommation—ce mémoire précise la signification du “literary supermarket” de Rachel Bowlby, en s'appuyant sur les travaux de Michael Pollan et Hiromi Goto; compare la haute cuisine d'Escoffier à la “hot-cuisine” d'Austin Clarke; recherche les connections entre l’acte de faire la cuisine et celui de l’écrire chez Luce Giard, Austin Clarke, et Fred Wah; confronte les préceptes d'Emily Post concernant les bonnes manières de la table à la cacophonie et aux bruits de mastication chez Hiromi Goto; et relie Tessa McWatt et Elspeth Probyn qui partagent, toutes deux, un intérêt et une approche à la sustentation des corps. Les textes qui composent ce corpus sont des “foodbooks” (“aliment-textes”). La nourriture, et les différentes activités qui y sont associées, y est transcrite. C’est pourquoi cette thèse accorde une grande importance aux particularités de ce moyen d'expression.

Hypoxie transitoire en relation avec les activités rythmiques des muscles de la mastication chez les patients atteints du bruxisme du sommeil

Study Objectives: Sleep bruxism (SB) is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible occurring during sleep. SB is scored, from electromyographic traces, as rhythmic masticatory muscle activity (RMMA). Most RMMA occurred during sleep in association with sleep arousal. Since not all RMMA episodes were associated with sleep arousal we hypothesized that some event could be observed in relation to small fluctuations of the oxygen level resulting in mild desaturation/hypoxia. Methods: Sleep laboratory or home recordings from 22 SB (teeth grinding) patients were analyzed from our data bank. A total of 143 RMMA/SB episodes were classified in 4 categories: (i) no arousal & no body movement; (ii) arousal + & no body movement; (iii) no arousal & body movement +; (iv) arousal + & body movement +. Minimum blood oxygen levels were assessed from finger oxymetry signal: 1) during the baseline period before RMMA, i.e., an average of 7 s before RMMA onset (-20 s to -14 s); 2) during RMMA, i.e. a window of 15 s corresponding to -5 s before the onset until +10 s after the episode. For all episodes, the minimum oximetry values were compared for each patient. Results: There was a significant variation of blood oxygen level over time (p=0.001) with a statistically significant transient hypoxia during RMMA at time (+7),(+8) and (+9) s. The variation over time was similar among the 4 groups (non significant group*time interaction p=0.10) and no overall difference was observed between groups (p=0.91). Of the 22 subjects, 6 subjects (27%) remained equal or had a slight increase in SaO2 (+8) s after the RMMA/SB onset compared to baseline (-20 s to -14) s, 10 subjects (45%) showed a small decrease in SaO2 (>0 to <1%) and 6 others (27%) had a decrease of 1-1.8%. Conclusions: These preliminary findings suggest that in some SB patients, RMMA episodes are potentially triggered by minor transient hypoxia. Key words: sleep bruxism, oximetry, desaturation, hypoxia, rhythmic masticatory muscle activity

Studies on Mastication Stage Binding of Antioxidants

Paraphenylenediamine and diphenylamine were chemically attached to natural rubber during mastication . The rubber bound antioxidants were characterized by TLC, 'H-NMR, IR and TGA. The efficiency and permenance of these bound antioxidants were compared with a conventional amine type antioxidant in filled natural rubber vulcanizates . The rubber bound antioxidants were found to be less volatile and less extractable as compared to conventional antioxidants. The vulcanizates showed improved ageing resistance as compared to vulcanizates containing conventional antioxidants. This semisolid rubber bound antioxidant can reduce the amount of plasticizer required for compounding.

Molecular breakdown of different forms of natural rubber and its influence on properties of their mixes and vulcanizates

The forms of natural rubber studied were sheet [RSS 4 and RSS 5], ISNR 20 and EBC. In the case of the latter two forms samples from estate and nonestate sectors were included. The samples were collected from different locations at specified intervals, for a particular period. The effect of the extent of mastication on raw rubber properties as well as the properties of the compounds and vulcanizates also studied. The consistency in raw rubber properties and breakdown behavior of skim rubber were studied by collecting samples periodically from selected processing units. The effect of incorporation of skim with ISNR 20 has also been investigated

Diet digestibility, rate of passage, and eating and rumination behavior of Jersey and Holstein cows

Diet digestibility and rate of passage, eating and rumination behavior, dry matter intake (DMI), and lactation performance were compared in 6 Jersey and 6 Holstein multiparous cows. Cows were fed gestation diets according to body weight (BW) beginning 7 wk before expected calving and ad libitum amounts of a lactation diet postpartum. Diet digestibility and rate of passage were measured in 5-d periods at wk 5 prepartum and wk 6 and 14 of lactation. Eating and ruminating behavior was measured over 5-d periods at wk 5 and 2 prepartum and wk 2, 6, 10, and 14 of lactation. Milk yield and DMI were higher in Holsteins, but milk energy output per kilogram of metabolic BW (BW0.75) and intake capacity (DMI/kg of BW) did not differ between breeds. Holsteins spent longer ruminating per day compared with Jerseys, but daily eating time did not differ between breeds. Jerseys spent more time eating and ruminating per unit of ingested feed. The duration and number of meals consumed did not differ between breeds, but the meals consumed by Jerseys were distributed more evenly throughout each 24-h period, providing a more regular supply of feed to the rumen. Feed passed through the digestive tract more quickly in Jerseys compared with Holsteins, suggesting particle breakdown and rumen outflow were faster in Jerseys, but this may also reflect the relative size of their digestive tract. Neutral detergent fiber digestibility was greater in Jerseys, despite the shorter rumen retention time, but digestibility of dry matter, organic matter, starch, and N did not differ between breeds. Utilization of digested N for tissue retention was higher at wk 5 prepartum and lower at wk 14 of lactation in Jerseys. In contrast to numerous published studies, intake capacity of Jerseys was not higher than that of Holsteins, but in the present study, cows were selected on the basis of equal expected milk energy yield per kilogram of metabolic BW. Digestibility of neutral detergent fiber and rate of digesta passage were higher in Jerseys, probably as a consequence of increased mastication per unit of feed consumed in Jerseys and their smaller size.

Mastication effort study using photorefractive holographic interferometry technique

The purpose of this work was the force-displacement response analysis of the masticatory process in a dried human skull by Double-Exposure Photorefractive Holographic Interferometry Technique (2E-PRHI). The load concentration and dissipation of the forces from dried human skull were analysed at applied loading stands as a Simulation of Isolated Contraction (SIC) of some mastication muscles. The 2EHI and Fringe Analysis Method were used to obtain the quantitative results of this force-displacement response. These results document quantitatively the real biomechanical response from dried human skull under applied loading and it can be used for complementary study by finite element model and others analysis type. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.

The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

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

Oropharyngeal dysphagia and language delay in partial trisomy 9p: case report

The phenotype of partial trisomy 9p includes global developmental delay, microcephaly, bulbous nose, downturned oral commissures, malformed ears, hypotonia, and severe cognitive and language disorders. We present a case report and a comparative review of clinical findings on this condition, focusing on speech-language development, cognitive abilities and swallowing evaluation. We suggest that oropharyngeal dysphagia should be further investigated, considering that pulmonary and nutritional disorders affect the survival and quality of life of the patient. As far as we know, this is the first study of a patient with partial trisomy 9p described with oropharyngeal dysphagia.

Electromyographic activity of the mandible muscles at the beginning and end of masticatory cycles in patients with complete dentures

The aim of this study was to assess the electrical activity of the masseter and anterior temporal muscles in subjects with severe bone resorption at two different times: ( a) the initial period, with the complete dentures they had worn for over 10 years, and (b) the final period, 5 months after having new dentures put into place. Twelve asymptomatic subjects were asked to respond to the questionnaire, according to the research diagnostic criteria for temporomandibular disorders, before denture rehabilitation and 5 months after the new dentures were put in place. The electrical activity of the muscles was recorded during mastication in the initial and final period, using artificial food (Optocal). The operator monitored the 35 chewing cycles that were repeated to grind the artificial food. After wearing the new dentures for 5 months, the right anterior temporal muscle showed a statistical difference before and after denture rehabilitation at the beginning and end of mastication. Muscular capacity and ability reduced the electrical activity in the masseter muscles after rehabilitation. Copyright (c) 2008 S. Karger AG, Basel.

Silent Period of Masticatory Cycles in Dentate Subjects and Complete Denture Wearers

Purpose: The purpose of this study was to assess, through electromyographic activity (EMG), the silent period (SP) of masseter and anterior temporal muscles in dentate subjects (DS) and complete denture wearers (CDW).Materials and Methods: The evaluations were performed at the initial and final period of the mastication for the DS group. For the CDW group, the evaluations were performed at the initial period of mastication, with old complete dentures worn for more than 10 years (OCDW) and at the final period of the mastication with new complete dentures (NCDW), 5 months after rehabilitation. Twenty-four asymptomatic subjects (12 DS, 12 CDW) answered a questionnaire based on the Research Diagnostic Criteria for temporomandibular disorders. The CDW group answered the questionnaire before and after new denture insertion and after 5 months of rehabilitation. The SP of the muscles was recorded through EMG at the initial and final periods of mastication using artificial food (Optocal). The operator monitored 35 chewing cycles performed to grind the artificial food and selected eight open-close-clench-chewing cycles for the record.Results: The SP of the muscles analyzed with new complete dentures showed no statistical difference in comparison to the old dentures. There was a statistically significant difference in the SP between the CDW and DS groups for initial and final chewing.Conclusion: Lowered muscular capacity and ability reduced the SP of muscles after rehabilitation with NCDWs.

Absence or weak correlation between chewing side preference and lateralities in primary, mixed and permanent dentition

Objectives: To determine whether chewing side preference (CSP) is correlated to lateralities (handedness, footedness, eyedness and earedness) in primary, mixed and permanent dentitions.Design: Three-hundred subjects were divided into 3 groups: Group 1-100 children 3-5 years old, primary dentition; Group 2-100 children 6-12 years old, mixed dentition; Group 3 - 100 subjects 18-47 years old, permanent dentition. CSP was determined using a method developed by Mc Donnell et al.(9) Subjects were given a piece of gum and the position of the chewing gum was recorded 7 times as right or left. Subjects were classified as 'observed preferred chewing side' (OPCS) when they performed 5/7, 6/7 or 7/7 strokes on the same side. OPCS corresponded to the CSP. Laterality tests were performed for handedness, footedness, eyedness and earedness tasks. The Chi-square (chi(2)) and phi correlation (r) tests were used to investigate significant correlations between CSP and sidedness.Results: There was a significant correlation between chewing and earedness (p = 0.00), although there was weak positive correlation (r = 0.30) for primary dentition. There were significant correlations between chewing and handedness (p = 0.02; r = 0.25) and chewing and footedness (p = 0.02; r = 0.26), however, there were weak positive correlations for mixed dentition; there were significant correlations between chewing and handedness (p = 0.02; r = 0.26); chewing and footedness (p = 0.00; r = 0.33) and chewing and earedness (p = 0.01; r = 0.29); however, there were weak positive correlations for permanent dentition.Conclusion: It may be concluded that CSP can be significantly correlated with: earedness for primary dentition; handedness and footedness for mixed dentition; handedness, footedness and earedness for permanent dentition, but these are weak positive relationships. Future work on larger samples of left- and right-sided individuals is required to validate the findings. (C) 2012 Elsevier Ltd. All rights reserved.

Relação entre perdas dentárias e queixas de mastigação, deglutição e fala em indivíduos adultos

OBJETIVO: investigar se as perdas dentárias em indivíduos adultos apresentam relação com as queixas de fala, mastigação e deglutição. MÉTODOS: participaram deste estudo 50 indivíduos adultos, trabalhadores de uma Avícola, do município de Bariri (SP), com faixa etária entre 18 e 52 anos. Os participantes selecionados foram submetidos à avaliação odontológica por um cirurgião-dentista e à entrevista fonoaudiológica, por duas fonoaudiólogas, em um consultório do município que mantém contrato de prestação de serviço com a Avícola. Para análise dos resultados, foram comparados os indivíduos com e sem perda dos elementos dentários, denominados de grupo experimental (GE) e grupo controle (GC), respectivamente, a partir da aplicação do teste Qui-Quadrado. RESULTADOS: os resultados revelaram maior ocorrência de mastigação unilateral no GE. Queixas quanto à dificuldade e dor na mastigação estiveram presentes apenas no GE, com diferença estatisticamente significante entre os grupos (p<0,05). O tempo de deglutição mostrou-se inadequado para a maioria dos indivíduos em ambos os grupos. A maioria dos indivíduos do GC mencionou utilizar algum tipo de líquido para facilitar a deglutição. Nenhum indivíduo mencionou queixas de fala. CONCLUSÃO: os achados revelaram que a ausência de elementos dentários em indivíduos adultos apresentou relação apenas entre dificuldade e dor durante a mastigação.