Swallowing changes related to chronic temporomandibular disorders

Objectives

To investigate whether chronic temporomandibular disorder (TMD) patients showed any changes in swallowing compared to a control group. Moreover, it was examined whether swallowing variables and a valid clinic measure of orofacial myofunctional status were associated.

Material and methods

Twenty-three patients with chronic TMD, diagnosed with disc displacement with reduction (DDR) and pain, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and 27 healthy volunteers (control group) were compared. Surface electromyography (EMG) of the temporalis, masseter, sternocleidomastoid, and suprahyoid muscles was performed during swallowing tasks of thin liquid (10 and 15 mL) and spontaneous saliva. Data were normalized.

Results

Compared to the control group, TMD patients showed a prolonged duration of swallowing for liquid and saliva and required a longer time to reach the activity peak and half the integral. While the overall mean value of the relative peaks was similar for the groups, the suprahyoid peak was significantly lower in the TMD group during swallowing of liquid. Moreover, TMD patients recruited the jaw elevator muscles proportionally more than controls. The orofacial myofunctional status was moderately correlated with EMG parameters.

Conclusion

Patients with chronic TMD showed temporal prolongation and changes in the relative activity of the muscles during the swallowing tasks.

Clinical relevance

The present results contribute additional evidence regarding the reorganization of muscle activity in patients with chronic TMD.

     

Four and a half LIM protein 1 gene mutations cause four distinct human myopathies: a comprehensive review of the clinical, histological and pathological features

Mutations in the four and a half LIM protein 1 (FHL1) gene were recently identified as the cause of four distinct skeletal muscle diseases. Since the initial report outlining the first fhl1 mutation in 2008, over 25 different mutations have been identified in patients with reducing body myopathy, X-linked myopathy characterized by postural muscle atrophy, scapuloperoneal myopathy and Emery-Dreifuss muscular dystrophy. Reducing body myopathy was first described four decades ago, its underlying genetic cause was unknown until the discovery of fhl1 mutations. X-linked myopathy characterized by postural muscle atrophy is a novel disease where fhl1 mutations are the only cause. This review will profile each of the FHL1, with a comprehensive analysis of mutations, a comparison of the clinical and histopathological features and will present several hypotheses for the possible disease mechanism(s).     

Magnetic nanoparticles for imaging dendritic cells

We report the development of superparamagnetic iron oxide (SPIOs) nanoparticles and investigate the migration of SPIO‐labeled dendritic cells (DCs) in a syngeneic mouse model using magnetic resonance (MR) imaging. The size of the dextran‐coated SPIO is roughly 30 nm, and the DCs are capable of independent uptake of these particles, although not at levels comparable to particle uptake in the presence of a transfecting reagent. On average, with the assistance of polylysine, the particles were efficiently delivered inside DCs within one hour of incubation. The SPIO particles occupy approximately 0.35% of cell surface and are equivalent to 34.6 pg of iron per cell. In vivo imaging demonstrated that the labeled cells migrated from the injection site in the footpad to the corresponding popliteal lymph node. The homing of labeled cells in the lymph nodes resulted in a signal drop of up to 79%. Furthermore, labeling DCs with SPIO particles did not compromise cell function, we demonstrated that SPIO‐enhanced MR imaging can be used to track the migration of DCs effectively in vivo. Magn Reson Med 63:1383–1390, 2010. © 2010 Wiley‐Liss, Inc.     

Stereotactic core breast biopsy of malignant calcifications: diagnostic yield of cores with and cores without calcifications on specimen radiographs

PURPOSE: To retrospectively compare core biopsy diagnosis with final diagnosis at surgical excision in cores with and cores without calcification on specimen radiographs. MATERIALS AND METHODS: One hundred thirteen consecutive patients underwent vacuum-assisted 11- or 14-gauge needle stereotactic core biopsy for calcifications with malignant histologic results in core samples from 116 lesions. For each lesion, calcification was identified in at least one core at specimen radiography. Cores with and those without calcification seen on magnified specimen radiographs were separately submitted to and reported on by pathologists, who obtained additional levels in cores with calcification. All patients underwent surgical excision of the lesion area within 7 weeks. The pathologic diagnosis in core samples with and those without calcification on specimen radiographs was compared with final diagnosis at surgical excision. Fisher exact test was used for all chi(2) determinations of statistical significance. RESULTS: Cores with calcification on specimen radiographs were more likely to enable a final diagnosis of malignancy than were cores without calcification (98 [84%] vs 82 [71%] of 116; P =.02). Cores without calcification were significantly more likely to cause a diagnosis of cancer to be missed than were those with calcification on specimen radiographs (13 [11%] vs one [1%] of 116; P <.001). Underestimates of malignancy were more frequent in 14- than in 11-gauge specimens (11 [18%] of 60 vs six [10%] of 56; P =.30). Regardless of needle size, there was no significant difference in underestimation of malignancy between cores with and without radiographically evident calcification (17 [15%] vs 21 [18%] of 116; P =.60). CONCLUSION: Specimen radiography is essential to document calcification retrieval. Cores without radiographically demonstrated calcification may fail to show a malignant lesion. Separate identification of calcium-containing cores may assist the pathologist, who can more thoroughly evaluate these cores with additional levels of section.     

Renal disease burden following liver transplantation

Significant chronic kidney disease (CKD) occurs following orthotopic liver transplant (OLT). Since CKD is associated with increased cardiovascular events, mortality, and hepatic allograft dysfunction, early recognition of CKD and implementation of changes may improve the long-term outcome. The purpose of this study was to determine the burden of renal disease following OLT. PATIENTS AND METHODS: We retrospectively reviewed our OLT recipients from 1997 until 2004. We calculated glomerular filtration rates (GFR) using the Modification of Diet in Renal Disease study (MDRD) method. The GFRs were further subdivided into pre-MELD and post-MELD eras. RESULTS: During the study period, we performed 407 OLTs. We censored data from living donor liver transplants (n = 14), combined liver-kidney transplants (n = 12), and from patients whom we did not have complete data for 6 months after transplant (n = 40). Mean MELD score at the time of transplant was 18 +/- 7 (mean +/- standard deviation). The mean GFR at 6 months following OLT was 63.7 +/- 30.2 mL/min per 1.73 m(2). Only 14% (n = 47) of our patients had normal renal function at 6 months, while 78% (n = 266) of our patients had mild to moderate risk for renal failure. Eight percent (n = 28) had stage 4 or 5 CKD. There were no differences between the pre-MELD and post-MELD GFRs. CONCLUSIONS: The burden of renal disease is significant in our patient population at 6 months posttransplantation. It may be important to introduce CKD management as early as 6 months after transplant to impact the outcomes of OLT recipients.     

Trends in body mass index and waist circumference among New Zealand adolescents, 1997/1998–2005

The objective of the current study is to examine changes in body mass index (BMI) and waist circumference among New Zealand adolescents between 1997/1998 and 2005. Data were drawn from two cross-sectional studies of high school students in an economically disadvantaged region of Auckland. In total, 608 adolescents from the 1998 survey and 897 adolescents from the 2005 survey participated. The prevalence of obesity increased from 19.4% in 1997/1998 to 30.7% in 2005. The mean BMI among adolescents significantly increased from 25.3 in 1997/1998 to 27.2 in 2005, with the greatest increases at the high end of the distribution. Increases in BMI did not differ by age, gender or ethnicity. The mean waist circumference increased from 76.2 cm in 1997/1998 to 89.4 cm in 2005, with increases in waist circumference measurements at all points in the distribution. The prevalence of obesity is increasing rapidly in this sample of ethnically diverse adolescents. Corresponding increases in waist circumference measurements suggest that this population of New Zealand adolescents are at increased risk for related chronic conditions.     

The burden of disease associated with infection with human papillomavirus

Human Papillomavirus is associated with a significant burden of disease globally, particularly with cancer of the cervix, for which persistent infection with high-risk types of HPV is necessary for the development of cervical cancer. Other cancers associated with HPV infection, particularly with HPV 16, include cancer of the vulva, vagina, penis, anus and some head and neck cancers. Globally approximately 600 000 cancers can be attributed to HPV infection. The advent of two commercially available vaccines had provided a new paradigm for the prevention of infection with HPV, particularly HPV infections associated with cancer.     

Elevated serum levels of tumor necrosis factor are associated with progressive encephalopathy in children with acquired immunodeficiency syndrome

The cytokine tumor necrosis factor (TNF) was assayed in the sera (n = 31) and cerebrospinal fluid (n = 26) of children with acquired immunodeficiency syndrome, using a competitive radioimmunoassay. Elevated serum levels of TNF were found in 15 (79%) of 19 patients with progressive encephalopathy (PE), compared with 1 (8%) of 12 patients without neurologic involvement. There was a significant association of PE with elevated serum TNF levels. Conversely, of 16 patients with elevated serum TNF levels, 15 (94%) were found to have PE, and of 8 patients with serum TNF levels greater than 100 pg/ml, all 8 (100%) had PE. No association was found between cerebrospinal fluid levels of TNF and PE. Neither serum nor cerebrospinal fluid TNF levels correlated with the degree of cachexia. These data suggest that circulating TNF may be responsible for the myelin damage that occurs in human immunodeficiency virus type 1-associated PE.     

Vitamin D (soltriol), light, and reproduction

Evidence from autoradiographic studies with 1,25(OH)2-vitamin D3 (vitamin D, soltriol) labeled with tritium and from the literature indicates that the steroid hormone soltriol regulates and modulates reproductive processes in the female, as it does in the male. Nuclear receptors for soltriol have been discovered in the uterus, oviduct, ovary, mammary gland, placenta, and fetal membranes, as well as in the pituitary and hypothalamus. Soltriol is recognized as a transducer and hormonal messenger of sunlight, acting as a somatotropic activator and modulator of vital processes for the seasonal and estival adaptation of growth, development, and procreation. Its influence on calcium equilibrium is just one of its many functions to serve this goal. This article reviews experimental, clinical, and epidemiologic evidence that suggests the involvement of soltriol in the control of reproductive processes, noting its importance for the onset of puberty, fertility, pregnancy, lactation, and probably sexual behavior. Cooperative actions between soltriol and other steroid hormones, especially estradiol, are pointed out.