Association between habitual snoring,middle ear disease,and speech problems in young children with non-syndromic cleft palate anomalies

The purpose of this study was to investigate the association between habitual snoring (HS), middle ear disease (MED), and speech problems in children with cleft palate. This cross-sectional study included children aged 2.0–7.9 years with non-syndromic cleft palate anomalies. Parents completed the Pediatric Sleep Questionnaire and a questionnaire about MED. Audiograms and speech assessment were also conducted. Ninety-five children were enrolled; 15.2% of families reported HS, 97.6% MED, and 17.1% speech problems. HS (37.5% vs 10.3%, P = 0.007) and early episodes of MED (92.3% vs 58.2%, P = 0.021) were more likely to be reported for children with isolated cleft palate when compared to those with cleft lip and palate. Children with cleft lip and palate had a higher frequency of MED with effusion compared to those with Robin sequence (86.4% vs 57.1%, P = 0.049). The odds ratio for HS in children with ≥1 episode of MED in the last year was 7.37 (95% confidence interval 1.55–35.15, P = 0.012). There was a trend for children with speech problems reported by parents to have HS (30.8% vs 11.5%, P= 0.076). Anatomical factors play a role in the frequency of upper airway symptoms in children with cleft palate. A recent history of at least one episode of MED was associated with an increased frequency of HS.     

Influence of footwear on postural sway: A systematic review and meta-analysis on barefoot and shod bipedal static posturography in patients and healthy subjects

BackgroundBipedal static posturography is widely used to assess postural control. However, standardized methods and evidence on the influence of footwear on balance in comparison to barefoot stance is sparse.Research questionsIs bipedal static posturography applied in a standardized way with respect to demographics and the experimental set-up (systematic review)? Does habitual footwear influence postural control in comparison to barefoot condition during bipedal static posturography in adult patients and healthy subjects (meta-analysis)?MethodsFor this systematic review and meta-analysis, a comprehensive follow-up literature search was conducted from March 2009 until January 2020 according to the PRISMA guidelines. Original, research articles reporting on bipedal, unsupported, static posturography in adults (≥18 years) were included according to inclusion criteria (age, sex, height, weight, duration, repetitions, visual/foot condition, sampling frequency). Studies comparing habitual footwear with barefoot condition during bipedal static posturography were included for the meta-analysis. Center of pressure parameters (sway velocity, range, root mean square, paths lengths) with subjects having eyes closed (EC) or open (EO) were analyzed using random effects models.ResultsFor this systematic review and meta-analysis, 207 and eight out of 5189 studies with 12'341 and 156 subjects, respectively, were eligible. Most studies (89%) reported barefoot, 5% shod, and 6% barefoot and shod measurements. Less than half of studies (44%) included patients of which the minority (13%) suffered from neurological disease. Sway velocity in the anterior-posterior direction was higher in habitual shoes compared to barefoot with EC (SMD: 1.08; 95% CI: 0.68–1.48; p < 0.01; I² = 0%), with EO (SMD: 0.68; 95% CI: 0.11–1.26; p = 0.02; I² = 1%), and in the medio-lateral direction with EC (SMD: 1.30; 95% CI: 0.76–1.85, p < 0.01; I² = 37%).SignificanceMethodical heterogeneity of bipedal static posturography hampers studies’ comparability. Thus, we provide a standardized approach to increase knowledge whether habitual footwear decrease postural control in comparison to barefoot stance.     

Prevalence and evolution of snoring and the associated factors in two-year-old children

ObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors.Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors.ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (OR_a) 2.8, 1.1–6.8), the mother's lower level of education (CS OR_a 2.9, 1.2–7.5, FB OR_a 2.1, 1.0–4.5), and the mother's lower monthly income (FB OR_a 2.9, 1.3–6.3) associated with the child's habitual snoring.ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.     

Analysis of MRI findings in minimum invasive treatment for habitual temporomandibular joint dislocation by autologous blood injection around the temporomandibular joint capsule

The aim of this study was to investigate magnetic resonance imaging (MRI) findings following autologous blood injection (ABI) for habitual temporomandibular joint (TMJ) dislocation. MRI was performed one hour and four and twelve weeks after ABI, revealing three types of significant findings. The first type was similar to hematoma and/or joint effusion in the articular capsule of the TMJ (type I). The second showed sporadic and diffuse T2 emphasis around the TMJ capsule (type II). The third involved a decreased range of condyle movement compared to before ABI (type III). Furthermore, we analyzed the three types of significant MRI findings.At one hour after ABI, type I was Grade 0 in 0 of 14 patients, Grade 1 in 8, Grade 2 in 2, and Grade 3 in 4. Type II was seen in 9 of the 14 cases and type III in 8. After twelve weeks, all cases of type I were Grade 0, no type II cases were evident, and type III was seen in 11 cases. Injecting autologous blood into surrounding TMJ tissues is an important factor in ABI. Minimally invasive treatment for habitual TMJ dislocation using ABI around the TMJ capsule appears to represent a very effective and safe treatment.     

Reproducibility of habitual intercuspation in vivo

Objectives

The aim of this in vivo study was to investigate how reproducible individuals find their habitual intercuspation.

Methods

A new type of highly accurate measuring procedure was involved using an intraoral optical scanning device (Cerec Bluecam). First, a pilot test investigated the accuracy of the procedure within a standardized setting. With regard to the in vivo study, fifteen participants with full dentition were selected. For each of these individuals, eight scans were taken both in the morning and in the afternoon. Furthermore, during each session, scans were taken both in horizontal and upright position. In order to compare this to ubiquitous used processes, plaster replicas of five individuals were investigated as well. The scans were analysed, and the differences in the position of the lower jaw were calculated by a specialized superimposition program (n = 570 comparisons/OraCheck).

Results

The results showed that there was no significant difference between the time of day and the position of the patient. The overall mean ± SD value for locating the habitual intercuspation was 42 ± 34 μm, however ranging from 22 ± 9 μm to 77 ± 58 μm for single individuals. On the other hand, the differences in positioning plaster replicas reached a mean of 135 ± 77 μm.

Conclusions

The reproducibility of the habitual intercuspation can be obtained under in vivo conditions by a newly developed and highly accurate measuring procedure. Individuals with full dentition show values in average of 42 μm.

Clinical significance

Determining the occlusal jaw relation is an important precondition in restorative dentistry and many methods are proposed for a proper occlusal registration. Although much is known about in vitro accuracy of these techniques, little is known how reproducible the habitual occlusal position itself is found between individuals.     

寿胎丸治疗习惯性流产23例

目的：探讨寿胎丸对习惯性流产的治疗效果,为习惯性流产治疗提供安全有效方法。方法47例习惯性流产患者,随机分为对照组24例和研究组23例。对照组给予临床常规治疗,研究组在常规治疗的基础上给予寿胎丸治疗,观察对比两组患者治疗效果。结果研究组患者治愈9例,有效12例,总有效率91.30%,对照组患者治愈5例,有效9例,总有效率58.33%,两组比较差异有统计学意义(P<0.05)。结论寿胎丸能够有效降低习惯性流产发生率,治疗安全可靠,临床可积极推广应用。     

小儿鼾症手术前后血浆生物标志物的变化及临床意义

探讨小儿鼾症患者行扁桃体和（或）腺样体手术对与心血管疾病密切相关的血浆生物标志物的影响。选取单纯非肥胖型小儿鼾症患者20例,进行术前和术后6个月血浆超敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、白介素6（IL-6）、脂联素和胎球蛋白 A 的水平的测定,结果显示术后6个月的血浆 hs-CRP、TNF-α、IL-6、脂联素的水平均明显低于相应的术前水平（P <0.001）,胎球蛋白 A 的水平均明显高于相应的术前水平（P <0.001）。小儿鼾症患者进行扁桃体和（或）腺样体切除术有助于降低其并发心血管疾病的风险。     

Obstructive sleep apnea‐related symptoms in Japanese people with Down syndrome

This study evaluated the prevalence of obstructive sleep apnea‐related symptoms and assessed the relationship with obesity or unusual sleep postures in Down syndrome patients in Japan. We obtained the demographic characteristics, sleep postures, and obstructive sleep apnea‐related symptoms experienced by 90 people as reported by their caregivers. Although 71% reported snoring and 59% arousals, obstructive sleep apnea‐related symptoms were not significantly different between obese and non‐obese participants. The youngest age group had the fewest obstructive sleep apnea‐related symptoms, especially symptoms of snoring. The odds for arousal, nocturia, and apnea tended to be higher in the unusual sleep‐postures group. Unusual sleep postures were most frequent in the group 6–15 years of age. People with Down syndrome might sleep in unusual postures to avoid upper airway obstruction caused by other anatomical factors. For nurses and other health professionals working in mainstream service, it is important to screen all persons with Down syndrome for symptoms suggestive of obstructive sleep apnea, particularly those six years of age and older, and to refer them for further evaluation for sleep disorders.     

复发性流产后宫腔粘连的临床研究

【目的】分析复发性流产（RS A ）、宫腔手术操作对宫腔粘连的影响。【方法】对106例RS A患者的临床资料进行回顾性分析。统计其流产次数、宫腔手术操作次数,超声结合宫腔镜检查诊断宫腔粘连的符合率。数据采用SAS统计软件进行分析,计数资料采用线性趋势χ2检验。【结果】106例RSA患者中发现宫腔粘连18例（17．0％）,宫腔粘连发生率随自然流产和宫腔手术操作频次增加而增高有统计学意义（ P ＜0．05）;经阴道超声与宫腔镜检查诊断宫腔粘连的符合率为88．9％（16／18）。【结论】自然流产频次增加宫腔粘连发生风险,尤其是宫腔手术是流产后发生宫腔粘连的重要危险因素。腔内超声检查对其诊断有重要临床应用价值。