Laryngeal function in postpolio patients

Of the 250,000 survivors of the polio epidemics, approximately 25% experience progressive muscle weakness known as postpolio syndrome (PPS). Laryngeal function in postpolio patients previously has not been studied. This paper presents data detailing laryngeal function in a group of postpolio patients who had been evaluated for swallowing complaints. Nine patients underwent comprehensive history and physical exam, acoustical voice analysis, and laryngeal videostroboscopic endoscopy. Three patients underwent laryngeal electromyography (EMG) evaluation. Results indicated some degree of phonatory or laryngeal deficit in all subjects. Subjects with dysphagia also demonstrated vocal fold paralysis. EMG revealed decreased recruitment and increased amplitude, findings consistent with EMG studies in skeletal muscle in postpolio patients. Results suggest that postpolio patients who complain of swallowing difficulties are at risk for laryngeal pathology.     

Morphine pharmacokinetics in premature and mature newborn infants

The pharmacokinetics of a single dose of morphine was investigated in five term infants (gestational age 37–40 weeks) and eight preterm infants (gestational age 25–32 weeks). In the five term infants, median (range) volume of distribution at steady state (Vd_β) was 1758 (634–2700) ml/kg, plasma clearance (Cl) was 4.73 (1–75–6.61) ml/kg/min and terminal half-life (T1/2) was 224 (107–394) min. In the eight preterm infants, Vd_β was 2366 (1662–2876) ml/kg, Cl was 2.82 (1.88–6.60) ml/kg/min and T1/2 was 556 (248–834) min. No correlation was found between clearance and gestational age, but we found a significant negative correlation between T1/2 and gestational age. We conclude that there is considerable variation in the pharmacokinetic properties of morphine in both term and preterm newborn infants. Because of this variation, careful individual assessment of the clinical effect of therapy with morphine in newborn infants should be exercised.     

Autogenic and nonautogenic sensorimotor actions in the control of multiarticulate hand movements

Summary The relationship between the size of an afferent volley and the size of the short-latency cerebral potential produced by the volley is not linear for purely cutaneous afferents, mixed cutaneous and muscle afferents or purely muscle afferents. The cerebral potential approaches a maximum when the responsible afferent input is 50% of maximum, while cerebral potentials of about half maximal size require an afferent volley of about one fifth of maximum. The relationship for sural (cutaneous) afferents rises less steeply. This saturation probably results from the convergence of the most rapidly conducting components in each afferent volley at sequential subcortical relay nuclei. The present data is compared with published data from animal experiments.     

Systemic chemotherapy induces microsatellite instability in the peripheral blood mononuclear cells of breast cancer patients

Introduction  

Systemic chemotherapy is an important part of treatment for breast cancer. We conducted the present study to evaluate whether systemic chemotherapy could produce microsatellite instability (MSI) in the peripheral blood mononuclear cell fraction of breast cancer patients.     

Sensorimotor integration for speech motor learning involves the inferior parietal cortex

Sensorimotor integration is important for motor learning. The inferior parietal lobe, through its connections with the frontal lobe and cerebellum, has been associated with multisensory integration and sensorimotor adaptation for motor behaviors other than speech. In the present study, the contribution of the inferior parietal cortex to speech motor learning was evaluated using repetitive transcranial magnetic stimulation (rTMS) prior to a speech motor adaptation task. Subjects' auditory feedback was altered in a manner consistent with the auditory consequences of an unintended change in tongue position during speech production, and adaptation performance was used to evaluate sensorimotor plasticity and short-term learning. Prior to the feedback alteration, rTMS or sham stimulation was applied over the left supramarginal gyrus (SMG). Subjects who underwent the sham stimulation exhibited a robust adaptive response to the feedback alteration whereas subjects who underwent rTMS exhibited a diminished adaptive response. The results suggest that the inferior parietal region, in and around SMG, plays a role in sensorimotor adaptation for speech. The interconnections of the inferior parietal cortex with inferior frontal cortex, cerebellum and primary sensory areas suggest that this region may be an important component in learning and adapting sensorimotor patterns for speech.     

Trattamento estetico di due casi clinici con metodica Invisalign

Objectives

To evaluate the state of the art of the Invisalign technique by reporting two cases.

Materials and methods

In order to meet the aesthetic needs of adult patients, the orthodontic research has long focused on the development of invisible and removable appliances. The result of sucvh evolution is the Invisalign technique, which is gaining popularity as a valid alternative to fixed appliances. This study shows that the Invisalign technique can be used to treat difficult cases such as impacted canines or class II malocclusions that have been treated by fixed appliances only up to now.

Results

The Invisalign technique proved to be successful.

Conclusions

Undoubtedly, the Invisalign technique can be considered a valid alternative to multibracket appliances in many cases, especially when patients require aesthetic treatments. It is indicated for patients with allergy to nickel, periodontal patients, as well as bruxists thanks to its bite effect.     

The anticonvulsant hypersensitivity syndrome

BACKGROUND: The anticonvulsant hypersensitivity syndrome is a potentially fatal multisystemic reaction to anticonvulsant medications. OBJECTIVES: The purpose of this study was to investigate the clinical characteristics of anticonvulsant hypersensitivity syndrome. RESULTS: A total 32 subjects, aged from 6 to 72 years, diagnosed as having anticonvulsant hypersensitivity syndrome based on clinical and histopathological findings, were included in the study. In 22 of the 32 cases, the anticonvulsants had been administered prophylactically after craniotomy and in 10 cases for epilepsy. When the cases were assessed for skin lesions, maculopapular eruption was registered in 22, Stevens-Johnson syndrome in five, and toxic epidermal necrolysis (TEN) in five. Treatment included suspension of the offending drug and then, except for the cases with toxic epidermal necrolysis, administration of corticosteroids. The 22 cases that required anticonvulsant therapy were treated with valproic acid. In all cases, we observed rapid clinical improvement corroborated by laboratory findings. CONCLUSIONS: It is essential that due importance be given to the development of an eruption in individuals to whom anticonvulsants are administered after craniotomy because anticonvulsant hypersensitivity syndrome is likely to be life-threatening.