Protraction of mandibular second and third molars into missing first molar spaces for a patient with an anterior open bite and anterior spacing.

PubMed

Baik, Un-Bong; Chun, Youn-Sic; Jung, Min-Ho; Sugawara, Junji

2012-06-01

In a young woman, aged 18 years 8 months, who had an anterior open bite and anterior spacing, the right and left mandibular first molar extraction spaces were closed by protraction of the second and third molars without reciprocal retraction of the incisors and the premolars. The amounts of protraction for the second molars were 12 mm on the right side and 11 mm on the left side. Two miniscrews were inserted into the mesiobuccal side of the edentulous spaces, and 2 more screws were inserted into the anterior sites after removing previous miniscrews. In addition, 4 miniscrews were inserted into the buccal and palatal sides between the first and second maxillary molars to intrude the maxillary posterior teeth, which had extruded into the missing mandibular spaces. Careful biomechanical consideration was used to prevent extrusion of the molars and worsening of the anterior open bite from protraction of the posterior teeth. Ultimately, the anterior open bite was corrected by both intrusion of the maxillary molars and extrusion of the maxillary anterior teeth. Excellent occlusion and correction of the anterior open bite were achieved without tipping, rotation of the posterior teeth, or other problems. The right mandibular third molar, which had been impacted at the beginning of treatment, erupted into the second molar space and functioned properly. At the 1-year follow-up examination, the patient had a slight anterior open bite, but closure of the first molar extraction spaces was well maintained. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Anterior open-bite orthodontic treatment in an adult patient: A clinical case report.

PubMed

Gracco, Antonio; Siviero, Laura; de Stefani, Alberto; Bruno, Giovanni; Stellini, Edoardo

2016-06-01

A 45-year-old woman presented with an anterior open-bite complaining chiefly of her unpleasant smile esthetics and masticatory and speech problems. Treatment included speech therapy initiated immediately after bonding. Lingual spurs were positioned on the mandibular incisors in order to help tongue rehabilitation. During the working phase, temporary anchorage devices (TADs) were used at the mandibular anterior segment to intrude the lower left premolars. A splint was used to ensure retention in the upper and lower arches; an enveloppe linguale nocturne (ELN) was provided. Non-surgical open-bite treatment could offer a valid alternative to orthognanthic surgery when cephalometric evaluation shows no vertical growth pattern; patient compliance is essential to prevent relapse. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

Chin remodeling in a patient with bimaxillary protrusion and open bite by using mini-implants for temporary anchorage.

PubMed

Jiang, Chunmiao; Liu, Yinghong; Cheng, Qian; He, Wei; Fang, Shanbao; Lan, Tingting; Wang, Jun

2018-03-01

Patients with bimaxillary protrusion may have an unattractive profile with a retruded chin contour. Correction of the severely protrusive anterior alveolar bone and teeth combined with a moderate open bite without orthognathic surgery can be challenging. This case report describes the orthodontic treatment of a woman with severe bimaxillary protrusion and a moderate open bite. Excellent chin morphology and facial appearance were obtained with the extraction of 4 first premolars and 4 third molars, and total distalization of both arches with 4 mini-implants, one in each quadrant between the second premolar and the first molar. The total treatment time was 30 months. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Treatment of hyperdivergent growth pattern and anterior open bite with posterior metallic bite planes.

PubMed

Ciavarella, Domenico; Lo Russo, Lucio; Nichelini, Jeffrey; Mastrovincenzo, Mario; Barbato, Ersilia; Laurenziello, Michele; Montaruli, Graziano; Lo Muzio, Lorenzo

2017-12-01

In the present paper, the authors analyze the effect of the "Swallowing Occlusal Contact Intercept Appliance" (SOCIA) in treatment of children with hyperdivergent Class II malocclusion. This functional appliance has no intra-oral anchorage, but induces a continuous periodontal, muscular, and articular stimulation. Twenty-six patients with hyperdivergent growth and class II malocclusion were selected and treated with SOCIA appliance. Cephalometric analysis was performed before treatment (T1) and immediately after the treatment (T2). After 24 months treatment authors observed a modification of maxillary growth with a reduction of the divergence with an increase of the posterior facial height, a modification of condylar inclination and forward position of the a hyoid. No modifications was observed about the ANB angle. After treatment the open bite was resolved with a reduction of the inclination of the upper incisors. SOCIA is a reliable functional appliance in growing age patients with a hyperdivergent pattern growth, anterior open bite and class II molar malocclusion.

Aesthetic and functional outcomes using a multiloop edgewise archwire for camouflage orthodontic treatment of a severe Class III open bite malocclusion.

PubMed

Marañón-Vásquez, Guido Artemio; Soldevilla Galarza, Luciano Carlos; Tolentino Solis, Freddy Antonio; Wilson, Cliff; Romano, Fábio Lourenço

2017-09-01

Occasionally, orthodontists will be challenged to treat malocclusions and skeletal disharmonies, which by their complexity one might think that the only treatment alternative is the surgical-orthodontic approach. A male patient, aged 17 years old, was diagnosed with a skeletal Class III malocclusion, anterior open bite and negative overjet. An unpleasant profile was the patient's 'chief complaint' showing interest in facial aesthetics improvement. Nevertheless, the patient and his parents strongly preferred a non-surgical treatment approach. He was treated with a multiloop edgewise archwire to facilitate uprighting and distal en-masse movement of lower teeth, correct the Class III open bite malocclusion, change the inclination of the occlusal plane and obtain the consequent morphological-functional adaptation of the mandible. The Class III malocclusion was corrected and satisfactory changes in the patient's profile were obtained. Active treatment was completed in 2 years, and facial result remained stable at 2 years 6 months after debonding.

Long-term Stability of a Camouflage Retreatment of an Asymmetric Class III/Posterior Open Bite Using Sliding Jigs.

PubMed

Oliveira, Dauro Douglas; de Oliveira, Bruno Franco; Figueiredo, Daniel Santos Fonseca; Antunes, Alberto Nogueira da Gama; Seraidarian, Paulo Isaías

2017-10-01

This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.

Management of post midface distraction occlusal discrepancy using temporary anchorage devices in a cleft patient

PubMed Central

Koteswara Prasad, N. K.; Hussain, Syed Altaf; Chitharanjan, Arun B.; Murthy, Jyotsna

2015-01-01

Open bite deformity following a successful midface advancement by distraction osteogenesis is a common complication. Temporary anchorage devices can be deployed during the distraction and post-distraction settling phases for restoring the occlusion even in severe cases. The following report describes the management of severe anterior open bite following maxillary distraction. PMID:25991895

Corticotomy-assisted orthodontic camouflage in a class III adult patient with a severe transverse discrepancy.

PubMed

Gracco, Antonio; Finotti, Marco; Bruno, Giovanni; de Stefani, Alberto

2018-04-06

A 25-year-old man presented with a maxillary transverse discrepancy, posterior cross bite, anterior open bite, molar and canine class III. Treatment included a corticotomy in the upper lateral and posterior teeth, a palatal expansor and a sectional archwire to assist the expansion. The following treatment phase included bonding with Incognito System lingual appliance, interproximal reduction to solve the crowding and bite blocks to control the verticality. Two months after the bonding intermaxillary class III elastics were used to solve the sagittal discrepancy and eight months after the bonding vertical elastics were used in order to solve the anterior open bite until the end of the treatment. A Boston splint was applied for the upper arch, an essix splint was applied for the lower arch. The patient compliance was an essential aspect in the success of the orthodontic treatment. Copyright © 2018. Published by Elsevier Masson SAS.

Evaluation of long-term stability of skeletal anterior open bite correction in adults treated with maxillary posterior segment intrusion using zygomatic miniplates.

PubMed

Marzouk, Eiman S; Kassem, Hassan E

2016-07-01

This study evaluated the long-term stability of maxillary molar intrusion and anterior open-bite correction in adults treated by maxillary posterior teeth intrusion with zygomatic miniplates. The sample included 26 skeletal anterior open-bite patients, who had maxillary posterior segment intrusion with zygomatic miniplates. Lateral cephalograms were taken at pretreatment, posttreatment, 1 year posttreatment, and 4 years posttreatment. The mean maxillary molar intrusion was 3.04 mm (P ≤0.01), and the mean bite closure was 6.93 mm (P ≤0.01). The intruded maxillary molars relapsed by 10.20% in the first year after treatment and by 13.37% by 4 years after treatment. Overbite relapsed by 8.19% and 11.18% after 1 year and 4 years posttreatment, respectively. The first year after treatment accounted for 76.29% and 73.2% of the total relapses of molar intrusion and overbite, respectively. The 4-year posttreatment relapse amounts of maxillary molar intrusion and overbite were positively correlated with the amount of pretreatment maxillary molar height and the initial open-bite severity, respectively, but negatively correlated with the amounts of maxillary molar intrusion and open-bite correction gained by treatment. Molar intrusion with zygomatic miniplates appears to be stable 4 years after treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Non-orthodontic intervention and non-nutritive sucking behaviours: A literature review.

PubMed

Tanny, Liyana; Huang, Boyen; Naung, Noel Ye; Currie, Geoffrey

2018-04-01

Anterior open bite (AOB) is one of the most complex malocclusions to manage. AOB is caused by either by skeletal, genetic or environmental factors. Numerous treatment options are currently utilised to manage AOB. These vary from non-invasive behavioural shaping to orthodontic and surgical interventions. This paper reviews the available orthodontic and non-orthodontic interventions used in the management of AOB. The literature review was carried out using the PubMed search engine from the first of January 2000 to the first of June 2017. Two major keywords (open bite and anterior open bite) were used in addition to 23 minor keywords in the review. AOB is one of the most complex malocclusions to treat with high relapse rates. Long term outcome in treatments of patients with AOB was substantially low. Relapse rates were not taken into consideration for some of the literature reviewed. Despite limitations of the literature, it is recommended that orofacial myofunctional therapy (OMT) and non-orthodontic intervention (NOI) be used in conjunction as an effective treatment option for Anterior Open Bite. Copyright © 2018. Published by Elsevier Taiwan.

Class III malocclusion with complex problems of lateral open bite and severe crowding successfully treated with miniscrew anchorage and lingual orthodontic brackets.

PubMed

Yanagita, Takeshi; Kuroda, Shingo; Takano-Yamamoto, Teruko; Yamashiro, Takashi

2011-05-01

In this article, we report the successful use of miniscrews in a patient with an Angle Class III malocclusion, lateral open bite, midline deviation, and severe crowding. Simultaneously resolving such problems with conventional Class III treatment is difficult. In this case, the treatment procedure was even more challenging because the patient preferred to have lingual brackets on the maxillary teeth. As a result, miniscrews were used to facilitate significant asymmetric tooth movement in the posterior and downward directions; this contributed to the camouflage of the skeletal mandibular protrusion together with complete resolution of the severe crowding and lateral open bite. Analysis of the jaw motion showed that irregularities in chewing movement were also resolved, and a stable occlusion was achieved. Improvements in the facial profile and dental arches remained stable at the 18-month follow-up. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Modified use of a dynamic bite opener--treatment and prevention of trismus in a child with head and neck cancer: a case report.

PubMed

Dijkstra, P U; Kropmans, T J; Tamminga, R Y

1992-10-01

Trismus may be a complication arising during or after treatment of patients with head and neck cancer. Treatment of trismus is difficult, making prevention very important. To prevent and treat trismus in a patient with a nasopharyngeal tumor, the Contract-Relax-Antagonist-Contract (CRAC) technique was applied, with the aid of a custom-made dynamic bite opener (DBO). The CRAC technique in combination with the DBO, as a therapy/prevention program for trismus, is not referred to in the literature. The combination of CRAC and DBO appeared to be a gentle and effective method well tolerated by the patient.

Camouflage of a high-angle skeletal Class II open-bite malocclusion in an adult after mini-implant failure during treatment.

PubMed

Franzotti Sant'Anna, Eduardo; Carneiro da Cunha, Amanda; Paludo Brunetto, Daniel; Franzotti Sant'Anna, Claudia

2017-03-01

The treatment of skeletal anterior open-bite malocclusion requires complex orthodontic planning that considers its multifactorial etiology, treatment limitations, and high relapse rates. This case report illustrates a successful treatment approach for a skeletal high-angle Class II malocclusion in an adult with a severe open bite. The treatment consisted of a high-pull headgear therapy after mini-implants failure during fixed orthodontic therapy. Adequate esthetics and function were achieved. Despite its low probability, the unexpected event of mini-implant loosening during complex treatments should be considered. Therefore, classic orthodontic mechanics should be established, especially when treating patients for whom invasive procedures such as miniplates or orthognathic surgery are not available options. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Interdisciplinary treatment for an adult patient with anterior open bite, severe periodontitis, and intellectual disability.

PubMed

Kang, Da-Young; Choi, Sung-Hwan; Jung, Young-Soo; Hwang, Chung-Ju

2015-05-01

This case report describes the beneficial effects of the interdisciplinary treatment of an adult patient with severe skeletal periodontal problems. A 30-year-old female patient presented with anterior open bite, gummy smile, and facial asymmetry. The patient had chronic generalized severe periodontitis with pathologic maxillary anterior teeth migration and mild intellectual disability. Treatment included 6 months of periodontal treatment, followed by presurgical orthodontic treatment, a Le Fort I osteotomy with anterior segmental osteotomy, a bilateral sagittal split ramus osteotomy, and postsurgical orthodontic treatment. After treatment completion, the patient exhibited functional and aesthetic improvements. Her periodontal condition improved and was maintained after the treatment. Here, we demonstrate a successful treatment outcome in a complicated case following a systematic interdisciplinary approach performed with the correct diagnosis and treatment planning.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report.

PubMed

Felicita, A Sumathi

2017-10-01

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite. A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite. Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch. Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Orthodontic treatment of a complex open-bite malocclusion with temporary anchorage devices: a case report.

PubMed

Waldman, Alexander B

2010-08-01

Orthodontic temporary anchorage devices provide a novel alternative to orthognathic surgery for the treatment of severe anterior open-bite malocclusions. These implantable devices provide skeletal anchorage for maxillary molar intrusion, allowing for mandibular autorotation and subsequent open-bite closure. This case demonstrates step-by-step treatment of a 41-year-old woman with a severe open-bite malocclusion. Detailed orthodontic mechanics are described at every stage of treatment.

[The influences of the stress distribution on the condylar cartilage surface by Herbst appliance under various bite reconstruction--a three dimensional finite element analysis].

PubMed

Hu, L; Zhao, Z; Song, J; Fan, Y; Jiang, W; Chen, J

2001-02-01

The distribution of stress on the surface of condylar cartilage was investigated. Three-dimensional model of the 'Temporomandibular joint mandible Herbst appliance system' was set up by SUPER SAP software (version 9.3). On this model, various bite reconstruction was simulated according to specified advanced displacement and vertical bite opening. The distribution of maximum and minimum principal stress on the surface of condylar cartilage were computerized and analyzed. When Herbst appliance drove the mandible forward, the anterior condyle surface was compressed while the posterior surface was drawn. The trend of stress on the same point on the condyle surface was consistent in various reconstruction conditions, but the trend of stress on various point were different in same reconstruction conditions. All five groups of bite reconstruction (3-7 mm advancement, 4-2 mm vertical bite opening of the mandible) designed by this study can be selected in clinic according to the patient's capability of adaptation, the extent of malocclusion and the potential and direction of growth.

Factors associated with the prevalence of anterior open bite among preschool children: A population-based study in Brazil

PubMed Central

Machado, Daniella Borges; Brizon, Valéria Silva Cândido; Ambrosano, Gláucia Maria Bovi; Madureira, Davidson Fróis; Gomes, Viviane Elisângela; de Oliveira, Ana Cristina Borges

2014-01-01

INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite. PMID:25715723

[The influences upon the passive tensile of the masticatory muscles and ligaments by Herbst appliance under various bite reconstruction--a three dimensional finite element analysis].

PubMed

Song, J; Zhao, Z; Hu, L; Jiang, W; Fan, Y; Chen, J

2001-02-01

This study aimed to provide some biomechanical references for the clinical use and improvement of Herbst appliance. The three-dimensional model of the 'Temporomandibular joint mandible Herbst appliance system' was set up by SUPER SAP software (version 9.3). On this model, the passive tensile in the masticatory muscles and ligaments were analyzed under various bit reconstruction designed according to specified advanced displacement and vertical bite opening. When Herbst appliance drove the mandible forward, there was not any tensile in the medial, lateral pterygoid and the collateral ligament, while the temporalis, the deep paret of masseter, the stylomandibular ligament, and the sphenomandibular ligament were passively drawn. Under various bite reconstruction, the passive tensile in the medial temporalis, the posterior temporalis, the stylomandibular ligament and the sphenomandibular ligament increased with the amount of the advancement of the mandible; The passive tensile in the posterior temporalis and the deep part of masseter increased with the amount of vertical bite opening of the mandible. The StL, SpL, PT and AT played an important role in functional reconstruction of mandible by Herbst. All five group of bite reconstruction (3-7 mm advancement, 4-2 mm vertical bite opening of the mandible) designed by this study can be selected in clinic according to the patient's capability of adaptation, the extent of malocclusion and the potential and direction of growth.

Bites by the Monocled Cobra, Naja kaouthia, in Chittagong Division, Bangladesh: Epidemiology, Clinical Features of Envenoming and Management of 70 Identified Cases

PubMed Central

Faiz, M. A.; Ahsan, M. F.; Ghose, A.; Rahman, M. R.; Amin, R.; Hossain, M.; Tareq, M. N. U.; Jalil, M. A.; Kuch, U.; Theakston, R. D. G.; Warrell, D. A.; Harris, J. B.

2017-01-01

We describe 70 cases of monocled cobra (Naja kaouthia) bite admitted to Chittagong Medical College Hospital, Bangladesh. The biting snakes were identified by examining the dead snake and/or detecting N. kaouthia venom antigens in patients' serum. Bites were most common in the early morning and evening during the monsoon (May–July). Ligatures were routinely applied to the bitten limb before admission. Thirty-seven patients consulted traditional healers, most of whom made incisions around the bite site. Fifty-eight patients experienced severe neurotoxicity and most suffered swelling and pain of the bitten limb. The use of an Indian polyvalent antivenom in patients exhibiting severe neurotoxicity resulted in clinical improvement but most patients experienced moderate-to-severe adverse reactions. Antivenom did not influence local blistering and necrosis appearing in 19 patients; 12 required debridement. Edrophonium significantly improved the ability of patients to open the eyes, endurance of upward gaze, and peak expiratory flow rate suggesting that a longer-acting anticholinesterase drug (neostigmine) could be recommended for first aid. The study suggested that regionally appropriate antivenom should be raised against the venoms of the major envenoming species of Bangladesh and highlighted the need to improve the training of staff of local medical centers and to invest in the basic health infrastructure in rural communities. PMID:28138054

Dystrophic changes in masticatory muscles related chewing problems and malocclusions in Duchenne muscular dystrophy.

PubMed

van den Engel-Hoek, L; de Groot, I J M; Sie, L T; van Bruggen, H W; de Groot, S A F; Erasmus, C E; van Alfen, N

2016-06-01

Dysphagia in Duchenne muscular dystrophy (DMD) worsens with age, with increasingly effortful mastication. The aims of this study were to describe mastication problems in consecutive stages in a group of patients with DMD and to determine related pathophysiological aspects of masticatory muscle structure, tongue thickness, bite force and dental characteristics. Data from 72 patients with DMD (4.3 to 28.0 years), divided into four clinical stages, were collected in a cross sectional study. Problems with mastication and the need for food adaptations, in combination with increased echogenicity of the masseter muscle, were already found in the early stages of the disease. A high percentage of open bites and cross bites were found, especially in the later stages. Tongue hypertrophy also increased over time. Increased dysfunction, reflected by increasingly abnormal echogenicity, of the masseter muscle and reduced occlusal contacts (anterior and posterior open bites) were mainly responsible for the hampered chewing. In all, this study shows the increasing involvement of various elements of the masticatory system in progressive Duchenne muscular dystrophy. To prevent choking and also nutritional deficiency, early detection of chewing problems by asking about feeding and mastication problems, as well as asking about food adaptations made, is essential and can lead to timely intervention. Copyright © 2016 Elsevier B.V. All rights reserved.

"Closed Reduction" Principles Can Manage Diverse Conditions of Temporomandibular Joint Vertical Height Loss: From Displaced Condylar Fractures to Idiopathic Condylar Resorption.

PubMed

Nitzan, Dorrit W; Palla, Sandro

2017-06-01

The aim of this case series was to describe a modification of the classic "closed reduction" technique to manage unilateral or anterior open bite owing to a loss in vertical height (LVH) caused by several disorders and pathologies other than displaced condylar fractures. The protocol included insertion of an occlusal appliance to increase the height of the premature contact and the width of the open bite, stabilization of the dental arches by rigid arches, and the use, during sleep, of rubber bands in the open bite region to pull the mandible cranially. In addition, when awake, the patient performed physiotherapy exercises to guide the mandible into maximum intercuspation. The increased open bite enhanced the effect of the rubber bands in guiding the mandible into the original habitual occlusion and the rigid arches served to minimize tooth eruption. The present cases showed the favorable outcome of this low-risk treatment in the re-establishment of the original habitual occlusion within 1 to 4 weeks and without reconstruction of the LVH. The efficacy of this complication-free approach to correct occlusion in various conditions of LVH suggests that this protocol should be applied before venturing into surgical intervention. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Breaking the Thumb Sucking Habit: When Compliance Is Essential

PubMed Central

Tanaka, Orlando; Oliveira, Wagner; Galarza, Melissa; Aoki, Vanessa; Bertaiolli, Bruno

2016-01-01

The anterior open bite (AOB) and posterior cross bite are the most frequent malocclusions associated with prolonged sucking habits. This clinical case illustrates and discusses the use of a Haas-type palatal expander for stopping a thumb sucking habit. The improvement in closing the open bite with discontinuation of the habit was observed. But with the return of the habit and lack of cooperation, the relapse of anterior open bite occurred. Therefore, different approaches are necessary. The need of a multidisciplinary approach, consent, and cooperation are keys to a good prognosis. PMID:26904311

Evaluation of Bite Force After Open Reduction and Internal Fixation Using Microplates

PubMed Central

Kumar, S Tharani; Saraf, Saurabh; Devi, S Prasanna

2013-01-01

The primary aim of this study is to determine maximum bite force in molar and incisor regions of healthy individuals, to evaluate the bite force after open reduction and internal fixation of mandibular fractures using micro plates, for a period of up to 6 weeks and to determine the rate of recovery of maximum bite force in an Indian population. PMID:24910656

Children using Day Nurseries' Facilities can be Associated with more Risk to Nonnutritive Sucking Habits.

PubMed

Alves, Fabiana Bt; Wambier, Denise S; Alvarez, Jenny Ha; da Rocha, José Cf; Kummer, Thais R; de Castro, Vanessa C; Cabral, Howard; Kozlowski, Vitoldo A

2016-09-01

This study evaluated the expression of nonnutritive sucking habits and the presence of malocclusion in children using day nurseries' facilities. The 195 children (7-40 months) attending 18 public day nurseries were evaluated clinically in Ponta Grossa, Brazil. Statistical package software was used for descriptive, univariate, bivariate, and multiple logistic regressions of the data about the socioeconomic condition, educational family status, malocclusions, and prevalence of nonnutritive sucking habits among the children. The pacifier users had a statistically significant, explanatory association with open bite [odds ratio (OR) = 10.97; 95% confidence interval (CI): 4.95, 24.31; p < 0.0001]. The children older than 25 months had more open bite than younger children (OR = 6.07; 95% CI: 2.81, 13.11; p < 0.0001). Of the children examined, 35.4% had an anterior open bite, 0.51% had posterior cross-bite, and 1.03% showed finger-sucking habits. A high frequency of pacifier-sucking habits was found (52%), with a significant association between this habit and anterior open bite (p < 0.0001, OR = 7.49; 95% CI: 3.71, 15.15). The 126 children without open bite (36.5%) were pacifier users. There was suggestive, though nonsignificant, evidence of a difference in pacifier use by gender (males, 34%; females, 46%; p = 0.07). The 69 children with open bite (81.16%) were pacifier users and (18.84%) nonusers. The boys showed a slightly greater association with open bite (OR = 21.33; 95% CI: 6.12, 74.40; p < 0.0001) than girls (OR = 5.03; 95% CI: 1.26, 20.00; p = 0.02) in the age group of 25 to 40 months; however, it was not observed in younger children. Pacifier use is a predictor for open bite in children from the lower socioeconomic classes using day nurseries' facilities. The parents, guardians, and caregivers working in public day nurseries should be advised to monitor nonnutritive sucking habits in order to avoid or minimize the occurrence of malocclusion. It demonstrates that the permanence of the children in day nurseries may be linked with deleterious oral habits, and it discusses strategies to minimize the occurrence of alterations in the normal occlusion.

Mandibular kinematic changes after unilateral cross-bite with lateral shift correction.

PubMed

Venancio, F; Alarcon, J A; Lenguas, L; Kassem, M; Martin, C

2014-10-01

The aim of this randomised prospective study was to evaluate the effects of slow maxillary expansion with expansion plates and Hyrax expanders on the kinematics of the mandible after cross-bite correction. Thirty children (15 boys and 15 girls), aged 7·1-11·8, with unilateral cross-bite and functional shift were divided into two groups: expansion plate (n = 15) and Hyrax expander (n = 15). Thirty children with normal occlusion (14 boys and 16 girls, aged 7·3-11·6) served as control group. The maximum vertical opening, lateral mandibular shift (from maximum vertical opening to maximum intercuspation, from rest position to maximum intercuspation and from maximum vertical opening to rest position) and lateral excursions were recorded before and 4 months after treatment. After treatment, the expansion plate group showed a greater lateral shift from rest position to maximum intercuspation than did the control group. The expansion plate patients also presented greater left/contralateral excursion than did the control group. Comparisons of changes after treatment in the cross-bite groups showed significant decreases in the lateral shift from the maximum vertical opening to maximum intercuspation and from the maximum vertical opening to rest position, a significant increase in the homolateral excursion and a significant decrease in the contralateral excursion in the Hyrax expander group, whereas no significant differences were found in the expansion plate group. In conclusion, the Hyrax expander showed better results than did the expansion plate. The Hyrax expander with acrylic occlusal covering significantly improved the mandibular lateral shift and normalised the range of lateral excursion. © 2014 John Wiley & Sons Ltd.

California Sea Lion (Zalophus californianus) and Harbor Seal (Phoca vitulina richardii) Bites and Contact Abrasions in Open-Water Swimmers: A Series of 11 Cases.

PubMed

Nuckton, Thomas J; Simeone, Claire A; Phelps, Roger T

2015-12-01

To review cases of bites and contact abrasions in open-water swimmers from California sea lions (Zalophus californianus) and harbor seals (Phoca vitulina richardii). Open-water swimmers from a San Francisco swimming club were questioned about encounters with pinnipeds (seals and sea lions) that resulted in bites or contact abrasions. When possible, wounds were documented with photographs. Medical follow-up and treatment complications were also reviewed. From October 2011 to December 2014, 11 swimmers reported bites by a sea lion (n = 1), harbor seal (n = 7), or unidentified pinniped (n = 3). Ten of the encounters occurred in San Francisco Bay; 1 occurred in the Eld Inlet, in Puget Sound, near Olympia, WA. None of the swimmers were wearing wetsuits. All bites involved the lower extremities; skin was broken in 4 of 11 bites and antibiotics were prescribed in 3 cases. One swimmer, who was bitten by a harbor seal, also had claw scratches. A treatment failure occurred with amoxicillin/clavulanate in another swimmer who was bitten by an unidentified pinniped; the wound healed subsequently with doxycycline, suggesting an infection with Mycoplasma spp. There were no long-lasting consequences from any of the bites. The majority of cases occurred at low tide, and bumping of the swimmer by the animal before or after a bite was common, but no clear tide or attack pattern was identified. Bites and contact abrasions from sea lions and harbor seals are reported infrequently in open-water swimmers and typically involve the lower extremities. Because of the risk of Mycoplasma infection, treatment with a tetracycline is recommended in pinniped bites with signs of infection or serious trauma. Attempting to touch or pet sea lions or seals is inadvisable and prohibited by the Marine Mammal Protection Act. Swimmers should leave the water as soon as possible after a bite or encounter. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Extreme skeletal open bite correction with vertical elastics.

PubMed

Cruz-Escalante, Marco Antonio; Aliaga-Del Castillo, Aron; Soldevilla, Luciano; Janson, Guilherme; Yatabe, Marilia; Zuazola, Ricardo Voss

2017-11-01

Severe skeletal open bites may be ideally treated with a combined surgical-orthodontic approach. Alternatively, compensations may be planned to camouflage the malocclusion with orthodontics alone. This case report describes the treatment of an 18-year-old man who presented with a severe open bite involving the anterior and posterior teeth up to the first molars, increased vertical dimension, bilateral Class III molar relationship, bilateral posterior crossbite, dental midline deviation, and absence of the maxillary right canine and the mandibular left first premolar. A treatment plan including the extraction of the mandibular right first premolar and based on uprighting and vertical control of the posterior teeth, combined with extrusion of the anterior teeth using multiloop edgewise archwire mechanics and elastics was chosen. After 6 months of alignment and 2 months of multiloop edgewise archwire mechanics, the open bite was significantly reduced. After 24 months of treatment, anterior teeth extrusion, posterior teeth intrusion, and counterclockwise mandibular rotation were accomplished. Satisfactory improvement of the overbite, overjet, sagittal malocclusion, and facial appearance were achieved. The mechanics used in this clinical case demonstrated good and stable results for open-bite correction at the 2-year posttreatment follow-up.

Successful and stable orthodontic camouflage of a mandibular asymmetry with sliding jigs.

PubMed

Oliveira, Dauro Douglas; Oliveira, Bruno Franco de; Mordente, Carolina Morsani; Godoy, Gabriela Martins; Soares, Rodrigo Villamarim; Seraidarian, Paulo Isaías

2018-03-12

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.

Prevalence of malocclusion among mouth breathing children: do expectations meet reality?

PubMed

Souki, Bernardo Q; Pimenta, Giovana B; Souki, Marcelo Q; Franco, Leticia P; Becker, Helena M G; Pinto, Jorge A

2009-05-01

The aim of this study was to report epidemiological data on the prevalence of malocclusion among a group of children, consecutively admitted at a referral mouth breathing otorhinolaryngological (ENT) center. We assessed the association between the severity of the obstruction by adenoids/tonsils hyperplasia or the presence of allergic rhinitis and the prevalence of class II malocclusion, anterior open bite and posterior crossbite. Cross-sectional, descriptive study, carried out at an Outpatient Clinic for Mouth-Breathers. Dental inter-arch relationship and nasal obstructive variables were diagnosed and the appropriate cross-tabulations were done. Four hundred and one patients were included. Mean age was 6 years and 6 months (S.D.: 2 years and 7 months), ranging from 2 to 12 years. All subjects were evaluated by otorhinolaryngologists to confirm mouth breathing. Adenoid/tonsil obstruction was detected in 71.8% of this sample, regardless of the presence of rhinitis. Allergic rhinitis alone was found in 18.7% of the children. Non-obstructive mouth breathing was diagnosed in 9.5% of this sample. Posterior crossbite was detected in almost 30% of the children during primary and mixed dentitions and 48% in permanent dentition. During mixed and permanent dentitions, anterior open bite and class II malocclusion were highly prevalent. More than 50% of the mouth breathing children carried a normal inter-arch relationship in the sagital, transversal and vertical planes. Univariate analysis showed no significant association between the type of the obstruction (adenoids/tonsils obstructive hyperplasia or the presence of allergic rhinitis) and malocclusions (class II, anterior open bite and posterior crossbite). The prevalence of posterior crossbite is higher in mouth breathing children than in the general population. During mixed and permanent dentitions, anterior open bite and class II malocclusion were more likely to be present in mouth breathers. Although more children showed these malocclusions, most mouth breathing children evaluated in this study did not match the expected "mouth breathing dental stereotype". In this population of mouth breathing children, the obstructive size of adenoids or tonsils and the presence of rhinitis were not risk factors to the development of class II malocclusion, anterior open bite or posterior crossbite.

Assessment of wound bio-burden and prevalence of multi-drug resistant bacteria during open wound management.

PubMed

Nolff, M C; Reese, S; Fehr, M; Dening, R; Meyer-Lindenberg, A

2016-05-01

To describe the bacterial bio-burden of open-treated wounds and make comparisons with bite wounds. Retrospective multicentre study. Microbial culture between 2011 and 2013 from open-treated wounds in dogs and cats (initiation of therapy n=88, follow-up n=52) were compared to those from bite wounds (n=184). Bacteria were identified and tested for antibiotic susceptibility by two accredited laboratories. In total, 77/88 (88%) of open-treated wounds yielded positive bacterial cultures at the beginning of treatment, decreasing to 27/52 (52%) during treatment. Upon initial evaluation, 42/88 (48 %) of open-treated wounds were considered infected with multi-drug-resistant bacteria, with a drop to 22/52 (41%) during therapy. Bite wounds yielded fewer positive cultures 88/184 (48%) with only 11/182 (6%) being affected by multi-drug-resistant bacteria. Bacteria found most commonly in open-treated wounds were Enterococcus subspecies, Escherichia coli, Staphylococcus pseudintermedius and Pseudomonas aeruginosa. The bacterial populations of open-treated wounds differed markedly from the bite wounds. The high incidence of multi-drug-resistant strains in open wounds highlights the need for alternatives to antibiotics. © 2016 British Small Animal Veterinary Association.

Coronoid process and residual ankylotic mass as an autograft in the management of ankylosis of the temporomandibular joint in young adolescent patients: a retrospective clinical investigation.

PubMed

Bansal, Vishal; Mowar, Apoorva; Dubey, Prajesh; Bhatnagar, Aditi; Bansal, Avi

2016-04-01

The aim of this non-randomised investigation was to assess the feasibility of using autogenous grafts (such as coronoid process and the resected ankylotic mass) in reconstruction of the condyle after gap arthroplasty for ankylosis of the temporomandibular joint (TMJ). Sixteen patients (23 joints) operated on between 2007 and 2009 were studied and postoperative measurements of maximum interincisal opening, bite force, range of movement, and infection were recorded. After a mean (SD) follow up of 55 (2.25) months mouth opening improved from 3 (3.84) mm to 33 (1.66) mm in patients treated with coronoid graft, while in patients treated with an ankylotic mass after a mean (SD) follow up of 58 (1.58) months it increased from 4 (2.64) mm to 26 (8.04) mm. Bite force six months postoperatively ranged from 18.25kg/cm(2) - 27.5kg/cm(2) after reconstruction with the coronoid process and 18.5kg/cm(2) - 23.25kg/cm(2) after reconstruction with the ankylotic mass. One patient developed reankylosis postoperatively and another developed infection, in both of which the ankylotic mass had been used. Both were managed successfully. Both the ankylotic mass and the coronoid process gave satisfactory results and seem to be options for reconstruction. However, the coronoid process graft was better than residual ankylotic mass in terms of masticatory efficiency, bite force, and range of movement. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Association between allergic rhinitis, bottle feeding, non‐nutritive sucking habits, and malocclusion in the primary dentition

PubMed Central

Vázquez‐Nava, F; Quezada‐Castillo, J A; Oviedo‐Treviño, S; Saldivar‐González, A H; Sánchez‐Nuncio, H R; Beltrán‐Guzmán, F J; Vázquez‐Rodríguez, E M

2006-01-01

Aim To determine the association between allergic rhinitis, bottle feeding, non‐nutritive sucking habits, and malocclusion in the primary dentition. Methods Data were collected on 1160 children aged 4–5 years, who had been longitudinally followed since the age of 4 months, when they were admitted to nurseries in a suburban area of Tampico–Madero, Mexico. Periodically, physical examinations were conducted and a questionnaire was given to their parents or tutors. Results Malocclusion was detected in 640 of the children (51.03% had anterior open bite and 7.5% had posterior cross‐bite). Allergic rhinitis alone (adjusted odds ratio = 2.87; 95% CI 1.57 to 5.25) or together with non‐nutritive sucking habits (adjusted odds ratio = 3.31; 95% CI 1.55 to 7.09) had an effect on anterior open bite. Bottle feeding alone (adjusted odds ratio = 1.95; 95% CI 1.07 to 3.54) or together with allergic rhinitis (adjusted odds ratio = 3.96; 95% CI 1.80 to 8.74) had an effect on posterior cross‐bite. Posterior cross‐bite was more frequent in children with allergic rhinitis and non‐nutritive sucking habits (10.4%). Conclusions Allergic rhinitis alone or together with non‐nutritive sucking habits is related to anterior open bite. Non‐nutritive sucking habits together with allergic rhinitis seem to be the most important factor for development of posterior open bite in children under the age of 5 years. PMID:16769710

Skeletal class III malocclusion treated using a non-surgical approach supplemented with mini-implants: a case report.

PubMed

Farret, Marcel Marchiori; Benitez Farret, Milton M

2013-09-01

We describe a 28-year-old man who sought orthodontic treatment complaining about the esthetics of his smile and difficulties associated with masticatory function. The patient had a straight facial profile, skeletal and dental class III relationship, anterior open bite and posterior crossbite. He refused orthognathic surgery and was therefore treated with camouflage orthodontics supplemented with the placement of one mini-implant in each side of the mandible to facilitate movement of the lower dentition distally, tooth-by-tooth. At the end of treatment, a class I molar relationship was obtained, with an ideal overjet and overbite and excellent intercuspation. Furthermore, the open bite and crossbite were corrected. Analysis 2 years after treatment revealed good stability of treatment outcome.

Posterior open occlusion management by registration of overlay removable partial denture: A clinical report

PubMed Central

Nosouhian, Saeid; Davoudi, Amin; Derhami, Mohammad

2015-01-01

This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions. PMID:26929544

Posterior open occlusion management by registration of overlay removable partial denture: A clinical report.

PubMed

Nosouhian, Saeid; Davoudi, Amin; Derhami, Mohammad

2015-01-01

This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.

Occlusal plane rotation: aesthetic enhancement in mandibular micrognathia.

PubMed

Rosen, H M

1993-06-01

Patients afflicted with extreme degrees of mandibular micrognathia typically have vertically deficient rami as well as sagittally deficient mandibular bodies. This results in deficient posterior facial height, an obtuse gonial angle, excessively steep occlusal and mandibular planes, and a compensatory increase in anterior facial height. The entire maxillomandibular complex is overrotated in a clockwise direction. Standard orthognathic surgical correction fails to address this rotational deformity. As a consequence, the achieved projection of the lower face is inadequate, posterior facial height is further reduced, and occlusal and mandibular planes remain steep. Eleven patients with severe mandibular micrognathia underwent a surgical correction involving occlusal plane rotation to its normal orientation relative to Frankfort horizontal. This was accomplished by Le Fort I osteotomy to shorten the anterior maxilla (creating open bites in seven patients and making preexisting open bites worse in four patients) and sagittal split ramus osteotomies to advance and rotate the mandibular body counterclockwise, thus closing the surgically produced open bite. Counterclockwise rotation of the mandible afforded significantly greater sagittal displacement at the B point (mean 17 mm) than at the first molar (mean 10 mm) and produced adequate degrees of projection of the lower face when accompanied by a modest sliding genioplasty (mean 6.9 mm). Total advancement at the pogonion was a mean of 25.2 mm. In addition, posterior facial height was preserved, and mandibular and occlusal planes were normalized to mean angles of 27 and 10 degrees, respectively. At follow-up, which ranged from 9 to 24 months with a mean of 14.1 months, the mean sagittal relapse at the B point was 1.9 mm. Although heretofore considered unstable and therefore not clinically accepted, maxillomandibular counterclockwise rotation to normalize the occlusal plane rotational deformity provides stable, aesthetically superior results in patients with extreme degrees of mandibular micrognathia. Extended follow-up will be necessary to document long-term stability.

Shark attack.

PubMed

Guidera, K J; Ogden, J A; Highhouse, K; Pugh, L; Beatty, E

1991-01-01

Shark attacks are rare but devastating. This case had major injuries that included an open femoral fracture, massive hemorrhage, sciatic nerve laceration, and significant skin and muscle damage. The patient required 15 operative procedures, extensive physical therapy, and orthotic assistance. A review of the literature pertaining to shark bites is included.

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report

PubMed Central

Aljhani, Ali S.; Aldrees, Abdullah M.

2010-01-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved. PMID:24151417

Orthodontic treatment of an anterior openbite with the aid of corticotomy procedure: Case report.

PubMed

Aljhani, Ali S; Aldrees, Abdullah M

2011-04-01

This case report illustrates the orthodontic treatment combined with the corticotomy technique in an adult patient to accelerate tooth movement and shorten the treatment time. The patient was a 22-year-old woman with an anterior open bite and flared and spaced upper and lower incisors. First, fixed orthodontic appliances (bidimensional edgewise brackets) were bonded, and a week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxillary arch from the first molar to the contralateral first molar, and from canine to canine in the mandibular arch was performed. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every 2 weeks. The total treatment time was 5 months and no adverse effects were observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful closure of the anterior open bite with adequate overbite and interdigitation of the teeth were achieved.

Case report: Management of severe posterior open bite due to primary failure of eruption.

PubMed

Mc Cafferty, J; Al Awadi, E; O'Connell, A C

2010-06-01

Primary failure of tooth eruption (PFE) is a rare condition affecting any or all posterior quadrants. Unilateral involvement of maxillary and mandibular quadrants causes a dramatic posterior open bite that requires complex management strategies. An 8 year-old boy attended the Dublin Dental School and Hospital regarding infra-occlusion of his right maxillary and mandibular primary molars. Both right first permanent molars had also failed to erupt. All permanent teeth were present radiographically. Facial appearance and soft tissues were normal and oral function was not affected. The patient had no significant medical history and his siblings had no similar dental abnormalities. The infra-occluded right first and second primary molars were extracted, and the right first permanent molars were surgically exposed. Eruption of the premolars and molars was monitored over the next 2 years. The premolars showed signs of eruption and continued root development. Exfoliation of the remaining primary teeth proceeded as usual. The right first permanent molars did not erupt and were subsequently extracted. Continued eruption of the canines and premolars reduced the inter-arch separation. A removable tongue shield appliance was suggested but declined by the patient. At age 13 years, orthodontic extrusion was used to further reduce the inter-dental distance between the canine and premolars. The reduction was from 5 mm to 1.5 mm between the right first premolars and from 10 mm to 5 mm between the right second premolars. Extrusion of the canine teeth was also attempted to improve the smile line. The canine extruded 1 mm to give a 2 mm overlap. There were no changes in centric occlusion and the midline was unaffected. In the 2 years since orthodontic treatment, the spaces have reopened slightly to 3 mm between first premolars and 6 mm between second premolars. The patient is now aged 16 years and is aware that an improved aesthetic smile line may be achieved by use of onlay restorations. In this unique case, a profound unilateral posterior open bite occurred due to primary failure of eruption of the maxillary and mandibular teeth on the affected side. Orthodontic therapy was used to modify the position of the permanent canines and premolars to reduce the posterior open bite.

An Investigation of the Posterior Component of Occlusal Force

DTIC Science & Technology

1994-05-01

of the hemostat allowed subjects to consistently orient the bite force transducer parallel to the occIusal plane , thus allowing the bite force to be...the anterior component of occlusal force was influenced by the steepness of the occlusal plane . Southard et al (1989) was the first to quantify the...young adult males yielded higher mean maximum bite forces at 20 mm opening and at 40 mm opening. The authors suggested that orientation and function of

Effects of breastfeeding and sucking habits on malocclusion in a birth cohort study.

PubMed

Peres, Karen Glazer; Barros, Aluísio J D; Peres, Marco Aurélio; Victora, César Gomes

2007-06-01

To estimate the prevalence of malocclusion and to examine the effects of breastfeeding and non-nutritive sucking habits on dentition in six-year-old children. A cross-sectional study was carried out nested into a birth cohort conducted in Pelotas, Southern Brazil, in 1999. A sample of 359 children was dentally examined and their mothers interviewed. Anterior open bite and posterior cross bite were recorded using the Foster & Hamilton criteria. Information regarding breastfeeding and non-nutritive sucking habits was collected at birth, in the first, third, sixth and 12th months of life, and at six years of age. Control variables included maternal schooling and child's birthweight, cephalic perimeter, and sex. Data were analyzed by Poisson regression. Prevalence of anterior open bite was 46.2%, and that of posterior cross bite was 18.2%. Non-nutritive sucking habits between 12 months and four years of age and digital sucking at age six years were the main risk factors for anterior open bite. Breastfeeding for less than nine months and regular use of pacifier between age 12 months and four years were risk factors for posterior cross bite. Interaction between duration of breastfeeding and the use of pacifier was identified for posterior cross bite. Given that breastfeeding is a protective factor for other diseases of infancy, our findings indicate that the common risks approach is the most appropriate for the prevention of posterior cross bite in primary or initial mixed dentition.

Changes of some functional speech disorders after surgical correction of skeletal anterior open bite.

PubMed

Knez Ambrožič, Mojca; Hočevar Boltežar, Irena; Ihan Hren, Nataša

2015-09-01

Skeletal anterior open bite (AOB) or apertognathism is characterized by the absence of contact of the anterior teeth and affects articulation parameters, chewing, biting and voice quality. The treatment of AOB consists of orthognatic surgical procedures. The aim of this study was to evaluate the effects of treatment on voice quality, articulation and nasality in speech with respect to skeletal changes. The study was prospective; 15 patients with AOB were evaluated before and after surgery. Lateral cephalometric x-ray parameters (facial angle, interincisal distance, Wits appraisal) were measured to determine skeletal changes. Before surgery, nine patients still had articulation disorders despite speech therapy during childhood. The voice quality parameters were determined by acoustic analysis of the vowel sound /a/ (fundamental frequency-F0, jitter, shimmer). Spectral analysis of vowels /a/, /e/, /i/, /o/, /u/ was carried out by determining the mean frequency of the first (F1) and second (F2) formants. Nasality in speech was expressed as the ratio between the nasal and the oral sound energies during speech samples. After surgery, normalizations of facial skeletal parameters were observed in all patients, but no statistically significant changes in articulation and voice quality parameters occurred despite subjective observations of easier articulation. Any deterioration in velopharyngeal insufficiency was absent in all of the patients. In conclusion, the surgical treatment of skeletal AOB does not lead to deterioration in voice, resonance and articulation qualities. Despite surgical correction of the unfavourable skeletal situation of the speech apparatus, the pre-existing articulation disorder cannot improve without professional intervention.

Describing the Relationship between Cat Bites and Human Depression Using Data from an Electronic Health Record

PubMed Central

Hanauer, David A.; Ramakrishnan, Naren; Seyfried, Lisa S.

2013-01-01

Data mining approaches have been increasingly applied to the electronic health record and have led to the discovery of numerous clinical associations. Recent data mining studies have suggested a potential association between cat bites and human depression. To explore this possible association in more detail we first used administrative diagnosis codes to identify patients with either depression or bites, drawn from a population of 1.3 million patients. We then conducted a manual chart review in the electronic health record of all patients with a code for a bite to accurately determine which were from cats or dogs. Overall there were 750 patients with cat bites, 1,108 with dog bites, and approximately 117,000 patients with depression. Depression was found in 41.3% of patients with cat bites and 28.7% of those with dog bites. Furthermore, 85.5% of those with both cat bites and depression were women, compared to 64.5% of those with dog bites and depression. The probability of a woman being diagnosed with depression at some point in her life if she presented to our health system with a cat bite was 47.0%, compared to 24.2% of men presenting with a similar bite. The high proportion of depression in patients who had cat bites, especially among women, suggests that screening for depression could be appropriate in patients who present to a clinical provider with a cat bite. Additionally, while no causative link is known to explain this association, there is growing evidence to suggest that the relationship between cats and human mental illness, such as depression, warrants further investigation. PMID:23936453

A new bite block for panoramic radiographs of anterior edentulous patients: A technical report.

PubMed

Park, Jong-Woong; Symkhampha, Khanthaly; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul

2015-06-01

Panoramic radiographs taken using conventional chin-support devices have often presented problems with positioning accuracy and reproducibility. The aim of this report was to propose a new bite block for panoramic radiographs of anterior edentulous patients that better addresses these two issues. A new panoramic radiography bite block similar to the bite block for dentulous patients was developed to enable proper positioning stability for edentulous patients. The new bite block was designed and implemented in light of previous studies. The height of the new bite block was 18 mm and to compensate for the horizontal edentulous space, its horizontal width was 7 mm. The panoramic radiographs using the new bite block were compared with those using the conventional chin-support device. Panoramic radiographs taken with the new bite block showed better stability and bilateral symmetry than those taken with the conventional chin-support device. Patients also showed less movement and more stable positioning during panoramic radiography with the new bite block. Conventional errors in panoramic radiographs of edentulous patients could be caused by unreliability of the chin-support device. The newly proposed bite block for panoramic radiographs of edentulous patients showed better reliability. Further study is required to evaluate the image quality and reproducibility of images with the new bite block.

Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

PubMed Central

Jacob, Helder Baldi; dos Santos-Pinto, Ary; Buschang, Peter H.

2014-01-01

Introduction Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. Methods The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). Results Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. Conclusions The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height. PMID:24713556

Innovation in prediction planning for anterior open bite correction.

PubMed

Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

2015-05-01

This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

Surgical management of cross-bites in orthognathic surgery: Surgically assisted rapid maxillary expansion (SARME) versus two-piece maxilla.

PubMed

Seeberger, Robin; Gander, Evelyn; Hoffmann, Jürgen; Engel, Michael

2015-09-01

The surgical treatment of cross-bites includes surgically-assisted maxillary expansion (SARME) or maxillary-bipartition during bimaxillary surgery. This study evaluates and compares the changes in the teeth and lower nasal passage, as well as the stability of the expansion. The measurements were performed on the cone-beam computed tomography (CBCT) scans of 32 patients with transverse (width) deficiencies of the maxilla. To expand the maxilla, 12 patients underwent the two-piece maxilla method, while 20 patients received SARME. The mean distraction width for SARME was 6.8 mm (SD 3.7), while that for the two-piece maxilla was 4.1 mm (SD 1.6). The expansion with SARME was over the entire length of the maxilla, from anterior to posterior, whereas the expansion of the two-piece patient group was only in the posterior part of the maxilla. The segments of the maxilla opened nearly parallel in SARME, while they were reverse V-shaped in the two-piece maxilla, from anterior to posterior. A key point in the planning of combined orthodontic-orthognathic therapy with surgical correction of a cross-bite is the precise determination of the area where the width needs to be increased, and the amount of correction needed to treat the patient using minimal surgical procedures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Camouflage treatment for class III malocclusion combined with traction of an impacted maxillary central incisor.

PubMed

Closs, Luciane Quadrado; Mundstock, Karina Santos; Ribeiro, Darlene Santos; Reston, Eduardo Galia; Silva, Aurelício Novaes

2010-01-01

This case report describes the treatment of a patient with an unerupted maxillary left central incisor, class III malocclusion with crossbite of the maxillary posterior teeth and lateral open bite. Treatment consisted of rapid maxillary expansion followed by anterior space opening, maxillary protraction and traction of the unerupted teeth with a light force system. Favorable results were obtained in terms of correcting incisor position and class III malocclusion. The results achieved remained stable throughout a 4-year retention period.

Resting position of the head and malocclusion in a group of patients with cerebral palsy

PubMed Central

Martinez-Mihi, Victoria; Orellana, Lorena M.; Silvestre-Rangil, Javier

2014-01-01

Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients. PMID:24596627

[Mandible function in taking construction bite for activator].

PubMed

Irie, M

1989-06-01

Functional effects of construction bite for activator (Andresen type) especially on lateral pterygoid muscle, as well as the positional changes of the mandible, hyoid bone and surface EMGs from bilateral anterior temporal (TA) and masseter (MM) muscle, were studied on the electric force scale, MKG, EMG and cephalometric radiographs in 14 subjects with anterior cross bite in mixed dentition. The cephalometric radiographs were taken at the start of each patient's treatment. One was taken with the mandible in the intercuspal position and one was also taken with the activator in the mouth at the overjet improvement. The activator patients were divided into two groups because of differences in the direction of movement of the hyoid bone in the FH plane. In group O (7 patients), the movement of the hyoid bone was at an oblique angle to the FH plane, while in group D (7 patients) the movement ot the hyoid bone with nearly direct below angle to FH plane. The patients were further divided into three types because of differences in the distance between the hyoid bone and mental spine, and combined with the groups OA (3 patients), OB (2 patients), OC (2 patients), DA (5 patients), DB (2 patients) and DC (Naught). The results obtained were as follows: The forces for the construction bite for groups O and D were 2.71 Kg and 2.72 kg, respectively. Type OC required significantly heavier force. (p less than 0.05) In the condylar test, O group was significantly smaller at the start of treatment, but not after overjet improvement. Type OA and OB were also significantly smaller at the start of treatment. (p less than 0.05) Velocity of opening for group D was significantly (p less than 0.05) faster at the start of treatment, but not after that. There was no significant difference in EMGs between the groups, with activator in the mouse D group much increased as it EMGs. The EMGs M/T ratio for both groups was approximately 100% at the start of treatment for overjet improvement. In cases with no or slight lateral shift in the recorded path of closure or in the incisal region, no large differences were recorded laterally. Large EMGs differences were recorded with lateral shift in the incisal region, especially when taking the construction bite.

Malocclusion of teeth

MedlinePlus

Crowded teeth; Misaligned teeth; Crossbite; Overbite; Underbite; Open bite ... Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). The upper teeth should fit slightly over the lower teeth. ...

Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint

PubMed Central

Scheffler, Nicole R.; Proffit, William R.; Phillips, Ceib

2015-01-01

Introduction Temporary skeletal anchorage devices now offer the possibility of closing anterior open bites and decreasing anterior face height by intruding maxillary posterior teeth, but data for treatment outcomes are lacking. This article presents outcomes and posttreatment changes for consecutive patients treated with a standardized technique. Methods The sample included 33 consecutive patients who had intrusion of maxillary posterior teeth with a maxillary occlusal splint and nickel-titanium coil springs to temporary anchorage devices in the zygomatic buttress area, buccal and apical to the maxillary molars. Of this group, 30 had adequate cephalograms available for the period of treatment, 27 had cephalograms including 1-year posttreatment, and 25 had cephalograms from 2 years or longer. Results During splint therapy, the mean molar intrusion was 2.3 mm. The mean decrease in anterior face height was 1.6 mm, less than expected because of a 0.6-mm mean eruption of the mandibular molars. During the postintrusion orthodontics, the mean change in maxillary molar position was a 0.2-mm extrusion, and there was a mean 0.5-mm increase in face height. Positive overbite was maintained in all patients, with a slight elongation (<2 mm) of the incisors contributing to this. During the 1 year of posttreatment retention, the mean changes were a further eruption of 0.5 mm of the maxillary molars, whereas the mandibular molars intruded by 0.6 mm, and there was a small decrease in anterior face height. Changes beyond 1 year posttreatment were small and attributable to growth rather than relapse in tooth positions. Conclusions Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior open bites, but 0.5 to 1.5 mm of reeruption of these teeth is likely to occur. Controlling the vertical position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height. PMID:25439210

Repeated Amblyomma testudinarium tick bites are associated with increased galactose-α-1,3-galactose carbohydrate IgE antibody levels: A retrospective cohort study in a single institution.

PubMed

Hashizume, Hideo; Fujiyama, Toshiharu; Umayahara, Takatsune; Kageyama, Reiko; Walls, Andrew F; Satoh, Takahiro

2018-06-01

Alpha-gal syndrome is a hypersensitivity reaction to red meat mediated by IgE antibody specific to galactose-α-1,3-galactose carbohydrate (alpha-gal). Amblyomma tick bites are associated with this condition, but the pathophysiology is not understood. To clarify the mechanism of development of alpha-gal syndrome after tick bites. We compared alpha-gal antibody levels between patients with and without a history of tick bites and examined histologic stainings of tick bite lesions between patients with and without detectable alpha-gal IgE antibody. Patients who had ≥2 tick bites had higher levels of alpha-gal IgE antibody compared with those with only 1 tick bite or healthy individuals. On histologic investigation, greater numbers of basophils and eosinophils, but not mast cells, were observed infiltrating lesions of patients with ≥2 tick bites compared with those with 1 tick bite. Type 2 cytokine-producing T-cell infiltration was predominantly observed in such patients. The study was conducted at a single institution in Japan. In Amblyomma tick bite lesions, basophils; eosinophils; and type 2, cytokine-producing T cells infiltrate the skin and alpha-gal IgE antibodies are produced. These findings provide a potential mechanistic connection between Amblyomma bites and red meat hypersensitivity. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The impact of snake bite on household economy in Bangladesh.

PubMed

Hasan, S M K; Basher, A; Molla, A A; Sultana, N K; Faiz, M A

2012-01-01

The present study aims to assess the different types of costs for treatment of snake bite patients, to quantify household economic impact and to understand the coping mechanisms required to cover the costs for snake bite patients in Bangladesh. The patients admitted to four tertiary level hospitals in Bangladesh were interviewed using structured questionnaires including health-care-related expenditures and the way in which the expenditures were covered. Of the snakes which bit the patients, 54.2% were non-venomous, 45.8% were venomous and 42.2% of the patients were given polyvalent antivenom. The total expenditure related to snake bite varies from US$4 (US$1 = Taka 72) to US$2294 with a mean of US$124 and the mean income loss was US$93. Expenditure for venomous snake bite was US$231, which is about seven times higher than non-venomous snake bite (US$34). The treatment imposes a major economic burden on affected families, especially in venomous snake bite cases.

Posterior Open Bite Due to Failure of Maxillary Molar Eruption.

PubMed

Yasumura, Toshihiko; Sueishi, Kenji

2016-01-01

Posterior open bite can cause problems with occlusion. It arises from systemic or local factors such as physical or functional interference, ankylosis, and failure of eruption. Primary failure of eruption (PFE) is a rare condition that is difficult to differentiate from ankylosis and requires complex treatment strategies. Here we report a 12-year-old girl who was referred to our hospital by her dentist for re-evaluation of eruption failure of the left maxillary secondary premolar and first and second molars with congenitally missing maxillary lateral teeth. The maxillary first molar was extracted for a therapeutic diagnosis. The left maxillary secondary premolar and second molar reacted well to subsequent orthodontic treatment. Auto-transplantation of the mandibular premolar to the maxil-lary arch was carried out to achieve optimal overjet, overbite, and occlusion. The active treatment period spanned 4 years and 1 month. Assessment of the patient's medical and dental history, prior trauma, and clinical conditions resulted in a therapeutic diagnosis of PFE. Satisfactory orthodontic treatment results were achieved.

Long-term stability of soft tissue changes in anterior open bite adults treated with zygomatic miniplate-anchored maxillary posterior intrusion.

PubMed

Marzouk, Eiman S; Kassem, Hassan E

2018-03-01

To evaluate soft tissue changes and their long-term stability in skeletal anterior open bite adults treated by maxillary posterior teeth intrusion using zygomatic miniplates and premolar extractions. Lateral cephalograms of 26 patients were taken at pretreatment (T1), posttreatment (T2), 1 year posttreatment (T3), and 4 years posttreatment (T4). At the end of treatment, the soft tissue facial height and profile convexity were reduced. The lips increased in length and thickness, with backward movement of the upper lip and forward movement of the lower lip. The total relapse rate ranged from 20.2% to 31.1%. At 4 years posttreatment, 68.9% to 79.8% of the soft tissue treatment effects were stable. The changes in the first year posttreatment accounted for approximately 70% of the total relapse. Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.

Nonhealing Wounds Caused by Brown Spider Bites: Application of Hyperbaric Oxygen Therapy.

PubMed

Hadanny, Amir; Fishlev, Gregory; Bechor, Yair; Meir, Oshra; Efrati, Shai

2016-12-01

Bites by Loxosceles spiders (also known as recluse spiders or brown spiders) can cause necrotic ulcerations of various sizes and dimensions. The current standard of care for brown spider bites includes analgesics, ice, compression, elevation, antihistamines, and surgical debridement. Hyperbaric oxygen therapy (HBOT) in the treatment of brown spider bites has been administered in the early stage of ulceration, or 2 to 6 days after the bite. Unfortunately, the diagnosis of spider bite-related ulcers is often delayed and weeks or months may elapse before HBOT is considered. To evaluate the effect of HBOT on nonhealing wounds caused by brown spider bites in the late, chronic, nonhealing stage. Analysis of 3 patients with brown spider-bite healing wounds treated at The Sagol Center for Hyperbaric Medicine and Research in Israel. Patients presented 2 to 3 months after failure of other therapies including topical dressings, antibiotics, and corticosteroids. All patients were treated with daily 2 ATA (atmospheres absolute) with 100% oxygen HBOT sessions. All 3 patients were previously healthy without any chronic disease. Their ages were 30, 42, and 73 years. They were treated once daily for 13, 17, and 31 sessions, respectively. The wounds of all 3 patients healed, and there was no need for additional surgical intervention. There were no significant adverse events in any of the patients. Microvascular injury related to brown spider bites may culminate in ischemic nonhealing wounds even in a relatively young, healthy population. Hyperbaric oxygen therapy should be considered as a valuable therapeutic tool even months after the bite.

Clinical Features and Outcomes of Pasteurella multocida Infection

PubMed Central

Giordano, Antonio; Dincman, Toros; Clyburn, Benjamin E.; Steed, Lisa L.; Rockey, Don C.

2015-01-01

Abstract Pasteurella multocida, a zoonotic infectious organism, has most often been described in patients after an animal bite. Here, we characterize the clinical features and outcomes of P multocida infection in a large cohort of patients according to the presence or absence of an animal bite. We retrospectively searched MUSC's laboratory information system for all patients with positive P multocida cultures from 2000 to 2014. Extensive data were abstracted, including clinical and outcome data. The Charlson comorbidity index (CCI) was used to assess comorbidities among patients. We identified 44 patients with P multocida infections, including 25 with an animal bite. The average age was 64 years and the majority of patients were women (N = 30). There was no difference in age and sex distribution among those with and without a bite (P = 0.38 and 0.75, respectively). A CCI ≥1 was significantly associated with the absence of a bite (P = 0.006). Patients presenting without a bite were more frequently bacteremic (37% vs 4%, respectively, P = 0.001), and were hospitalized more often (84% vs 44%, respectively, P = 0.012). Of the 8 patients who required intensive care unit (ICU)-based care, 7 were non-bite-related. There were 4 deaths, all occurring in patients not bitten. P multocida infections not associated with an animal bite were often associated with bacteremia, severe comorbidity(ies), immune-incompetent states, the need for ICU management, and were associated with substantial mortality. PMID:26356688

[Features of facioscapulohumeral muscular dystrophy in oral and maxillofacial region and MRI analysis of facial muscles].

PubMed

Liu, Y H; Ma, Y X; Hu, J; Gao, G D; Wu, Y K; Zhang, Z Y

2016-12-09

Objective: To investigate the manifestation of facioscapulohumeral muscular dystrophy (FSHD) in oral and maxillofacial region. Methods: A total of 12 patients diagnosed as FSHD and 20 healthy volunteers were included in the study. Their medical history was collected from these patients. The decayed missing filled teeth (DMFT), calculus index-simplified (CI-S), occlusal relationship, maximal opening of mouth and maximum bite force were recorded. The impressions were taken to measure the maximal hight of palate and the width of palate. The lateral cephalometric radiographs were also taken to measure the mandibular plane-frankfurt horizontal plane angle (MP-FH). They finally received oral and maxillofacial region MRI examination to observe the masseter muscle, medial pterygoid muscle and lateral pterygoid muscle. The data were analyzed by t -test or Wilcoxon signed ranks test. Results: There was no significant gender difference in FSHD group. The average age of treatment was (27.5 ± 8.1) years and the average age of onset was (15.7±7.5) years. Nine patients liked to eat soft foods, 4 patients had difficulties of closing eyes, 8 patients had difficulties of cheek-bulging, 10 patients showed pouty lips and 9 patients had mesio-malocclusion. DMFT (4.0±2.3), CI-S (5.8±2.1), male maximal hight of palate (20.5±2.1) mm , female maximal hight of palate (17.9±1.6) mm, MP-FH (31.8°±2.2°) of FSHD group were greater than those of the control group. Male width of palate (34.8±1.4) mm, female width of palate (33.7±1.5) mm, male maximum bite force (451.7 ± 39.0) N, female maximum bite force (326.7 ± 21.6) N, maximal opening of mouth (3.5 ± 0.4) cm of FSHD group were less than those of the control group ( P <0.05). Maxillofacial MRI showed muscle asymmetr in 11 cases of masseter and 6 cases of medial pterygoid muscle, 5 cases of lateral pterygoid, and these muscle showed mild fatty infiltration mainly concentrating in the grade 0, grade 1 and grade 2. Conclusions: The FSHD patients have poor oral hygiene, low masticatory function, limited mouth opening, high palate and narrow arch and different degree of malocclusion. The patients' masseter muscle, medial pterygoid muscles and lateral pterygoid muscles exhibit asymmetrical atrophy and fatty infiltration.

Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry.

PubMed

Spyres, Meghan B; Ruha, Anne-Michelle; Seifert, Steven; Onisko, Nancy; Padilla-Jones, Angela; Smith, Eric Anthony

2016-12-01

In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR). This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management. Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2-19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication. The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations.

Pharyngeal airway space and frontal and sphenoid sinus changes after maxillomandibular advancement with counterclockwise rotation for class II anterior open bite malocclusions

PubMed Central

Prado, FB; Rossi, AC; Freire, AR; Groppo, FC; De Moraes, M; Caria, PHF

2012-01-01

Objectives The purpose of this study was to cephalometrically evaluate the pharyngeal airway space and frontal and sphenoid sinus changes after maxillomandibular advancement counterclockwise rotation for class II anterior open bite malocclusion. Methods The study included 49 patients (98 lateral teleradiographs; 36 females and 13 males) who were analysed in the pre-operative (1 week before surgery) and post-operative (6 months after surgery) periods. In each lateral teleradiography, the dimensions of the inferior and superior pharyngeal airway space, TB-PhW1 [the point between the posterior aspect of the tongue to the dorsal pharyngeal wall (oropharynx) (TB) and the point on the dorsal pharyngeal wall closest to TB (PhW1)] and UP-PhW2 [and the point between the posterior aspect of the soft palate to the dorsal pharyngeal wall (nasopharynx) (UP) (PhW2)] measurements were evaluated, as well as the dimensions of the frontal and sphenoid sinuses. The differences between the two operative times were evaluated by Student's t-test. Results All measurements showed excellent reproducibility for the intraclass correlation coefficient (ICC > 0.9; p < 0.0001). There was an increase in the measurements TB-PhW1 and UP-PhW2 and a decrease in the dimensions of the frontal and sphenoid sinuses after orthognathic surgery. Conclusions The morphology of the superior and inferior pharyngeal airway space and frontal and sphenoid sinuses changes after 6 months of maxillomandibular advancement counterclockwise rotation for class II anterior open bite malocclusion. PMID:22116128

Fight Bite Injuries: Aggressive Tendencies Associated with Smaller Second to Fourth Digit Ratio.

PubMed

Joyce, Cormac W; O' Regan, Andrew; Kelly, Jack L; O' Shaughnessy, Michael

2017-12-01

Fight bite injuries are typically sustained by young, combative males and are the direct consequence of an aggressive act. Second to fourth digit ratios (2D:4D) are dependent on prenatal androgen exposure and lower ratios have been shown to be linked to various psychological and physical traits, including aggression. The aim of this study was to examine the 2D:4D ratios in a cohort of patients with fight bite injuries and compare these to an age and gender-matched control group. The 2D:4D ratios were calculated using plain films of the hand from 133 patients (122 males, 11 females) with fight bite injuries. A further 133 radiographs were obtained from patients that did not have fight bite injuries and digit ratios were calculated in the same fashion. Statistical analysis was then carried out to compare the 2D:4D ratios between the different groups. The 2D:4D ratios for male fight bite patients was significantly smaller than the male control group (p < 0.05). No significant difference was observed between the female fight bite patients and the female control group (p > 0.05). Fight bite injuries are usually sustained as a result of aggression. 2D:4D ratios are reflect intrauterine androgen exposure and low ratios have been linked to aggressive tendencies. We have demonstrated that male patients who sustained fight bite injuries have a lower 2D:4D ratio then the general population, thereby suggesting that exposure to prenatal androgens can lead to aggressive tendencies in adulthood. This suggests that lower ratios may predict a predisposition to acts of aggression, and as such result in an increased likelihood of sustaining an injury such as a fight bite.

Changes of oral sensibility in subjects with partial anterior open bite and the incorrect position of the tongue.

PubMed

Koczorowski, Maciej; Gedrange, Tomasz; Koczorowski, Ryszard

2012-03-20

Neuromuscular disorders lead to an imbalance in the position of the jaw. The aim of this study has been to analyse gnostic sensibility in subjects with partial anterior open bite and the incorrect position of the tongue. The study involved 20 subjects with partial anterior open bite and an incorrect tongue position. The control group consisted of 20 individuals with correct occlusion and tongue position. The basic study method was a stereognostic examination using 4 silicon shapes - a square, triangle, circle and semicircle. The accuracy of shape identification and the time that the subjects needed to identify the shapes were analysed before and after the tip of the tongue was anaesthetized. Results showed that correct identification of the shapes was 7.4% worse in the study group than in the control group and that the difference was greatest when the tip of the tongue was anaesthetized - 28.8%. The time needed to identify the shapes was shorter in the study group than in the control group. The results indicate that people with partial anterior open bite and incorrect tongue position exhibit impaired gnostic sensibility, especially at the tip of the tongue. Impaired gnostic sensibility, which is a symptom of the disturbed sensomotoric correlation of the tongue, leads to the tongue's incorrect position in the process of swallowing and speaking. Copyright © 2011 Elsevier GmbH. All rights reserved.

Analysis of primary gingivoperiosteoplasty in alveolar cleft repair. Part I: Facial growth.

PubMed

Henkel, K O; Gundlach, K K

1997-10-01

The primary gingivoperiosteoplasty by Millard consists of presurgical active orthognathic treatment ('Latham device') of the alveolar margins at the age of 3 months and of surgical closure of the alveolar cleft with local gingivoperiosteal flaps at the age of 5 months. The aim of this investigation was to analyse the facial growth following this treatment. The following material was studied: lateral head X-rays and plaster casts from 146 patients with unilateral (UCLP) and bilateral (BCLP) clefts of lip and palate from birth to 16 years of age. Ninety-one of these patients formed the control group, who received neither gingivoperiosteoplasty nor pre-surgical active orthognathic treatment. The same surgeon and orthodontist treated all 146 patients. A three-dimensional growth disturbance after gingivoperiosteoplasty was observed: 42% patients with UCLP and 40% patients with BCLP had an 'open bite' following closure of the alveolar cleft (control group 5%/10%). The length of the upper jaw in patients who underwent gingivoperiosteoplasty was shorter than in the control group. The frequency of posterior cross bite was also higher in the gingivoperiosteoplasty group. These results demonstrate that treatment with a 'Latham device' disturbs facial growth. Therefore, this treatment should be abandoned.

Tick-host conflict: immunoglobulin E antibodies to tick proteins in patients with anaphylaxis to tick bite

PubMed Central

Mateos-Hernández, Lourdes; Villar, Margarita; Moral, Angel; GarcíaRodríguez, Carmen; Arias, Teresa Alfaya; de la Osa, Verónica; Brito, Francisco Feo; Fernández de Mera, Isabel G.; Alberdi, Pilar; Ruiz-Fons, Francisco; Cabezas-Cruz, Alejandro; Estrada-Peña, Agustín; de la Fuente, José

2017-01-01

Tick-borne infectious diseases and allergies are a growing problem worldwide. Tick bite allergy has been associated with the direct effect of immunoglobulin E (IgE) response to tick salivary antigens, or secondary to the induction of allergy to red meat consumption through IgE antibodies against the carbohydrate α-Gal (Gal α 1-3Gal β 1-(3)4GlcNAc-R). However, despite the growing burden of this pathology, the proteins associated with anaphylaxis to tick bite have not been characterized. To address this question, a comparative proteomics approach was used to characterize tick proteins producing an IgE antibody response in a healthy individual with record of tick bites, which had not resulted in any allergic reactions, and two patients with anaphylactic reactions to Rhipicephalus bursa or Hyalomma marginatum tick bites. Both patients and the healthy individual were red meat tolerant. The results supported a patient-specific IgE antibody response to tick species responsible for the anaphylaxis to tick bite. Both patients and the healthy individual serologically recognized tick proteins with and without α-Gal modifications, with proteins differentially recognized by patients but not control sera. These proteins could be used as potential antigens for diagnostics, treatment and prevention of tick bite-induced allergies. PMID:28423486

An Algorithmic Approach to Operative Management of Complex Pediatric Dog Bites: 3-Year Review of a Level I Regional Referral Pediatric Trauma Hospital

PubMed Central

Shayesteh, Ali; Xu, Min Li

2017-01-01

Background: Incidence of dog bites continues to rise among the pediatric population and serves as a public health threat for the well-being of children. Plastic surgeons are at the forefront of initial management and eventual outcome of these devastating injuries. This study set out to determine the nature of dog bite injuries treated over a 3-year period at a large level 1 pediatric trauma center. Methods: A retrospective review of emergency room records of all pediatric patients (age, 0–18 years old) who sustained dog bites between January 2012 and December 2014 were gathered. All details about age of patient, location and severity of dog bites, type of dog breed, antibiotics given, and emergency versus operative treatment were recorded and analyzed. Results: One hundred eight patients aged 5 months to 18 years old were treated in the emergency department after suffering dog bite injuries during the study period. The highest incidence of dog bites occurred in preschool children. The mean age for patients who required operative repair was lower than the mean age for patients who underwent primary closure in the emergency department. The location of injury was most commonly isolated to the head/neck region. Of the 56 cases that had an identified dog breed, pit bulls accounted for 48.2% of the dog bites, and 47.8% of pit bull bites required intervention in the operating room. Conclusion: Children with large dog bite injuries require more immediate care in a level 1 pediatric trauma hospitals in order to optimize their hospitalization course and eventual outcome. PMID:29184724

Frameless stereotactic radiosurgery with a bite-plate: our experience with brain metastases.

PubMed

Furuse, M; Aoki, T; Takagi, T; Takahashi, J A; Ishikawa, M

2008-12-01

Non-invasive frameless stereotactic radiosurgical systems have recently been developed. We report our experience of frameless stereotactic radiosurgery (SRS) with a bite-plate for brain metastases. Between February 2002 and December 2005, 147 patients with brain metastases were treated with C-arm linear accelerator-based SRS and 122 patients were followed up by our institute. An optic tracking system with infrared light-emitting diodes was used for real-time monitoring. A bite-plate with fiducial markers was applied as a first-line method for frameless SRS. Head-ring fixation was used in patients lacking teeth. Lung carcinomas (63%) were the most common primary tumors, followed by breast carcinomas (13%). Ninety patients underwent radiosurgery with a bite-plate and 32 patients underwent fixation of a head ring. Males were significantly more predominant in the head-ring group (26 men and 6 women), compared with the bite-plate group (47 men and 43 women, p < 0.01). The average age (62 years) in the bite-plate group was significantly younger than that (68 years) in the head-ring group (p < 0.01). The median survival time was 12.0 months in the bite-plate group and 8.0 months in the head-ring group (p = 0.0621). Nine patients who had brain metastases in or close to the brain stem were treated with fractionated stereotactic radiotherapy. The frameless stereotactic radiosurgical system with a bite-plate is safe and effective for the treatment of brain metastasis. Elderly male patients sometimes are edentulous and require placement of a head ring for radiosurgery.

Clinical Features of Idiopathic Parotid Pain Triggered by the First Bite in Japanese Patients with Type 2 Diabetes: A Case Study of Nine Patients.

PubMed

Chiba, Masatoshi; Hirotani, Hiroaki; Takahashi, Tetsu

2018-01-01

First bite syndrome, characterized by pain in the parotid region after the first bite of each meal, predominantly develops in patients who have had head and neck surgery. Idiopathic parotid pain (IPP) that mimics first bite syndrome may present in patients without a history of surgery or evidence of an underlying tumor, but its clinical features are unclear. This study characterized the clinical characteristics of IPP in patients with diabetes. A retrospective case review involving the clinical findings and pain characteristics of nine patients with IPP and diabetes who presented to our department between 2013 and 2016. All the patients were men diagnosed with type 2 diabetes (median age, 43 years). IPP developed unilaterally in seven patients and bilaterally in two. The median intensity of the first bite pain was 8 on a numerical rating scale of 0-10. The trigger factor was gustatory stimuli, and the trigger area was the posterior section of the tongue. Postprandial pain occurred within 1-10 min after meals in six patients. IPP may be considered a separate disorder, in which the pain characteristics are similar to those of first bite syndrome but the clinical features and pathophysiology are different.

Clinical Features of Idiopathic Parotid Pain Triggered by the First Bite in Japanese Patients with Type 2 Diabetes: A Case Study of Nine Patients

PubMed Central

Hirotani, Hiroaki; Takahashi, Tetsu

2018-01-01

Objective First bite syndrome, characterized by pain in the parotid region after the first bite of each meal, predominantly develops in patients who have had head and neck surgery. Idiopathic parotid pain (IPP) that mimics first bite syndrome may present in patients without a history of surgery or evidence of an underlying tumor, but its clinical features are unclear. This study characterized the clinical characteristics of IPP in patients with diabetes. Study Design A retrospective case review involving the clinical findings and pain characteristics of nine patients with IPP and diabetes who presented to our department between 2013 and 2016. Results All the patients were men diagnosed with type 2 diabetes (median age, 43 years). IPP developed unilaterally in seven patients and bilaterally in two. The median intensity of the first bite pain was 8 on a numerical rating scale of 0–10. The trigger factor was gustatory stimuli, and the trigger area was the posterior section of the tongue. Postprandial pain occurred within 1–10 min after meals in six patients. Conclusions IPP may be considered a separate disorder, in which the pain characteristics are similar to those of first bite syndrome but the clinical features and pathophysiology are different. PMID:29796314

Epidemiological characteristics, hospital course and outcome of snakebite victims in West Texas.

PubMed

Abbey, James M; Jaffar, Nabil A; Abugrara, Hazem L; Nazim, Muhammad; Smalligan, Roger D; Khasawneh, Faisal A

2015-01-01

Numerous snakebites are reported every spring and summer in the United States especially in the Southwestern part of the country. This is usually associated with significant morbidity but fatalities are rare. Most victims are male and the majority of bites are on the extremities. A search for all cases coded with a discharge diagnosis of snakebite injury revealed 90 patients admitted to Northwest Texas Hospital, the trauma center in Amarillo, Texas, between January 2002 and December 2012. These charts were retrospectively reviewed and data extracted including patient demographics, severity of snakebite, treatment given, and ultimate outcome. Ninety patients were admitted to the hospital due to snakebite. It was a rattlesnake in 83 cases. The mean age of the victims was 29.7 years and 74 of them were male. Fifty-one bites were on the upper extremities, thirty-eight bites were on the lower extremities and one bite was on the abdominal wall. About 95% of the lower extremity bites were moderate or severe compared to 74.5% of the upper extremity bites, Cramer's coefficient 0.3, p=0.02. Thirty-one patients had complications and twenty patients required surgical intervention. Eighty-eight patients received a median of 10 vials of antivenin that was well tolerated. Median hospital length of stay was 3 days. None of the patients died. Rattlesnake bites cause significant morbidity although mortality is rare. Early administration of antivenin and appropriate supportive measures and monitoring for complications with surgical intervention when needed leads to improved patient outcomes.

Mosquito bite anaphylaxis: immunotherapy with whole body extracts.

PubMed

McCormack, D R; Salata, K F; Hershey, J N; Carpenter, G B; Engler, R J

1995-01-01

Adverse reactions to mosquito bites have been recognized for some time. These usually consist of large local swellings and redness, generalized urticaria, angioedema and less easily definable responses such as nausea, dizziness, headaches, and lethargy. We report two patients who experienced systemic anaphylaxis from mosquito bites. Both were skin tested and given immunotherapy using whole body mosquito extracts. Skin testing using whole body mosquito extracts was positive to Aedes aegypti at 1/1,000 weight/volume (wt/vol) in one patient and to Aedes aegypti at 1/100,000 wt/vol, and Culex pipiens at 1/10,000 wt/vol in the other. Skin testing of ten volunteers without a history of adverse reactions to mosquito bites was negative. Immunotherapy using these extracts resulted in resolution of adverse reactions to mosquito bites in one patient and a decrease in reactions in the other. Immunotherapy with whole body mosquito extracts is a viable treatment option that can play a role in patients with mosquito bite-induced anaphylaxis. It may also result in severe side effects and one must determine the benefit versus risks for each individual patient.

Prospective audit of 106 consecutive human bite injuries: the importance of history taking

PubMed Central

Wallace, C; Robertson, C

2005-01-01

Methods: Patients with cutaneous wounds who did not present with a history of human bite were asked a follow up question. Those who then gave a history of human bite were noted. Results: Certain groups of patients with human bites were significantly more likely to provide a factitious history and/or delay presentation. Conclusion: Follow up questioning dramatically increased the case-detection rate, prompting specific management. PMID:16299201

Orthodontic treatment of severe anterior open bite and alveolar bone defect complicated by an ankylosed maxillary central incisor: a case report.

PubMed

Lin, Feiou; Sun, Hao; Yao, Linjie; Chen, Qiushuo; Ni, Zhenyu

2014-11-21

Incisor trauma is common in children, and can cause severe complications during adolescent growth and development. This report describes the treatment of a 16-year-old patient with severe anterior open bite due to ankylosis of the maxillary left incisor after dental trauma as an 8-year-old. No examination or active treatment was undertaken until he was 16 years old. Clinical examination revealed that the maxillary left incisor was severely intruded accompanied by a vertical alveolar bone defect. Orthodontic treatment combined with surgical luxation took 3 years and 7 months. During treatment, the intruded incisor was moved to the occlusal level and the alveolar bone defect was restored, achieving normal occlusion. After two years of retention, the maxillary left incisor was retained in a stable normal position with a slightly reduced overbite. This case demonstrates that surgical luxation with orthodontic traction can be an effective approach, especially when the ankylosed tooth has a single root. Long-term monitoring of orthodontic stability and the maintenance of periodontal health are crucial in the post-treatment period.

Class II malocclusion with complex problems treated with a novel combination of lingual orthodontic appliances and lingual arches.

PubMed

Yanagita, Takeshi; Nakamura, Masahiro; Kawanabe, Noriaki; Yamashiro, Takashi

2014-07-01

This case report describes a novel method of combining lingual appliances and lingual arches to control horizontal problems. The patient, who was 25 years of age at her first visit to our hospital with a chief complaint of crooked anterior teeth, was diagnosed with skeletal Class II and Angle Class II malocclusion with anterior deep bite, lateral open bite, premolar crossbite, and severe crowding in both arches. She was treated with premolar extractions and temporary anchorage devices. Conventionally, it is ideal to use labial brackets simultaneously with appliances, such as a lingual arch, a quad-helix, or a rapid expansion appliance, in patients with complex problems requiring horizontal, anteroposterior, and vertical control; however, this patient strongly requested orthodontic treatment with lingual appliances. A limitation of lingual appliances is that they cannot be used with other conventional appliances. In this report, we present the successful orthodontic treatment of a complex problem using modified lingual appliances that enabled combined use of a conventional lingual arch. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The management of bite wounds in children--a retrospective analysis at a level I trauma centre.

PubMed

Jaindl, Manuela; Grünauer, Judith; Platzer, Patrick; Endler, Georg; Thallinger, Christiane; Leitgeb, Johannes; Kovar, Florian M

2012-12-01

Animal bite wounds are a significant problem, which have caused several preventable child deaths in clinical practice in the past. The majority of bite wounds is caused by dogs and cats, and also humans have to be considered to lead to those extreme complicated diagnosis in the paediatric patient population. Early estimation of infection risk, adequate antibiotic therapy and, if indicated, surgical treatment, are cornerstones of successful cures of bite wounds. However, antibiotic prophylaxis and wound management are discussed controversially in the current literature. In our study, we retrospectively investigated the bite source, infection risk and treatment options of paediatric bite wounds. A total of 1592 paediatric trauma patients were analysed over a period of 19 years in this retrospective study at a level I trauma centre, Department of Trauma Surgery, Medical University of Vienna, Austria. Data for this study were obtained from our electronic patient records and follow-up visits. In our database, all paediatric patients triaged to our major urban trauma centre have been entered retrospectively. During the 19-year study period, 1592 paediatric trauma patients met the inclusion criteria. The mean age was 7.7 years (range 0-18.9), 878 (55.2%) were males and 714 (44.8%) were females. In our study population, a total of 698 dog bites (43.8%), 694 human bites (43.6%), 138 other bites (8.7%) and 62 cat bites (3.9%) have been observed. A total of 171 wounds (10.7%) have been infected. Surgical intervention was done in 27 wounds (1.7%). Gender-related incidence in bite wounds for dog and cat could be detected. Second, our findings for originator of bite wounds reflect the findings in the published literature. Total infection rate reached 10.7%, primary antibiotic therapy was administered in 221 cases (13.9%) and secondary antibiotic therapy in 20 (1.3%) cases. Observed infection rate of punctured wounds and wounds greater than 3 cm was 3 times higher than for all other wounds. Our findings need to be proven in further prospective clinical trials. Copyright © 2012 Elsevier Ltd. All rights reserved.

Bite wounds and antibiotic prescription among patients presenting to an Australian emergency department.

PubMed

Birdsey, Matthew; Edwards, Gail; Abetz, Jeremy; Jennings, Natasha; Mitra, Biswadev

2016-07-01

Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014. An explicit chart review was conducted to determine management of each case. Cases were subgrouped into high- and low-risk groups as defined by the Australian Therapeutic Guidelines for animal bites. There were 160 cases of mammalian bite wounds included, with 143 (89.4%) patients grouped as high-risk and 17 (10.6%) patients identified as low-risk. High-risk features were delayed presentation > 8 hours (57 patients, 35.6%), bites to the head, hand or face (113 patients, 70.6%), and puncture wounds unable to be adequately debrided (74 patients, 46.3%). There was a significant association with delayed presentation of more than eight hours and clinically established infection [OR 36.2; 95% CI: 12.6-103.6; P < 0.001]. Prescriptions for antibiotics that adhered to current guidelines occurred in 99 (61.9%) cases. This study highlights variability in antibiotic prescription practice among clinicians and the need for ongoing education on antibiotic stewardship. Intervention strategies, including ongoing education, are indicated to improve adherence to antibiotic guidelines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary closure versus non-closure of dog bite wounds. a randomised controlled trial.

PubMed

Paschos, Nikolaos K; Makris, Eleftherios A; Gantsos, Apostolos; Georgoulis, Anastasios D

2014-01-01

Dog bite wounds represent a major health problem. Despite their importance, their management and especially the role of primary closure remain controversial. In this randomised controlled trial, the outcome between primary suturing and non-closure was compared. 168 consecutive patients with dog bite injuries were included in this study. The wounds were allocated randomly in two treatment approaches: Group 1, consisting of eighty-two patients, had their wound sutured, whilst Group 2, consisting of eighty-six patients, did not have their wounds sutured. All wounds were cleansed using high-pressure irrigation and povidone iodine. All patients received the same type of antibiotic treatment. Our measured outcomes included presence of infection and cosmetic appearance. Cosmetic outcome was evaluated using the Vancouver Scar Scale (VSS). Wound and patient characteristics, such as time of management, wound location and size, and patient age, were recorded and analysed for their potential role in the resulting outcome. The overall infection rate was 8.3%. No difference in the infection rate between primary suturing and non-suturing group was detected in the present study. The cosmetic appearance of the sutured wounds was significantly better (mean score 1.74) compared to the wounds that were left open (mean score 3.05) (p=0.0001). The infection rate was comparable among all age groups. Wounds treated within 8h of injury demonstrated an infection rate of 4.5%, which is lower compared to the 22.2% rate observed in wounds treated later than 8h. The wounds located at the head and neck exhibited better results in both infection rate and cosmetic outcome. Additionally, wounds >3 cm negatively affected the cosmetic appearance of the outcome. Primary suturing of wounds caused by dog bites resulted in similar infection rate compared to non-suturing. However, primary suturing exhibited improved cosmetic appearance. Time of management appeared to be critical, as early treatment resulted in lower infection rate and improved cosmetic appearance regardless suturing or not. Furthermore, wounds located at the head and face demonstrated better results. Copyright © 2013 Elsevier Ltd. All rights reserved.

Helical tomotherapy setup variations in canine nasal tumor patients immobilized with a bite block.

PubMed

Kubicek, Lyndsay N; Seo, Songwon; Chappell, Richard J; Jeraj, Robert; Forrest, Lisa J

2012-01-01

The purpose of our study was to compare setup variation in four degrees of freedom (vertical, longitudinal, lateral, and roll) between canine nasal tumor patients immobilized with a mattress and bite block, versus a mattress alone. Our secondary aim was to define a clinical target volume (CTV) to planning target volume (PTV) expansion margin based on our mean systematic error values associated with nasal tumor patients immobilized by a mattress and bite block. We evaluated six parameters for setup corrections: systematic error, random error, patient-patient variation in systematic errors, the magnitude of patient-specific random errors (root mean square [RMS]), distance error, and the variation of setup corrections from zero shift. The variations in all parameters were statistically smaller in the group immobilized by a mattress and bite block. The mean setup corrections in the mattress and bite block group ranged from 0.91 mm to 1.59 mm for the translational errors and 0.5°. Although most veterinary radiation facilities do not have access to Image-guided radiotherapy (IGRT), we identified a need for more rigid fixation, established the value of adding IGRT to veterinary radiation therapy, and define the CTV-PTV setup error margin for canine nasal tumor patients immobilized in a mattress and bite block. © 2012 Veterinary Radiology & Ultrasound.

Patients' and therapists' experiences of general change mechanisms during bug-in-the-eye and delayed video-based supervised cognitive-behavioral therapy. A randomized controlled trial.

PubMed

Probst, Thomas; Jakob, Marion; Kaufmann, Yvonne M; Müller-Neng, Julia M B; Bohus, Martin; Weck, Florian

2018-04-01

This secondary analysis of a randomized controlled trial investigated whether bug-in-the-eye (BITE) supervision (live computer-based supervision during a psychotherapy session) affects the manner in which patients and therapists experience general change mechanisms (GCMs) during cognitive-behavioral therapy (CBT). A total of 23 therapists were randomized either to the BITE condition or the control condition (delayed video-based [DVB] supervision). After each session, both patients (BITE: n = 19; DVB: n = 23) and therapists (BITE: n = 11; DVB: n = 12) completed the Helping Alliance Questionnaire (HAQ) and the Bernese Post Session Report (BPSR). The HAQ total score and the 3 secondary factors of the BPSR (interpersonal experiences, intrapersonal experiences, problem actuation) functioned as GCMs. Multilevel models were performed. For patients, GCMs did not develop differently between BITE and DVB during CBT. Therapists rated the alliance as well as interpersonal and intrapersonal experiences not significantly different between BITE and DVB during CBT, but they perceived problem actuation to increase significantly more in BITE than in DVB (p < .05). BITE supervision might be helpful in encouraging CBT therapists to apply interventions, which focus on the activation of relevant problems and related emotions. © 2017 Wiley Periodicals, Inc.

Retrospective analysis of snake victims in Northern India admitted in a tertiary level institute

PubMed Central

Ahmed, Syed Moied; Nadeem, Abu; Islam, Mohd. Sabihul; Agarwal, Shiwani; Singh, Lalit

2012-01-01

Context: Snake bites are the common cause of morbidity and mortality in tropical countries. Aims: To analyze the outcome of snake bite victims Settings and Design: Retrospective analysis of data from Intensive care unit, Department of Anesthesiology. Materials and Methods: All the patients admitted in the intensive care unit for snake bite management during the year May 2004 - April 2009 were retrospectively reviewed. The data included age, sex, month and time of incident, site of bite, dose of anti--snake venom, time of anti--snake venom, administration, duration of mechanical ventilation, complications and death of a victim. Statistical analysis used: Pearson's correlation test, paired samples t-test. Results and Conclusions: 113 patients reported to the Accident and Emergency with history of snake bite. 26 patients were referred to other hospital, 17 patients were brought dead, and 70 patients were admitted to the intensive care unit. In 59 snake-bite victims, maximum data could be recovered. Krait was the most common type of snake bite reported. There was a male preponderance (69.4%) with age ranging between 20 and 40 years (52.5%). The mean lag time (time elapsed between bite and first dose of anti--snake venom) was 5.3 ± 1.4 h and the mean anti-snake venom dose was 12.3 ± 2.4 vials. There was a positive and significant correlation between lag time and total dose of anti--snake venom (correlation coefficient =0.956, P<0.0001). Overall 72.9% patients required mechanical ventilation with a mean duration of 56.2 ± 16.1 h. 10.2% patients sustained cardiac arrest, 8.7% patients developed ventilator associated pneumonia, 6.7% suffered mild anti-snake venom reaction, 6.7% had hypotension and 5.1% patients developed renal failure. The overall mortality was 5.1%. PMID:22345945

Phantom bite: a real or a phantom diagnosis? A case report.

PubMed

Sutter, Ben A

2017-01-01

This case report describes computer-guided occlusal therapy in a patient who met the unified diagnostic criteria for phantom bite. After a review of the patient's medical history, along with a diagnostic work-up that included cone beam computed tomography, temporomandibular joint vibration analysis, and digital occlusal analysis, problematic dental components were discovered (including prolonged disclusion time and imbalanced bite force). A digital occlusal analyzer evaluated the patient's occlusion and systematically guided the necessary changes. After reduction of the disclusion time and correction of the occlusal force imbalance, the patient reported significant improvement in comfort. The results suggest that phantom bite could be an abnormal occlusal condition and not a psychological or neurologic somatoform disorder.

Animal and human bite injuries: a 5-year retrospective study in a large urban public hospital in Venezuela.

PubMed

Gelvez, Muñoz; Enrique, Ruben; Gajos, Golaszewski; Bladimir, Jose; Carvajal, Diaz; Luis, Alvaro

2017-12-01

Animal bite injuries to the head and neck regions are an important public health problem. Most of these bites are from dogs. A 10-year retrospective study was undertaken to determine the prevalence of animal and human bites. This retrospective study was done from January 2011 to December 2016 and included 387 patients with a mean age of 21.51 years. Data collection included age, sex, days of hospitalization, lesion type, and clinical management. Majority of patients were in age group of 21-29 years, followed by 31-55 years. Out of the total 281 patients, 42 patients (51.60%) were males and 34 patients (48.40%) were females. Mean hospital stay was 7.2 days with a minimum of 5 days and a maximum of 12 days. Surgical management included cleansing and primary closure of the wound. We concluded that the use of empiric antibiotic prophylaxis is essential for management of facial animal bite, and the antibiotic of first choice is amoxicillin-clavulanic acid. The aim of immediate surgical repair (< 6 h) is to avoid infections. The persistence of dog bite is public health problem in Venezuela.

First molar cross-bite is more closely associated with a reverse chewing cycle than anterior or pre-molar cross-bite during mastication.

PubMed

Tomonari, H; Ikemori, T; Kubota, T; Uehara, S; Miyawaki, S

2014-12-01

A posterior cross-bite is defined as an abnormal bucco-lingual relationship between opposing molars, pre-molars or both in centric occlusion. Although it has been reported that patients with unilateral posterior cross-bite often show unique chewing patterns, the relationship between the form of cross-bite and masticatory jaw movement remains unclear in adult patients. The objective of this study was to investigate masticatory jaw movement among different forms of cross-bite. One hundred and one adults were recruited in this study: 27 had unilateral first molar cross-bite (MC group); 28, unilateral pre-molar cross-bite (PC group); 23, anterior cross-bite (AC group); and 23, normal occlusion (control group). Masticatory jaw movement of the lower incisor point was recorded with six degrees of freedom jaw-tracking system during unilateral mastication. Our results showed that the reverse chewing ratio during deliberate unilateral mastication was significantly larger in the MC group than in the PA (P < 0.001), AC (P < 0.001) and control (P < 0.001) groups. These findings suggest that compared to the anterior or pre-molar cross-bite, the first molar cross-bite is more closely associated with a higher prevalence of a reverse chewing cycle. © 2014 John Wiley & Sons Ltd.

Management of Tissue Loss After Agkistrodon Snakebite: Appropriate Use of Crotalidae-Fab Antivenin.

PubMed

Larson, Kenneth W; Schaefer, Keith R; Austin, Cindy; Norton, Rhy; Finley, Phillip J

2016-01-01

Although initially created for the treatment of rattlesnake (genus: Crotalus) bites, Crotalidae-Fab antivenin is used to treat many different pit viper envenomations. However, the efficacy of Crotalidae-Fab in preventing tissue loss from copperhead (Agkistrodon contortrix) or cottonmouth (Agkistrodon piscivorus) snakebites remains unclear. Recent reports show that Agkistrodon-related bites rarely require treatment beyond simple observation and pain control. The purpose of this study was to examine the amount of tissue loss in patients who received Crotalidae-Fab compared with those who did not after an Agkistrodon bite. After institutional review board approval, a retrospective study was completed at a Level 1 trauma center. Between 2009 and 2013, a total of 57 snakebites were identified. Of the 57 bites, the snake species was documented in 36 cases including 31 copperheads, 1 cottonmouth, and 4 rattlesnakes. The other 21 bites were from unknown or nonvenomous species. Of the 32 Agkistrodon-related bites, 15 patients received Crotalidae-Fab (average of 3 vials administered) and 17 did not receive Crotalidae-Fab. None of the 32 patients, regardless of treatment option, had tissue loss or required surgical interventions. Only 1 patient received Crotalidae-Fab and debridement of a vesicle associated with the bite. No clinically significant differences were observed between the groups. These findings support previous literature that failed to show added benefit of Crotalidae-Fab treatment for Agkistrodon bites beyond patient comfort and pain control. Evaluation of current protocols for Agkistrodon envenomations is warranted. Snakebite wound education in trauma physicians and nurses may decrease unnecessary use of antivenom medication.

Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

PubMed

Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

2012-07-01

We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Tongue Blade Bite Test Predicts Mandible Fractures

PubMed Central

Neiner, John; Free, Rachael; Caldito, Gloria; Moore-Medlin, Tara; Nathan, Cherie-Ann

2015-01-01

The aim of the study is to evaluate the utility of a simple tongue blade bite test in predicting mandible fractures and use this test as an alternative screening tool for further workup. This is a retrospective chart review. An institutional review board approved the retrospective review of patients evaluated by the Department of Otolaryngology at a single institution for facial trauma performed from November 1, 2011, to February 27, 2014. Patients who had a bite test documented were included in the study. CT was performed in all cases and was used as the gold standard to diagnose mandible fractures. Variables analyzed included age, sex, fracture type/location on CT, bite test positivity, and operative intervention. A total of 86 patients met the inclusion criteria and of those 12 were pediatric patients. Majority of the patients were male (80.2%) and adult (86.0%; average age: 34.3 years). Fifty-seven patients had a negative bite test and on CT scans had no mandible fracture. Twenty-three patients had a positive bite test and a CT scan confirmed fracture. The bite test revealed a sensitivity of 88.5% (95% CI: 69.8–97.6%), specificity of 95.0% (95% CI:86.1–99%), positive predictive value [PPV] of 88.5% (95% CI: 69.8–97.6%), and negative predictive value [NPV] of 95.0% (95% CI: 86.1–99.0%). Among pediatric patients, the sensitivity was 100% (95% CI: 29.9–100%), specificity was 88.9% (95% CI: 68.4–100%), PPV was 75.0% (95% CI: 19.4–99.4%), and NPV was 100% (95% CI: 63.1–100%). The tongue blade bite test is a quick inexpensive diagnostic tool for the otolaryngologist with high sensitivity and specificity for predicting mandible fractures. In the pediatric population, where avoidance of unnecessary CT scans is of highest priority, a wider range of data collection should be undertaken to better assess its utility. PMID:27162567

Miniplate With a Bendable C-Tube Head Allows the Clinician to Alter Biomechanical Advantage in Extremely Complicated Anatomic Structure.

PubMed

Seo, Kyung Won; Iskenderoglu, Nur Serife; Hwang, Eui Hwan; Chung, Kyu-Rhim; Kim, Seong-Hun

2017-05-01

This article reports C-tube miniplates as a practical temporary anchorage device choice to treat open bite patients with maxillary sinus pneumatization. The C-tube components are titanium anchor plates and monocortical screws that are basically similar to any other miniplate systems, but it has the unique characteristic of the tube head to be malleable. The manipulation of the head part is easy due to the composition of pure titanium. The I-shaped C-tube with 3 holes and T-shaped C-tube miniplates were placed above the apices of maxillary molars as an absolute anchorage system to intrude the posterior maxilla. The bending of the tube heads assisted in reduction of severe open bite patient with maxillary sinus pneumatization. Sinus perforation during placement of skeletal anchorage system weakens stability of the anchorage and further cause complications. Placement of titanium C-tube miniplates allowed reliable skeletal anchorage and avoided maxillary sinus perforation in patients with extreme pneumatizations. Simple bending of C-tube miniplates ensured increased orthodontic intrusion force without having to replace them, and eliminated consequences such as perforation of maxillary sinus, sinusitis, soft tissue irritation, or infection. Anatomic difficulties in the placement of temporary anchorage device can be easily managed by using the bendable C-tube miniplate. It can serve as a great alternative over miniscrews or regular miniplates with reduced risk of sinus perforation and ability to bend the head portion to control orthodontic vectors and forces.

Geographic Variation in Access to Dog-Bite Care in Pakistan and Risk of Dog-Bite Exposure in Karachi: Prospective Surveillance Using a Low-Cost Mobile Phone System

PubMed Central

Zaidi, Syed Mohammad Asad; Labrique, Alain B.; Khowaja, Saira; Lotia-Farrukh, Ismat; Irani, Julia; Salahuddin, Naseem; Khan, Aamir Javed

2013-01-01

Background Dog-bites and rabies are under-reported in developing countries such as Pakistan and there is a poor understanding of the disease burden. We prospectively collected data utilizing mobile phones for dog-bite and rabies surveillance across nine emergency rooms (ER) in Pakistan, recording patient health-seeking behaviors, access to care and analyzed spatial distribution of cases from Karachi. Methodology and Principal Findings A total of 6212 dog-bite cases were identified over two years starting in February 2009 with largest number reported from Karachi (59.7%), followed by Peshawar (13.1%) and Hyderabad (11.4%). Severity of dog-bites was assessed using the WHO classification. Forty percent of patients had Category I (least severe) bites, 28.1% had Category II bites and 31.9% had Category III (most severe bites). Patients visiting a large public hospital ER in Karachi were least likely to seek immediate healthcare at non-medical facilities (Odds Ratio = 0.20, 95% CI 0.17–0.23, p-value<0.01), and had shorter mean travel time to emergency rooms, adjusted for age and gender (32.78 min, 95% CI 31.82–33.78, p-value<0.01) than patients visiting hospitals in smaller cities. Spatial analysis of dog-bites in Karachi suggested clustering of cases (Moran's I = 0.02, p value<0.01), and increased risk of exposure in particular around Korangi and Malir that are adjacent to the city's largest abattoir in Landhi. The direct cost of operating the mHealth surveillance system was USD 7.15 per dog-bite case reported, or approximately USD 44,408 over two years. Conclusions Our findings suggest significant differences in access to care and health-seeking behaviors in Pakistan following dog-bites. The distribution of cases in Karachi was suggestive of clustering of cases that could guide targeted disease-control efforts in the city. Mobile phone technologies for health (mHealth) allowed for the operation of a national-level disease reporting and surveillance system at a low cost. PMID:24349590

Effect of non-functional teeth on accumulation of supra-gingival calculus in children.

PubMed

Ashkenazi, M; Miller, R; Levin, L

2012-10-01

To evaluate the occurrence of supra-gingival calculus in children aged 6-9 years with disuse conditions such as: presence of dental pain, open-bite or erupting teeth. A cohort of 327 children aged 7.64±2.12 (range: 6-9) years (45% girls) were screened for presence of supra-gingival calculus in relation to open bite, erupting teeth and dental pain. Presence of dental calculus was evaluated dichotomically in the buccal, palatinal/lingual and occlusal surfaces. Plaque index (PI) and gingival index (GI) were also evaluated. Supra-gingival calculus was found in 15.9% of the children mainly in the mandibular incisors. Children aged 6-7 years had a higher prevalence of calculus as compared to children aged 7-8 years (23% vs. 13.5%, p=0.057) or 8-9 years (23% vs. 12.4%, p=0.078), respectively. No statistical relation was found between plaque and gingival indices and presence of calculus. The prevalence of calculus among children with openbite was significantly higher than that of children without open-bite (29.4% vs. 10.7%, p=0.0006, OR=3.489). The prevalence of calculus among children with erupting teeth in their oral cavity was higher than that of children without erupting teeth (17.7% vs. 9%, respectively, p=0.119). No statistical correlation was found between presence of dental pain and calculus (15.4% vs. 15.9%; p=0.738). Accumulation of calculus in children aged 6-10 years was found mainly in the mandibular incisors, decreased with age and was correlated with open-bite.

Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi arabian adolescents: a research report

PubMed Central

Feteih, Rabab M

2006-01-01

Background The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunction habits among Saudi adolescents in the permanent dentition stage. Methods A total of 385 (230 females and 155 males) school children age 12–16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation. Results The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5%) followed by restricted opening (4.7%) and opening deviation (3.9%). The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%). Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41%) with females significantly more than males, followed by nail biting (29%). Bruxism and thumb sucking were only 7.4% and 7.8% respectively. Conclusion The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%. PMID:16914032

Snake bite envenomation in Riyadh province of Saudi Arabia over the period (2005-2010).

PubMed

Al-Sadoon, Mohammed K

2015-03-01

The present investigation is a retrospective review of snake bites in Riyadh province over the period (2005-2010). A total of 1019 cases of bites admitted to the Ministry of Health medical centers in Riyadh province were analyzed on the basis of age, sex, time of bite and its site on the body, outcome of treatment, antiserum dose and type of snake. Bites occurred throughout the six years with the highest frequency in 2005 and least in 2006 where most of the bite cases were mild and all evolved to cure except four patients who died following the administration of antivenom during 24 h after snake bite. Most of the patients were males (81.7%) and the most attacked age was within the range of 11-30 years (51.5%). All the bites were mainly in the exposed limbs and the most frequently bitten anatomical regions were the lower limbs (427 cases, 41.9%), principally the feet. The study incriminates Cerastes cerastes gasperettii in most of the bites indicating it as the snake of medical importance in Riyadh province. Also, the study indicates low degree of threat in spite of high rate of snake bites as a result of the availability of the medical facilities and the antivenin use in medical centers in Riyadh province.

Sexual dimorphism in bite performance drives morphological variation in chameleons.

PubMed

da Silva, Jessica M; Herrel, Anthony; Measey, G John; Tolley, Krystal A

2014-01-01

Phenotypic performance in different environments is central to understanding the evolutionary and ecological processes that drive adaptive divergence and, ultimately, speciation. Because habitat structure can affect an animal's foraging behaviour, anti-predator defences, and communication behaviour, it can influence both natural and sexual selection pressures. These selective pressures, in turn, act upon morphological traits to maximize an animal's performance. For performance traits involved in both social and ecological activities, such as bite force, natural and sexual selection often interact in complex ways, providing an opportunity to understand the adaptive significance of morphological variation with respect to habitat. Dwarf chameleons within the Bradypodion melanocephalum-Bradypodion thamnobates species complex have multiple phenotypic forms, each with a specific head morphology that could reflect its use of either open- or closed-canopy habitats. To determine whether these morphological differences represent adaptations to their habitats, we tested for differences in both absolute and relative bite performance. Only absolute differences were found between forms, with the closed-canopy forms biting harder than their open-canopy counterparts. In contrast, sexual dimorphism was found for both absolute and relative bite force, but the relative differences were limited to the closed-canopy forms. These results indicate that both natural and sexual selection are acting within both habitat types, but to varying degrees. Sexual selection seems to be the predominant force within the closed-canopy habitats, which are more protected from aerial predators, enabling chameleons to invest more in ornamentation for communication. In contrast, natural selection is likely to be the predominant force in the open-canopy habitats, inhibiting the development of conspicuous secondary sexual characteristics and, ultimately, enforcing their overall diminutive body size and constraining performance.

Sexual Dimorphism in Bite Performance Drives Morphological Variation in Chameleons

PubMed Central

da Silva, Jessica M.; Herrel, Anthony; Measey, G. John; Tolley, Krystal A.

2014-01-01

Phenotypic performance in different environments is central to understanding the evolutionary and ecological processes that drive adaptive divergence and, ultimately, speciation. Because habitat structure can affect an animal’s foraging behaviour, anti-predator defences, and communication behaviour, it can influence both natural and sexual selection pressures. These selective pressures, in turn, act upon morphological traits to maximize an animal’s performance. For performance traits involved in both social and ecological activities, such as bite force, natural and sexual selection often interact in complex ways, providing an opportunity to understand the adaptive significance of morphological variation with respect to habitat. Dwarf chameleons within the Bradypodion melanocephalum-Bradypodion thamnobates species complex have multiple phenotypic forms, each with a specific head morphology that could reflect its use of either open- or closed-canopy habitats. To determine whether these morphological differences represent adaptations to their habitats, we tested for differences in both absolute and relative bite performance. Only absolute differences were found between forms, with the closed-canopy forms biting harder than their open-canopy counterparts. In contrast, sexual dimorphism was found for both absolute and relative bite force, but the relative differences were limited to the closed-canopy forms. These results indicate that both natural and sexual selection are acting within both habitat types, but to varying degrees. Sexual selection seems to be the predominant force within the closed-canopy habitats, which are more protected from aerial predators, enabling chameleons to invest more in ornamentation for communication. In contrast, natural selection is likely to be the predominant force in the open-canopy habitats, inhibiting the development of conspicuous secondary sexual characteristics and, ultimately, enforcing their overall diminutive body size and constraining performance. PMID:24475183

[The primary closure approach of dog bite injuries of the nose].

PubMed

Zieliński, Tomasz

2010-01-01

Biting of humans by domestic animals, especially by dogs, is common injury which causes suffering and pain, might be a cause of disability or even death. It is associated with high risk of bacterial infection of the wounds or even transfection of rabies virus. Bites are usually to the upper and lower limbs, while the face is third in a raw localization of bites. Within the face, the nose and lips are injured the most often. The goal of this paper is presentation selected methods and obtained results of primary closure of dog bite injures of the nose. There were 16 patients with dog bites injures of the nose treated in the Department of Plastic, Reconstructive and Aesthetic Surgery of the Medical University of Łódź in the years 2003-2008. The patients were 11 to 46 years old. Bites caused either superficial laceration of the skin, tearing of the nostril wing or even major defects of the tissues. In 7 patients superficial wounds a direct closure was done and antibiotic ointment was applied. In 7 patients a defect of the skin was covered with a skin graft taken from retroauricular area, but in 2 of the patients of this group repair of mucosa and alar cartilage was done. In two persons with full thickness defects of the nose reconstruction was performed with the use of a pedicled nosolabial flap. Complications occurred only in 1 patient who developed infection in the wound. In all other patients there were no complications. Good aesthetic results were obtained. Primary closure approach of bite injures with tissue defect is not associated with larger risk than in the case in secondary such approach, and should be implemented always whenever it is possible in order to avoid risk of wound and scars which require further reconstructive procedures in future.

[Prevalence of reactions secundary to mosquito bites Aedes aegypti at en el Regional Center of Allergy and Clinical Immunology, University Hospital, de Monterrey, Nuevo Leon].

PubMed

González Diaz, Sandra Nora; Cruz, Alfredo Arias; Sedó Mejía, Giovanni A; Rojas Lozano, Antonio A; Valenzuela, Enrique Avitia; Vidaurri Ojeda, Alma C

2010-01-01

although systemic reactions resulting from hymenoptera stings have been studied extensively, the prevalence of allergic reactions to mosquitoes is unknown. to investigate the prevalence of allergic reactions to Aedes aegypti bites in patients seeking treatment at the Allergy and Clinical Immunology Regional Center of Jose E Gonzalez University Hospital in Monterrey, Mexico. we carried out a cross-sectional, descriptive study that included patients receiving skin tests for aeroallergens; skin sensitivity to mosquito bites was also tested. A questionnaire was used to obtain information about previous allergic reactions to mosquito bites. a total of 482 patients between 2 and 60 years of age were included; 53% were female, 407 (84.4%) had a history of local reactions to mosquito bites. Twelve patients (2.4%) stated a history of large local reaction; three (0.6%) of them with a positive skin prick test, one (0.2%) of those had systemic reaction history to mosquito. Eighty five (17.6%) patients had a positive mosquito skin test and 307 (63.6%) had a positive skin test for at least one aeroallergen. Seventy-eight (91.7%) of the 85 patients with a positive mosquito skin test had a history of local skin reactions to mosquito bite (odds ratio: 2.303 [confidence interval (CI) 1.037-5.10]. There was no statistically significance association between allergic diseases and mosquito allergy. adverse reactions and allergic reactions to mosquito bites occur frequently. However mosquito allergy is low. Further studies are required to determine the prevalence of mosquito allergy in the general population.

Comparison of Preferred Bite Sites between Mites and Ticks on Humans in Korea

PubMed Central

Jang, Mi-Sun; Kim, Choon-Mee; Kim, Dong-Min; Yoon, Na Ra; Han, Mi Ah; Kim, Hyun-Kuk; Oh, Won Sup; Yoon, Hee-Jung; Wie, Seong-Heon; Hur, Jian

2016-01-01

Identification of mite and tick bite sites provides important clinical information. The predominant mite species in Korea associated with scrub typhus are Leptotrombidium pallidum and Leptotrombidium scutellare. The most abundant tick species is Haemaphysalis longicornis. To date, there has been no comparative study on preferred bite sites between mites and ticks in humans. This study included a review of medical records and a field study. For mite bite sites, eschars were checked on 506 patients with scrub typhus, confirmed by indirect immunofluorescence assay or nested polymerase chain reaction on the 56-kDa type-specific antigen gene of Orientia tsutsugamushi. Tick bite sites were identified and marked on a diagram for 91 patients who experienced tick bites within the previous year through a field epidemiological investigation. The mite and tick bite sites in Koreans were compared. The most frequently observed mite bite sites were the anterior chest, including the axillae (29.1%) and the abdominal region, including the inguinal area (26.1%). Tick bite sites were most frequent on the lower extremities (33.0%), followed by the abdominal region, including the inguinal area (26.4%), and upper extremities (26.4%). The distribution was significantly different between mite and tick bite sites (P < 0.001). There was a statistically significant difference in the mite bite (P = 0.001), but not tick bite sites (P = 0.985), between men and women. This is the first report on the differences between tick and mite bite sites, and may help clinicians reach a rapid diagnosis of mite- or tick-borne infection. PMID:27645781

Epidemiological aspects of snake bites on a Liberian rubber plantation.

PubMed

Stahel, E

1980-12-01

During a one-year period 95 patients with a history of snake bite were admitted to the hospital of a Liberian rubber plantation. The population at risk included the field workers (tappers and slashers) with an incidence of 4.2 symptomatic snake bites per thousand per year. The incidence of symptomatic bites was 1.7 per thousand in the group of non-field employees and 0.4 per thousand per year in the group of non-employees. The temporary disability was between 3 and 5 days, and the loss of workings days due to snake bites was one day per 10,000 working days on the plantation. Among the 95 patients 27 did not show any symptoms of envenoming except occasional fang marks. 64 patients developed cytotoxic symptoms alone. In this group, the night adder (Causus maculatus) was the main responsible snake. 4 patients showed signs of systemic envenoming. Two were haematological and two were neurological in nature and caused by Bitis species and Naja species, respectively. No fatalities were noted. A definite maximum of snake bites was observed during October and November which corresponds to the transition from rainy to dry season.

Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

PubMed

Rizkallah, Jean; Schwartz, Stephane; Rauch, Frank; Glorieux, Francis; Vu, Duy-Dat; Muller, Katia; Retrouvey, Jean-Marc

2013-03-01

Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P <0.05). The mean United States weighted PAR scores were 32.2 (SD, 15.0) for patients with osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P <0.05). The average modified DI scores were 29.8 (SD, 20.2) for the osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P <0.05). Group differences were greatest for lateral open bite (osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Management of pediatric snake bites: are we doing too much?

PubMed

Correa, Jesus A; Fallon, Sara C; Cruz, Andrea T; Grawe, Glenda H; Vu, Phong V; Rubalcava, Daniel M; Kaziny, Brent; Naik-Mathuria, Bindi J; Brandt, Mary L

2014-06-01

The optimal management of children with snake bite injuries is not well defined. The purpose of this study was to review the use of antivenom, diagnostic tests, and antibiotics in children bitten by venomous snakes in a specific geographic region (Southeast Texas). This is a retrospective single-center review of all patients with snake bite injury from 1/2006 to 6/2012. An envenomated bite was defined as causing edema, discoloration of the skin, necrosis, or systemic effects. The severity of injury was scored using a novel 4-point scale based on initial physical examination alone. One hundred fifty-one children (mean age 8.4±4.3years) were treated for a snake bite. There were no mortalities. Lower extremity injuries were most common (60%). Most bites were from copperheads (43%). Envenomation was evident in 82% (average wound score: 2.61±0.81). The median hospital stay for admitted patients (79%) was 2days (range 1-7). Four patients required surgery for complications of the snake bite. Fifty-two children (34%) received CroFab, with one allergic reaction. 22/135 (16%) had evidence of coagulopathy. Seventy-two children (48%) received IV antibiotics. Despite a high rate of envenomated bites in Southeast Texas, significant morbidity is rare. Children with an envenomation score of 1 or 2 are unlikely to be coagulopathic, suggesting that laboratory investigation should be reserved for patients with higher scores. The indications for the administration of CroFab deserve further prospective study. Copyright © 2014 Elsevier Inc. All rights reserved.

[Investigation into the actual condition of patients with occlusal disharmony at the Pedodontic Clinic of Kyushu University. Cases of anterior cross-bite in the deciduous dentition].

PubMed

Yamasaki, K; Hirota, K; Yamasaki, Y; Nonaka, K; Nakata, M

1989-01-01

The total number of subjects was 2754 children (1354 boys and 1402 girls), who visited the Pedodontic Clinic of Kyushu University during the 5 year period from April 1st 1981 to March 31st 1986. We investigated the actual conditions of patients who complained of occlusal disharmony and who were ascertained to be associated with occlusal disharmony. The results were as follows: 1. The percentage ratio of patients with chief complaints concerning occlusions was 14.5% and the percentage of patients with various type of complaints as well as the problem of occlusion was 8.1%. The ratio of the sex of the patients who complained of their occlusal disharmony was 43.0% for boys and 57.0% for girls. 2. The age distributions of the patients who had as the chief complaint occlusal disharmony were at the ages of 3 and 6 to 7 at the maximum. 3. The number of patients who were diagnosed with occlusal disharmony at the first examination was 28.5%. These included anterior cross-bite 32.5%, edge to edge bite 14.1%, cross-bite 13.0%, crowding 11.8% and et al. 4. The distribution of anterior cross-bites due to the developmental stage was divided into the deciduous dentition 59.9%, the mixed dentition 39.3% and the permanent dentition 0.8%. 5. The sex ratios of anterior cross-bites in the deciduous dentition were 45.6% for boys and 54.4% for girls. 6. The treatment of occlusal guidance for anterior cross-bite in the deciduous dentition started from ages 3 to 5. 7. The appliances used for the treatment of anterior cross-bite in the deciduous dentition were maxillary protraction 25.0%, the chin cap 20.0%, the FKO 17.5%, and the lingual arch with herical springs 15.0% and et al. 8. The status of the patients with the anterior cross-bite in the deciduous dentition as of August 1986 was that the 36.2% was under the observation, and 24.4% was under the treatment of occlusal guidance or under the observation after the treatment was done.

Multiple lesions by vampire bat bites in a patient in Niterói, Brazil - Case report*

PubMed Central

Bernardes, Fred; Martins, Gustavo; Luchi, Gustavo Sabaini; Kac, Bernard Kawa; Nery, José Augusto da Costa; Azulay-Abulafia, Luna; Azulay, David Rubem

2014-01-01

Over the last few centuries, the expansion of urbanization brought bats closer to urbanized areas, increasing the risk of accidents by bat bites. The morphology of bat bites can be varied, usually having an elliptical shape, about 0.5 cm along its greatest length, and the characteristic corkscrew bite pattern. The authors present the case of a patient who was repeatedly bitten by vampire bats for two months. A polymerase chain reaction was performed in the cutaneous nerves at the base of the hair follicles which showed negativity towards the rabies virus. The authors highlight the public health importance of this case, and discuss the morphological characteristics of these hematophagous bat bites. PMID:24770518

First bite syndrome: our experience of laser tympanic plexus ablation.

PubMed

Amin, N; Pelser, A; Weighill, J

2014-02-01

First bite syndrome is a condition characterised by severe facial pain brought on by the first bite of each meal. This can severely affect the patient's ability to eat. We present a 70-year-old woman for whom we performed a laser ablation of the left ear tympanic plexus, as treatment of first bite syndrome. A permeatal approach was used to raise a tympanomeatal flap. The tympanic plexus was identified on the promontory and a 4 mm2 area of the plexus was ablated using CO2 laser. The flap was repositioned and a dressing was placed with topical antibiotics. At two-month follow up, there was full resolution of the patient's symptoms. First bite syndrome carries a high morbidity; treatment options are variable, and often unsuccessful. We describe the first documented case of laser tympanic plexus ablation, with a very effective initial response. This procedure represents a useful therapeutic option for first bite syndrome.

Biting into the Yellow Pepper: The Development of the Interdisciplinary Learner

ERIC Educational Resources Information Center

Haynes, Carolyn

2014-01-01

In the opening credits of the television cult classic "Iron Chef," Chairman Kaga takes a huge bite out of a big yellow bell pepper. With the ensuing smirk on his face, he introduces the famous "Kitchen Stadium," which he notes is his "dream in a form never seen before." What follows is a learning experience in which…

Black widow spider bite: a case study.

PubMed

Gaisford, Kristine; Kautz, Donald D

2011-01-01

This article is a case study of a patient cared for in the hours before her death. After the patient's death, we learned the patient died of a black widow spider bite. This article sheds light on the potential seriousness of this venom and allows for more rapid detection and treatment of those who are unfortunate enough to be bitten. The authors have documented the sequence of events for the patient, outlined the care the patient received, examined the pathophysiology of the body to a spider bite, and then made a passionate appeal for other nurses who work in critical care to do the same with patients in similar situations.

Snakebite Survivors Club: retrospective review of rattlesnake bites in Central California.

PubMed

Spano, Susanne; Macias, Fernando; Snowden, Brandy; Vohra, Rais

2013-07-01

We investigated clinical patterns of crotaline envenomation presenting to a tertiary-care academic hospital in Central California over a 10-year period. An IRB-approved, retrospective chart review was conducted on all patients diagnosed with snakebite from December 2000 to December 2010. Data abstracted: demographics, anatomic location of bite, comorbid conditions and intoxicants, length of stay, antivenom dose, laboratory results, and complications or procedures. There were 46 snakebite cases admitted over the study period. Five were "dry bites"; the remaining cases (41/46) received antivenom. There was a male predominance (83% male victims). Upper extremity bites were more common (32/41 upper vs 10/42 lower extremity). One victim sustained bilateral bites to the hands. Thirty-five patients (85%) were admitted, with an average length of stay 2.12 days. The longest hospitalization was 15 days. There were no fatalities. The average time from bite to ED presentation was 2 h 44 min. Bites occurred during every month except November, with the majority occurring during spring and summer months and peaking in June (12/42 cases). Most bites occurred in the hours between noon and 8 pm. The amount of antivenom given ranged from 2 to 35 vials (average, 9 vials). Interfacility transfers were common in our study population: thirteen (32%) patients were transferred into our emergency department for a higher level of care, and 3 (7%) were transferred out (two because of insurance requirements, and one for higher level of Pediatric ICU care). There were no surgical interventions in our study group. Intoxication did not appear to play a major role in this population as only 3 patients (7%) were found to be acutely intoxicated: one with cannabis and amphetamines, 1 with alcohol, and 1 with opioids. In Central California, crotaline envenomations occurred mainly in adult males. Dry bites, or bites not requiring antivenom administration, were uncommon, comprising only 10% of bites in this study population. Contrary to popular and clinical beliefs, substance abuse and/or alcohol intoxication did not appear to play a role in the majority of patients in this study. Care providers and snakebite specialists should be aware that snakebite patients are often transferred between facilities, a finding that may be useful in designing future first aid protocols and research. We hope these findings add concrete data and help correct some common misconceptions about snakebites in Central California. Copyright © 2012 Elsevier Ltd. All rights reserved.

Snake bite envenomation in Riyadh province of Saudi Arabia over the period (2005–2010)

PubMed Central

Al-Sadoon, Mohammed K.

2014-01-01

The present investigation is a retrospective review of snake bites in Riyadh province over the period (2005–2010). A total of 1019 cases of bites admitted to the Ministry of Health medical centers in Riyadh province were analyzed on the basis of age, sex, time of bite and its site on the body, outcome of treatment, antiserum dose and type of snake. Bites occurred throughout the six years with the highest frequency in 2005 and least in 2006 where most of the bite cases were mild and all evolved to cure except four patients who died following the administration of antivenom during 24 h after snake bite. Most of the patients were males (81.7%) and the most attacked age was within the range of 11–30 years (51.5%). All the bites were mainly in the exposed limbs and the most frequently bitten anatomical regions were the lower limbs (427 cases, 41.9%), principally the feet. The study incriminates Cerastes cerastes gasperettii in most of the bites indicating it as the snake of medical importance in Riyadh province. Also, the study indicates low degree of threat in spite of high rate of snake bites as a result of the availability of the medical facilities and the antivenin use in medical centers in Riyadh province. PMID:25737653

Medico-legal significance of the identification of offending snake in a fatal snake bite: a case report.

PubMed

Silva, Anjana; Gamlaksha, Dayal; Waidyaratne, Dhananjaya

2013-11-01

A 19 year old male was admitted to a tertiary care centre in Sri Lanka, with a history of snake bite while sleeping at night. A killed specimen of a snake was brought with the patient. It had been identified as a non-venomous snake by the doctor and handed over to relatives, with a comment to that effect. Patient had no clinical or laboratory evidence of envenoming on admission. Patient developed bilateral ptosis six hours after alleged snake bite, soon followed by respiratory paralysis and was treated with Indian polyvalent anti-venom serum. After 12 h of the bite, patient had developed hypotension that did not respond to ionotropes. Despite intensive management, patient had become deeply comatose and deceased 46 h following the snake bite. Autopsy revealed features suggestive of disseminated intravascular coagulation. Since an allegation of medical negligence too had been levelled by the relations of the patient against the clinical staff, the buried specimen of the snake was recovered by police, on a judicial order, a week later. It was found to be almost completely disintegrated and only the scales and bones were remaining. According to the scale characters, the reconstructed specimen was identified as Indian krait (Bungarus caeruleus). Authentication of snake is important in investigating a death due to snake bite, especially when the snake was initially claimed to be a non-venomous snake. This case suggests the usefulness of forensic identification of species of the snake in investigating suspected snake bite cases. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The relationship between oral tori and bite force.

PubMed

Jeong, Chan-Woo; Kim, Kyung-Ho; Jang, Hyo-Won; Kim, Hye-Sun; Huh, Jong-Ki

2018-01-12

Objective The relationship between bite force and torus palatinus or mandibularis remains to be explained. The major aim of this study was to determine the correlation between bite force and oral tori. Methods The bite force of 345 patients was measured with a bite force recorder; impressions of the shape and size of the oral tori were taken on plaster models prior to orthodontic treatments. Subsequently, the relationship between oral tori and bite force was analyzed. Results The size, shape, and incidence of torus palatinus was not significantly correlated with bite force. However, the size of torus mandibularis increased significantly in proportion to the bite force (p = 0.020). The occurrence of different types of oral tori was not correlated with the bite force. Discussion The size of torus mandibularis provides information about bite force and can thus be used to clinically assess occlusal stress.

Pathologic mandibular fracture after biting crab shells following ramal bone graft.

PubMed

Kwon, Ik Jae; Lee, Byung Ho; Eo, Mi Young; Kim, Soung Min; Lee, Jong Ho; Lee, Suk Keun

2016-10-01

The mandibular ramus is considered an appropriate choice for reconstruction of maxillofacial defects because of sufficient amounts of material and fewer donor site complications. Although bone harvesting from the mandibular ramus has many advantages, in rare cases it can result in pathologic fracture of the mandible. Here, we present a case of 59-year-old man who suffered a pathologic mandible fracture related to biting hard foods, such as crab shells, after a sinus bone lifting with ramal bone graft procedure performed 2 weeks prior. He underwent closed reduction by intermaxillary fixation with an arch bar over the course of 4 weeks. Three months later, the patients had a stable occlusion with normal mouth opening and sensation. To prevent this complication, the osteotomy should be performed in such a way that it is not too vertical during ramal bone harvesting. Furthermore, we wish to emphasize the importance of patients being instructed to avoid chewing hard foods for at least 4 weeks after ramal bone harvesting. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sepsis by Pasteurella multocida in an Elderly Immunocompetent Patient after a Cat Bite.

PubMed

Caserza, Lara; Piatti, Gabriella; Bonaventura, Aldo; Liberale, Luca; Carbone, Federico; Dallegri, Franco; Ottonello, Luciano; Gustinetti, Giulia; Del Bono, Valerio; Montecucco, Fabrizio

2017-01-01

Pasteurella multocida colonizes animal scratches and bites. This bacterium was described to cause sepsis or endocarditis mainly in immunocompromised patients. We report the case of a 92-year-old woman presenting at the Emergency Department with coma and fever a week after the bite of her cat. The cat bite was misdiagnosed at admission partly due to an underestimation of this event by the patient's relatives. An inflamed area localized at perimalleolar skin of the right leg was detected. Laboratory biomarkers of inflammation were elevated. The cerebral computed tomography (CT) scan with angiographic sequences showed a complete occlusion of right intracranial vertebral artery. Total body CT scan and abdominal echocardiography were negative for foci of infection. Three consecutive blood cultures were positive for Pasteurella multocida . A diagnosis of sepsis by Pasteurella multocida was made, and the patient recovered after a specific antimicrobial treatment. In order to confirm the animal transmission, the cat saliva was cultured and found positive for Pasteurella multocida with a similar antibiotic sensitivity to that isolated from the patient. In conclusion, the case of a patient with coma and fever after a cat bite was presented. The transmission of pathogens from pets has to be carefully considered as an important route of infection in immunocompetent patients.

The comparative effectiveness of two digit-sucking deterrent methods.

PubMed

Bourne, C O

2005-09-01

A study was conducted to compare the effectiveness of the crib and positive reinforcement in eliminating anterior open bites and increased overjets caused by digit-sucking. The overjet and overbite were measured using an overjet ruler at the start and end of the seventeen-week observation period. Forty patients consented to participate but measurements were only obtained for 11 subjects. The trend in this study is that the crib is more effective than positive reinforcement in preventing digit-sucking.

Streptococcus oralis cerebral abscess following monkey bite in a 2-month-old infant.

PubMed

Thiagarajan, Srinivasan; Krishnamurthy, Sriram; Raghavan, Renitha; Mahadevan, Subramanian; Madhugiri, Venkatesh S; Sistla, Sujatha

2016-05-01

Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.

Morbidity of pediatric dog bites: a case series at a level one pediatric trauma center.

PubMed

Garvey, Erin M; Twitchell, Denice K; Ragar, Rebecca; Egan, John C; Jamshidi, Ramin

2015-02-01

Pediatric dog bite injuries are common and vary in severity. We sought to characterize predisposing factors, required interventions, and morbidity. A prospective clinical database at a level one pediatric trauma center was reviewed for dog bite injuries over 74 consecutive months ending December 2013. This included all patients brought in by ambulance and/or seen by the trauma team. Of 650 dog bite incidents, 282 met the criteria for inclusion in the trauma database. Median age was 5 years (range, 2 months to 17 years) and 55% (154/282) of patients were male. Pit bulls were most frequently responsible, accounting for 39% (83/213) of incidents in which dog breed was documented. Fifty-three percent (150/282) of dogs belonged to the patient's immediate or extended family. Sixty-nine percent (194/282) of patients required operative intervention: 76% laceration repairs, 14% tissue transfers, and 2% neurosurgical interventions. The most severe injuries were depressed skull fractures, intracranial hemorrhage, laryngotracheal transection, and bilateral orchiectomy. Median length of stay was 1 day (range, 0 to 25 days). There were no mortalities. Pediatric dog bites span a wide range of ages, frequently require operative intervention, and can cause severe morbidity. Dog familiarity did not confer safety, and in this series, Pit bulls were most frequently responsible. These findings have great relevance for child safety. Pediatric dog bites are common and can vary in severity from superficial wounds to life-threatening injuries. Dog familiarity may confer a false sense of safety. A national dog bite prevention and education campaign should be developed with the goal of decreasing the incidence of pediatric dog bites. Copyright © 2015 Elsevier Inc. All rights reserved.

Biting Force and Muscle Activity in Implant-Supported Single Mandibular Overdentures Opposing Fixed Maxillary Dentition.

PubMed

Al-Magaleh, Wafaʼa R; Abbas, Nadia A; Amer, Ashraf A; Abdelkader, Ann A; Bahgat, Basma

2016-04-01

This study aimed to investigate the relation between biting force and masticatory muscle activity in patients treated by 3 modalities of single mandibular dentures. Forty implants were placed in 10 patients with completely edentulous mandibles. The study was divided into 3 treatment stages. Initially, each patient received a conventional mandibular complete denture. At the second stage, 4 mandibular implants were placed and the denture was refitted to their abutments. Third stage comprised connecting the denture to the implants through ball attachments. During each treatment stage, maximum biting force and muscle activity were measured during maximum clenching and chewing of soft and hard food. Biting force demonstrated a statistically significant increase by time for the 3 treatment stages. The highest muscle activity was recorded for the conventional denture followed by the implant-supported overdenture without attachment, whereas the lowest values were recorded for the implant-supported overdenture with attachment. Biting force was related mainly to the quality of denture support. Muscle activity was higher in patients with conventional denture than with implant-supported prostheses (with or without attachments).

Haematophagous bat bites in Ecuadorian Amazon: characterisation and implications for sylvatic rabies prevention.

PubMed

Romero-Sandoval, N; Parra, C; Gallegos, G; Guanopatín, A; Campaña, M F; Haro, M; Calapaqui, S; Moreta, C; Viteri, F; Feijoo-Cid, M; Martin, M

2013-03-21

To characterise the risk factors of haematophagous bat bites and to provide information to contribute to the prevention of rabies in Ecuador. Cross-sectional study based on interviews with 3518 individuals, from which two sets of variables were generated: characteristics of haematophagous bat attacks in the previous year among humans and risk factors for being bitten. Data were analysed using multivariate logistic regression models, taking history of bat bites in the previous year as the response variable. In the previous year 723 (20.6%, 95%CI 19.3-21.9) of the participants declared having received haematophagous bat bites and 50.4% in the previous month, giving an incidence rate of 10.4% (95%CI 9.6-11.6) per month. Sleeping on the floor or in a hammock (adjusted odds ratio [aOR] 1.58, 95%CI 1.21-2.06), not using a protective bed net (aOR 1.25, 95%CI 1.03-1.50) and living in a dwelling with permanent openings in the structure (aOR 1.49, 95%CI 1.12-1.95) were associated with a higher probability of bat bites. Those most affected were the group aged ≤12 years (age 13-19 years, aOR 0.39, 95%CI 0.32-0.48; age ≥20 years, aOR 0.67, 95%CI 0.50-0.90). Primary prevention based on pre-exposure vaccination would be justifiable given the high dispersion of the population and the high incidence of bat bites. As a secondary protective measure, communities should work towards increasing the use of protective measures and putting barriers in permanent openings in their dwellings.

Retrospective analysis of facial dog bite injuries at a Level I trauma center in the Denver metro area.

PubMed

Gurunluoglu, Raffi; Glasgow, Mark; Arton, Jamie; Bronsert, Michael

2014-05-01

Facial dog bite injuries pose a significant public health problem. Seventy-five consecutive patients (45 males, 30 females) treated solely by plastic surgery service for facial dog bite injuries at a Level I trauma center in the Denver Metro area between 2006 and 2012 were retrospectively reviewed. The following information were recorded: breed, relationship of patient to dog, location and number of wounds, the duration between injury and surgical repair and dog bite incident, type of repair, and antibiotic prophylaxis. Primary end points measured were wound infection, the need for revision surgery, and patient satisfaction. Ninety-eight wounds in the head and neck region were repaired (46 children; mean age, 6.8 years) and (29 adults; mean age, 47.3 years). Twelve different breeds were identified. There was no significant association between the type of dog breed and the number of bite injuries. The duration between injury and repair ranged from 4 hours to 72 hours (mean [SD], 13.7 [10.9] hours). The majority of bite wounds (76 of 98) involved the cheek, lip, nose, and chin region. Direct repair was the most common surgical approach (60 of 98 wounds) (p < 0.05). There was no statistically significant association between wounds needing reconstruction versus direct repair according to dog breed (p = 0.25). Ten wounds required grafting. Twenty-five wounds were managed by one-stage or two-stage flaps. Only three patients (3.06 %) underwent replantation/revascularization of amputated partial lip (n = 2) and of cheek (n = 1). There was one postoperative infection. Data from five-point Likert scale were available for fifty-two patients. Forty patients were satisfied (5) with the outcome, while five patients were somewhat satisfied (4), and seven were neutral. Availability of the plastic surgery service at a Level I trauma center is vital for the optimal treatment of facial dog bite injuries. Direct repair and reconstruction of facial dog bite injuries at the earliest opportunity resulted in good outcomes as evidenced by the satisfaction survey data and low complication rate. Therapeutic study, level V. Epidemiologic study, level III.

Prediction of changes due to mandibular autorotation following miniplate-anchored intrusion of maxillary posterior teeth in open bite cases.

PubMed

Kassem, Hassan E; Marzouk, Eiman S

2018-05-14

Prediction of the treatment outcome of various orthodontic procedures is an essential part of treatment planning. Using skeletal anchorage for intrusion of posterior teeth is a relatively novel procedure for the treatment of anterior open bite in long-faced subjects. Data were analyzed from lateral cephalometric radiographs of a cohort of 28 open bite adult subjects treated with intrusion of the maxillary posterior segment with zygomatic miniplate anchorage. Mean ratios and regression equations were calculated for selected variables before and after intrusion. Relative to molar intrusion, there was approximately 100% vertical change of the hard and soft tissue mention and 80% horizontal change of the hard and soft tissue pogonion. The overbite deepened two folds with 60% increase in overjet. The lower lip moved forward about 80% of the molar intrusion. Hard tissue pogonion and mention showed the strongest correlations with molar intrusion. There was a general agreement between regression equations and mean ratios at 3 mm molar intrusion. This study attempted to provide the clinician with a tool to predict the changes in key treatment variables following skeletally anchored maxillary molar intrusion and autorotation of the mandible.

Does pain in the masseter and anterior temporal muscles influence maximal bite force?

PubMed

Goiato, Marcelo Coelho; Zuim, Paulo Renato Junqueira; Moreno, Amália; Dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas; de Caxias, Fernanda Pereira; Turcio, Karina Helga Leal

2017-11-01

The aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment. Thirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7days, and 30days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p<0.05). A simple regression analysis was performed to verify the relation between pain level and bite force. Results revealed that there was a statistical difference in pain level over time for both muscles and sides (p<0.01). In the molar region, the bite force exhibited significantly higher values after 30days of treatment, when compared with the baseline (p<0.001). There was a correlation between pain level and bite force only for the temporal muscle in all periods analyzed (p<0.05). There was no strong correlation in the response level points to support the association of pain and bite force. Pain level decreased and bite force increased in the molar region after treatment. No strong correlation or dispersion in the relationship between pain levels and bite force was seen in women with myofascial pain and bruxism. Copyright © 2017 Elsevier Ltd. All rights reserved.

Periocular dog bite injuries and responsible care.

PubMed

Burroughs, John R; Soparkar, Charles N S; Patrinely, James R; Williams, Patrick D; Holck, David E E

2002-11-01

To report patients who received dog bite injuries to the periocular area and the incidence of repeat attacks by the biting dog and its disposition. To discuss the demographics of bite attacks, occult injuries, steps to avoid medicolegal problems, and the appropriate options for animal disposition. Single-practice prospective case series of dog attacks on 18 victims. Patients were followed and questioned about any repeat attacks by the offending dog. Of 18 individuals who received dog bites to the perio-ocular area, only 2 were >12 years old. Of the 16 cases available for follow-up (4 months to 3 years; mean, 16 months), 7 of the dogs were euthanized and 1 was sent away from the family. Of the 8 remaining animals, 5 (63%) bit again. All the dogs bit family members or family friends. Although most dogs make wonderful pets, canine bites pose a significant public health concern, and some simple steps may be taken to protect against personal injury and legal fallout from repeat attacks.

Bite Injuries to the Hand - Review of the Literature

PubMed Central

Raval, Pradyumna; Khan, Wasim; Haddad, Behrooz; Mahapatra, Anant Narayan

2014-01-01

Patients presenting to the emergency department with bite injuries to the hand sustain them through a number of causes including domesticated as well as stray animal bites, and human bites commonly sustained as a result of violence. The nature of the injuries sustained can be very deceptive. A small tooth mark on the exterior can be a fulminant infection in the tissues deeper down. Tendon injuries, fractures of the metacarpals and phalanges and management of the wound are critical issues faced by a surgeon in dealing with such patients. Similarly the less common bite injuries to the hand, often with disastrous and sometimes fatal complications, do also present to the emergency department. A high incidence of suspicion is needed in dealing with these injuries effectively. In our article we discuss the common as well as uncommon causes of bite injuries to the hand and their management. In addition to reviewing the literature to ascertain the management of such injuries, we also discuss interesting and rare case reports. PMID:25097675

Gingival abscess due to an unusual nail-biting habit: a case report.

PubMed

Sousa, Denise; Pinto, Daniela; Araujo, Rebecca; Rego, Rodrigo Otavio; Moreira-Neto, Jose

2010-03-01

Nail-biting is one of the most frequent deleterious oral habits in children. It can result in systemic diseases or oral traumatic lesion. This report describes a case of gingival abscess in a child due to a fingernail-biting habit. A 5-year, 6-month-old female presented gingival swelling and fistula in the primary maxillary left central and right lateral incisors as an unusual sequelae to the periodontal tissues from fingernail-biting. A periodontal curette was used to remove the fragments and to curette the area. After the curettage, an exudate of blood and pus was drained. Then the area was irrigated with 0.12% chlorhexidine solution; applying finger pressure controlled the secretion. After one week, the patient returned with gingival swelling present in the same teeth. The same curettage procedure was performed. It was suggested that the deleterious habit was related to emotional tension and anxiety behaviors and the patient was referred for psychological treatment. When the patient returned one month later, she was still biting her fingernails, but she had stopped placing fragments into the gingival crevice. No more gingival inflammation or swelling was observed. his paper presents an unusual case report of a gingival abscess due to a fingernail-biting habit in a child, probably related to an emotional condition. The fingernail-biting habit can induce a periodontal traumatic injury yielding a more serious complication such as a gingival abscess.

Epidemiologic and clinical aspects of animal bite injuries.

PubMed

Kizer, K W

1979-04-01

During 1975, 332 animal bite injuries accounted for 1.2% of all surgical problems treated at the UCLA Hospital Emergency Department. Data on 307 bite injuries were available and analyzed for environmental, animal, human, interaction, and clinical factors. More than half of the dog bites and almost three fourths of the cat bites-scratches happened at or near the victims' homes. Dog bites were almost twice as common among men, while cat bites-scratches were twice as common among women. Of the incidents in which ownership information was available, 85% of dog bites and 80% of cat bites-scratches were from an animal belonging to the victim, his family or friends, or another known person. Forty-three percent of dog bites, and 52% of cat bites-scratches were provoked, that is, happened while the victim was interacting with the animal. Of bites of the head and/or neck, 38% injured the upper lip; 17% of dog bites injured the eye or adjacent tissues; 48% were in children less than ten-years-old. On fifth of cat bites-scratches involved the head and/or neck, 60% of these injured orbital or periorbital tissues. Over 2% of patients were hospitalized. Five percent of dog bite victims and 29% of cat bite-scratch victims returned with complications, mostly cellulitis or lymphangitis. Pasteurella multocida was the most common pathogen cultured, as evidenced by the 50% and 80% culture-positive rates for dog and cat bite-scratches respectively in this series.

Tick bite and Lyme disease-related emergency department encounters in New Hampshire, 2010-2014.

PubMed

Daly, E R; Fredette, C; Mathewson, A A; Dufault, K; Swenson, D J; Chan, B P

2017-12-01

Lyme disease (LD) is a common tick-borne disease in New Hampshire (NH). While LD is a reportable condition and cases are counted for public health surveillance, many more people receive care for tick bites or diagnoses of LD than are reflected in surveillance data. NH's emergency department (ED) data system was queried for tick bite and LD-related encounters. Chief complaint text was queried for words related to LD or tick bites. International Classification of Diseases 9th Revision (ICD-9) codes were queried for the LD diagnosis code (088.81). Emergency department patient data were matched to reportable disease data to determine the proportion of ED patients reported to the health department as a suspected LD case. Data were analysed to calculate frequencies for key demographic and reporting characteristics. From 2010 to 2014, 13,615 tick bite or LD-related ED encounters were identified in NH, with most due to tick bites (76%). Of 3,256 patients with a LD-related ED encounter, 738 (23%) were reported to the health department as a suspected LD case. The geographic distribution of ED patients was similar to reported LD cases; however, the regions of the state that experienced higher rates of ED encounters were different than the regions that observed higher rates of reported LD cases. Seasonal distribution of ED encounters peaked earlier than reported LD cases with a second peak in the fall. While age and sex distribution was similar among ED patients and reported LD cases, the rates for children 5 years and younger and adults 65 years and older were greater for ED encounters. Patients frequently visit the ED to seek care for tick bites and suspected LD. Results of ED data analyses can be used to target education, in particular for ED providers and the public through timely distribution of evidence-based educational materials and training programmes. © 2017 Blackwell Verlag GmbH.

Pilot study assessing the effectiveness of long-lasting permethrin-impregnated clothing for the prevention of tick bites.

PubMed

Vaughn, Meagan F; Meshnick, Steven R

2011-07-01

Tick-borne diseases such as Lyme disease, Rocky Mountain spotted fever, and ehrlichiosis are a significant concern for many thousands of workers who have frequent and unavoidable exposure to tick-infested habitats. Many North Carolina state employees with outdoor occupations report multiple tick bites each year, indicating that existing tick preventive strategies may be underutilized or ineffective. Treatment of clothing with permethrin, a nontoxic chemical with insecticidal, knockdown, and repellent properties, is highly effective against ticks. However, most permethrin products must be reapplied after several washings to maintain insecticidal activity. Recently, a factory-based method for long-lasting permethrin impregnation of clothing has been developed by Insect Shield, Inc., that allows clothing to retain insecticidal activity for over 70 washes. A nonrandomized open label pilot study was conducted to determine the effectiveness of Insect Shield-treated clothing for the prevention of tick bites among 16 outdoor workers from the North Carolina Division of Water Quality under actual field conditions. Participants completed questionnaires at the start of follow-up (March, 2008) and at the end of follow-up (September, 2008), and tick bites and outdoor work hours were reported on weekly tick bite logs for the entire follow-up period. Subjects wearing Insect Shield-treated clothing had a 93% reduction (p < 0.0001) in the total incidence of tick bites compared to subjects using standard tick bite prevention measures. This study provides preliminary evidence that long-lasting permethrin-impregnated clothing may be highly effective against tick bites.

Biomechanical implications of lateral pterygoid contribution to biting and jaw opening in humans.

PubMed

Osborn, J W

1995-12-01

The contributions of the lateral pterygoid muscle to a variety of different tasks were analysed by a linear programming mode based on the equations for static equilibrium in three dimensions and containing 12 muscles. The model was used to study lateral pterygoid activity at maximum bite force (MBF) for changes in (i) the direction and point of application of the bite force, (ii) the orientation of the masseter and medial pterygoid muscles and (iii) the slope of the articular eminence (glenoid slope). The effects on MBF of removing one or both lateral pterygoids were also examined. Lateral pterygoid provided a very important indirect contribution to some clenching forces. Under some conditions removing one lateral pterygoid muscle (simulating guarding an injured muscle) halved the MBF. Its activity at MBF was reduced as masseter was tilted more forward, the glenoid slope was made more horizontal and the bite force was made more vertical. The muscle helped to oppose (balance) the horizontal reaction forces at the bite point and joints, which potentially pushed the condyle backward. A balancing muscle is now defined as one (like lateral pterygoid) whose activity increases the output force by far more than its direct contribution to that force. In a larger model containing 16 muscles, every muscle was most active when its line of action was parallel to the output force. Finally, in a model which divided lateral pterygoid into superior and inferior heads, activity suddenly switched from the superior head to the inferior head when the angle of opening changed from 120 degrees (forward from the vertical) to 140 degrees.

Fast and Powerful: Biomechanics and Bite Forces of the Mandibles in the American Cockroach Periplaneta americana

PubMed Central

Weihmann, Tom; Reinhardt, Lars; Weißing, Kevin; Siebert, Tobias; Wipfler, Benjamin

2015-01-01

Knowing the functionality and capabilities of masticatory apparatuses is essential for the ecological classification of jawed organisms. Nevertheless insects, especially with their outstanding high species number providing an overwhelming morphological diversity, are notoriously underexplored with respect to maximum bite forces and their dependency on the mandible opening angles. Aiming for a general understanding of insect biting, we examined the generalist feeding cockroach Periplaneta americana, characterized by its primitive chewing mouth parts. We measured active isometric bite forces and passive forces caused by joint resistance over the entire mandibular range with a custom-built 2D force transducer. The opening angle of the mandibles was quantified by using a video system. With respect to the effective mechanical advantage of the mandibles and the cross-section areas, we calculated the forces exerted by the mandible closer muscles and the corresponding muscle stress values. Comparisons with the scarce data available revealed close similarities of the cockroaches’ mandible closer stress values (58 N/cm2) to that of smaller specialist carnivorous ground beetles, but strikingly higher values than in larger stag beetles. In contrast to available datasets our results imply the activity of faster and slower muscle fibres, with the latter becoming active only when the animals chew on tough material which requires repetitive, hard biting. Under such circumstances the coactivity of fast and slow fibres provides a force boost which is not available during short-term activities, since long latencies prevent a specific effective employment of the slow fibres in this case. PMID:26559671

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

PubMed Central

Sprong, Hein; van den Wijngaard, Cees C.; Harms, Margriet G.; Fonville, Manoj; Docters van Leeuwen, Arieke; Simões, Mariana; van Pelt, Wilfrid

2017-01-01

Background Understanding and quantification of the risk of Lyme borreliosis after a tick bite can aid development of prevention strategies against Lyme borreliosis. Methods We used 3,525 single tick bite reports from three large prospective studies on the transmission risk of tick-borne pathogens to humans, with 50 reports of Lyme borreliosis during the follow-up period, among 1,973 reports with known outcome. A structural equation model was applied to estimate the risk of Lyme borreliosis after a tick bite, and quantify the influence of: developmental stage of the tick, detection of Borrelia burgdorferi s.l. DNA in the tick by PCR, tick engorgement, patient-estimated duration of tick attachment, and patient age. Results The overall risk of developing Lyme borreliosis after a tick bite was 2.6% (95%CI 1.4–5.1). The risk increased with: - Tick engorgement: 1.4% (95%CI 0.7%-2.3%) for low engorgement to 5.5% (95%CI 2.8%-9.2%) for substantially engorged ticks; - Rising patient-estimated tick attachment duration: 2.0% (95%CI 1.3%-2.8%) after <12 hours, to 5.2% (95%CI 3.0%-8.9%) after ≥4 days; - Detection of Borrelia burgdorferi s.l. DNA in ticks: 6.7% (95%CI 3.6%-13.5%), versus 1.4% (95%CI 0.7%-2.9%) when ticks tested negative. The highest observed risk of Lyme borreliosis was 14.4% (95%CI 6.8%-24.6%) after one tick bite of a substantially engorged tick that tested positive for Borrelia burgdorferi s.l. DNA, which corresponds to one new case of Lyme borreliosis per 7 (95%CI 4–15) of such tick bites. Conclusions An individual's risk of Lyme borreliosis after a tick bite can be predicted with tick engorgement, patient-estimated duration of tick attachment, and detection of Borrelia burgdorferi s.l. DNA in the tick. PMID:28742149

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model.

PubMed

Hofhuis, Agnetha; van de Kassteele, Jan; Sprong, Hein; van den Wijngaard, Cees C; Harms, Margriet G; Fonville, Manoj; Docters van Leeuwen, Arieke; Simões, Mariana; van Pelt, Wilfrid

2017-01-01

Understanding and quantification of the risk of Lyme borreliosis after a tick bite can aid development of prevention strategies against Lyme borreliosis. We used 3,525 single tick bite reports from three large prospective studies on the transmission risk of tick-borne pathogens to humans, with 50 reports of Lyme borreliosis during the follow-up period, among 1,973 reports with known outcome. A structural equation model was applied to estimate the risk of Lyme borreliosis after a tick bite, and quantify the influence of: developmental stage of the tick, detection of Borrelia burgdorferi s.l. DNA in the tick by PCR, tick engorgement, patient-estimated duration of tick attachment, and patient age. The overall risk of developing Lyme borreliosis after a tick bite was 2.6% (95%CI 1.4-5.1). The risk increased with: - Tick engorgement: 1.4% (95%CI 0.7%-2.3%) for low engorgement to 5.5% (95%CI 2.8%-9.2%) for substantially engorged ticks;- Rising patient-estimated tick attachment duration: 2.0% (95%CI 1.3%-2.8%) after <12 hours, to 5.2% (95%CI 3.0%-8.9%) after ≥4 days;- Detection of Borrelia burgdorferi s.l. DNA in ticks: 6.7% (95%CI 3.6%-13.5%), versus 1.4% (95%CI 0.7%-2.9%) when ticks tested negative.The highest observed risk of Lyme borreliosis was 14.4% (95%CI 6.8%-24.6%) after one tick bite of a substantially engorged tick that tested positive for Borrelia burgdorferi s.l. DNA, which corresponds to one new case of Lyme borreliosis per 7 (95%CI 4-15) of such tick bites. An individual's risk of Lyme borreliosis after a tick bite can be predicted with tick engorgement, patient-estimated duration of tick attachment, and detection of Borrelia burgdorferi s.l. DNA in the tick.

Protraction of mandibular second and third molars assisted by partial corticision and miniscrew anchorage.

PubMed

Mimura, Hiroshi

2013-08-01

A woman, aged 47 years 6 months, with an anterior open bite and a left-shifted mandible was treated with a mandibular right first molar extraction and without orthognathic surgery. However, her mandibular second molar did not move mesially during treatment because of the dense lamina dura; therefore, corticision was applied only on the mesial aspect of the mandibular second molar, and a miniscrew was inserted simultaneously. Corticision was introduced as a supplemental dentoalveolar surgery in orthodontic therapy to achieve accelerated tooth movement with minimal surgical intervention. In this technique, a reinforced scalpel was used as a thin chisel to separate the interproximal cortices transmucosally without a flap. This technique was applied not to accelerate tooth movement, but to protract the mandibular molars. One miniscrew was inserted on the mesiobuccal side of the mandibular right molar for protraction and intrusion. In addition, 2 miniscrews were inserted in the buccal sides of the maxillary first and second molars and the palatal side of the maxillary first molar to intrude them for correction of the mandibular shift and the cant of the occlusal plane. Excellent occlusion and correction of the anterior open bite were achieved without surgery. At the 2-year follow-up examination, the patient had a good occlusion and showed good stability with no opening of the extraction space. A partial corticision is an effective option for facilitating movement of mandibular molars. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Human cytokine response to Texas crotaline envenomation before and after antivenom administration.

PubMed

Crocker, Patrick; Zad, Omid; Milling, Truman; Maxson, Todd; King, Benjamin; Whorton, Elbert

2010-10-01

The aim of this study was to characterize the human cytokine response to Texas crotaline envenomation before and after antivenom administration. This study enrolled crotaline bite victims presenting to a regional trauma center and children's hospital from March to November 2007 and age-matched unbitten controls. Blood spot cards were obtained from bite victims at presentation and at 1 and 6 hours after antivenom administration. One control sample was drawn from each of the age-matched controls selected from urgent care patients presenting for minor complaints. Samples were delivered to a laboratory using a proprietary method for quantitative evaluation of a large number of biomarkers in parallel with bead-based multiplex immunoassays. After obtaining informed consent, 14 crotaline bite victims (age range, 5-85 years; median age, 45 years; 50% female) (Snakebite Severity Score, 2-7; median, 3) and 14 age-matched controls were enrolled. There were 7 copperhead (Agkistrodon contortrix) bites, 4 rattlesnake (probably Western Diamondback Crotalus atrox) bites, 2 cottonmouth (Agkistrodon piscivorus) bites, and 1 bite from a snake that was not identified by the victim. In t tests, the means in the presentation samples for apolipoprotein A-I (Apo A-I), Apo C3, interleukin 4 (IL-4), myeloperoxidase, plasminogen activator inhibitor 1 (PAI-1), epidermal growth factor, and regulated upon activation, normal t-cell expressed and secreted were significantly lower and Apo H was significantly higher in the bite patients than in the controls. In the 1-hour sample, α(1)-antitrypsin, Apo A-I, Apo C3, eotaxin, IL-4, myeloperoxidase, and PAI-1 levels were lower and prostatic acid phosphatase and cancer antigen 125 levels were higher in the bite patients than in the controls. And in the 6-hour sample, α(1)-antitrypsin, Apo A-I, Apo C3, endothelin-1, IL-4, macrophage inflammatory protein 1β, myeloperoxidase, and epidermal growth factor levels were lower and Apo H level was higher in the bite patients than in controls (all P values < .05). Crotaline venom produces a broad cytokine response in human bite victims. In particular, IL-4, myeloperoxidase, and Apo A-I and C3 levels remain altered despite antivenom therapy, whereas PAI-1 and regulated upon activation, normal t-cell expressed and secreted levels seem to normalize after antivenin as other markers are affected. Understanding this profile and further study of the markers identified might lead to improved therapies and better prognostic indicators. Copyright © 2010 Elsevier Inc. All rights reserved.

[Mammal bite management].

PubMed

Contreras-Marín, Misael; Sandoval-Rodríguez, Jorge Issac; García-Ramírez, Raúl; Morales-Yépez, Héctor Adolfo

Animal bites are a major public health problem, it is estimated that 2% of the population is bitten each year. Most bites are by dogs and the risk factors include young children, men, certain breeds of dogs and untrained dogs. The risk of infection after bites differs between animal species and depends on the animal teeth and oral flora. Animal bites are still a major cause of morbidity in patients of all ages and have caused several preventable childhood deaths. These wounds often become infected. If the wound requires it, early surgical evaluation must be performed. The use of antibiotics is only recommended for high risk bite wounds. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Utility of Vaccum Pressed Silicon Sheet as a Bite Raising Appliance in the Management of TMJ Dysfunction Syndrome.

PubMed

Datarkar, Abhay; Daware, Surendra; Dande, Ravi

2017-09-01

Temporomandibular disorders (TMDs) represent a group of painful conditions involving the muscles of mastication and the temporomandibular joint (TMJ) that frequently encountered in general clinical practice. This study is designed to assess the utility of vacuum pressed silicon sheet as a bite raising appliance in the management of TMJ dysfunction syndrome. The patients for this study were selected from those with the chief complaint of TMJ disorder. Out of 200 patients, 104 patients were diagnosed with subluxation and 96 patients were diagnosed with internal derangement of temporomandibular joint. All the reported cases were managed conservatively with physiotherapy and muscle relaxant therapy for one week period and followed with silicon bite raising appliance over both the arches in the subsequent period. All the patients had pain relief within six months duration as graded over verbal analog scale. ANOVA scale was used for comparision of VAS scores. The use of vacuum pressed bite raising appliance in the management of TMJ disorder was found to be satisfactorily effective in alleviation of pain symptom in our study group.

Mortality, mauling, and maiming by vicious dogs.

PubMed

Bini, John K; Cohn, Stephen M; Acosta, Shirley M; McFarland, Marilyn J; Muir, Mark T; Michalek, Joel E

2011-04-01

Maiming and death due to dog bites are uncommon but preventable tragedies. We postulated that patients admitted to a level I trauma center with dog bites would have severe injuries and that the gravest injuries would be those caused by pit bulls. We reviewed the medical records of patients admitted to our level I trauma center with dog bites during a 15-year period. We determined the demographic characteristics of the patients, their outcomes, and the breed and characteristics of the dogs that caused the injuries. Our Trauma and Emergency Surgery Services treated 228 patients with dog bite injuries; for 82 of those patients, the breed of dog involved was recorded (29 were injured by pit bulls). Compared with attacks by other breeds of dogs, attacks by pit bulls were associated with a higher median Injury Severity Scale score (4 vs. 1; P = 0.002), a higher risk of an admission Glasgow Coma Scale score of 8 or lower (17.2% vs. 0%; P = 0.006), higher median hospital charges ($10,500 vs. $7200; P = 0.003), and a higher risk of death (10.3% vs. 0%; P = 0.041). Attacks by pit bulls are associated with higher morbidity rates, higher hospital charges, and a higher risk of death than are attacks by other breeds of dogs. Strict regulation of pit bulls may substantially reduce the US mortality rates related to dog bites.

[Sensitivity and specificity of prick skin test with two concentrations of standardized extract of Culex quinquefasciatus in allergic children].

PubMed

Castro-Almarales, Raúl Lázaro; Álvarez-Castelló, Mirta; Ronquillo-Díaz, Mercedes; Rodríguez-Canosa, José S; González-León, Mayda; Navarro-Viltre, Bárbara I; Betancourt-Mesia, Daniel; Enríquez-Domínguez, Irene; Reyes-Zamora, Mary Carmen; Oliva-Díaz, Yunia; Mateo-Morejón, Maytee; Labrada-Rosado, Alexis

2016-01-01

Diagnostic options for immune reactions to mosquito bites are limited. In Cuba, IgE-mediated reactions are frequently related to Culex quinquefasciatus bite. To determine the sensitivity and specificity of skin prick test with two doses of standardized extract in nitrogen protein units (PNU of Culex quinquefasciatus (BIOCEN, Cuba). An analytical study was conducted on 100 children between 2 and 15 years old. Fifty atopic patients with a history of allergy to mosquito bite and positive specific serum IgE Culex quinquefasciatus and fifty atopic patients without a history of allergy to mosquito bite and negative specific serum IgE to Culex quinquefasciatus. Skin prick tests (SPT) were performed by duplicates on the forearms of the patients. Investigated doses were 100 PNU/mL and 10 PNU/mL. SPT with the highest concentration obtained a mean wheal size of 22.09 mm2 and for lower doses of 8.09 mm2, a statistically significant difference (p=0.001, Student's t test). Positive skin test correlated in 100% of patients with the presence of specific IgE. Testing with both doses showed a 94% of specificity and 88% of sensitivity. The diagnostic accuracy of SPT using both doses of standardized extract was similar, which justifies its use for diagnosis of sensitization to Culex quinquefasciatus in patients with symptoms of allergy to mosquito bite.

Crown-root Fracture Restoration on a Patient with Autism Spectrum Disorder.

PubMed

Perez, Edna; Behar-Horenstein, Linda S; Guelmann, Marcio

2016-09-01

Children with intellectual and physical disabilities including autism are susceptible to dental trauma as a sequela from falls due to poor muscular coordination. In addition, their altered muscle tonus often results in an open bite with labial flaring of the maxillary incisors and lip incompetence, predisposing these teeth to fractures. This case report describes an alternative approach of restoring a fractured maxillary permanent central incisor with a composite strip crown during surgical repositioning of the periodontium on an autistic patient. The prognosis of the incisor is guarded due to the probability of re-injury. However, the decision to maintain the tooth clinically was esthetically preferable in comparison to an extraction or decoronation.

Stinging and biting insect allergy: an Australian experience.

PubMed

Solley, Graham O

2004-12-01

Stings and bites from various insects are responsible for many anaphylactic events. To document the clinical features of specific forms of anaphylaxis and investigate clinical concerns regarding stinging and biting insect allergy. All patients presenting for evaluation of adverse reactions to insect stings or bites between December 1980 and December 1997 had the clinical details of their reactions recorded and their reactions classified. The spectrum of clinical symptoms and signs is similar to that seen in anaphylaxis from other sources; stings on the head or neck are not more likely to cause life-threatening reactions than stings elsewhere on the body; a lesser reaction will not necessarily lead to a more serious reaction from a future sting; asthmatic patients do appear to have an increased risk of asthma as a feature of their anaphylactic response; anaphylaxis is usually confined to a particular insect species for the individual patient; patients who have had multiple stings at one time may have experienced true anaphylaxis and not a "toxic" response; and patients who have had anaphylaxis from other sources are at no greater risk than that of the general population of reacting similarly to insect stings or bites. Anaphylactic events from insect stings show the same clinical features as those from other sources. Systemic reactions seem confined to a specific insect species. Patients who experience RXN3 reactions from multiple stings at one time should undergo specific venom testing, because many have experienced true anaphylaxis and not a toxic response. Future consideration should be given to the role of beta-adrenergic antagonists and ACE inhibitors in patients with systemic reactions.

Ocular Trauma From Dog Bites: Characterization, Associations, and Treatment Patterns at a Regional Level I Trauma Center Over 11 Years.

PubMed

Prendes, Mark A; Jian-Amadi, Arash; Chang, Shu-Hong; Shaftel, Solomon S

2016-01-01

Canine bites frequently result in periocular injury. The authors aimed to further characterize the dog breeds, types of injuries inflicted, and treatment outcomes. A retrospective chart review was performed on all dog bites recorded in the University of Washington trauma registry from 2003 to 2013. Cases involving ocular injury were further investigated to identify ocular tissues affected, treatment patterns, and outcomes. A total of 342 dog bite victims were identified, of whom 91 sustained ocular trauma (27%). The mean age of patients with ocular injuries was significantly lower than those without (14.1 ± 1.9 vs. 30.0 ± 1.3 years, p < 0.001). Children bitten by dogs were 4.2 times more likely to sustain ocular injuries than adults (45.2% vs. 10.8%). The most common breed of dog inflicting ocular injury was the pit bull (25%). Forty percent of patients with ocular trauma sustained canalicular lacerations and epiphora was noted in only 3 patients (8%) after repair. Three percent had orbital fractures and 2% sustained ruptured globes. Infections were rare, affecting only 2% of patients. To our knowledge, this study is the largest to date to report the incidence and characteristics of ocular injuries sustained from dog bites. These injuries were disproportionately more common in children and have a high incidence of canalicular laceration. Though rare, globe injuries and orbital fractures were seen in this population. Importantly, this study establishes that pit bulls are the most frequent breed associated with ocular injuries from dog bites.

Dog bites of the head and neck: an evaluation of a common pediatric trauma and associated treatment

PubMed Central

O'Brien, Daniel C.; Andre, Tyler B; Robinson, Aaron D.; Squires, Lane D.

2014-01-01

Purpose To identify which patients and canines are involved in dog bites of the head and neck, and how they impact health systems. Materials and Methods This is a single center, retrospective cohort study conducted from January 2012 to June 2013 from an academic, tertiary care center situated between multiple suburban and urban communities. Patients were identified by queried search for all bite-related diagnoses codes. Results 334 unique dog bites were identified, of which 101 involved the head and neck. The mean patient age was 15.1 years ± 18.1. Of the more than 8 different breeds identified, one-third were caused by pit bull terriers and resulted in the highest rate of consultation (94%) and had 5 times the relative rate of surgical intervention. Unlike all other breeds, pit bull terriers were relatively more likely to attack an unknown individual (+31%), and without provocation (+48%). Injuries of the head and neck had an average follow-up of 1.26 ± 2.4 visits, and average specialty follow-up of 3.1 ± 3.5 visits. Conclusions The patients most likely to suffer dog bite injuries of the head and neck are children. Although a number of dog breeds were identified, the largest group were pit bull terriers, whose resultant injuries were more severe and resulted from unprovoked, unknown dogs. More severe injuries required a greater number of interventions, a greater number of inpatient physicians, and more outpatient follow-up encounters. Healthcare utilization and costs associated with dog bites warrant further investigation. PMID:25311183

Occlusion in the primary and early mixed dentitions in a group of Tanzanian and Finnish children.

PubMed

Kerosuo, H

1990-01-01

Two high and two low socioeconomic areas were selected for the Tanzanian portion of this study, with all nursery schools located in those areas included, for a subtotal of 580 children. The Finnish group was comprised of a total of 575 Caucasian children examined. The Tanzanian children (83 percent Black African, 10 percent Asian, 7 percent Arab) had fewer occlusal anomalies than the Finnish children did. Finnish children had a 13-percent incidence rate of lateral cross-bite; among African children, 8 percent showed anterior crossbite; and among the combined Asian/Arab group of children, 10 percent had an anterior open bite. African children had significantly fewer prevalences of distal bite, lateral crossbite and crowding than Finnish children did.

[Prevalence of cross-bite in Mexican children].

PubMed

Ojeda León, S; De la Teja Angeles, E

1990-10-01

As observed, the problem of lining and accommodation of teeth in the child population is increasingly larger. This fact prompted the authors to attempt determining the prevalence of cross-bite in a sample of Mexican children. A total of 306 patients, aged between two and 17 and attending the Stomatology service of the National Institute of Pediatrics, were evaluated, from which all pertinent data regarding age, sex, molar-temporal relationship (terminal, rectus, distal, messial and exaggerated messial planes), permanent molar status (Angle I, II, III), cross-bite, type of dentition affected (primary, mixed or permanent), cross-bite classification (anterior, posterior or mixed), whether unilateral, bilateral, dental or skeletal, right or left, and number of teeth affected, were duly recorded. Out of 306 evaluated patients (160 males, 146 female), 112 evidenced cross-bite (36.6%), 56 of each sex; in 69.6% the teeth were anterior, in 17.8% they were posterior, and in 15.5% their position was mixed. Their average age was 8 years, and malocclusion was Angle class I. From this experience, it is to be concluded that early detection and correction of any dental occlusion abnormality will permit correcting defects in dentofacial development; it is thus necessary to ascertain the frequency of cross-bite.

Cannulation in patients with large periampullary diverticulum using SpyBite miniforceps.

PubMed

Balkrishanan, Mahadevan; Jain, Mayank; Snk, Chenduran; Cg, Sridhar; Ramakrishnan, Ravi; Venkataraman, Jayanthi

2018-03-01

Cannulation is difficult in patients with periampullary diverticulum (PAD). The described success rate varies from 61% to 95.4%. Four cases with PAD in which, despite repeated attempts, we were unable to locate the papilla and cannulate. To overcome this difficulty, we used SpyBite forceps (Boston Scientific) to pull out the papillary orifice and then perform the cannulation using a sphincterotome introduced through the same working channel. This method reduced the time required for cannulation. In all four of our cases, we had 100% success in cannulation. Use of SpyBite miniforceps in difficult cannulations in patients with PAD is useful and has an excellent success rate.

Long-term complications of rattlesnake bites: a telephone survey from Central California.

PubMed

Spano, Susanne J; Vohra, Rais; Macias, Fernando

2014-06-01

The purpose of this institutional review board-approved, cross-sectional study was to identify residual symptoms and signs of envenomation reported by snakebite survivors via a telephone survey. Victims of rattlesnake bite who were treated at a single hospital center during a 10-year period were contacted through a telephone survey. Study subjects were included through a diagnosis-based retrospective chart review of snakebite victims, and excluded if they did not receive rattlesnake antivenom. Data collection was done using a standardized form that included sections about residual, recurrent, or new pain, weakness, paresthesias, or other limitations of the bitten limb. We identified 46 snakebite cases including 5 of 46 "dry" bites. The remaining cases (41 of 46) all received Crofab. Interviews were completed for 31% of these patients (13 of 41), and the remainder were lost to follow-up. Most bites occurred in men (12 cases, 92% males) and on the arms (9 cases, 69%). Six of the 13 respondents (46%) reported residual symptoms from the bite. Persistent symptoms described included localized pain at the bite site (3 cases), numbness or paresthesias (2 cases), abnormal skin peeling and discoloration at the bite site (2 cases), and persistent weakness of the bitten extremity (1 case). Among patients reporting persistent symptoms, the bite-to-survey interval ranged from 7 months to 12 years, with a median interval of 4 years. Our study population demonstrated a notable incidence (43%) of self-reported persistent symptoms related to their rattlesnake bites, although the overall level of disability from these injuries seems low. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

A case of Tinea nigra associated to a bite from a European rabbit (Oryctolagus cuniculus, Leporidae): the role of dermoscopy in diagnosis.

PubMed

Rossetto, André Luiz; Corrêa, Patricia Rossetto; Cruz, Rosana Cé Bella; Pereira, Eduardo Figueiredo; Haddad Filho, Vidal

2014-01-01

We report a case of Tinea nigra in an adolescent living in Itapema, Santa Catarina, Brazil, who presented a hyperchromic macule on the palm of the left hand, close to another erythematous macule caused by a rabbit bite. The patient received guidance on accidents and animal bites and evolved well treated with topical butenafine for the dermatomycosis. The authors also highlight the efficacy of the dermoscopic exam in diagnosing Tinea nigra with animal bite lesions and other traumas.

A case of Tinea nigra associated to a bite from a European rabbit (Oryctolagus cuniculus, Leporidae): the role of dermoscopy in diagnosis*

PubMed Central

Rossetto, André Luiz; Corrêa, Patricia Rossetto; Cruz, Rosana Cé Bella; Pereira, Eduardo Figueiredo; Haddad Junior, Vidal

2014-01-01

We report a case of Tinea nigra in an adolescent living in Itapema, Santa Catarina, Brazil, who presented a hyperchromic macule on the palm of the left hand, close to another erythematous macule caused by a rabbit bite. The patient received guidance on accidents and animal bites and evolved well treated with topical butenafine for the dermatomycosis. The authors also highlight the efficacy of the dermoscopic exam in diagnosing Tinea nigra with animal bite lesions and other traumas. PMID:24626667

Fighting Against Disuse of the Masticatory System in Duchenne Muscular Dystrophy: A Pilot Study Using Chewing Gum.

PubMed

van Bruggen, H Willemijn; van den Engel-Hoek, Lenie; Steenks, Michel H; van der Bilt, Andries; Bronkhorst, Ewald M; Creugers, Nico H J; de Groot, Imelda J M; Kalaykova, Stanimira I

2015-10-01

Duchenne muscular dystrophy patients report masticatory problems. The aim was to determine the efficacy of mastication training in Duchenne muscular dystrophy using chewing gum for 4 weeks. In all, 17 patients and 17 healthy age-matched males participated. The masticatory performance was assessed using a mixing ability test and measuring anterior bite force before, shortly after and 1 month after the training. In the patient group the masticatory performance improved and remained after 1-month follow-up, no significant changes in anterior maximum bite force was observed after mastication training. In the healthy subject the bite force increased and remained at the 1-month follow-up; no significant differences in masticatory performance were observed. Mastication training by using sugar-free chewing gum in Duchenne muscular dystrophy patients improved their masticatory performance. Since bite force did not improve, the working mechanism of the improvement in chewing may relate to changes of the neuromuscular function and coordination, resulting in improvement of skills in performing mastication. © The Author(s) 2015.

Indication for and frequency of early orthodontic therapy or interceptive measures.

PubMed

Schopf, Peter

2003-05-01

The early treatment of nonskeletal and skeletal orthodontic anomalies in the deciduous and early mixed dentition is intended to prevent the development of pronounced anomalies in the late mixed and permanent dentition with the ultimate aim of reducing or even eliminating the need for later orthodontic treatment. There is a general consensus in the international literature that early therapy is indicated in cases of anterior and lateral crossbite and Class III malocclusion, and possibly for extreme forms of mandibular retrognathism (overjet > or =10 mm) and of open bite. However, evidence of the efficiency of early orthodontic measures is just as rare as studies providing serviceable information on the incidence of tooth malalignments and malocclusions in the deciduous and early mixed dentition, some of whose findings are in any case highly divergent. This makes it substantially more difficult to draw conclusions on the extent to which early orthodontic therapy may be indicated. In order to obtain information on the incidence of nonskeletal and skeletal orthodontic problems constituting a treatment need, 2326 first-year schoolchildren aged between 6 and 7 years were examined in Frankfurt am Main and in the Rural District of Offenbach. In only 14.7% of the children were no relevant orthodontic findings recorded. 77.2% displayed mild to severe dysgnathic symptoms, though without early orthodontic therapy being considered indicated. Treatment with orthodontic appliances was considered urgent for 187 of the children (8.04%). With 8.3% and 7.9% respectively, lateral and anterior crossbite were top of the list of anomalies with an urgent treatment need. Among the patients with lateral crossbite, the prognostically less favorable unilateral form was recorded approximately four times more often than the bilateral form. Markedly increased sagittal overjet > or =10 mm) was registered in only 1.4% of the children, and negative overjet (Class III) (with the exception of edge-to-edge bite) in 1.9%. Extreme anterior open bite > or =6 mm) was recorded in only two children (0.09%). In 19.6% of the children, a supporting zone was reduced in at least one quadrant, necessitating interceptive measures such as the insertion of a space maintainer or later orthodontic treatment (space opening or extraction therapy).

[Facial dog bite injuries in children: retrospective study of 77 cases].

PubMed

Hersant, B; Cassier, S; Constantinescu, G; Gavelle, P; Vazquez, M-P; Picard, A; Kadlub, N

2012-06-01

The face is the area most vulnerable for dog bites in children. Surgical management is an emergency to prevent infection, functional and aesthetic outcomes. The aim of this study was to define a new gravity scale, and to determine a prevention policy. In our maxillofacial and plastic surgery department, we conducted a retrospective study from 2002 to 2010, including 77 children under 16 years old, victims of facial dog bite. We analyzed epidemiological, clinical data, surgical outcomes. The mean age was 5.36 years. Dogs were principally represented by class I and II dogs; 27,7% of them had ever bitten before. In almost all the cases, the dogs belong to the family or closers. Twenty-one percent of children belong to an unfavourable social environment; 71.43% of dog bites interested the central area of the face. The bites were deep in 77% of cases with amputation or extensive loss of substance in 31% of cases. The healing time was 10.54 months. Nearly a third of patients required several surgeries; 41.56% of patients had aesthetic and functional sequelae; 35.1% of children had psychological problems afterward. Facial children dog bites require a multidisciplinary approach, and a long-term follow-up. We propose a new classification of dog bite severity, more appropriate to the face. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Unmasking the Effect of Analgesics on Endodontic Diagnosis Using a Novel Bite Force Sensor Device: A Prospective, Randomized Clinical Trial.

PubMed

Kishnani, Sushil; Saha, Suparna Ganguly; Bhardwaj, Anuj; Dubey, Sandeep; Saha, Mainak; Kala, Shubham; Jain, Sohini; Narwani, Shweta

2016-10-01

A definitive diagnosis is of primary importance before initiating any endodontic treatment; yet, there are occasions when the dental professional is unable to accurately reproduce the patient's chief complaint, as it can pose a dilemma and may require consideration of multiple variables in order to reach an accurate diagnosis. So to overcome this problem, a methodical approach in providing endodontic treatment should be implemented which includes diagnosis, definitive dental treatment and adjunctive drug therapy, known as the "3D" strategy. The purpose of this study was to evaluate the possible "masking" effect of these analgesics on endodontic diagnosis using a novel bite force sensor device. A total of 90 patients with endodontic pain were selected and they were given either a placebo or 400 mg ibuprofen (brufen) or 50mg diclofenac sodium (voveron). Both patients and operators were completely blinded to the drugs administered. Bite force tolerance values were noted before and one hour after administration of medication using the self designed bite force sensor. The pre- and post-bite force tolerance values were tabulated for both contralateral and affected tooth. For the affected tooth, there was statistically significant difference between pre- and post-bite force tolerance values in Group I (i.e., ibuprofen) and Group II (i.e., diclofenac sodium) (p<0.05) with no significant difference observed in Group III (placebo). The easily available over the counter self administered analgesics in addition to providing symptomatic relief to patients suffering from symptomatic apical periodontitis may also cloud the definitive diagnosis of the clinician, thus jeopardising the treatment plan. The self designed bite force sensor was effective in arriving at a definitive diagnosis in teeth with chronic irreversible pulpitis with symptomatic apical periodontitis, where the allodynia has been camouflaged by the use of analgesics like ibuprofen and diclofenac sodium.

Necrotizing fasciitis due to Streptococcus mitis caused by accidental human bite.

PubMed

Bastug, Aliye; Kislak, Sumeyye; Mutlu, Nevzat Mehmet; Akcaboy, Zeynep Nur; Koksal, Asude; Sertcelik, Ahmet; Ünlü, Ramazan Erkin; Akinci, Esragul; Bodur, Hurrem

2016-01-31

Human bite wounds are more prone to infection than animal bites, which may cause necrotizing soft tissue infections such as myositis, fasciitis. Both aerobic and anaerobic microorganisms may be responsible, including Streptococcus spp., Staphylococcus aureus, Peptostreptococcus spp. Necrotizing fasciitis is characterized by serious tissue destruction and systemic toxicity with high morbidity and mortality. We report a patient with Streptococcus mitis associated necrotizing fasciitis on the upper extremity resulting from an accidental human bite, which caused nearly fatal infection. Prophylactic antibiotic treatment should be given after a human bite to prevent infection. If the infection signs and symptoms develop, rapid diagnosis, appropriate antibiotic and surgical therapy should be administered immediately. Streptococcus mitis is a viridans streptococcus, usually known as a relatively benign oral streptococcus. To our knowledge, this is the first necrotizing fasciitis case due to Streptococcus mitis after human bite.

Early correction of unilateral scissor bite using transforce appliance and modified twin block appliance

PubMed Central

Chandorikar, Harshal; Nagrik, Arun; Bhad, Wasundhara A; Chavan, Santosh J; Doshi, Umal H

2017-01-01

Early treatment of scissor bite has been advocated mainly to prevent function jaw shift that can eventually lead to permanent skeletal asymmetry and temporomandibular joint pathosis. Although unilateral scissor bite is more common, most of the times, bilateral mandibular expansion is indicated. Lingual transforce appliance can be useful in such cases. This article presents a patient with unilateral scissor bite in mixed dentition with alveolar narrowing. Transforce appliance was used for scissor bite correction followed by modified twin block appliance for stabilization and settling of occlusion till the eruption of premolars. The case was finished with fixed mechanotherapy. Two years after completion of treatment, results were well maintained. Our results suggest that lingual transforce appliance along with careful management of occlusion is effective in the early management of severe unilateral scissor bite. PMID:28546961

A verified spider bite and a review of the literature confirm Indian ornamental tree spiders (Poecilotheria species) as underestimated theraphosids of medical importance.

PubMed

Fuchs, Joan; von Dechend, Margot; Mordasini, Raffaella; Ceschi, Alessandro; Nentwig, Wolfgang

2014-01-01

Literature on bird spider or tarantula bites (Theraphosidae) is rare. This is astonishing as they are coveted pets and interaction with their keepers (feeding, cleaning the terrarium or taking them out to hold) might increase the possibility for bites. Yet, this seems to be a rare event and might be why most theraphosids are considered to be harmless, even though the urticating hairs of many American species can cause disagreeable allergic reactions. We are describing a case of a verified bite by an Indian ornamental tree spider (Poecilotheria regalis), where the patient developed severe, long lasting muscle cramps several hours after the bite. We present a comprehensive review of the literature on bites of these beautiful spiders and conclude that a delayed onset of severe muscle cramps, lasting for days, is characteristic for Poecilotheria bites. We discuss Poecilotheria species as an exception from the general assumption that theraphosid bites are harmless to humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sleep endoscopy with simulation bite for prediction of oral appliance treatment outcome.

PubMed

Vroegop, Anneclaire V M T; Vanderveken, Olivier M; Dieltjens, Marijke; Wouters, Kristien; Saldien, Vera; Braem, Marc J; Van de Heyning, Paul H

2013-06-01

The aim of this study was to assess the value of drug-induced sleep endoscopy (DISE) using a custom-made simulation bite in maximal comfortable protrusion (MCP) of the mandible, in the prediction of treatment outcome for obstructive sleep apnea (OSA) with a mandibular advancement device (MAD). Two hundred patients (74% male; age 46 ± 9 years; apnea-hypopnea index [AHI] 19 ± 13 h(-1) sleep; body mass index [BMI] 27 ± 4 kg m(-2) ) with sleep-disordered breathing underwent DISE with a simulation bite in MCP. One hundred and thirty-five patients with an established diagnosis of OSA commenced MAD treatment. The associations between the findings during DISE with simulation bite and treatment outcome were evaluated. Treatment response was defined as a reduction in AHI following MAD treatment of ≥ 50% compared to baseline. Overall MAD treatment response in the studied population was 69%. The results of this study demonstrated a statistically significant association between a positive effect of the simulation bite on the upper airway patency during DISE and treatment response with MAD (P < 0.01). The results of this study suggest that the use of a simulation bite in maximal comfortable protrusion (MCP) of the mandible, as used during DISE in patients with OSA, tends to be effective in predicting treatment response of MAD treatment. © 2012 European Sleep Research Society.

Combined orthodontic and surgical correction of adult skeletal class II with hyperdivergent jaws.

PubMed

Abraham, Jiku; Bagchi, Paulami; Gupta, Swati; Gupta, Hemant; Autar, Ram

2012-01-01

A case of severe Class II skeletal malocclusion with anterior open bite having vertical growth pattern and matching soft tissue profile is presented. Considering age of the patient and the severity of the malocclusion, it was decided to combine orthodontic treatment with surgery. A 0.022 Roth Pre-adjusted Edgewise Appliance was chosen for the orthodontic correction and Le-Fort 1 differential vertical impaction of maxilla with mandibular autorotation and augmentation genioplasty was considered as the treatment plan. The main aim was to reduce the gummy smile and correct the class II profile.

Insect Allergy.

PubMed

Lee, Hobart; Halverson, Sara; Mackey, Regina

2016-09-01

Insect bites and stings are common. Risk factors are mostly associated with environmental exposure. Most insect bites and stings result in mild, local, allergic reactions. Large local reactions and systemic reactions like anaphylaxis are possible. Common insects that bite or sting include mosquitoes, ticks, flies, fleas, biting midges, bees, and wasps. The diagnosis is made clinically. Identification of the insect should occur when possible. Management is usually supportive. For anaphylaxis, patients should be given epinephrine and transported to the emergency department for further evaluation. Venom immunotherapy (VIT) has several different protocols. VIT is highly effective in reducing systemic reactions and anaphylaxis. Copyright © 2016 Elsevier Inc. All rights reserved.

Deadly case of Pasteurella multocida aortitis and mycotic aneurysm following a cat bite.

PubMed

Cho, Dennis Dane; Berliner, Yaniv; Carr, David

2016-06-16

Animal bites are frequently encountered in the emergency department (ED). Aortitis leading to mycotic abdominal aortic aneurysm is a rare and potentially deadly complication of Pasteurella multocida (P. multocida) following an animal bite. We present the case of a 68-year-old male who presented to the ED after falling at home. He complained of weakness and abdominal pain. He was in septic shock and was treated empirically with broad-spectrum antibiotics and intravenous fluids. He reported previous antibiotic treatment of a cellulitis secondary to a cat bite injury to his right thumb four weeks prior. Abdominal ultrasound and subsequent computed tomography scan revealed a leaking mycotic abdominal aneurysm that was surgically repaired. Blood cultures and aortic wall tissue cultures grew P. multocida. Given how common animal bite presentations are in the ED, this case highlights the need to consider aortitis and mycotic abdominal aortic aneurysm in an unwell patient with an animal bite.

Envenoming by coral snakes (Micrurus) in Argentina, during the period between 1979-2003.

PubMed

de Roodt, Adolfo Rafael; De Titto, Ernesto; Dolab, Jorge Adrián; Chippaux, Jean-Philippe

2013-01-01

Envenomation by coral snakes (Micrurus sp.) is one of the most dangerous injuries in America and it is considered as a serious medical emergency, however bites by these snakes appear to be rare. We analyzed epidemiological data, clinical signs and antivenom use in Argentina during the period between 1979-2003. During this period of study 46 non-fatal Micrurus bites were reported. The majority of cases were men from 31 to 40 years old. Bites occurred primarily in spring and summer. Most cases were reported from the northeast and northwest provinces of the country. The bites were mostly located on hands or feet and occurred mostly during agricultural activities and so mainly involved farmers. Only four cases occurred as a result of handling snakes. The median time it took for antivenom to be administrated was 60 minutes after the bite, and the median number of vials applied was 2. Local pain was mentioned and edema was reported in 41% of patients. All patients recovered without sequelae. This study showed a low incidence of Micrurus bites and low severity of envenomation. However, although no deaths have been reported during the last 30 years, given the toxicity of the venom of Micrurus snakes, the risk of severe envenomation should be considered.

Scissor bite in a young patient treated with an orthodontic-orthopedic device. A case report.

PubMed

Favero, V; Sbricoli, L; Favero, L

2013-06-01

Scissor bite is a rare malocclusion that often leads to minor facial asymmetry. An orthodontic and orthopaedic correction is advisable in young patients to prevent subsequent temporomandibular diseases requesting maxillofacial intervention. In this case report a 8-year-old girl in mixed dentition with unilateral left scissor bite was treated with a modified Rapid Palatal Expander. To modify an overexpanded maxilla (width 39 mm measured between both upper first molars) the device was used to close rather than to expand, without need of patient compliance. Orthodontic correction was then completed with traditional bracketing. Results were tangible (width 36 mm) and remained stable even for at least 2 years after retention. This original device has proved to be useful in this kind of situations and can be easily applied to young patient to correct such malocclusions.

Prosthodontic management of segmental mandibulectomy patient with guidance appliance and overlay denture.

PubMed

Aruna, U; Thulasingam, C

2013-12-01

Patients who undergo segmental or hemi-mandibulectomy suffer from various postoperative problems in esthetics and function. The solution to such problem is providing a mandibular guidance appliance to correct mandibular deviation to resected side due to loss of muscle action on the affected side. This article describes the treatment of a female patient who underwent segmental mandibulectomy on right side secondary to adenoid cystic carcinoma of the base of tongue. An acrylic guidance appliance was constructed to help control the mandibular deviation and co-ordinate masticatory movements. The prosthesis was worn continuously by the patient for 1 month which corrected the occlusion on the left side. To compensate for the open-bite caused due to rotation of mandible following partial mandibulectomy, an overlay removable partial denture was given. The patient was satisfied with the improvement in esthetics and mastication.

Cephalometric evaluation of maxillary retrognathism cases treated with FR-3 appliance.

PubMed

Biren, S; Erverdi, N

1993-09-01

The purpose of this investigation was to evaluate the efficiency of the FR-3 appliance on functional Cl III malocclusion cases. A total of 45 functional Cl III cases were chosen from a general clinic intake of which 25 were treated with the FR-3 appliance and 20 were untreated and were taken as a control group. Patients that were treated with FR-3 had the following characteristics: Cl III with maxillary deficiency; functional anterior cross-bite; absence of anterior open-bite; patients in mixed dentition. The mean age in the treatment group was 8.4 years 8.8 years in the control group. The observation period was one year for both groups. The results were as follows: Sagittal forward growth stimulation was not observed in the maxilla. Mandibular growth was redirected in the vertical direction. The SNB angle decreased in that the mandible rotated downward and backward. The ANB angle increased. There was an increase in total and lower anterior facial height and reduction in the overbite. Another skeletal change observed was the increase in the cranial flexure angle. Improved dental results were a significant amount of overjet increase and a decrease in the IMPA. There was also a beneficial effect on the soft tissue profile.

Changes in serial laboratory test results in snakebite patients: when can we safely exclude envenoming?

PubMed

Ireland, Graham; Brown, Simon G A; Buckley, Nicholas A; Stormer, Jeff; Currie, Bart J; White, Julian; Spain, David; Isbister, Geoffrey K

2010-09-06

To determine which laboratory tests are first associated with severe envenoming after a snakebite, when (ie, how long after the bite) the test results become abnormal, and whether this can determine a safe observation period after suspected snakebite. Prospective cohort study of 478 patients with suspected or confirmed snakebite recruited to the Australian Snakebite Project from January 2002 to April 2009, who had at least three sets of laboratory test results and at least 12 hours of observation in hospital after the bite. Severe envenoming was defined as venom-induced consumption coagulopathy (VICC), myotoxicity, neurotoxicity or thrombotic microangiopathy. International normalised ratio (INR), activated partial thromboplastin time (aPTT), creatine kinase (CK) level, and neurological examination. There were 240 patients with severe envenoming, 75 with minor envenoming and 163 non-envenomed patients. Of 206 patients with VICC, 178 had an INR > 1.2 (abnormal) on admission, and the remaining 28 had an INR > 1.2 within 12 hours of the bite. Of 33 patients with myotoxicity, a combination of CK > 250 U/L and an abnormal aPTT identified all but two cases by 12 hours; one of these two was identified within 12 hours by leukocytosis. Nine cases of isolated neurotoxicity had a median time of onset after the bite of 4 hours (range, 35 min - 12 h). The combination of serial INR, aPTT and CK tests and repeated neurological examination identified 213 of 222 severe envenoming cases (96%) by 6 hours and 238 of 240 (99%) by 12 hours. Laboratory parameters (INR, aPTT and CK) and neurological reassessments identified nearly all severe envenoming cases within 12 hours of the bite, even in this conservative analysis that assumed normal test results if the test was not done.

Clinical and epidemiological features of human rabies cases in the Philippines: a review from 1987 to 2006.

PubMed

Dimaano, Efren M; Scholand, Stephen J; Alera, Maria Theresa P; Belandres, Domingo B

2011-07-01

Rabies viral infection causes a fatal encephalomyelitis. In humans, classic features include hydrophobia, aerophobia, hypersalivation, agitation, and neurological symptoms. In the Philippines, canine rabies contributes to a significant burden of human disease. We retrospectively reviewed the medical records of 1839 patients admitted to San Lazaro Hospital, Manila, Philippines between 1987 and 2006, with a clinical diagnosis of rabies. We used the World Health Organization case definition for clinical rabies, which is defined by the presence of hydrophobia. Male patients outnumbered females by 2.2 to 1 and twice the number of adults were affected compared with children. Most patients were indigent. Dog bites occurred more than cat bites (97.1% vs. 2.9%) and most cases were caused by a single bite (86.2%), compared to multiple bites (8.7%). Bites to the face, head, and neck led to shorter incubation times, yet the incubation period varied, with most cases (42.7%) occurring in the bracket of 91-365 days post-exposure. Clinical symptoms included hydrophobia in all cases, as per our case definition, and aerophobia in 95.5%; only 9.4% had fever, 9.2% exhibited restlessness, and 6.7% exhibited hypersalivation. Localized neurological symptoms included pain (4.1%), numbness (2.6%), and itching (2.3%). None of the patients received appropriate post-exposure prophylaxis (PEP). This study examines the largest cohort of rabies patients reported to-date. Better understanding of clinical disease manifestations may help in salvage efforts to save patients with rabies. Knowledge of epidemiological factors will improve preventative efforts to reduce suffering from rabies. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Bilateral cross-bite treated by repeated rapid maxillary expansions: a 17-year follow-up case.

PubMed

Cozzani, M; Mazzotta, L; Caprioglio, A

2014-07-01

The objective of this paper is to show the clinical results after the repeated application of a Haas expander for rapid maxillary expansion (RME) anchored onto deciduous teeth in a 7-year-old patient that presented bilateral cross-bite, superior crowding and no space for permanent lateral incisors eruption. A first Haas expander was applied to the patient. She was told to activate it once a day, each activation was equal to 0.20 mm. After the first RME, the bilateral cross-bite was solved but still there was not enough space for lateral incisor eruption. A second and then a third Haas expander were applied, with the same activation protocol as the first one, in order to gain space in the anterior region and to achieve proper eruption of the lateral incisors. The patient was then treated with fixed appliances. At debonding the patient presented well aligned arch-forms: space for lateral incisor eruption was gained and superior crowding was solved. Bilateral cross-bite was also corrected. She was seen again 10 years and 17 years after expansions: she showed no relapse and presented a good functional occlusion that had remained stable, and an aesthetically pleasant smile, however she exhibited gingival recessions. Repeated rapid maxillary expansion, anchored onto deciduous teeth, performed in early mixed dentition represents a safe and successful treatment to correct severe bilateral cross- bites and to create space for maxillary incisor eruption.

Primary repair of facial dog bite injuries in children.

PubMed

Wu, Peter S; Beres, Alana; Tashjian, David B; Moriarty, Kevin P

2011-09-01

The management of dog bite wounds is controversial, and current data on risk of infection are variable and inconsistent. Furthermore, the use of prophylactic or empiric antibiotics for the treatment of these wounds is debatable. We investigate the rate of wound infections and other complications after primary repair of pediatric facial dog bite injuries. We reviewed 87 consecutive patients aged 18 years or younger who had facial dog bite injuries from January 2003 to December 2008. Variables examined were age, sex, setting of repair, number of sutures used for repair, whether surgical drains were used, and antibiotic administration. End points measured were incidence of wound infection, need for scar revision, and any wound complications. The mean age of patients was 6.8 years, and the majority were women (53%). All facial injuries were primarily repaired at the time of presentation either in the emergency department (ED; 46%), operating room (OR; 51%), or an outpatient setting (3%). All patients received an antibiotic course, none of the patients developed wound infection, and no subsequent scar revisions were performed. Three patients repaired in the OR underwent placement of a total of 4 closed-suction drains. The mean (SD) age of patients repaired in the OR was significantly younger than those repaired in the ED (5.7 [3.9] vs 8.0 [4.5] years, respectively; P < 0.01). The number of sutures used were greater for patients repaired in the OR than in the ED (66.4 [39.6] vs 21.7 [12.5], respectively; P < 0.01). Intuitively, younger patients and patients with greater severity injuries are more likely to undergo repair in the OR, and this was supported by our data. Overall, we found that primary repair of pediatric facial dog bite injuries, including complex soft-tissue injuries, is safe when performed in conjunction with antibiotic administration; however, further cross-specialty studies are needed to fully characterize these end points in a larger population.

Jaw tremor as a physiological biomarker of bruxism.

PubMed

Laine, C M; Yavuz, Ş U; D'Amico, J M; Gorassini, M A; Türker, K S; Farina, D

2015-09-01

To determine if sleep bruxism is associated with abnormal physiological tremor of the jaw during a visually-guided bite force control task. Healthy participants and patients with sleep bruxism were given visual feedback of their bite force and asked to trace triangular target trajectories (duration=20s, peak force <35% maximum voluntary force). Bite force control was quantified in terms of the power spectra of force fluctuations, masseter EMG activity, and force-to-EMG coherence. Patients had greater jaw force tremor at ∼8 Hz relative to controls, along with increased masseter EMG activity and force-to-EMG coherence in the same frequency range. Patients also showed lower force-to-EMG coherence at low frequencies (<3 Hz), but greater coherence at high frequencies (20-40 Hz). Finally, patients had greater 6-10 Hz force tremor during periods of descending vs. ascending force, while controls showed no difference in tremor with respect to force dynamics. Patients with bruxism have abnormal jaw tremor when engaged in a visually-guided bite force task. Measurement of jaw tremor may aid in the detection/evaluation of bruxism. In light of previous literature, our results also suggest that bruxism is marked by abnormal or mishandled peripheral feedback from the teeth. Copyright © 2015. Published by Elsevier Ireland Ltd.

Streptobacillus moniliformis Bacteremia in a Pet Shop Employee: Case Report and Literature Review.

PubMed

Suzuki, Kiyozumi; Hirai, Yuji; Morita, Fujiko; Nakamura, Ayako; Uehara, Yuki; Naito, Toshio

2017-01-01

A 39-year-old pet shop employee who sustained a bite from one of his store's rats developed fever and arthritis. Streptobacillus moniliformis was cultured from the patient's blood, confirming a diagnosis of rat-bite fever. Treatment with standard antibiotics was successful. Although rat-bite fever is commonly considered a zoonosis transmitted by wild or laboratory rats, our case emphasizes that it may be transmitted by pet animals as well.

Nonextraction and nonsurgical treatment of an adult with skeletal Class II open bite with severe retrognathic mandible and temporomandibular disorders.

PubMed

Kondo, Etsuko

2007-01-01

The treatment of an adult patient with a skeletal Class II Division 1 malocclusion, retrognathic mandible with downward and backward rotation, anterior open bite, and temporomandibular disorders is presented. Treatment objectives included establishing a stable occlusion with normal respiration, eliminating temporomandibular disorder symptoms, and improving facial esthetics through nonextraction and nonsurgical treatment. The patient was a Japanese adult female, who had previously been advised to have orthognathic surgery. An expansion plate was used to reshape the maxillary dentoalveolar arch. Distalization of the maxillary arch and forward movement of the mandible were achieved by reduced excessive posterior occlusal vertical dimension, through uprighting and intruding the mandibular posterior teeth, and rotating the mandible slightly upward and forward. The functional occlusal plane was reconstructed by uprighting and intruding the mandibular posterior teeth with a full-bracket appliance, combined with a maxillary expansion plate and short Class II elastics. Myofunctional therapy and masticatory and cervical muscle training involved chewing gum exercises and neck-muscle massage. The excessive posterior vertical occlusal dimension was significantly reduced, creating a small clearance between the posterior maxilla and mandible. The occlusal interferences in the posterior area were eliminated by the expansion of the maxillary dentoalveolar arch. As a result, the mandible moved forward, creating a more favorable jaw relationship. Distal movement of the maxillary arch was also achieved. The functional occlusal plane was reconstructed and a normal overjet and overbite were created. Adequate tongue space for normal respiration was established during the early stage of treatment. A stable occlusion with adequate posterior support and anterior guidance was established in a treatment time of 25 months, without orthognathic surgery, extraction, or headgear; this result was maintained at more than 1 year 8 months posttreatment.

A Technique for Digital Impression and Bite Registration for a Single Edentulous Arch.

PubMed

Fang, Yiqin; Fang, Jing-Huan; Jeong, Seung-Mi; Choi, Byung-Ho

2018-03-09

Few studies have reported the application of digital technology for the process of impression and interocclusal recordings in edentulous patients. This article describes a digitizing system for generating digital edentulous models with a jaw relationship by taking direct digital impressions and a virtual bite registration using intraoral digital scanning. A specialized scan retractor was used to make digital impressions of edentulous jaws in patients' mouths using an intraoral scanner. Virtual bite registration was obtained with optical scanning of the buccal surfaces of both jaws at the occlusal vertical dimension. The registration was then used as a reference for aligning both jaws. Digital edentulous models that include the jaw relationship would be clinically beneficial for the fabrication of complete dentures in edentulous patients. © 2018 by the American College of Prosthodontists.

Coral snake bites and envenomation in children: a case series.

PubMed

Sasaki, Jun; Khalil, Paul A; Chegondi, Madhuradhar; Raszynski, Andre; Meyer, Keith G; Totapally, Balagangadhar R

2014-04-01

North America is home to 2 families of venomous snakes, Crotalinae (pit viper family) and Elapidae (coral snake family). Although there are several published reports describing and reviewing the management of pit viper snakebites in children, there are no recent similar publications detailing the clinical course and management of coral snake envenomation. Our case series describes the hospital course of children with coral snake bites admitted to our regional pediatric intensive care. We also reviewed prior published case reports of coral snake bites in the United States. We identified 4 patients with either confirmed or suspected coral snake envenomation from our hospital's records. In 2 cases, the snakebite occurred after apparent provocation. Antivenom was administered to 3 patients. The regional venom response team was consulted for management advice and supplied the antivenom. One patient had a prolonged hospital course, which was complicated by respiratory failure, bulbar palsy, and ataxia. All survived to discharge. Admission to pediatric intensive care is warranted after all Eastern coral snake bites. A specialized regional or national venom response team can be a useful resource for management advice and as a source of antivenom.

Flow cytometric analysis of skin blister fluid induced by mosquito bites in a patient with chronic active Epstein-Barr virus infection.

PubMed

Wada, Taizo; Yokoyama, Tadafumi; Nakagawa, Hiroyasu; Asai, Erika; Toga, Akiko; Sakakibara, Yasuhisa; Shibata, Fumie; Tone, Yumi; Shimizu, Masaki; Toma, Tomoko; Yachie, Akihiro

2009-12-01

In chronic active Epstein-Barr virus (EBV) infection (CAEBV), ectopic EBV infection has been described in T or natural killer (NK) cells. NK cell-type infection (NK-CAEBV) is characterized by large granular lymphocytosis, high IgE levels and unusual reactions to mosquito bites, including severe local skin reactions, fever and liver dysfunction. However, the mechanisms underlying these reactions remain undetermined. Herein, we describe a patient with NK-CAEBV whose blister fluid after mosquito bites was analyzed. The patient exhibited significant increases in the percentage of CD56(+) NK cells in the fluid compared with a simple mosquito allergy, in which the majority of infiltrated cells were CD203c(+) cells, indicating basophils and/or mast cells. His fluid also contained CD203c(+) cells, and his circulating basophils were activated by mosquito extracts in vitro. These results suggest that CD203c(+) cells as well as NK cells may play pathogenic roles in the severe skin reactions to mosquito bites in NK-CAEBV.

Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany.

PubMed Central

Maiwald, M.; Oehme, R.; March, O.; Petney, T. N.; Kimmig, P.; Naser, K.; Zappe, H. A.; Hassler, D.; von Knebel Doeberitz, M.

1998-01-01

The risk of Borrelia burgdorferi infection and the value of antibiotic prophylaxis after tick bite are controversial. In this study, performed in two areas of southwestern Germany, ticks were collected from 730 patients and examined by the polymerase chain reaction (PCR) for B. burgdorferi. To assess whether transmission of B. burgdorferi occurred, the patients were clinically and serologically examined after tick removal and during follow-up examinations. Data from all tick bites gave a total transmission rate of 2.6% (19 patients). Eighty-four ticks (11.3%) were PCR positive. Transmission occurred to 16 (26.7%) of 60 patients who were initially seronegative and could be followed up after the bite of an infected tick. These results indicate that the transmission rate from infected ticks in Europe is higher than previously assumed. Examination of ticks and antibiotic prophylaxis in the case of positivity appears to be indicated. PMID:9747761

Occlusal characteristics of children with hypertrophied adenoids in Nigeria.

PubMed

Osiatuma, Vivien Ijeoma; Otuyemi, Olayinka Donald; Kolawole, Kikelomo Adebanke; Ogunbanjo, Babatunde Ogunbiyi; Amusa, Yemisi Bola

2015-03-01

Nasorespiratory function and its relation to craniofacial growth are of great interest because of the basic biological relationship between form and function, and the accumulating findings of the relationship between mode of breathing, craniofacial growth and orthodontic treatment. The aim of this study was to evaluate the effect of adenoid hypertrophy and sociodemographic variables on the occlusion of children. A total of 180 subjects aged 3-12 years were selected at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Ninety subjects had hypertrophied adenoids while 90 normal children served as the control group. Orthodontic examinations were carried out and impressions for study models taken. Occlusion was assessed in the anterior-posterior, transverse and vertical planes. Class I relationship was the most prevalent occlusion in both adenoid and control subjects (55.6% and 72.2%, respectively). The occurrence of class II division 1 was significantly higher among adenoid than control subjects (P=0.003). Posterior crossbites occurred significantly more in adenoid subjects in the 9-12 years category. In the vertical plane, the occurrence of deep bite was significantly greater in male than female adenoid subjects. Age had a statistically significant but weak correlation with anterior open bite (r=0.37). Age and BMI also had significant though weak correlations with posterior crossbite in female adenoid subjects (r=0.39 and r=0.36, respectively). Regression analysis also showed that age had a significant effect on the occurrence of anterior open bite, while BMI had a significant effect on the occurrence of class II occlusion in adenoid subjects (P<0.05). The presence of hypertrophied adenoids affects the occlusion in the three planes. Age and BMI have significant effects on the occurrence of anterior open bite and class II division 1 malocclusion respectively in adenoid subjects. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Cat scratch disease

MedlinePlus

... t scratch and bite. Don't allow a cat to lick your skin, eyes, mouth, or open wounds or scratches. Use flea control measures to lower the risk your cat develops the disease. Don't touch feral cats. ...

[Management of dog bite trauma of the external genital organs].

PubMed

Dubosq, Francis; Traxer, Olivier; Boublil, Véronique; Gattegno, Bernard; Thibault, Philippe

2004-04-01

Animal bites to the scrotum are rare, but potentially serious. In the light of a personal case, the authors discuss the management of these lesions. An animal bite comprises a triple infectious risk: bacterial, tetanus and rabies. Surgical exploration is indicated for assessment of the structures involved and debridement. The morbidity is related to the severity of the bite and the waiting time before consultation, and complications are rare. Orchidectomy is sometimes necessary, as in the case reported here, and the patient must be warned about this possibility. Antibiotic therapy is empirical: tetracycline and anti-anaerobe antibiotic. Rabies and tetanus prophylaxis must be performed according to vaccine guidelines.

Chronic fluoxetine treatment induces anxiolytic responses and altered social behaviors in medaka, Oryzias latipes.

PubMed

Ansai, Satoshi; Hosokawa, Hiroshi; Maegawa, Shingo; Kinoshita, Masato

2016-04-15

Medaka (Oryzias latipes) is a small freshwater teleost that is an emerging model system for neurobehavioral research and toxicological testing. The selective serotonin reuptake inhibitor class of antidepressants such as fluoxetine is one of the widely prescribed drugs, but little is known about the effects of these drugs on medaka behaviors. To assess the behavioral effects of fluoxetine, we chronically administrated fluoxetine to medaka adult fish and analyzed the anxiety-related and social behaviors using five behavioral paradigms (diving, open-field, light-dark transition, mirror-biting, and social interaction) with an automated behavioral testing system. Fish chronically treated with fluoxetine exhibited anxiolytic responses such as an overall increased time spent in the top area in the diving test and an increased time spent in center area in the open-field test. Analysis of socially evoked behavior showed that chronic fluoxetine administration decreased the number of mirror biting times in the mirror-biting test and increased latency to first contact in the social interaction test. Additionally, chronic fluoxetine administration reduced the horizontal locomotor activity in the open-field test but not the vertical activity in the diving test. These investigations are mostly consistent with previous reports in the other teleost species and rodent models. These results indicate that behavioral assessment in medaka adult fish will become useful for screening of effects of pharmaceutical and toxicological compounds in animal behaviors. Copyright © 2016 Elsevier B.V. All rights reserved.

The syntactic organization of pasta-eating and the structure of reach movements in the head-fixed mouse.

PubMed

Whishaw, Ian Q; Faraji, Jamshid; Kuntz, Jessica R; Mirza Agha, Behroo; Metz, Gerlinde A S; Mohajerani, Majid H

2017-09-08

Mice are adept in the use of their hands for activities such as feeding, which has led to their use in investigations of the neural basis of skilled-movements. We describe the syntactic organization of pasta-eating and the structure of hand movements used for pasta manipulation by the head-fixed mouse. An ethogram of mice consuming pieces of spaghetti reveals that they eat in bite/chew bouts. A bout begins with pasta lifted to the mouth and then manipulated with hand movements into a preferred orientation for biting. Manipulation involves many hand release-reach movements, each with a similar structure. A hand is advanced from a digit closed and flexed (collect) position to a digit extended and open position (overgrasp) and then to a digit closed and flexed (grasp) position. Reach distance, hand shaping, and grasp patterns featuring precision grasps or whole hand grasps are related. To bite, mice display hand preference and asymmetric grasps; one hand (guide grasp) directs food into the mouth and the other stabilizes the pasta for biting. When chewing after biting, the hands hold the pasta in a symmetric resting position. Pasta-eating is organized and features structured hand movements and so lends itself to the neural investigation of skilled-movements.

[Effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition].

PubMed

Chen, X X; Xia, B; Ge, L H; Yuan, J W

2016-12-18

To assess the effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Beijing. This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior cross bite, posterior cross bite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple Logistic regressions were applied to analyze the associations. It was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR=3.13, 95%CI=1.11-8.82, P=0.031) and no maxillary space (OR=1.63, 95%CI=1.23-2.98, P=0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR=4.21, 95%CI=1.85-9.60, P=0.000 2). The children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of class II canine relationship compared with those who were bottle-fed for 6-18 months. Non-nutritive sucking habits were also found to affect occlusion: a prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit was associated with excessive overjet and absence of lower arch developmental space. Tongue-thrust habit was associated with anterior open bite (OR=4.21, 95%CI=1.85-9.60, P=0.000 2) and posterior cross bite (OR=7.24, 95%CI=1.30-40.13, P=0.024). Lower lip sucking habit was associated with deep overjet and had a negative association with class III canine relationship. Unilateral chewing was associated with spacing in mandibular (OR=1.57, 95%CI=1.03-2.41, P=0.037). Mouth breathing was associated with chronic rhinitis and adenoidal hypertrophy and had an association with spacing in maxillary. The chi-square test did not indicate a statistically significant association between upper lip sucking habit and any occlusal characteristics. Breast-feeding duration was shown to be associated with the prevalence of posterior crossbite, or no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a longer duration of bottle-feeding were more likely to develop class II canine relationship. Children who had an oral habit were more likely to develop abnormal occlusal characteristics.

Rabies Situation in Cambodia

PubMed Central

Ly, Sowath; Buchy, Philippe; Heng, Nay Yim; Ong, Sivuth; Chhor, Nareth; Bourhy, Hervé; Vong, Sirenda

2009-01-01

Background Rabies, a fatal but preventable zoonosis, is a major public health problem in developing countries. In Cambodia the disease burden is largely underestimated because patients with encephalitis following dog bites are rarely hospitalized and die at home. Since 1998 Institut Pasteur in Cambodia (IPC), Phnom Penh has been the only source of free post-exposure prophylaxis (PEP) and post-mortem diagnosis. Methods The 1998–2007 data compiled by IPC was analyzed to describe all treated patients for PEP, results of human testing and confirmed rabies cases, and results of animal testing. From dog bites' characteristics, we defined a suspected rabid dog bite injury (SRDBI) in humans as a bite that was unprovoked, from a dog that died spontaneously, or from a dog that was reported sick. We applied a deterministic probability model to estimate 2007 rabies human mortality nationwide from the estimated incidence of rabid dog bites, the body distribution of bite wounds, and the probability of PEP access. Results During 1998–2007, 124,749 patients received PEP at IPC (average 12,470; range 8,907–14,475), and 63 fatal human cases presenting with encephalitis following a dog bite were reported, in which 73% were confirmed positive for rabies by direct immunofluorescence assay or by reverse-transcriptase polymerase chain reaction. During 1998–2007, IPC tested 1,255 animal brain samples; 1,214 (97%) were from dogs including 610 (49%) positive samples. In 2007, 14,475 patients received PEP (100 PEP/100,000 people in Cambodia) including 95% who resided in Phnom Penh (615 PEP/100,000) or five neighboring provinces. The predictive model estimated 810 human rabies deaths would occur in 2007 (95%confidence interval [CI] 394–1,607), an incidence of 5.8/100,000 (95% CI 2.8–11.5). Conclusions Access to PEP is only sufficient for Phnom Penh residents. In 2007, the estimated rabies related mortality exceeded that of malaria and that of dengue. A national rabies control program is needed to improve surveillance and access to PEP, and to initiate vaccination campaigns in dogs. PMID:19907631

The relationship between facial skeleton morphology and bite force in people with a normal relation of the bases of jaws and skull.

PubMed

Sidorowicz, Ł; Szymańska, J

2015-01-01

Better knowledge on the relationship between craniofacial structure and bite force may serve as a reference point for prophylactic and therapeutic activities targeted at developmental age patients. The aim of the study was to assess the correlation between facial skeletal morphology and bite force. The study included 54 subjects aged 7-16 years with a normal relation of the bases of jaws and skull, according to Segner's and Hasund's analysis standards (ML-NL and ML-NSL angles values were 20.0 ± 7.0° and 28.0 ± 5.0°, respectively). The study group included patients who volunteered to diagnosis and possible orthodontic treatment. Bite force was tested with a digital dynamometer calibrated in Newtons. The measurement was performed at the level of the first permanent molars. Cephalometric analysis was based on lateral cephalometric radiographs. The vertical relations were assessed using the following measurements: ML-NSL, ML-NL, NL-NSL, N-Me, Sp-Me, SpMe:NMe, ms-NL, SGo:NMe. Bite force does not depend on the following factors: lower anterior face height (Sp-Me), lower anterior face height to total anterior face height ratio (SpMe:NMe), posterior to anterior face height ratio (SG0:NMe), and the value of ML-NL, ML-NSL and NL-NSL angles. The posterior height of the maxilla alveolar process (ms-NL) exerts the greatest influence on bite force in people with a normal relation of the bases of jaws and skull: with an increase in ms-NL value bite force is reduced.

Category 2: Adult malocclusion with open bite.

PubMed

Kim, Keum-Ryung

2009-01-01

This case report was displayed by the American Board of Orthodontics at the Annual Session of the American Association of Orthodontists, as an example of a successfully completed case from the 2006 ABO clinical exam.

Severe Angle Class III skeletal malocclusion associated to mandibular prognathism: orthodontic-surgical treatment

PubMed Central

Souki, Marcelo Quiroga

2016-01-01

ABSTRACT The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate. PMID:28125146

Combined Orthodontic and Surgical Treatment in a 8-Years-Old Patient Affected By Severe Obstructive Sleep Apnea: A Case-Report.

PubMed

Gracco, Antonio; Bruno, Giovanni; de Stefani, Alberto; Ragona, Rosario Marchese; Mazzoleni, Sergio; Stellini, Edoardo

An eight-years-old girl showed a restless sleep with snoring and severe apnea episodes, a mandibular retrognathia, mouth breathing, maxillary transverse discrepancy, mandibular transverse discrepancy, moderate crowding and anterior open-bite. The CBCT showed an anterior collapse of the epiglottis. The treatment consisted in a rapid palatal expansion, an epiglottoplasty and a reduction of the tongue base. Polysomnography revealed that apnea-hypopnea index improved from 21,8 episodes/hr at the baseline to 0,6 episodes/hr, average oxygen saturation from 96,5% to 98,1%, oxygen desaturation events from 23,4 episodes/hr to 1/hr.

Capnocytophaga canimorsus Sepsis Following a Minor Dog Bite to the Finger: Case Report.

PubMed

Dedy, Nicolas J; Coghill, Sarah; Chandrashekar, Nanda Kumar S; Bindra, Randy R

2016-01-01

Capnocytophaga canimorsus is a gram-negative bacillus present in the oral cavities of 22% to 74% of healthy dogs. Capnocytophaga canimorsus has unique virulence factors that enable it to evade the human immune system and cause life-threatening sepsis following a dog bite. We report a previously well 68-year-old woman who presented with septic shock and multiorgan failure following a seemingly minor dog bite to the finger. The patient required intensive care treatment, intravenous antibiotic therapy, and multiple surgical procedures including amputation of the affected finger. The septicemia and coagulopathy that ensued resulted in gangrene and amputation of additional fingers and toes. The purpose of this report is to raise awareness of this organism among hand surgeons when faced with a patient presenting in septic shock and minimal signs at the site of a dog bite. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Development of Low-Cost Remote-Control Generators Based on BiTe Thermoelectric Modules

NASA Astrophysics Data System (ADS)

Juanicó, Luis E.; Rinalde, Fabián; Taglialavore, Eduardo; Molina, Marcelo

2013-07-01

This paper presents a new thermogenerator based on moderate-temperature (up to 175°C) BiTe modules available on the open market. Despite this handicap relative to commercial thermogenerators based on high-temperature proprietary-technology PbBi modules (up to 560°C), this new design may become economically competitive due to its innovative thermal sink. Our thermal sink is based on a free-convection water loop built with standard tubing and household hot-water radiators, leading to a more practical, modular design. So, the specific cost of about 55,000 USD/kW obtained for this 120-W prototype is improved to 33,000 USD/kW for a 1-kW unit, which represents about half the price of commercial thermogenerators. Moreover, considering recently launched BiTe modules (that withstand up to 320°C), our proposition could have an even more favorable outlook.

Angle’s Class II division 1 associated to mandibular retrusion and skeletal open bite: a 5-year post-orthodontic/orthopedic treatment follow-up

PubMed Central

Rodrigues, Gustavo Tirado

2017-01-01

ABSTRACT Obtaining long term stability allied to functional and aesthetic balance is the main goal of any orthodontic-orthopedic therapy. This case report describes the orthodontic therapy applied to a 7-year-9-month old child, who presented a Class II, division 1 malocclusion associated to skeletal open bite. Functional and skeletal corrections (sagittally and vertically) were obtained by means of mandible advancement achieved with a closed Balter’s bionator appliance followed by a fixed appliance. This approach showed to be efficient in accomplishing both functional and aesthetic goals, that were kept stable five years after the treatment was finished. This case report was presented to the Board of Directors of the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as partial requirement to becoming a Diplomate of the BBO. PMID:29160350

Contemporary update on the treatment of dog bite: injuries to the oral and maxillofacial region.

PubMed

Foster, Michael D; Hudson, John W

2015-05-01

The purpose of the present retrospective record review was to evaluate the patient demographics, treatment rendered, and long-term outcomes of patients injured in dog bite attacks to the oral and maxillofacial region. In the present study, a retrospective medical record review was conducted of patients treated by the oral and maxillofacial surgery department at the University of Tennessee Medical Center who had presented with injuries to the head, neck, and face region from dog bite attacks from February 1, 2006 to October 31, 2013. Each patient included had to have had at least 1 follow-up visit. The data obtained from the patients' medical records included patient demographics, event details, injuries sustained, and treatment rendered and analyzed. The medical records from 20 patients were included and reviewed. More than one half (60%) of the patients were younger than 12 years old. The dog was owned by the patient or a relative in 58% of the cases. The children sustained injuries requiring hospital admission and repair in an operating room setting more often than did the adults. Pit bulls were more frequently associated with injuries than other breeds (9 of 20). Our patients required a total of 28 hospital inpatient days, 29 total procedures, and follow-up treatment for up to 2 years. Our review has shown the complexity of soft tissue injury treatment and the significant financial impact associated with dog bite injuries owing to the multiple hospital admissions, surgical revisions, and lengthy follow-up period required. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Biology of biomechanics: Finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion.

PubMed

Roberts, W Eugene; Viecilli, Rodrigo F; Chang, Chris; Katona, Thomas R; Paydar, Nasser H

2015-12-01

In the absence of adequate animal or in-vitro models, the biomechanics of human malocclusion must be studied indirectly. Finite element analysis (FEA) is emerging as a clinical technology to assist in diagnosis, treatment planning, and retrospective analysis. The hypothesis tested is that instantaneous FEA can retrospectively simulate long-term mandibular arch retraction and occlusal plane rotation for the correction of a skeletal Class III malocclusion. Seventeen published case reports were selected of patients treated with statically determinate mechanics using posterior mandible or infrazygomatic crest bone screw anchorage to retract the mandibular arch. Two-dimensional measurements were made for incisor and molar movements, mandibular arch rotation, and retraction relative to the maxillary arch. A patient with cone-beam computed tomography imaging was selected for a retrospective FEA. The mean age for the sample was 23.3 ± 3.3 years; there were 7 men and 10 women. Mean incisor movements were 3.35 ± 1.55 mm of retraction and 2.18 ± 2.51 mm of extrusion. Corresponding molar movements were retractions of 4.85 ± 1.78 mm and intrusions of 0.85 ± 2.22 mm. Retraction of the mandibular arch relative to the maxillary arch was 4.88 ± 1.41 mm. Mean posterior rotation of the mandibular arch was -5.76° ± 4.77° (counterclockwise). The mean treatment time (n = 16) was 36.2 ± 15.3 months. Bone screws in the posterior mandibular region were more efficient for intruding molars and decreasing the vertical dimension of the occlusion to close an open bite. The full-cusp, skeletal Class III patient selected for FEA was treated to an American Board of Orthodontics Cast-Radiograph Evaluation score of 24 points in about 36 months by en-masse retraction and posterior rotation of the mandibular arch: the bilateral load on the mandibular segment was about 200 cN. The mandibular arch was retracted by about 5 mm, posterior rotation was about 16.5°, and molar intrusion was about 3 mm. There was a 4° decrease in the mandibular plane angle to close the skeletal open bite. Retrospective sequential iterations (FEA animation) simulated the clinical response, as documented with longitudinal cephalometrics. The level of periodontal ligament stress was relatively uniform (<5 kPa) for all teeth in the mandibular arch segment. En-masse retraction of the mandibular arch is efficient for conservatively treating a skeletal Class III malocclusion. Posterior mandibular anchorage causes intrusion of the molars to close the vertical dimension of the occlusion and the mandibular plane angle. Instantaneous FEA as modeled here could be used to reasonably predict the clinical results of an applied load. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Rat-bite fever presenting with rash and septic arthritis.

PubMed

Kanechorn Na Ayuthaya, Rajyani; Niumpradit, Nucha

2005-11-01

Rat-bite fever is an uncommon disease known for its endemicity to occur worldwide. Although most patients tend to develop mild symptoms with improvement from conventional antibiotics, it can progress with severe complications with a mortality rate as high as 13% without proper treatment. The authors report a complicated case of rat bite-fever involving a 61-year old woman who presented with fever petechial rash, and septic arthritis following a rat bite. Initially, multiple antibiotics were administered but were not effective. As a consequence, invasive procedures such as arthrotomy and joint debridement were done and prolonged antibiotic was administered until clinical resolution. Since many cases do not have a history of rat bite and may present with fever, rashes, and arthritis it is essential to distinguish it from other diseases. Here, the authors will provide details on the etiology, clinical manifestations, diagnosis, and management to aid prompt detection and treatment of the disease.

A rare cause of severe periorbital edema and dermonecrotic ulcer of the eyelid in a child: brown recluse spider bite.

PubMed

Taşkesen, Mustafa; Akdeniz, Sedat; Taş, Taşkin; Keklikçi, Uğur; Taş, Mehmet Ali

2011-01-01

Spider bites are a worldwide problem. Brown recluse spider bites can lead to severe local or systemic clinical effects, such as edema, necrotic ulcer, rashes, fever, chills, nausea, vomiting, malaise, arthralgia, myalgia, hemolysis, leukocytosis, disseminated intravascular coagulation, renal failure, and death. Eyelid bites from brown recluse spiders are rare. We report a child with severe facial edema and a dermonecrotic ulcer on the eyelid. Upon laboratory examination, leukocytosis with a significant left shift was detected. The patient was treated with antibiotics, systemic corticosteroid and conservative therapy that included saline compresses and ocular lubrication. No surgical excision was required. Vision was not impaired. A dermonecrotic ulcer is a severe complication of brown recluse spider bites. Since the diagnosis is difficult, clinical and epidemiological findings and a detailed history are important for an accurate diagnosis.

Design and clinical outcome of a novel 3D-printed prosthetic joint replacement for the human temporomandibular joint.

PubMed

Ackland, David; Robinson, Dale; Lee, Peter Vee Sin; Dimitroulis, George

2018-05-11

Stock prosthetic temporomandibular joint replacements come in limited sizes, and do not always encompass the joint anatomy that presents clinically. The aims of this study were twofold. Firstly, to design a personalized prosthetic total joint replacement for the treatment of a patient's end-stage temporomandibular joint osteoarthritis, to implant the prosthesis into the patient, and assess clinical outcome 12-months post-operatively; and secondly, to evaluate the influence of changes in prosthetic condyle geometry on implant load response during mastication. A 48-year-old female patient with Grade-5 osteoarthritis to the left temporomandibular joint was recruited, and a prosthesis developed to match the native temporomandibular joint anatomy. The prosthesis was 3D printed, sterilized and implanted into the patient, and pain and function measured 12-months post-operatively. The prosthesis load response during a chewing-bite and maximum-force bite was evaluated using a personalized multi-body musculoskeletal model. Simulations were performed after perturbing condyle thickness, neck length and head sphericity. Increases in prosthetic condyle neck length malaligned the mandible and perturbed temporomandibular joint force. Changes in condylar component thickness greatly influenced fixation screw stress response, while a more eccentric condylar head increased prosthetic joint-contact loading. Post-operatively, the prosthetic temporomandibular joint surgery reduced patient pain from 7/10 to 1/10 on a visual analog scale, and increased intercisal opening distance from 22 mm to 38 mm. This study demonstrates effectiveness of a personalized prosthesis that may ultimately be adapted to treat a wide-range of end-stage temporomandibular joint conditions, and highlights sensitivity of prosthesis load response to changes in condylar geometry. Copyright © 2018 Elsevier Ltd. All rights reserved.

[An overview on envenomings inflicted by the Common adder (Vipera berus) and their treatment in Hungary. Facts and beliefs -- part I].

PubMed

Malina, Tamás; Babocsay, Gergely; Krecsák, László; Schuller, Péter; Zacher, Gábor; Vasas, Gábor

2012-07-15

Consequences of bites by the Common adder (Vipera berus) were reviewed in this study. Patients bitten by snakes from different populations may develop variable symptoms due to geographical venom variation. The correct diagnosis of snake bites and the knowledge of the distribution of venomous snake taxa have a crucial impact on snake bite therapy. The characteristic symptoms of patients bitten by V. berus in Hungary are highlighted. The habitat characteristics, seasonal activity and the Hungarian distribution of the adder are described based on literature data, museum specimens and field observations. However, envenomings are uncommon in Hungary, the annual 3 to 4 incidents have to be taken seriously, regardless of the age and actual health condition of the patients. Contrary to beliefs persisting both among laymen and professionals, the venom of V. berus is powerful. Medical observation of the patients is necessary in the first 5 to 6 hours. Any systemic symptom or progression of the edema requires hospital admission.

[Tetanus after cat scratch and bites in a previously immunized patient].

PubMed

Fica, Alberto; Gaínza, Daniela; Ortigosa, Pablo

2017-04-01

Tetanus is declining due to vaccination, professional labor management and appropriate wound care. Tetanus cases have been reported despite immunization. We report the case of a previously healthy 21 years old female patient that presented a mild generalized tetanus requiring admission after mild and recurrent cat scratch and bites. She had received six vaccine shots during childhood, and a booster dose five years earlier after a rabbit bite. Symptoms appeared seven weeks after the last contact, and included headache, muscle spasms and mild opisthotonus. Laboratory evaluation, including CSF analysis and microbiological investigation, as well as imaging studies were all normal. The patient received 6,000 IU of human antitoxin immunoglobulin. No autonomic manifestations or respiratory compromise were registered. Symptoms resolved rapidly and she was discharge after seven days with an order to complete a tetanus toxoid immunization schedule with three doses. Tetanus is possible in urban settings with a declining epidemiologic curve of disease in previously immunized patients. Severity of disease is modulated by previous vaccination.

Multidisciplinary treatment approach in Treacher Collins syndrome.

PubMed

Hylton, Joseph B; Leon-Salazar, Vladimir; Anderson, Gary C; De Felippe, Nanci L O

2012-01-01

Treacher Collins syndrome (TCS) is a common genetic disorder with high penetrance and phenotypic variability. First and second branchial arches are affected in TCS, resulting in craniofacial and intraoral anomalies such as: severe convex facial profile; mid-face hypoplasia; microtia; eyelid colobomas; mandibular retrognathism; cleft palate; dental hypoplasia; heterotopic teeth; maxillary transverse hypoplasia; anterior open bite; and Angle Class II molar relationship. A high incidence of caries is also a typical finding in TCS patients. Nonetheless, even simple dental restorative procedures can be challenging in this patient population due to other associated medical conditions, such as: congenital heart defects; decreased oropharyngeal airways; hearing loss; and anxiety toward treatment. These patients often require a multidisciplinary treatment approach, including: audiology; speech and language pathology; otorhinolaryngology; general dentistry; orthodontics; oral and maxillofacial surgery; and plastic and reconstructive surgeries to improve facial appearance. This paper's purpose was to present a current understanding of Treacher Collins syndrome etiology, phenotype, and current treatment approaches.

Protective value of prophylactic antibiotic treatment of tick bite for Lyme disease prevention: an animal model.

PubMed

Piesman, Joseph; Hojgaard, Andrias

2012-06-01

Clinical studies have demonstrated that prophylactic antibiotic treatment of tick bites by Ixodes scapularis in Lyme disease hyperendemic regions in the northeastern United States can be effective in preventing infection with Borrelia burgdorferi sensu stricto, the Lyme disease spirochete. A large clinical trial in Westchester County, NY (USA), demonstrated that treatment of tick bite with 200mg of oral doxycycline was 87% effective in preventing Lyme disease in tick-bite victims (Nadelman, R.B., Nowakowski, J., Fish, D., Falco, R.C., Freeman, K., McKenna, D., Welch, P., Marcus, R., Agúero-Rosenfeld, M.E., Dennis, D.T., Wormser, G.P., 2001. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N. Engl. J. Med. 345, 79-84.). Although this excellent clinical trial provided much needed information, the authors enrolled subjects if the tick bite occurred within 3 days of their clinical visit, but did not analyze the data based on the exact time between tick removal and delivery of prophylaxis. An animal model allows for controlled experiments designed to determine the point in time after tick bite when delivery of oral antibiotics would be too late to prevent infection with B. burgdorferi. Accordingly, we developed a tick-bite prophylaxis model in mice that gave a level of prophylactic protection similar to what had been observed in clinical trials and then varied the time post tick bite of antibiotic delivery. We found that two treatments of doxycycline delivered by oral gavage to mice on the day of removal of a single potentially infectious nymphal I. scapularis protected 74% of test mice compared to controls. When treatment was delayed until 24 h after tick removal, only 47% of mice were protected; prophylactic treatment was totally ineffective when delivered ≥2 days after tick removal. Although the dynamics of antibiotic treatment in mice may differ from humans, and translation of animal studies to patient management must be approached with caution, we believe our results emphasize the point that antibiotic prophylactic treatment of tick bite to prevent Lyme disease is more likely to be efficacious if delivered promptly after potentially infectious ticks are removed from patients. There is only a very narrow window for prophylactic treatment to be effective post tick removal. Published by Elsevier GmbH.

[Hypersensitivity to mosquito bite manifested as Skeeter síndrome].

PubMed

Pérez-Vanzzini, Rafael; González-Díaz, Sandra Nora; Arias-Cruz, Alfredo; Palma-Gómez, Samuel; Yong-Rodríguez, Adrián; Gutiérrez-Mujica, José Julio; García-Calderín, Diego; Ibarra, Jesús Arturo

2015-01-01

The reactions to mosquito bites are immunological reactions with involvement of IgE, IgG and T cells mediated hypersensitivity. These reactions are common and range from small local reactions, large local reactions to systemic allergic reactions. Skeeter syndrome is defined as a large local induced inflammatory reaction to mosquito bite and sometimes accompanied by systemic symptoms such as fever and vomiting. Diagnosis is based on clinical history and physical examination, supported by the identification of specific IgE by skin testing. Treatment includes prevention, antihistamines and steroids in some cases. Specific immunotherapy still requires further study. This paper reports two cases of patients with hypersensitivity reactions to mosquito bites, which were evaluated in our center presenting positive skin tests.

Epidemiological and clinical features of human rabies cases in Bali 2008-2010

PubMed Central

2012-01-01

Background Previously thought to be rabies free, Bali experienced an outbreak of animal and human rabies cases in November 2008. We describe the epidemiological and clinical data of human rabies cases occurring in the first two years of the outbreak. Methods We analysed the patient records of all rabies cases from the Sanglah General Hospital in Denpasar, and district hospitals in Buleleng and Tabanan. A conventional reverse transcriptase polymerase chain reaction was developed to detect the rabies virus genome in saliva, corneal swabs, and ante- and post-mortem cerebrospinal fluid (CSF). Results There were 104 human rabies cases in Bali during November 2008-November 2010. Patients' mean age was 36.6 years (range 3-84 years; SD 20.7), most were male (56.7%), and originated from rural districts. Almost all (92%) cases had a history of dog bite. Only 5.8% had their wounds treated and received an anti-rabies vaccine (ARV) after the bite incident. No patients received rabies immunoglobulin (RIG). The estimated time from dog bite to the onset of signs and symptoms was 110.4 days (range 12-720 days; SD 118.2). The mean length of medical care until death was 21.8 hours (range 1-220 hours; SD 32.6). Less than 50% of patients had prodromal symptoms. The most frequent prodromal symptom was pain or paraesthesia at the bite site (37.6%). The two most common central nervous system infection signs were agitation (89.2%) and confusion (83.3%). Signs of autonomic nervous system dysfunction included hydrophobia (93.1%), hypersalivation (88.2%), and dyspnea (74.4%). On admission, 22 of 102 patients (21.6%) showed paralytic manifestations, while the rest (78.4%) showed furious rabies manifestations. The case-fatality rate was 100%. The rabies virus genome was detected in 50 of 101 patients (49.5%) with the highest detection rate from post-mortem CSF samples. Conclusions Rabies is a major public health problem in Bali. Human fatalities occur because of a lack of knowledge regarding rabies risk, the poor management of dog bites, and the limited availability of RIG. Increasing public awareness of dog bite management, increasing the availability of ARV and RIG, and implementing an island-wide dog vaccination campaign will help prevent human rabies cases. PMID:22471410

Epidemiological and clinical features of human rabies cases in Bali 2008-2010.

PubMed

Susilawathi, Ni M; Darwinata, Agus E; Dwija, Ida B N P; Budayanti, Nyoman S; Wirasandhi, Gusti A K; Subrata, Ketut; Susilarini, Ni K; Sudewi, Raka A A; Wignall, Frank S; Mahardika, Gusti N K

2012-04-02

Previously thought to be rabies free, Bali experienced an outbreak of animal and human rabies cases in November 2008. We describe the epidemiological and clinical data of human rabies cases occurring in the first two years of the outbreak. We analysed the patient records of all rabies cases from the Sanglah General Hospital in Denpasar, and district hospitals in Buleleng and Tabanan. A conventional reverse transcriptase polymerase chain reaction was developed to detect the rabies virus genome in saliva, corneal swabs, and ante- and post-mortem cerebrospinal fluid (CSF). There were 104 human rabies cases in Bali during November 2008-November 2010. Patients' mean age was 36.6 years (range 3-84 years; SD 20.7), most were male (56.7%), and originated from rural districts. Almost all (92%) cases had a history of dog bite. Only 5.8% had their wounds treated and received an anti-rabies vaccine (ARV) after the bite incident. No patients received rabies immunoglobulin (RIG). The estimated time from dog bite to the onset of signs and symptoms was 110.4 days (range 12-720 days; SD 118.2). The mean length of medical care until death was 21.8 hours (range 1-220 hours; SD 32.6). Less than 50% of patients had prodromal symptoms. The most frequent prodromal symptom was pain or paraesthesia at the bite site (37.6%). The two most common central nervous system infection signs were agitation (89.2%) and confusion (83.3%). Signs of autonomic nervous system dysfunction included hydrophobia (93.1%), hypersalivation (88.2%), and dyspnea (74.4%). On admission, 22 of 102 patients (21.6%) showed paralytic manifestations, while the rest (78.4%) showed furious rabies manifestations. The case-fatality rate was 100%. The rabies virus genome was detected in 50 of 101 patients (49.5%) with the highest detection rate from post-mortem CSF samples. Rabies is a major public health problem in Bali. Human fatalities occur because of a lack of knowledge regarding rabies risk, the poor management of dog bites, and the limited availability of RIG. Increasing public awareness of dog bite management, increasing the availability of ARV and RIG, and implementing an island-wide dog vaccination campaign will help prevent human rabies cases.

Dog bite injuries in children: a preliminary survey.

PubMed

Gandhi, R R; Liebman, M A; Stafford, B L; Stafford, P W

1999-09-01

Dog bite injuries in children are a preventable health problem. To characterize this type of injury, we have undertaken to define demographic criteria and patterns of injury inflicted by dogs in our pediatric population. A retrospective chart review was conducted of pediatric patients with dog bite injuries admitted to a Level I pediatric trauma center from January 1986 through June 1998. Patient demographics, canine characteristics, and hospital patient data were collected and analyzed using the Excel program and appropriate statistical methodology. There were 67 patient records reviewed. Thirty-eight (57%) of the patients were male, and 29 (43%) were female. There were 43 (64%) white children, 22 (33%) African-American children, and 2 (3%) Hispanic children. The average age of the children was 6.2 +/- 4.2 years, with an average weight of 23.3 +/- 13.7 kg. More than half the attacks occurred in the afternoon and 55 per cent of these attacks were documented as "unprovoked" attacks. Thirty-one (46%) of these attacks involved family pets, and 30 (45%) dogs were known to the attacked child. The head and neck was involved in greater than 67 per cent of these injuries. Pit bulls caused 25 per cent of the bite injuries. Large dogs were responsible for 88 per cent of the attacks. Forty-four (66%) patients required operative intervention. Twenty-eight of these patients had multiple anatomical areas injured. There were 44 procedures involving the head and neck, 21 involving extremities, and 6 involving other areas of the body. All patients 5 years of age and under had head and neck injuries. Dog bite injuries requiring admission occur more in male children. Caucasian and African American children were the majority of children affected. The children under 5 years of age suffered the most devastating injuries. More than half of these attacks were not provoked. More than two-thirds of the injuries to these children involved the head and neck. We conclude that effective prevention strategies must stress careful supervision of young children and the family or neighbor's dog, a scenario that may easily lead to complacency and set the stage for a severe injury.

[Orofacial alterations and surface electromyography in neurodevelopmental disorders].

PubMed

Rosell-Clari, V

2017-02-24

Surface electromyography has become a widely used technique for measuring the activity of different muscle groups. Although the reliability and validity of the technique are discussed, there is an important body of scientific literature that defends the use of this technique. To present through a case study, the two basic uses of surface electromyography: the measurement of orofacial muscular activity and use it as biofeedback modulator of the muscular activity itself. A 10 years-old girl with a dolichocephalic and prognosis facial profile, anterior open bite and bilateral cross bite, bilateral Angle class II occlusion and atypical swallowing with lingual interposition. The MioTool Face by Miotec Suite 1.0, it could use until 8-channel bipolar surface electromyography. Surface electrodes were placed in the orofacial musculature and the results obtained were measured and visualized through the software Miograph and Biotrainer. The results confirm those obtained through the clinical exploration of the patient and support the use of these measurements for the estimation and validation of mechanical models of the masticatory and swallowing system. Electromyographic biofeedback is shown as an effective technique to self-control the force performed in key muscle groups by performing primary activities such as chewing and swallowing.

Acute Generalized Exanthematous Pustulosis Due to Insect Bites?

PubMed

Bhat, Yasmeen J; Hassan, Iffat; Sajad, Peerzada; Yaseen, Atiya; Wani, Rohi

2015-01-01

Acute generalized exanthematous pustulosis is a rare severe cutaneous adverse reaction pattern that is mostly caused by the intake of drugs and rarely associated with viral infections, food allergens or toxins. Here we present the report of three patients who got admitted in our hospital for generalized pustulosis and fever after insect bites. The diagnosis of acute generalized exanthematous pustulosis was made by EuroSCAR scoring. The drug etiology was excluded and spider bite was implicated as the etiological agent in these cases of AGEP which are the first such reported cases in India.

Functional benefits of implants placed during ablative surgery: A 5-year prospective study on the prosthodontic rehabilitation of 56 edentulous oral cancer patients.

PubMed

Wetzels, Jan Willem; Koole, Ron; Meijer, Gert J; de Haan, Anton F J; Merkx, Matthias A W; Speksnijder, Caroline M

2016-04-01

The timing of placement as well as the functional benefit of interforaminal implants in edentulous patients treated for oral cancer is unclear. Fifty-six patients were recruited at 2 institutions. In 1 institution, interforaminal implants were placed during ablative surgery, the other institution used conventional prosthodontics with optional placement of implants postsurgery (postponed-placement). Masticatory performance, bite force, and subjective masticatory function were assessed before and 6 months, 1 year, and 5 years after surgery. Implant-retained overdentures (IODs) demonstrated the highest bite force and the least problems with solid food and food choice. Masticatory performance was equal for IODs and conventional dentures. After 5 years, IODs from patients in the during-ablative-surgery cohort tend to have higher bite force and masticatory performance than those from patients in the postponed-placement cohort. IODs produce the highest overall masticatory function. Implant placement during ablative surgery seems to be functionally beneficial. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2103-E2111, 2016. © 2016 Wiley Periodicals, Inc.

Botulinum toxin as a therapeutic agent to prevent relapse in deep bite patients.

PubMed

Mücke, Thomas; Löffel, Anja; Kanatas, Anastasios; Karnezi, Sandy; Rana, Majeed; Fichter, Andreas; Haarmann, Stephan; Wolff, Klaus-Dietrich; Loeffelbein, Denys John

2016-05-01

The etiology of deep bite is multifactorial. One of the causes is increased muscular activity. This makes the treatment of deep bite malocclusions difficult and often results in relapse in many cases. In this work we compared patients with surgical orthognathic treatment only and surgical orthognathic treatment with additional injections of botulinum toxin after mandibular advancement for class II division 2 malocclusion. This is a prospective study. Adult patients were assessed pretreatment (T1), posttreatment (T2), and long-term after 1 year (T3). In total, 32 patients (mean age, 30.7 years; 23 women and 9 men) reached the study end point (T3); 24 patients were treated without botulinum toxin and 8 patients received preoperative injections of botulinum toxin. Significant differences between both groups were observed, with a more stable result for the experimental group treated with botulinum toxin. In a selective group of adult patients with a class II division II incisor relationship and with a class II skeletal base, botulinum toxin injections can effectively prevent relapse. This may present an alternative to a conventional myotomy. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.

PubMed

Luo, Shufang; Li, Bo; Long, Xing; Deng, Mohong; Cai, Hengxing; Cheng, Yong

2011-07-01

The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment. Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height. Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis. The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of the Correlation of Ramus Height, Gonial Angle, and Dental Height with Different Facial Forms in Individuals with Deep Bite Disorders

PubMed Central

Ahila, SC; Sasikala, C; Kumar, B Muthu; Tah, Rajdeep; Abinaya, K

2016-01-01

Background: Restoring the vertical dimension is a critical procedure in prosthetic dentistry. Anterior facial height has a significant impact on the length of the ramus. Patients with deep bite will exhibit a shorter lower facial height; hence, restoring the vertical dimension esthetically without altering the facial form is highly challenging. Aim: To evaluate the relationship of gonial angle, ramus height, and dental height with different facial forms. Subjects and Methods: A total of 51 subjects in all facial form aged between 20 and 40 with deep bite were randomly selected. Lateral cephalograms and facial photographs were made for each patient. Ramus height was measured on lateral cephalogram by measuring the distance from articulare to gonion. The gonial angles were calculated and anterior and posterior dental height were measured from cephalogram. Facial forms were evaluated using patient's photographs. Results: The obtained measurements were evaluated, and compared statistically with one way analysis of variance and regression correlation test. Statistical analysis revealed that there was no correlation found between the gonial angle and ramus height. Conclusion: Correlation found between the ramus height and anterior and posterior dental height in patients with deep bite disorders. The ramus height can be calculated using the formulas 46.42 + (0.095 × AD height), 46.046+ (0.123 × PD height). PMID:28480098

Decrease in tick bite consultations and stabilization of early Lyme borreliosis in the Netherlands in 2014 after 15 years of continuous increase.

PubMed

Hofhuis, Agnetha; Bennema, Sita; Harms, Margriet; van Vliet, Arnold J H; Takken, Willem; van den Wijngaard, Cees C; van Pelt, Wilfrid

2016-05-23

Nationwide surveys have shown a threefold increase in general practitioner (GP) consultations for tick bites and early Lyme borreliosis from 1994 to 2009 in the Netherlands. We now report an update on 2014, with identical methods as for the preceding GP surveys. To all GPs in the Netherlands, a postal questionnaire was sent inquiring about the number of consultations for tick bites and erythema migrans diagnoses (most common manifestation of early Lyme borreliosis) in 2014, and the size of their practice populations. Contrasting to the previously rising incidence of consultations for tick bites between 1994 and 2009, the incidence decreased in 2014 to 488 consultations for tick bites per 100,000 inhabitants, i.e., 82,000 patients nationwide. This survey revealed a first sign of stabilization of the previously rising trend in GP diagnosed erythema migrans, with 140 diagnoses per 100,000 inhabitants of the Netherlands. This equals about 23,500 annual diagnoses of erythema migrans nationwide in 2014. In contrast to the constantly rising incidence of GP consultations for tick bites and erythema migrans diagnoses in the Netherlands between 1994 and 2009, the current survey of 2014 showed a first sign of stabilization of erythema migrans diagnoses and a decreased incidence for tick bite consultations.

First bite syndrome: Our experience with intraparotid injections with botulinum toxin type A.

PubMed

Ghosh, Ankona; Mirza, Natasha

2016-01-01

First bite syndrome is the sudden onset of acute and severe pain in the parotid region at the initiation of mastication. Although it generally lasts less than a minute, it is disabling for these individuals and leads to a fear of oral intake. It is typically seen after parapharyngeal or deep parotid space surgery. Intraparotid injection of botulinum toxin A (BTA) has been suggested as a treatment for this condition, but there is little supporting literature to this effect. The purpose of this study is to document our experience using this treatment method for first bite syndrome. Retrospective case review. Five patients with first bite syndrome, developed after parapharyngeal space surgery, were treated by multisite injection of BTA into the parotid gland. Between 17.5 and 50 total U of BTA were injected into four or more sites in the parotid region. The patients were then followed up every 4 months. Three of five patients reported a significant improvement in symptoms at the 4-month follow-up visit, although complete resolution was not reported. One patient reported only moderate improvement, and despite two series of injections there was no improvement in one patient, leading us to question our initial diagnosis. Unilateral BTA injection into the affected parotid gland produces a decrease in the severity of symptoms. It is a safe and viable noninvasive treatment for this difficult to treat condition and may lead to permanent resolution of symptoms in some patients. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

A personalized 3D-printed prosthetic joint replacement for the human temporomandibular joint: From implant design to implantation.

PubMed

Ackland, David C; Robinson, Dale; Redhead, Michael; Lee, Peter Vee Sin; Moskaljuk, Adrian; Dimitroulis, George

2017-05-01

Personalized prosthetic joint replacements have important applications in cases of complex bone and joint conditions where the shape and size of off-the-shelf components may not be adequate. The objective of this study was to design, test and fabricate a personalized 3D-printed prosthesis for a patient requiring total joint replacement surgery of the temporomandibular joint (TMJ). The new 'Melbourne' prosthetic TMJ design featured a condylar component sized specifically to the patient and fixation screw positions that avoid potential intra-operative damage to the mandibular nerve. The Melbourne prosthetic TMJ was developed for a 58-year-old female recipient with end-stage osteoarthritis of the TMJ. The load response of the prosthesis during chewing and a maximum-force bite was quantified using a personalized musculoskeletal model of the patient's masticatory system developed using medical images. The simulations were then repeated after implantation of the Biomet Microfixation prosthetic TMJ, an established stock device. The maximum condylar stresses, screw stress and mandibular stress at the screw-bone interface were lower in the Melbourne prosthetic TMJ (259.6MPa, 312.9MPa and 198.4MPa, respectively) than those in the Biomet Microfixation device (284.0MPa, 416.0MPa and 262.2MPa, respectively) during the maximum-force bite, with similar trends also observed during the chewing bite. After trialing surgical placement and evaluating prosthetic TMJ stability using cadaveric specimens, the prosthesis was fabricated using 3D printing, sterilized, and implanted into the female recipient. Six months post-operatively, the prosthesis recipient had a normal jaw opening distance (40.0 mm), with no complications identified. The new design features and immediate load response of the Melbourne prosthetic TMJ suggests that it may provide improved clinical and biomechanical joint function compared to a commonly used stock device, and reduce risk of intra-operative nerve damage during placement. The framework presented may be useful for designing and testing customized devices for the treatment of debilitating bone and joint conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Insights into the epidemiological link between biting flies and pemphigus foliaceus in southeastern Brazil.

PubMed

Vernal, Sebastian; Pepinelli, Mateus; Casanova, Claudio; Goulart, Thais M; Kim, Olivia; De Paula, Natalia A; Pinto, Mara C; Sá-Nunes, Anderson; Roselino, Ana Maria

2017-12-01

Black fly and sandfly bites are related to the endemicity of pemphigus foliaceus (PF); however, an immune reaction against the salivary proteins from these flies still requires confirmation in the case of PF patients living in southeastern Brazil. To georeference the distribution of Simuliidae (Diptera: Simuliidae) and Phlebotominae (Diptera: Psychodidae) and of PF cases in the northeastern region of São Paulo State, and to assess the humoral immune response against salivary gland extracts (SGEs) from biting flies in PF patients, relatives, and neighbours. PF patients' medical information recorded between 1965 and 2014 were obtained from the database of the University Hospital. Data on the distribution of fly species were collected from scientific reports and epidemiological databases. Spatial maps relating the distribution of biting flies with PF cases were plotted. Serum IgG antibodies against the SGEs from Simulium nigrimanum, Nyssomyia neivai, and Aedes aegypti (as control) were determined by ELISA. Two hundred and eighty-five PF cases were distributed in 60 municipalities with a prevalence of 57.5 per million inhabitants, revealing well-defined geographical clusters. S. nigrimanum and N. neivai specimens were registered in eight (13.3%) and 26 (43.3%) of these municipalities, respectively. PF patients, and their relatives presented higher levels of IgG against the SGEs of S. nigrimanum and N. neivai (P<0.001 for both), but not against the SGE from A. aegypti (P=0.115 and P=0.552, respectively), as compared to controls. IgG against the SGEs from S. nigrimanum and N. neivai but not against the SGE from A. aegypti correlated with levels of anti-Desmoglein 1 in PF patients (r=0.3848, P=0.039; and r=0.416, P=0.022, respectively). An epidemiological link between biting flies and PF in southeastern Brazil is proposed, implying a possible role of the salivary proteins from these flies in PF etiopathogenesis. Copyright © 2017 Elsevier B.V. All rights reserved.

Specific Diurnal EMG Activity Pattern Observed in Occlusal Collapse Patients: Relationship between Diurnal Bruxism and Tooth Loss Progression

PubMed Central

Kawakami, Shigehisa; Kumazaki, Yohei; Manda, Yosuke; Oki, Kazuhiro; Minagi, Shogo

2014-01-01

Aim The role of parafunctional masticatory muscle activity in tooth loss has not been fully clarified. This study aimed to reveal the characteristic activity of masseter muscles in bite collapse patients while awake and asleep. Materials and Methods Six progressive bite collapse patients (PBC group), six age- and gender-matched control subjects (MC group), and six young control subjects (YC group) were enrolled. Electromyograms (EMG) of the masseter muscles were continuously recorded with an ambulatory EMG recorder while patients were awake and asleep. Diurnal and nocturnal parafunctional EMG activity was classified as phasic, tonic, or mixed using an EMG threshold of 20% maximal voluntary clenching. Results Highly extended diurnal phasic activity was observed only in the PBC group. The three groups had significantly different mean diurnal phasic episodes per hour, with 13.29±7.18 per hour in the PBC group, 0.95±0.97 per hour in the MC group, and 0.87±0.98 per hour in the YC group (p<0.01). ROC curve analysis suggested that the number of diurnal phasic episodes might be used to predict bite collapsing tooth loss. Conclusion Extensive bite loss might be related to diurnal masticatory muscle parafunction but not to parafunction during sleep. Clinical Relevance: Scientific rationale for study Although mandibular parafunction has been implicated in stomatognathic system breakdown, a causal relationship has not been established because scientific modalities to evaluate parafunctional activity have been lacking. Principal findings This study used a newly developed EMG recording system that evaluates masseter muscle activity throughout the day. Our results challenge the stereotypical idea of nocturnal bruxism as a strong destructive force. We found that diurnal phasic masticatory muscle activity was most characteristic in patients with progressive bite collapse. Practical implications The incidence of diurnal phasic contractions could be used for the prognostic evaluation of stomatognathic system stability. PMID:25010348

[Effects of socializing piglets in lactation on behaviour, including tail-biting, in growing and finishing pigs].

PubMed

Klein, Sandrina; Patzkéwitsch, Dorian; Reese, Sven; Erhard, Michael

2016-06-16

The aim of this study was to determine whether early socialising of piglets influences the later behaviour and the risk of tail biting in growing and finishing pigs. The behaviour of 183 animals (divided in three successive runs) was recorded from birth until the end of the fattening period. Furthermore, the condition of the teats of the sows as well as the integument and tails of the growing and finishing pigs were evaluated. To socialize the piglets, four litters of the experimental group (V) were provided with additional space (walkway) by opening "piglet-doors" (day 10 postpartum of the youngest litter). The piglets of the control group (K) were reared in conventional farrowing crates located in the same compartment of the stable. Post-weaning, the piglets were assigned to three groups: the experimental group (V/V, two litters of group V), the control group (K/K, two litters of group K) and the mixed group (V/K, one litter of group V and one litter of group K). After opening the "piglet-doors", piglets of group V displayed significantly more playing behaviour than piglets of group K. Additionally, the agonistic behaviour increased in group V. Post-weaning, at allocation and mixing, animals of group V/V showed significantly less agonistic behaviour than pigs of group K/K. Tail-biting behaviour occurred in all three groups, but only in runs two and three. On the 100th day of the fattening period, 58.7% of the pigs of group V/V, 51.7% of group V/K and 43.3% of group K/K still had intact tails. In pigs of group K/K, the tails were significantly shorter compared to the other two groups. Early socialization enhances piglet welfare in farrowing pens by encouraging playing behaviour. Less agonistic behaviour at allocation could furthermore reduce stress at mixing and allocation. The aim to reduce the incidence of tail-biting could not be achieved. However, socializing piglets in lactation could contribute, in accordance with other measures, to an influence on biting behaviour.

Two-year follow-up of changes in bite force and occlusal contact area after intraoral vertical ramus osteotomy with and without Le Fort I osteotomy.

PubMed

Choi, Y J; Lim, H; Chung, C J; Park, K H; Kim, K H

2014-06-01

This study was performed to examine the longitudinal changes in bite force and occlusal contact area after mandibular setback surgery via intraoral vertical ramus osteotomy (IVRO). Patients with mandibular prognathism who underwent IVRO (surgical group: 39 men and 39 women) were compared with subjects with class I skeletal and dental relationships (control group; 32 men and 35 women). The surgical group was divided into two subgroups: 1-jaw surgery (n = 30) and 2-jaw surgery (n = 48). Bite force and contact area were measured in maximum intercuspation with the Dental Prescale System before treatment, within 1 month before surgery, and at 1, 3, 6, 9, 12, and 24 months postsurgery. A linear mixed model was used to investigate the time-dependent changes and associated factors. Bite force and contact area decreased during presurgical orthodontic treatment, were minimal at 1 month postsurgery, and increased gradually thereafter. The 1-jaw and 2-jaw subgroups showed no significant differences in bite force. The time-dependent changes in bite force were significantly different according to the contact area (P < 0.05). The results of this study suggest that bite force and occlusal contact area gradually increase throughout the postsurgical evaluation period. Increasing the occlusal contact area may be essential for improving bite force after surgery. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Acute Generalized Exanthematous Pustulosis Due to Insect Bites?

PubMed Central

Bhat, Yasmeen J; Hassan, Iffat; Sajad, Peerzada; Yaseen, Atiya; Wani, Rohi

2015-01-01

Acute generalized exanthematous pustulosis is a rare severe cutaneous adverse reaction pattern that is mostly caused by the intake of drugs and rarely associated with viral infections, food allergens or toxins. Here we present the report of three patients who got admitted in our hospital for generalized pustulosis and fever after insect bites. The diagnosis of acute generalized exanthematous pustulosis was made by EuroSCAR scoring. The drug etiology was excluded and spider bite was implicated as the etiological agent in these cases of AGEP which are the first such reported cases in India. PMID:26288442

Coadjuvant treatment with surgery and pirfenidone in severe facial trauma due to dog bite.

PubMed

Cantú-Cantú, María Zulema; Lyra-González, Iván; Armendáriz-Borunda, Juan

2013-03-01

This case report assesses the effectiveness of surgery plus pirfenidone (PFD) as a concomitant therapy in the management of facial trauma after severe dog bite. A 16-month-old female patient who suffered a severe attack by a big-sized dog (Rottweiler) in the midface area was managed with surgery/PFD combination and followed up for 20 months to evaluate the efficacy to control, prevent, and improve injury sequels. Surgery/PFD combination offered a good complementary therapy downregulating inflammatory activity, improving blood supply, and activating cytokine modulation and collagen synthesis/biosynthesis (scar control). No side effects were reported in this case report. Surgery/PFD management for severe facial dog bites represents a safe and effective therapeutic option to protect and improve a patient's quality of life, minimizing long-time sequels.

A Prospective Study among Patients Presenting at the General Practitioner with a Tick Bite or Erythema Migrans in the Netherlands

PubMed Central

Hofhuis, Agnetha; Herremans, Tineke; Notermans, Daan W.; Sprong, Hein; Fonville, Manoj; van der Giessen, Joke W. B.; van Pelt, Wilfrid

2013-01-01

Background We performed a nationwide prospective study on the transmission risk for Borrelia to humans, investigating symptoms and serology at enrolment and three months after tick bites, and after standard treatment for erythema migrans (EM). Aiming to quantify the infection risk at point of care by physicians, we explored risk factors such as tick testing for Borrelia and assessment of the duration of the tick's blood meal. Methods and Findings Questionnaires, blood samples and ticks from patients who consulted one of 307 general practitioners for tick bites (n = 327) or EM (n = 283) in 2007 and 2008, were collected at enrolment and three months later at follow-up. Borrelia burgdorferi sensu lato DNA was detected in 29.3% of 314 ticks, using PCR/reverse line blot and real-time PCR on the OspA gene. Seroconversion in C6 ELISA, IgM or IgG immunoblots for Borrelia-specific antibodies was observed in 3.2% of tick bite cases. Fourteen tick bite cases had evidence of early Borrelia infection, of which EM developed among seven cases. The risk of developing EM after tick bites was 2.6% (95%CI: 1.1%–5.0%), and the risk of either EM or seroconversion was 5.1% (95%CI: 2.9%–8.2%). Participants with Borrelia-positive ticks had a significantly higher risk of either EM or seroconversion (odds ratio 4.8, 95%CI: 1.1–20.4), and of seroconversion alone (odds ratio 11.1, 95%CI: 1.1–108.9). A third (34%) of the cases enrolled with EM did not recall preceding tick bites. Three EM cases (1%) reported persisting symptoms, three months after standard antibiotic treatment for EM. Conclusions One out of forty participants developed EM within three months after tick bites. The infection risk can be assessed by tick testing for Borrelia at point of care by physicians. However, further refining is needed considering sensitivity and specificity of tick tests, accuracy of tick attachment time and engorgement. PMID:23696884

[Comparison of the antibacterial efficacy of polyhexanide, cold atmospheric argon plasma and saline in the treatment of canine bite wounds].

PubMed

Winter, Selina; Nolff, Mirja Christine; Reese, Sven; Meyer-Lindenberg, Andrea

2018-04-01

To evaluate the bacterial contamination rate and to compare the efficacy of polyhexanide, cold argon plasma and saline at reducing bacterial bio-burden in dog bite wounds. Dogs with bite-wound injuries were included when surgical debridement was pursued with subsequent treatment using either polyhexanide-biguanide lavage (A), cold argon plasma treatment (B) or saline lavage (C). Culture swabs were taken after debridement as well as after lavageor argon treatment. Statistical analysis was performed using the chi-square test. A total of 40 dogs were enrolled in the study (A: n = 12; B: n = 10; C: n = 18). The majority of injuries were minor and 87.5% of patients had positive bacterial culture results pre-lavage, with 19.8% of isolates classified as multidrug resistant. A reduction in wound bioburden was achieved in 8/12 patients in group A, 5/10 patients in group B and 14/18 patients in group C. Complete decontamination was achieved in 5/12 patients in group A, 2/10 in group B and 9/18 in group C. None of these differences were statistically significant nor associated with the development of complications. No statistically significant differences were detected between the treatment groups; however, the cold argon plasma treatment provided the least effective decontamination. Bite wounds yield a high rate of bacterial contamination, with increasing multidrug-resistance rates. Based on these preliminary results, no superior effect was detected for lavage using polyhexanidebiguanide or cold argon plasma. Schattauer GmbH.

Using Risk Group Profiles as a Lightweight Qualitative Approach for Intervention Development: An Example of Prevention of Tick Bites and Lyme Disease

PubMed Central

van Velsen, Lex; van Gemert - Pijnen, Julia EWC; Maat, Angelique; van Steenbergen, Jim E; Crutzen, Rik

2013-01-01

Background Many public health campaigns use a one-size-fits-all strategy to achieve their desired effect. Public health campaigns for tick bites and Lyme disease (LD) in many countries convey all relevant preventive measures to all members of the public. Although preventing tick bites (eg, by wearing protective clothing or using repellants) and checking for tick bites after visiting a risk area are effective and cost-efficient methods to prevent an individual from contracting a tick-borne disease, public compliance to these methods is low. Objective We aimed to identify the group of individuals within the general Dutch population that are at high risk of being bitten by a tick or developing LD and to describe their characteristics, knowledge, and perceptions. The incidence of patients visiting their general practitioner for tick bites and erythema migrans (the first sign of LD) has increased tremendously in the last decades in the Netherlands and other European countries; therefore, our efforts can be used to counter this troubling trend. Methods We conducted in-depth semi-structured interviews to identify individuals belonging to the average risk group. Participants were recruited in two ways. Patients who visited two municipal health services travel health clinics (one in a high-endemic area and one in a low-endemic area) were asked to participate. This resulted in 18 interviews. Further, parents were recruited using the convenience sampling method, which resulted in 7 interviews. We discontinued interviewing when the point of data saturation was reached. We analyzed the results immediately after each interview to identify the point of data saturation. Data saturation is when the new interviews provided no new information compared to the previous interviews. The interviews were transcribed and analyzed using inductive thematic analysis. Results We identified four groups at risk of being bitten by ticks and developing LD among the general Dutch population. The groups were as follows: (1) outdoor people that check for tick bites, (2) outdoor people that do not check for tick bites, (3) parents that check their children for tick bites, and (4) parents that do not check their children for tick bites. Previous experience with ticks or LD was the main denominator between the groups. Checking for tick bites is a more easily adopted measure than preventing tick bites. Therefore, for all groups, public health efforts in the future should primarily emphasize on the importance of checking for tick bites. Conclusions The lightweight qualitative approach presented in this paper is highly relevant in tailoring public health efforts toward specific groups. The profiles of members in each risk group and the motivations underlying the behaviors of the members in each risk group can be used to determine the features and content of a targeted communication strategy about ticks and LD. PMID:24172875

Relocatable fixation systems in intracranial stereotactic radiotherapy. Accuracy of serial CT scans and patient acceptance in a randomized design.

PubMed

Theelen, A; Martens, J; Bosmans, G; Houben, R; Jager, J J; Rutten, I; Lambin, P; Minken, A W; Baumert, B G

2012-01-01

The goal was to provide a quantitative evaluation of the accuracy of three different fixation systems for stereotactic radiotherapy and to evaluate patients' acceptance for all fixations. A total of 16 consecutive patients with brain tumours undergoing fractionated stereotactic radiotherapy (SCRT) were enrolled after informed consent (Clinical trials.gov: NCT00181350). Fixation systems evaluated were the BrainLAB® mask, with and without custom made bite-block (fixations S and A) and a homemade neck support with bite-block (fixation B) based on the BrainLAB® frame. The sequence of measurements was evaluated in a randomized manner with a cross-over design and patients' acceptance by a questionnaire. The mean three-dimensional (3D) displacement and standard deviations were 1.16 ± 0.68 mm for fixation S, 1.92 ± 1.28 and 1.70 ± 0.83 mm for fixations A and B, respectively. There was a significant improvement of the overall alignment (3D vector) when using the standard fixation instead of fixation A or B in the craniocaudal direction (p = 0.037). Rotational deviations were significantly less for the standard fixation S in relation to fixations A (p = 0.005) and B (p = 0.03). EPI imaging with off-line correction further improved reproducibility. Five out of 8 patients preferred the neck support with the bite-block. The mask fixation system in conjunction with a bite-block is the most accurate fixation for SCRT reducing craniocaudal and rotational movements. Patients favoured the more comfortable but less accurate neck support. To optimize the accuracy of SCRT, additional regular portal imaging is warranted.

Animal bite injuries to the face : A Case Report.

PubMed

Simao, Niverso Rodrigues; Borba, Alexandre Meireles; da Silva, Andre Luis Fernandes; Vieira, Evanice Menezes Marcal; Carvalhosa, Artur Aburad; Bandeca, Matheus Coelho; Borges, Alvaro Henrique

2013-08-01

Traumatic lacerations to the skin are problems frequently seen and treated by emergency centers around the world. Among all wounds, dog and cat bites are commonly seen. As in many mammals, different species of microorganisms are found in dog and cat mouths with a potential pathological effect to humans, as represented by rabies. The injuries have disfiguration effect with possible psychological repercussion to the patient. This article aimed presenting up to date considerations regarding the management of animal bite injuries to the face, exemplified by a case report that should be the interest of all professions that deal with facial tissues, as dentists do. How to cite this article: Simao NR, Borba AM, da Silva ALF, Vieira EMM, Carvalhosa AA, Bandeca MC, Borges AH. Animal bite injuries to the face: A Case Report. J Int Oral Health 2013; 5(4):68-72.

Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

PubMed

Rosa, M; Lucchi, P; Manti, G; Caprioglio, A

2016-12-01

The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

Endophagy of biting midges attacking cavity-nesting birds.

PubMed

Votýpka, J; Synek, P; Svobodová, M

2009-09-01

Feeding behaviour, host preferences and the spectrum of available hosts determine the role of vectors in pathogen transmission. Feeding preferences of blood-feeding Diptera depend on, among others factors, the willingness of flies to attack their hosts either in the open (exophagy) or in enclosed places (endophagy). As far as ornithophilic blood-feeding Diptera are concerned, the biting midges (Diptera: Ceratopogonidae) and blackflies (Diptera: Simuliidae) are generally considered to be strictly exophagous. We determined which blood-sucking Diptera enter nest cavities and feed on birds by placing sticky foil traps inside artificial nest boxes. A total of 667 females of eight species of biting midges of the genus Culicoides (Latreille, 1809) were captured on traps during 2006-2007, with Culicoides truncorum (Edwards, 1939) being the dominant species. DNA blood analyses of blood-engorged females proved that midges actually fed on birds nesting in the boxes. Three species were identified as endophagous: Culicoides truncorum, Culicoides pictipennis (Staeger, 1839), and Culicoides minutissimus (Zetterstedt, 1855). Our study represents the first evidence that ornithophilic biting midges are endophagous. The fact that we caught no blackflies in the bird boxes supports the exophagy of blackflies. We believe that our findings are important for surveillance programmes focusing on Diptera that transmit various bird pathogens.

Coral snake bites (Micrurus spp.) in Brazil: a review of literature reports.

PubMed

Bucaretchi, Fábio; Capitani, Eduardo Mello De; Vieira, Ronan José; Rodrigues, Cinthia K; Zannin, Marlene; Da Silva, Nelson J; Casais-e-Silva, Luciana L; Hyslop, Stephen

2016-03-01

In the Americas, the main representatives of the family Elapidae are coral snakes of the genus Micrurus, of which 33 species are in Brazil. They are the smallest cause of venomous snakebite in Brazil. We analyzed literature reports of coral snake bites in Brazil from 1867 to 2014, and provide a brief review of case series and reports of coral snake bites in the Americas in general. Only reports with clinical descriptions of envenomation were included. The variables recorded included identification of the offending snake, patient's age, sex, bite site, clinical manifestations, treatment, including antivenom and anticholinesterase drugs, and general evolution of the cases. 30 published reports describing bites caused by Micrurus spp. in Brazil were identified and involved 194 distinct cases. Since no information on the clinical manifestations was available in 44 cases, the analysis was restricted to 25 reports (150 cases). Most patients were from southern (61.3%; primarily Santa Catarina state, 60%) and southeastern (20%) Brazil and were male (70.7%), with a median age of 27 years (interquartile interval = 18 to 40 years). The offending snakes were described in 59 cases (M. corallinus 36, M. frontalis 12, M. lemniscatus 5, M. hemprichi 2, M. filiformis 1, M. ibiboboca 1, M. spixii 1 and M. surinamensis 1); in 22 cases only the genus (Micrurus spp.) was reported. Of the 143 cases in which the bite site was recorded, most involved the hands (46.2%) and feet (26.6%). The main clinical features were local numbness/paresthesia (52.7%), local pain (48%), palpebral ptosis (33.3%), dizziness (26.7%), blurred vision (20.7%), weakness (20%), slight local edema (16%), erythema (16%), dysphagia (14.7%), dyspnea (11.3%), inability to walk (10.7%), myalgia (9.3%), salivation (8%) and respiratory failure (4.3%). Fang marks were described in 47.3% of cases and 14% of bites were classified as asymptomatic. A slight increase in total blood creatine kinase was reported in 3 children, suggesting mild myotoxicity. Therapeutic procedures included coral snake antivenom (77.3%), anticholinesterase drugs (6%), and mechanical ventilation (3.3%). Two patients reported in 1933 developed paralysis/respiratory failure and died 6 h and 17 h post-bite. Four more deaths probably caused by coral snakes were reported (2 in 1867, 1 in 1959, 1 in 1962), but no clinical information was available. Neuromuscular blockade was the hallmark of systemic envenomation by Micrurus spp., with signs of myasthenia such as weakness and ptosis that may evolve to paralysis and respiratory failure. Local features, mainly numbness/paresthesia and pain, were frequently reported, with the pain being intense in some cases. Although myotoxicity has been detected in experimental studies with Micrurus spp. venoms, few human reports described laboratory findings compatible with myotoxicity. Most coral snake bites reported in Brazil were caused by M. corallinus and M. frontalis, with several patients showing signs of acute myasthenia. Serious complications such as paralysis with respiratory failure were observed but comparatively rare. The deaths occurred where respiratory support (mechanical ventilation) was unavailable when needed.

The use of biodegradable plates and screws to stabilize facial fractures.

PubMed

Bell, R Bryan; Kindsfater, Craig S

2006-01-01

The purpose of this preliminary retrospective study was to review the demographics and outcome of patients with a variety of facial fractures that were stabilized with PL bone plates and screws. The records of 295 consecutive patients with facial fractures treated by open reduction and internal fixation, performed by the author from 2001 through 2004, were retrospectively reviewed. Patients were selected to receive biodegradable fixation on the basis of mechanism of injury, the degree of bony displacement demonstrated on clinical and radiographic examination, patient age, and fracture pattern or location. Outcome measures such as infection, non-union, and mal-union were identified and subjectively assessed. Descriptive statistics were recorded and analyzed. Two hundred eighty-one patients met the criteria for inclusion in the study with follow-up of 3 weeks to 3 years. Fifty-nine (21%) patients were identified as having received biodegradable plates and screws. All patients eventually went on to satisfactory healing with favorable restoration of form and function. Complications occurred in 16 patients overall (6%). Of these, 2 patients were treated with resorbable plates and screws; 1 patient with a zygomatico-maxillary complex fracture developed a sterile abscess that presented 1 year postoperatively and responded to local measures. Another patient with a Le Fort I fracture developed an anterior open bite necessitating Le Fort I osteotomy for correction. Favorable healing can be observed through the use of biodegradable PL plates and screws to stabilize selected midface fractures in patients of all ages, as well as mandible fractures in early childhood.

Effectiveness of base-of-skull immobilization system in a compact proton therapy setting.

PubMed

Shafai-Erfani, Ghazal; Willoughby, Twyla; Ramakrishna, Naren; Meeks, Sanford; Kelly, Patrick; Zeidan, Omar

2018-05-01

The purpose of this study was to investigate daily repositioning accuracy by analyzing inter- and intra-fractional uncertainties associated with patients treated for intracranial or base of skull tumors in a compact proton therapy system with 6 degrees of freedom (DOF) robotic couch and a thermoplastic head mask indexed to a base of skull (BoS) frame. Daily orthogonal kV alignment images at setup position before and after daily treatments were analyzed for 33 patients. The system was composed of a new type of thermoplastic mask, a bite block, and carbon-fiber BoS couch-top insert specifically designed for proton therapy treatments. The correctional shifts in robotic treatment table with 6 DOF were evaluated and recorded based on over 1500 planar kV image pairs. Correctional shifts for patients with and without bite blocks were compared. Systematic and random errors were evaluated for all 6 DOF coordinates available for daily vector corrections. Uncertainties associated with geometrical errors and their sources, in addition to robustness analysis of various combinations of immobilization components were presented. Analysis of 644 fractions including patients with and without a bite block shows that the BoS immobilization system is capable of maintaining intra-fraction localization with submillimeter accuracy (in nearly 83%, 86%, 95% of cases along SI, LAT, and PA, respectively) in translational coordinates and subdegree precision (in 98.85%, 98.85%, and 96.4% of cases for roll, pitch, and yaw respectively) in rotational coordinates. The system overall fares better in intra-fraction localization precision compared to previously reported particle therapy immobilization systems. The use of a mask-attached type bite block has marginal impact on inter- or intra-fraction uncertainties compared to no bite block. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

[Case report: Snake bite - an odd case].

PubMed

Evers, Bettina; Muth, Claus-Martin; Georgieff, Michael; Dinse-Lambracht, Alexander

2015-10-01

Emergency medical service is called by a 54-year-old man bitten by his rattlesnake. Upon initial survey we find the patient in a cardiopulmonary stable condition. He has bite marks and pain on his rapidly swelling middle finger of his right hand. Our initial treatment is immobilization of the patient. The snake raiser has already called the poison control center in Munich. By the help of this institution we bring him to a hospital having the right antivenom on hand. © Georg Thieme Verlag Stuttgart · New York.

Aesthetic Treatment of Bruxism

PubMed Central

Aguilera, Shino Bay; Perico, Viviana Andrea

2017-01-01

Bruxism is a diurnal or nocturnal parafunctional activity that includes unconscious clenching, grinding, or bracing of the teeth. An extensive medical history should be taken in these patients so proper diagnosis can be made. Habits such as biting the tongue, cheeks or lips, chewing gum or eating seeds for many hours per day, biting nails, and/or biting hard objects, will cause and/or exacerbate pre-existing bruxism. The etiology of bruxism is uncertain, but it is hypothesized to be associated with genetic, structural, and psychosocial factors. Over time, chronic clenching of the jaw leads to hypertrophy of masseters and temporalis musculature causing the face to take on a masculine and square appearance. Patients commonly present to dermatology cosmetic practices wishing to have a more slim, softer appearing face. This review is the first paper to discuss aesthetic treatment options for complications of bruxism including masseter and temporalis hypertrophy and the associated accelerated aging of the lower face. PMID:28670358

Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse.

PubMed

Ohba, Seigo; Nakatani, Yuya; Kawasaki, Takako; Tajima, Nobutaka; Tobita, Takayoshi; Yoshida, Noriaki; Sawase, Takashi; Asahina, Izumi

2015-08-01

Increasing numbers of older patients are seeking orthognathic surgery to treat jaw deformity. However, orthodontic and orthognathic surgical treatment is difficult in cases without occlusal vertical stop. A 55-year-old man presented with Class III malocclusion and mandibular protrusion including esthetic problems and posterior bite collapse. He underwent dental implant treatment to reconstruct an occlusal vertical stop before orthognathic surgery. His occlusal function and esthetic problems improved after surgery, and his skeletal and occlusal stability has been maintained for 6 years. Dental implant placement at appropriate positions could help to determine the position of the proximal segment at orthognathic surgery and could shorten the time required to restore esthetic and occlusal function. This case demonstrates how skeletal and dental stability can be maintained long after surgery in a patient with jaw deformity and posterior bite collapse.

Envenomation by Micrurus coral snakes in the Brazilian Amazon region: report of two cases.

PubMed

Pardal, Pedro Pereira de Oliveira; Pardal, Joseana Silva de Oliveira; Gadelha, Maria Apolônia da Costa; Rodrigues, Líliam da Silva; Feitosa, Darlan Tavares; Prudente, Ana Lúcia da Costa; Fan, Hui Wen

2010-01-01

Two cases of proven coral snake bites were reported in Belém, Pará State, Brazil. The first case was a severe one caused by Micrurus surinamensis. The patient required mechanical ventilation due to acute respiratory failure. The second case showed just mild signs of envenomation caused by Micrurus filiformis. Both patients received specific Micrurus antivenom and were discharged without further complications. Coral snake bites are scarcely reported in the Amazon region and there is a broad spectrum of clinical manifestations, varying from extremely mild to those which may rapidly lead to death if the patient is not treated as soon as possible.

Rat bite fever without fever.

PubMed

Stehle, P; Dubuis, O; So, A; Dudler, J

2003-09-01

Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.

Differences in bite force between dolichofacial and brachyfacial individuals: Side of mastication, gender, weight and height.

PubMed

Quiudini, Paulo Roberto; Pozza, Daniel Humberto; Pinto, Ary Dos Santos; de Arruda, Mauricio Ferraz; Guimarães, Antonio Sergio

2017-07-01

Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals was significantly higher than in severe dolichofacial individuals, being influenced by gender, weight and height. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Range of motion exercise of temporo-mandibular joint with hot pack increases occlusal force in patients with Duchenne muscular dystrophy.

PubMed

Nozaki, S; Kawai, M; Shimoyama, R; Futamura, N; Matsumura, T; Adachi, K; Kikuchi, Y

2010-12-01

The purpose of this study is to evaluate whether the range of motion exercise of the temporo-mandibular joint (jaw ROM exercise) with a hot pack and massage of the masseter muscle improve biting disorder in Duchenne muscular dystrophy (DMD). The subjects were 18 DMD patients (21.3+/- 4.1 years old). The jaw ROM exercise consisted of therapist-assisted training (2 times a week) and self-training (before each meal every day). The therapist-assisted training consisted of the application of a hot pack on the cheek of the masseter muscle region (15 minutes), the massage of the masseter (10 minutes), and jaw ROM exercise (5 minutes). The self-training involved jaw ROM exercise by opening the mouth to the maximum degree, ten times. These trainings continued for six months. Outcomes were evaluated by measuring the greatest occlusal force and the distance at the maximum degree of mouth opening between an incisor of the top and that of the bottom. Six months later, the greatest occlusal force had increased significantly compared with that at the start of jaw ROM exercise (intermediate values: from 73.8N to 97.3N) (p = 0.005) as determined by the Friedman test and Scheffi's nonparametric test. The patients' satisfaction with meals increased. However, the maximum degree of mouth opening did not change after six months of jaw ROM exercise. Jaw ROM exercise in DMD is effective for increasing the greatest occlusal force.

Prevalence of Malocclusion among 6 to 10 Year old Nalgonda School Children

PubMed Central

Reddy, E Rajendra; Manjula, M; Sreelakshmi, N; Rani, S Thabitha; Aduri, Rajesh; Patil, B Dharamraj

2013-01-01

Background: To evaluate the prevalence of malocclusion among 6 to 10 year old children of Nalgonda District. Materials & Methods: A total of 3000 children were examined, out of which 2135 children (1009 boys and 1126 girls) who fulfilled the inclusion criteria were included. The selected sample was examined for Class I, Class II, Class III molar relationship, lower anterior crowding, cross bite (anterior and posterior), open bite, and pseudo class III [edge to edge bite] discrepancies after obtaining the written consent from the concerned school authorities. The collected data was tabulated and statistically analysed using chi-square test. Results: Among the selected sample, 648 (30.35%) children had minor tooth alignment discrepancies. Angle’s Class I molar relation with and without minor discrepancies was observed in 78.6%, Class II in 13.9%, Class III in 7.8% of the subjects surveyed. Lower anterior crowding in 11.8%, anterior cross bite in 4.5%, posterior cross bite in 3.75%, openbite in 3% and Pseudo class III [edge to edge] in 5.97% was noticed among the studied population. There was no statistical significant difference observed gender wise. Conclusion: In the current study, 52% of the studied population had malocclusion with a higher prevalence of Angle’s Class I molar relation with lower anterior crowding. How to cite this article: Reddy ER, Manjula M, Sreelakshmi N, Rani ST, Aduri R, Patil BD. Prevalence of Malocclusion among 6 to 10 Year old Nalgonda School Children. J Int Oral Health 2013; 5(6):49-54 . PMID:24453444

[The influence of breathing mode on the oral cavity].

PubMed

Surtel, Anna; Klepacz, Robert; Wysokińska-Miszczuk, Joanna

2015-12-01

Nose breathing is one of the key factors in the proper development and functioning of the oral cavity. The air passing through the nasal cavity is warmed and humidified while dust and other particulate matter is removed. It is also important as far as bone formation is concerned. The obstruction or congestions of the upper respiratory tract may negatively affect the correct and most optimal (nasal) respiratory tract. The switch from nasal to mouth breathing may lead to serious clinical consequences. Children with the clinical diagnosis of mouth breathing are usually pale, apathetic and they lack concentration and often get tired. Disorders resulting from hypoxy may also be the reason from sleep disturbances, such as frequent waking-up, nocturia, difficulties falling aslee. The main clinical manifestations of mouth breathing appear in the craniofacial structures. Mouth breathers frequently suffer from dental malocclusions and craniofacial bone abnormalities. Chronic muscle tension around the oral cavity could result in the widening of cranio-vertebral angle, posterior position of mandibula and narrow maxillary arch. Among dental alterations the most common are class II malocclusion (total or partial) with the protrusion of the anterior teeth, cross bite (unilateral or bilateral), anterior open bite and primary crowded teeth. Apart from malocclusion, chronic gingivitis, periodontitis, candida infections and halitosis are frequently present in mouth--breathing patients. © 2015 MEDPRESS.

Treatment of the first bite syndrome.

PubMed

Costales-Marcos, María; López Álvarez, Fernando; Fernández-Vañes, Laura; Gómez, Justo; Llorente, José Luis

First bite syndrome is a potential complication of surgery involving the infratemporal fossa, deep lobe of the parotid gland and parapharyngeal space. It is described as an acute and intense pain in the parotid region caused with the first bite of each meal. It is related to damage to sympathetic innervation of the parotid gland. Parasympathetic hyperactivation is believed to stimulate an exaggerated myoepithelial cell contraction causing pain. Usual analgesic treatments have poor results. Botulinum toxin type A causes parasympathetic nerve paralysis of the parotid gland and this fact would minimize salivation and decrease first bite syndrome. The aim of this study is to show the details of the technique and our outcomes in 5 patients treated with botulinum toxin type A. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Animal bite injuries to the face : A Case Report

PubMed Central

Simao, Niverso Rodrigues; Borba, Alexandre Meireles; da Silva, Andre Luis Fernandes; Vieira, Evanice Menezes Marcal; Carvalhosa, Artur Aburad; Bandeca, Matheus Coelho; Borges, Alvaro Henrique

2013-01-01

Traumatic lacerations to the skin are problems frequently seen and treated by emergency centers around the world. Among all wounds, dog and cat bites are commonly seen. As in many mammals, different species of microorganisms are found in dog and cat mouths with a potential pathological effect to humans, as represented by rabies. The injuries have disfiguration effect with possible psychological repercussion to the patient. This article aimed presenting up to date considerations regarding the management of animal bite injuries to the face, exemplified by a case report that should be the interest of all professions that deal with facial tissues, as dentists do. How to cite this article: Simao NR, Borba AM, da Silva ALF, Vieira EMM, Carvalhosa AA, Bandeca MC, Borges AH. Animal bite injuries to the face: A Case Report. J Int Oral Health 2013; 5(4):68-72. PMID:24155623

Comparison of safety and immunogenicity of 2 WHO prequalified rabies vaccines administered by one week, 4 site intra dermal regimen (4-4-4-0-0) in animal bite cases.

PubMed

Narayana, Ashwath; Manoharan, Aravind; Narayan, Madhusudana Shampur; Kalappa, Sudarshan Mysore; Biligumba, Gangaboraiah; Haradanahalli, Ravish; Anand, Ashwini Manoor

2015-01-01

The currently advocated rabies post-exposure prophylaxis regimens are of one month duration with reduced patient compliance. WHO recommended research on shortened vaccination regimens which have a practical and economic advantage over the existing regimens. Hence, the present study was undertaken to assess the safety and immunogenicity of 2 WHO prequalified rabies vaccines administered by one week, 4 site intra dermal regimen (4-4-4-0-0) in animal bite cases. This study was a comparative, open label, phase III, randomized clinical trial conducted at Anti rabies clinic, KIMS Hospital, Bangalore, India. The study was registered in Clinical Trials Registry of India (CTRI) bearing the registration number CTRI/2012/12/003230. Ninety subjects with category II/III animal bites/exposures were enrolled. Equine rabies immunoglobulin was administered to all category III exposures. 0.1 mL of either purified chick embryo cell vaccine (Rabipur) or purified verocell rabies vaccine (Verorab) was administered intradermally into 4 sites on days 0, 3 and 7 to all the study subjects. Serum of subjects collected on day 0, 14, 90 and 365 were analyzed for rabies virus neutralizing antibody (RVNA) concentration. The incidence of ADR in Rabipur and Verorab group was 2.96% and 1.14% respectively. In Rabipur group, geometric mean concentration (95% confidence interval) of RVNA was 14.5 (13.50, 15.57), 11.78 (11.27, 12.31) and 5.95 (5.50, 6.44) IU/mL on days 14, 90 and 365 respectively; In Verorab group geometric mean concentration (95% confidence interval) of RVNA was 14.43 (13.41, 15.53), 11.93 (11.47, 12.40) and 5.67 (5.29, 6.08) IU/mL on days 14, 90 and 365 respectively. In conclusion, Rabipur and Verorab were found to be safe, immunogenic and comparable with each other, when administered using one week, 4 site intradermal regimen (4-4-4-0-0) in animal bite cases.

Ontogeny of Infantile Oral Reflexes and Emerging Chewing.

ERIC Educational Resources Information Center

Sheppard, Justine Joan; Mysak, Edward D.

1984-01-01

To document movement patterns and to examine developmental interrelationships, the ontogeny of rooting, lip, lateral tongue, mouth opening, biting, and Babkin reflexes and the development of emerging chewing behaviors were observed in two normal infants over a period from 1 week to 35 weeks of age. (Author/RH)

Disease Vector Ecology Profile: Somalia. Fourth Edition

DTIC Science & Technology

1993-09-15

excrement, decaying plant material and other debris). Eggs hatch in 1-3 weeks. Larval stage 4-6 weeks. Often associated with termite mounds . Biting...lengths of up to 14 feet. It occurs primarily in the forest and open bush country of northern Somalia, where it is found in tree stumps, termite mounds

Modified protrusion arch for anterior crossbite correction - a case report.

PubMed

Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

2013-01-01

Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

Common errors observed at the American Board of Orthodontics clinical examination.

PubMed

Chung, Chun-Hsi; Tadlock, Larry P; Barone, Nicholas; Pangrazio-Kulbersh, Valmy; Sabott, David G; Foley, Patrick F; Trulove, Timothy S; Park, Jae Hyun; Dugoni, Steven A

2017-08-01

The American Board of Orthodontics has developed tools to help examinees select patients to be used for the Board examination. The Case Management Form can be used to evaluate aspects of a patient's treatment that cannot be measured by other tools. The Case Management Form is a structured treatment-neutral assessment of orthodontic objectives and outcomes associated with a patient's treatment. Despite the availability of this form, examiners continue to see problems, including lack of attention to finishing details, inappropriate treatment objectives, excessive proclination of mandibular incisors due to treatment mechanics, excessive expansion of mandibular intercanine width, closing skeletal open bite with extrusion of anterior teeth leading to excessive gingival display, and failure to recognize the importance of controlling the eruption or extrusion of molars during treatment. In addition, some examinees exhibit a lack of understanding of proper cephalometric tracing and superimposition techniques, which lead to improper interpretation of cephalometric data and treatment outcomes. Copyright © 2017. Published by Elsevier Inc.

Use of antivenom for snakebites reported to United States poison centers.

PubMed

Spiller, Henry A; Bosse, George M; Ryan, Mark L

2010-09-01

In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome. The study used a retrospective review of all snakebites to humans reported to the National Poison Center Database System from 2000 to 2007. During the 8 years, there were 37,760 snakebites, with a mean of 4720 bites per year. There was a 27% increase in bites reported to a Poison center for the 8-year period and an overall 13.5% increase in the use of antivenin. The 2 categories primarily responsible for the increased use of antivenin were copperhead and crotaline-unknown. Rattlesnake bites remained the category most frequently treated with antivenin with a mean 52.5% treatment rate and only moderate increase for the 8 years. There was no change in the percentage or number of patients with a major outcome (mean, 3.8%) or death (mean, 0.5%). There was a decrease in patients with a minor outcome and an increase in patients with a moderate outcome. The new antivenin is reported to have a reduced potential for adverse reactions. This may have had a role in the decision of which snakebite victims received antivenin. With the introduction of a new antivenin, there has been a dramatic increase in the number of snakebite patients treated with antivenin. This has been most noticeable in snake bite categories that were less frequently treated with antivenin in the past. Copyright © 2010 Elsevier Inc. All rights reserved.

Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition.

PubMed

Chen, Xiaoxian; Xia, Bin; Ge, Lihong

2015-04-21

Early transition from breastfeeding and non-nutritive sucking habits may be related to occlusofacial abnormalities as environmental factors. Previous studies have not taken into account the potential for interactions between feeding practice, non-nutritive sucking habits and occlusal traits. This study assessed the effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Peking city. This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior crossbite, posterior crossbite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple logistic regressions were applied to analyze the associations. It was found that a short duration of breast-feeding (never or ≤ 6 months) was directly associated with posterior cross bite (OR = 3.13; 95% CI = 1.11-8.82; P = 0.031) and no maxillary space (OR = 1.63; 95% CI = 1.23-2.98; P = 0.038). In children breast-fed for ≤ 6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR = 4.21; 95% CI = 1.85-9.60; P = 0.0002). Children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of a class II canine relationship compared with those who were bottle-fed for up to 18 months. Non-nutritive sucking habits were also found to affect occlusion: A prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit associated with excessive overjet and absence of lower arch developmental space. Breastfeeding duration was shown to be associated with the prevalence of posterior crossbite, no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a digit-sucking habit were more likely to develop an open bite.

PubMed Central

Nozaki, S.; Kawai, M.; Shimoyama, R.; Futamura, N.; Matsumura, T.; Adachi, K.; Kikuchi, Y.

2010-01-01

The purpose of this study is to evaluate whether the range of motion exercise of the temporo-mandibular joint (jaw ROM exercise) with a hot pack and massage of the masseter muscle improve biting disorder in Duchenne muscular dystrophy (DMD). The subjects were 18 DMD patients (21.3 ± 4.1 years old). The jaw ROM exercise consisted of therapist-assisted training (2 times a week) and self-training (before each meal every day). The therapist-assisted training consisted of the application of a hot pack on the cheek of the masseter muscle region (15 minutes), the massage of the masseter (10 minutes), and jaw ROM exercise (5 minutes). The self-training involved jaw ROM exercise by opening the mouth to the maximum degree, ten times. These trainings continued for six months. Outcomes were evaluated by measuring the greatest occlusal force and the distance at the maximum degree of mouth opening between an incisor of the top and that of the bottom. Six months later, the greatest occlusal force had increased significantly compared with that at the start of jaw ROM exercise (intermediate values: from 73.8N to 97.3N) (p = 0.005) as determined by the Friedman test and Scheffé's nonparametric test. The patients' satisfaction with meals increased. However, the maximum degree of mouth opening did not change after six months of jaw ROM exercise. Jaw ROM exercise in DMD is effective for increasing the greatest occlusal force. PMID:21574523

Comparative Biomechanical Modeling of Metatherian and Placental Saber-Tooths: A Different Kind of Bite for an Extreme Pouched Predator.

PubMed

Wroe, Stephen; Chamoli, Uphar; Parr, William C H; Clausen, Philip; Ridgely, Ryan; Witmer, Lawrence

2013-01-01

Questions surrounding the dramatic morphology of saber-tooths, and the presumably deadly purpose to which it was put, have long excited scholarly and popular attention. Among saber-toothed species, the iconic North American placental, Smilodon fatalis, and the bizarre South American sparassodont, Thylacosmilus atrox, represent extreme forms commonly forwarded as examples of convergent evolution. For S. fatalis, some consensus has been reached on the question of killing behaviour, with most researchers accepting the canine-shear bite hypothesis, wherein both head-depressing and jaw closing musculatures played a role in delivery of the fatal bite. However, whether, or to what degree, T. atrox may have applied a similar approach remains an open question. Here we apply a three-dimensional computational approach to examine convergence in mechanical performance between the two species. We find that, in many respects, the placental S. fatalis (a true felid) was more similar to the metatherian T. atrox than to a conical-toothed cat. In modeling of both saber-tooths we found that jaw-adductor-driven bite forces were low, but that simulations invoking neck musculature revealed less cranio-mandibular stress than in a conical-toothed cat. However, our study also revealed differences between the two saber-tooths likely reflected in the modus operandi of the kill. Jaw-adductor-driven bite forces were extremely weak in T. atrox, and its skull was even better-adapted to resist stress induced by head-depressors. Considered together with the fact that the center of the arc described by the canines was closer to the jaw-joint in Smilodon, our results are consistent with both jaw-closing and neck musculature playing a role in prey dispatch for the placental, as has been previously suggested. However, for T. atrox, we conclude that the jaw-adductors probably played no major part in the killing bite. We propose that the metatherian presents a more complete commitment to the already extreme saber-tooth 'lifestyle'.

Adder bite: an uncommon cause of compartment syndrome in northern hemisphere

PubMed Central

2010-01-01

Snakebite envenomation is an uncommon condition in the northern hemisphere, but requires high vigilance with regard to both the systemic effects of the venom and the locoregional impact on the soft tissues. Bites from the adder, Vipera Berus, may have serious clinical consequences due to systemic effects. A case of a 44-year-old man is reported. The patient was bitten in the right hand. He developed fasciotomy-requiring compartment syndrome of the upper limb. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgical decompression. PMID:20854675

Study of occlusal characteristics of primary dentition and the prevalence of maloclusion in 4 to 6 years old children in India

PubMed Central

Bhayya, Deepak P; Shyagali, Tarulatha R; Dixit, Uma B; Shivaprakash

2012-01-01

Background: To assess the prevalence of malocclusion and to determine the different occlusal characteristics in primary dentition of 4 to 6 years old children in India. Materials and Methods: The target population comprised 4 to 6 years old children attending different nursery, kindergarten and primary schools of Bagalkot city. Stratified cluster random sampling procedure was executed to collect the representative sample. Each subject was assessed for various occlusal characteristics. Results: Occlusal characteristic found were flush terminal plane (52.5%), class I canine relationship (84%), maxillary developmental spaces (35.4%), primate spaces in maxilla (47.6%), mandibular crowding (4.6%), mandibular midline shift (5.6%), anterior multiple tooth crossbite (1.3%), scissors bite (0.6%), anterior open bite (1%), over bite of 0-2 mm (81.6%) and overjet of 0-2 mm (84.5%). The age wise difference for the occlusal characteristics was statistically significant. Conclusions: The data revealed that most of the children had malocclusion. This highlights the importance of identifying children who are in need of orthodontic treatment for dental health or aesthetic reasons. PMID:23559929

Effect of Ibuprofen on masking endodontic diagnosis.

PubMed

Read, Jason K; McClanahan, Scott B; Khan, Asma A; Lunos, Scott; Bowles, Walter R

2014-08-01

An accurate diagnosis is of upmost importance before initiating endodontic treatment; yet, there are occasions when the practitioner cannot reproduce the patient's chief complaint because the patient has become asymptomatic. Ibuprofen taken beforehand may "mask" or eliminate the patient's symptoms. In fact, 64%-83% of patients with dental pain take analgesics before seeing a dentist. The purpose of this study was to examine the possible "masking" effect of ibuprofen on endodontic diagnostic tests. Forty-two patients with endodontic pain underwent testing (cold, percussion, palpation, and bite force measurement) and then received either placebo or 800 mg ibuprofen. Both patients and operators were blinded to the medication received. One hour later, diagnostic testing was repeated and compared with pretreatment testing. Ibuprofen affected testing values for vital teeth by masking palpation 40%, percussion 25%, and cold 25% on affected teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. There was no observed masking effect in the placebo group on palpation, percussion, or cold values. When nonvital teeth were included, the masking effect of ibuprofen was decreased. However, little masking occurred with the bite force measurement differences. Analgesics taken before the dental appointment can affect endodontic diagnostic testing results. Bite force measurements can assist in identifying the offending tooth in cases in which analgesics "mask" the endodontic diagnosis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Orthodontic treatment of a patient with unilateral orofacial muscle dysfunction: The efficacy of myofunctional therapy on the treatment outcome.

PubMed

Sugawara, Yasuyo; Ishihara, Yoshihito; Takano-Yamamoto, Teruko; Yamashiro, Takashi; Kamioka, Hiroshi

2016-07-01

The orofacial muscle is an important factor in the harmony of the occlusion, and its dysfunction significantly influences a patient's occlusion after craniofacial growth and development. In this case report, we describe the successful orthodontic treatment of a patient with unilateral orofacial muscle dysfunction. A boy, 10 years 0 months of age, with a chief complaint of anterior open bite, was diagnosed with a Class III malocclusion with facial musculoskeletal asymmetry. His maxillomandibular relationships were unstable, and he was unable to lift the right corner of his mouth upon smiling because of weak right orofacial muscles. A satisfactory occlusion and a balanced smile were achieved after orthodontic treatment combined with orofacial myofunctional therapy, including muscle exercises. An acceptable occlusion and facial proportion were maintained after a 2-year retention period. These results suggest that orthodontic treatment with orofacial myofunctional therapy is an effective option for a patient with orofacial muscle dysfunction. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Anchorage onto deciduous teeth: effectiveness of early rapid maxillary expansion in increasing dental arch dimension and improving anterior crowding.

PubMed

Mutinelli, Sabrina; Manfredi, Mario; Guiducci, Antonio; Denotti, Gloria; Cozzani, Mauro

2015-01-01

Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion. However, replacing first permanent molars with the second deciduous molars seems to be an option to reduce some negative side effects during orthodontic treatment. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition. Twenty patients with a lateral cross-bite treated exclusively by a Haas expander in early mixed dentition were retrospectively analyzed before treatment, at appliance removal, and at 21 months out of retention. The sagittal and transverse dimensions, together with the inter-canine arch and irregularity index, were digitally measured on scanned images of dental casts. The patients were compared with three balanced control groups (in total, 60 individuals) matched for gender. Two control groups had the same canine dental class as the treated group at T1, were in the inter-transitional period, and either had or lacked a lateral cross-bite. The last control group was comprised of adolescents in permanent dentition with a dental class I. The statistical analysis was performed by means of repeated-measures ANOVA for paired data and one-way ANOVA, the Kruskal-Wallis test, and the Mann-Whitney test for independent measures (α-level p < 0.05). At the end of follow-up (inter-transitional period of dentition), the dental arch dimensions of treated patients were similar to those of adolescents with a dental class I and significantly wider than those of patients with a lateral cross-bite. Also, the anterior irregularity index was lower among patients who had undergone expansion treatments than in all untreated study participants. The Haas expander anchored to the deciduous teeth is effective in increasing the dental arch width in patients with a lateral cross-bite. The dimensions of the dental arch were modified earlier toward the values of the permanent dentition.

[Emergencies of the external genital area].

PubMed

Kaminsky, A; Sperling, H

2016-04-01

In addition to epididymitis and testicular torsion, emergencies of the external genital are rare. Rapid diagnosis and therapy are essential so that immediate therapy can be provided, which is important for survival (Fournier gangrene) of the patient or for the preservation of erectile function (priapism and penile fracture). A detailed patient history and clinical examination are generally sufficient for correct diagnosis. Under certain circumstances, it might be useful to perform ultrasound, computed tomography scan or magnetic resonance imaging or retrograde urethrography. A urine analysis is obligatory. In case of penetrating injuries and genital trauma in females, additional imaging should be performed because these are often associated with concomitant injuries of the rectum, vagina, or bladder. Special cases are gunshot wounds, in which caliber and type of weapon play an important role for the degree of damage, and animal or human bites. For animal bites, the risk for rabies infection and in case of a human bite the risk for transmission of HIV and hepatitis should be taken into consideration and post-exposure prophylaxis should possibly be offered.

Tularaemia in southwest Germany: Three cases of tick-borne transmission.

PubMed

Boone, I; Hassler, D; Nguyen, T; Splettstoesser, W D; Wagner-Wiening, C; Pfaff, G

2015-07-01

Tularaemia, caused by Francisella tularensis, is an endemic zoonosis frequently occurring in southwest Germany. Since 2005 there is an increase in the number of reported cases of tularaemia in Germany. We report on two cases of ulceroglandular tularaemia and one case of glandular tularaemia that occurred in the summer of 2012 and 2013 in two counties in the Federal State of Baden-Wuerttemberg. Bacteria were transmitted through tick bites, which to date has only rarely been reported in Germany. Inadequate treatment of the patients and an aggravation of clinical symptoms were caused by a delay between disease onset and the detection of the pathogen. Although contact to or consumption of infected hares are the most often reported transmission routes of tularaemia in Germany, tick-bites should also be taken into account. Health professionals should include Francisella tularensis in the differential diagnosis of patients with fever and/or ulcerative lymphadenopathy following a tick bite. Copyright © 2015 Elsevier GmbH. All rights reserved.

Low Health System Performance, Indigenous Status and Antivenom Underdosage Correlate with Spider Envenoming Severity in the Remote Brazilian Amazon

PubMed Central

Sampaio, Vanderson Souza; Gomes, André Alexandre; Silva, Iran Mendonça; Sachett, Jacqueline; Ferreira, Luiz Carlos Lima; Oliveira, Sâmella; Sabidò, Meritxell; Chalkidis, Hipócrates; Barbosa Guerra, Maria Graças Vale; Salinas, Jorge Luis; Wen, Fan Hui; Lacerda, Marcus Vinícius Guimarães; Monteiro, Wuelton Marcelo

2016-01-01

Background A better knowledge of the burden and risk factors associated with severity due to spider bites would lead to improved management with a reduction of sequelae usually seen for this neglected health problem, and would ensure proper use of antivenoms in remote localities in the Brazilian Amazon. The aim of this study was to analyze the profile of spider bites reported in the state of Amazonas in the Western Brazilian Amazon, and to investigate potential risk factors associated with severity of envenomation. Methodology/Principal Findings We used a case-control study in order to identify factors associated with spider bite severity in the Western Brazilian Amazon from 2007 to 2014. Patients evolving to any severity criteria were considered cases and those with non-severe bites were included in the control group. All variables were retrieved from the official Brazilian reporting systems. Socioeconomical and environmental components were also included in a multivariable analysis in order to identify ecological determinants of incidence and severity. A total of 1,181 spider bites were recorded, resulting in an incidence of 4 cases per 100,000 person/year. Most of the spider bites occurred in males (65.8%). Bites mostly occurred in rural areas (59.5%). The most affected age group was between 16 and 45 years old (50.9%). A proportion of 39.7% of the bites were related to work activities. Antivenom was prescribed to 39% of the patients. Envenomings recorded from urban areas [Odds ratio (OR) = 0.40 (95%CI = 0.30–0.71; p<0.001)] and living in a municipality with a mean health system performance index (MHSPI >median [OR = 0.64 (95%CI = 0.39–0.75; p<0.001)] were independently associated with decreased risk of severity. Work related accidents [OR = 2.09 (95%CI = 1.49–2.94; p<0.001)], Indigenous status [OR = 2.15 (95%CI = 1.19–3.86; p = 0.011)] and living in a municipality located >300 km away from the state capital Manaus [OR = 1.90 (95%CI = 1.28–2.40; p<0.001)] were independently associated with a risk of severity. Living in a municipality located >300 km away from the state capital Manaus [OR = 1.53 (95%CI = 1.15–2.02; p = 0.003)] and living in a municipality with a MHSPI 300 km away from the state capital Manaus could be contributing factors to higher severity of spider envenomings in this area, as well as to antivenom underdosage. PMID:27227455

Australian Fur Seals (Arctocephalus pusillus doriferus) Use Raptorial Biting and Suction Feeding When Targeting Prey in Different Foraging Scenarios

PubMed Central

Hocking, David P.; Salverson, Marcia; Fitzgerald, Erich M. G.; Evans, Alistair R.

2014-01-01

Foraging behaviours used by two female Australian fur seals (Arctocephalus pusillus doriferus) were documented during controlled feeding trials. During these trials the seals were presented with prey either free-floating in open water or concealed within a mobile ball or a static box feeding device. When targeting free-floating prey both subjects primarily used raptorial biting in combination with suction, which was used to draw prey to within range of the teeth. When targeting prey concealed within either the mobile or static feeding device, the seals were able to use suction to draw out prey items that could not be reached by biting. Suction was followed by lateral water expulsion, where water drawn into the mouth along with the prey item was purged via the sides of the mouth. Vibrissae were used to explore the surface of the feeding devices, especially when locating the openings in which the prey items had been hidden. The mobile ball device was also manipulated by pushing it with the muzzle to knock out concealed prey, which was not possible when using the static feeding device. To knock prey out of this static device one seal used targeted bubble blowing, where a focused stream of bubbles was blown out of the nose into the openings in the device. Once captured in the jaws, prey items were manipulated and re-oriented using further mouth movements or chews so that they could be swallowed head first. While most items were swallowed whole underwater, some were instead taken to the surface and held in the teeth, while being vigorously shaken to break them into smaller pieces before swallowing. The behavioural flexibility displayed by Australian fur seals likely assists in capturing and consuming the extremely wide range of prey types that are targeted in the wild, during both benthic and epipelagic foraging. PMID:25390347

The prevalence of premature loss of primary teeth and its impact on malocclusion in the Eastern Province of Saudi Arabia.

PubMed

Al-Shahrani, Nasser; Al-Amri, Abdulaziz; Hegazi, Fahad; Al-Rowis, Khalid; Al-Madani, Abdullah; Hassan, Khalid S

2015-01-01

The present study was designed to determine the prevalence of premature loss of primary teeth and its effect on malocclusion in Eastern Province, Saudi Arabia. This is an observational, cross-sectional study that included 307 male children aged 9-11 years old. Clinical examinations were performed using a disposable sharp explorer, a UNC periodontal probe and a dental mirror. The samples were examined clinically to detect the following traits: Angle's classification of malocclusion, overjet, overbite, anterior open-bite, lateral open-bite, midline shift and cross-bite. Additionally, a dental caries examination was performed using WHO methods. Questionnaires in Arabic were coded and sent to the students' parents. The mean DMFT was 5.61 (SD = 3.01). The d-component was the highest, with a mean of 4 (SD = 2.83). Of the 307 children, it was found that 204 (66.4%) had a high DMFT score, which is defined as a score above 4. It was found that 156/307 (51%) children had premature loss of deciduous teeth. A high prevalence of premature loss of teeth was found in this study. This finding emphasizes the importance of increasing awareness levels about this issue and focuses attention on the need for more preventive efforts to maintain healthy and normal dentitions that would improve the masticatory function and aesthetics of individuals and the whole population. In addition, the findings emphasize the importance of the early detection of premature loss of primary teeth to prevent future malocclusion.

Antimicrobial Prophylaxis in Adults

PubMed Central

Enzler, Mark J.; Berbari, Elie; Osmon, Douglas R.

2011-01-01

Antimicrobial prophylaxis is commonly used by clinicians for the prevention of numerous infectious diseases, including herpes simplex infection, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract infections in women, spontaneous bacterial peritonitis in patients with cirrhosis, influenza, infective endocarditis, pertussis, and acute necrotizing pancreatitis, as well as infections associated with open fractures, recent prosthetic joint placement, and bite wounds. Perioperative antimicrobial prophylaxis is recommended for various surgical procedures to prevent surgical site infections. Optimal antimicrobial agents for prophylaxis should be bactericidal, nontoxic, inexpensive, and active against the typical pathogens that can cause surgical site infection postoperatively. To maximize its effectiveness, intravenous perioperative prophylaxis should be administered within 30 to 60 minutes before the surgical incision. Antimicrobial prophylaxis should be of short duration to decrease toxicity and antimicrobial resistance and to reduce cost. PMID:21719623

TICK INFESTATION: A 200-PATIENTS' SERIES.

PubMed

Guven, Oya; Satilmis, Dilay; Sonmez, Feruza Turan; Demir, Bilgehan; Erdogan, Özgür

2017-01-01

A great number of zoonotic diseases with high mortality rate are transmitted by ticks. We performed this study in order to investigate patients admitted to emergency department following a tick bite. We examined the patients and get knowledge about the infestation and we followed up them for possible tick-conducted disease symptoms and laboratory findings both clinically and serologically. The study presented was hold for one year, between 01.01.2012 and 31.12.2012. 200 tick infested cases, admitted to Emergency Department of Haydarpasa Numune Training and Research Hospital, were subjected in the study. Demographic patterns of the patients and the region they come from, infested area on body, admission time and blood analyzing results were detected. Rate of adult patients to pediatric was 2:1; gender distribution was similar to each other. The most common body areas that ticks were removed from were lower extremity. The highest tick bite incidence was in summer and on weekends. No tick bite incident of Istanbul surrounding from the year 2012 progressed to a zoonotic disease. Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and patients should be informed for the risks. Knowledge of local area fauna risks may guide physicians so studies on this topic are essential.

Not All Erythema Migrans Lesions Are Lyme Disease.

PubMed

Goddard, Jerome

2017-02-01

Lyme disease is the number one arthropod-transmitted disease in the US, and one of the diagnostic criteria for the illness is development of an erythematous bull's-eye rash around a tick bite that may expand over time, hence the term erythema migrans. However, there are other erythema migrans-like rashes, such as those from a condition known as southern tick-associated rash illness. This article describes a patient with an erythema migrans-like lesion similar to that associated with Lyme disease, resulting from a bite by a nymphal-stage lone star tick, Amblyomma americanum. A tick removed from the center of an erythema migrans-like lesion in a patient was identified to species and then submitted to the Centers for Disease Control and Prevention for testing for the agent of Lyme disease, Borrelia burgdorferi. The patient was evaluated by an internist 7 weeks later. After another 3 weeks, the patient's blood was tested serologically for Lyme disease by American Esoteric Laboratories, Memphis, Tenn. Both the tick and human blood sample from this patient were negative for evidence of Lyme disease. Clinically, other than the erythema migrans-like lesion, the patient displayed no signs or symptoms consistent with Lyme disease. This case presents clinical, serological, and molecular evidence that erythema migrans lesions may occur after tick bites in patients and that these lesions may not be due to infection with the agent of Lyme disease. Copyright © 2016 Elsevier Inc. All rights reserved.

Influence of sustained submaximal clenching fatigue test on electromyographic activity and maximum voluntary bite forces in healthy subjects and patients with temporomandibular disorders.

PubMed

Xu, L; Fan, S; Cai, B; Fang, Z; Jiang, X

2017-05-01

This study aimed to investigate whether the fatigue induced by sustained motor task in the jaw elevator muscles differed between healthy subjects and patients with temporomandibular disorder (TMD). Fifteen patients with TMD and thirteen age- and sex-matched healthy controls performed a fatigue test consisting of sustained clenching contractions at 30% maximal voluntary clenching intensity until test failure (the criterion for terminating the fatigue test was when the biting force decreased by 10% or more from the target force consecutively for >3 s). The pre- and post-maximal bite forces (MBFs) were measured. Surface electromyographic signals were recorded from the superficial masseter muscles and anterior temporal muscles bilaterally, and the median frequency at the beginning, middle and end of the fatigue test was calculated. The duration of the fatigue test was also quantified. Both pre- and post-MBFs were lower in patients with TMD than in controls (P < 0·01). No significant difference was found in the percentage change in MBF between groups. The duration of the fatigue test in TMD patients was significantly shorter than that of the controls (P < 0·05). Our results suggest that, compared to healthy subjects, patients with TMD become more easily fatigued, but the electromyographic activation process during the fatigue test is similar between healthy subjects and patients with TMD. However, the mechanisms involved in this process remain unclear, and further research is warranted. © 2017 John Wiley & Sons Ltd.

Transparent aligners: An invisible approach to correct mild skeletal class III malocclusion

PubMed Central

Yezdani, A. Arif

2015-01-01

This case report highlights the treatment of a mild skeletal class III malocclusion with an invisible thermoplastic retainer. A 15-year-old female patient presented with a mild skeletal class III malocclusion with a retrognathic maxilla, orthognathic mandible, a low mandibular plane angle with Angle's class III malocclusion with maxillary lateral incisors in anterior cross-bite with crowding of maxillary anteriors, imbricated and rotated mandibular incisors and deep bite. Accurate upper and lower impressions and a bite registration were taken with polyvinyl siloxane rubber base impression material. This was then sent to the lab for the processing of a series of ClearPath aligners. The ClearPath virtual set-up sent from the lab provided the treatment plan and interproximal reduction estimation complete with posttreatment results. This enabled the clinician to actively participate in the treatment plan and provide the necessary suggestions. The ClearPath three-dimensional aligner was found to have effectively corrected the anterior cross-bite and crowding of the maxillary anteriors. PMID:26015738

Tick-borne infectious diseases in Australia.

PubMed

Graves, Stephen R; Stenos, John

2017-04-17

Tick bites in Australia can lead to a variety of illnesses in patients. These include infection, allergies, paralysis, autoimmune disease, post-infection fatigue and Australian multisystem disorder. Rickettsial (Rickettsia spp.) infections (Queensland tick typhus, Flinders Island spotted fever and Australian spotted fever) and Q fever (Coxiella burnetii) are the only systemic bacterial infections that are known to be transmitted by tick bites in Australia. Three species of local ticks transmit bacterial infection following a tick bite: the paralysis tick (Ixodes holocyclus) is endemic on the east coast of Australia and causes Queensland tick typhus due to R. australis and Q fever due to C. burnetii; the ornate kangaroo tick (Amblyomma triguttatum) occurs throughout much of northern, central and western Australia and causes Q fever; and the southern reptile tick (Bothriocroton hydrosauri) is found mainly in south-eastern Australia and causes Flinders Island spotted fever due to R. honei. Much about Australian ticks and the medical outcomes following tick bites remains unknown. Further research is required to increase understanding of these areas.

Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes.

PubMed

Ariaratnam, Christeine A; Sheriff, Mohamed H Rezvi; Arambepola, Carukshi; Theakston, R David G; Warrell, David A

2009-10-01

Of 860 snakes brought to 10 hospitals in Sri Lanka with the patients they had bitten, 762 (89%) were venomous. Russell's vipers (Daboia russelii) and hump-nosed pit vipers (Hypnale hypnale) were the most numerous and H. hypnale was the most widely distributed. Fifty-one (6%) were misidentified by hospital staff, causing inappropriate antivenom treatment of 13 patients. Distinctive clinical syndromes were identified to aid species diagnosis in most cases of snake bite in Sri Lanka where the biting species is unknown. Diagnostic sensitivities and specificities of these syndromes for envenoming were 78% and 96% by Naja naja, 66% and 100% by Bungarus caeruleus, 14% and 100% by Daboia russelii, and 10% and 97% by Hypnale hypnale, respectively. Although only polyspecific antivenoms are used in Sri Lanka, species diagnosis remains important to anticipate life-threatening complications such as local necrosis, hemorrhage and renal and respiratory failure and to identify likely victims of envenoming by H. hypnale who will not benefit from existing antivenoms. The technique of hospital-based collection, labeling and preservation of dead snakes brought by bitten patients is recommended for rapid assessment of a country's medically-important herpetofauna.

Comparison of digital and conventional impression techniques: evaluation of patients' perception, treatment comfort, effectiveness and clinical outcomes.

PubMed

Yuzbasioglu, Emir; Kurt, Hanefi; Turunc, Rana; Bilir, Halenur

2014-01-30

The purpose of this study was to compare two impression techniques from the perspective of patient preferences and treatment comfort. Twenty-four (12 male, 12 female) subjects who had no previous experience with either conventional or digital impression participated in this study. Conventional impressions of maxillary and mandibular dental arches were taken with a polyether impression material (Impregum, 3 M ESPE), and bite registrations were made with polysiloxane bite registration material (Futar D, Kettenbach). Two weeks later, digital impressions and bite scans were performed using an intra-oral scanner (CEREC Omnicam, Sirona). Immediately after the impressions were made, the subjects' attitudes, preferences and perceptions towards impression techniques were evaluated using a standardized questionnaire. The perceived source of stress was evaluated using the State-Trait Anxiety Scale. Processing steps of the impression techniques (tray selection, working time etc.) were recorded in seconds. Statistical analyses were performed with the Wilcoxon Rank test, and p < 0.05 was considered significant. There were significant differences among the groups (p < 0.05) in terms of total working time and processing steps. Patients stated that digital impressions were more comfortable than conventional techniques. Digital impressions resulted in a more time-efficient technique than conventional impressions. Patients preferred the digital impression technique rather than conventional techniques.

Assessment of orofacial characteristics and oral pathology associated with cri-du-chat syndrome.

PubMed

Rodríguez-Caballero, A; Torres-Lagares, D; Yáñez-Vico, R-M; Gutiérrez-Pérez, J-L; Machuca-Portillo, G

2012-03-01

To obtain a deeper insight into the difficulties individuals with cri-du-chat syndrome experience by means of the analysis of the most common features and oral pathology observed in the subjects enrolled in the study. Intra-oral and extra-oral features of a total of 33 patients with cri-du-chat syndrome (the larger sample so far analyzed) through their clinical and photographic examination. Models, orthopantomographies, and teleradiographies have been collected to establish a pattern as accurate as possible of the oral pathology associated with these patients. The present descriptive study shows that patients with cri-du-chat syndrome present with a series of orofacial features such as mandibular retrognathism, high palate, and variable malocclusion, more commonly anterior open-bite. Most patients also present with perioral muscle relaxation with labial incompetence and short philtrum. As regards oral pathology, these patients suffer dental erosions provoked by gastroesophageal reflux and attritions because of intense day-and-night bruxism. The odontologists' familiarity with the orofacial pathology associated with cri-du-chat syndrome and with the specific needs such disorder conveys should improve the quality of the buccodental treatment these professionals may offer to these patients. © 2011 John Wiley & Sons A/S.

Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite.

PubMed

Khan, Mohammad Iqbal; Tariq, Mohammad; Rehman, Ahmed; Zafar, Afsheeen; Sheen, Salman Najam

2008-01-01

Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p < 0.05) as compared to conservative management. Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite.

A comparative double blind study of amoxycillin/clavulanate vs placebo in the prevention of infection after animal bites.

PubMed Central

Brakenbury, P H; Muwanga, C

1989-01-01

The value of prophylactic antibiotics in the treatment of animal bites is uncertain. A prospective double blind stratified trial was performed comparing a broad spectrum antibiotic amoxycillin/clavulanate with placebo in full thickness animal bite wounds in a series of 185 consecutive patients. In wounds less than 9 h old, no significant benefit was found with the antibiotic. In older wounds, presenting 9-24 h after injury, the infection rate was reduced significantly (P = 0.023), although the numbers were small. We recommend the use of such an antibiotic on wounds 9-24 h old and query its use in more recent injuries, unless tendons or joints are likely to be involved. PMID:2692580

Australian taipan (Oxyuranus spp.) envenoming: clinical effects and potential benefits of early antivenom therapy - Australian Snakebite Project (ASP-25).

PubMed

Johnston, Christopher I; Ryan, Nicole M; O'Leary, Margaret A; Brown, Simon G A; Isbister, Geoffrey K

2017-02-01

Taipans (Oxyuranus spp.) are medically important venomous snakes from Australia and Papua New Guinea. The objective of this study was to describe taipan envenoming in Australian and its response to antivenom. Confirmed taipan bites were recruited from the Australian Snakebite Project. Data were collected prospectively on all snakebites, including patient demographics, bite circumstances, clinical effects, laboratory results, complications and treatment. Blood samples were taken and analysed by venom specific immunoassay to confirm snake species and measure venom concentration pre- and post-antivenom. There were 40 confirmed taipan bites: median age 41 years (2-85 years), 34 were males and 21 were snake handlers. Systemic envenoming occurred in 33 patients with neurotoxicity (26), complete venom induced consumption coagulopathy (VICC) (16), partial VICC (15), acute kidney injury (13), myotoxicity (11) and thrombocytopenia (7). Venom allergy occurred in seven patients, three of which had no evidence of envenoming and one died. Antivenom was given to 34 patients with a median initial dose of one vial (range 1-4), and a median total dose of two vials (range 1-9). A greater total antivenom dose was associated with VICC, neurotoxicity and acute kidney injury. Early antivenom administration was associated with a decreased frequency of neurotoxicity, acute kidney injury, myotoxicity and intubation. There was a shorter median time to discharge of 51 h (19-432 h) in patients given antivenom <4 h post-bite, compared to 175 h (27-1104 h) in those given antivenom >4 h. Median peak venom concentration in 25 patients with systemic envenoming and a sample available was 8.4 ng/L (1-3212 ng/L). No venom was detected in post-antivenom samples, including 20 patients given one vial initially and five patients bitten by inland taipans. Australian taipan envenoming is characterised by neurotoxicity, myotoxicity, coagulopathy, acute kidney injury and thrombocytopenia. One vial of antivenom binds all measurable venom and early antivenom was associated with a favourable outcome.

Prospective evaluation of pain, swelling, and disability from copperhead envenomation.

PubMed

Roth, Brett; Sharma, Kapil; Onisko, Nancy; Chen, Tiffany

2016-03-01

In light of the existing controversy regarding antivenin treatment for copperhead envenomation, a more detailed analysis of the disability from this species is needed. Our objective was to prospectively determine the duration of pain, swelling, and functional disability, i.e., residual venom effects, in patients with copperhead envenomation. Patients with venomous snakebite reported to the North Texas Poison Center between April 2009 and November 2011 were assessed. Patients with confirmed envenomations were contacted by a specialist in poison information. Day zero was the day of the bite and verbal phone consent for study enrollment was obtained at that time. The patient (or their guardian) was contacted by phone daily thereafter, and asked to rate their pain, edema/swelling, and disability using the modified DASH and LEFS scales. Patients were followed to resolution of all symptoms or return to baseline. About 104 cases of venomous snakebite were followed; of which 17 were excluded due to being a dry bites (5) or for having insufficient data during follow-up (11) or due to coagulopathy (1). Overall, residual venom effects from copperhead bites for most patients last between 7 and 13 days. Median time to complete pain resolution was 7 days (mean = 10.7 days). Median length of time to resolution of swelling was 10 days (mean = 13 days) and median length of time to resolution of functional disability was 9 days (mean = 12.2 days). Residual venom effects from copperhead envenomation in this study had a slightly shorter duration than some other studies. Data are skewed due to outliers where residual venom effects lasted for up to 89 days. Initial reoccurrence of some symptoms may be seen. Antivenom (AV) is currently being used for a large percentage of patients with copperhead envenomation. Finally, no differences in duration of venom effects were seen based on age or location of bite. Our study suggests that residual venom effects from copperhead species persist for between 10 and 13 days but may persist for months. Future studies are necessary to identify risk factors for severe/prolonged injury and to define the benefit of AV in patients with copperhead envenomation.

Clinical and patient reported outcomes of bleaching effectiveness.

PubMed

Klaric Sever, Eva; Budimir, Zrinka; Cerovac, Matea; Stambuk, Mario; Par, Matej; Negovetic Vranic, Dubravka; Tarle, Zrinka

2018-01-01

The objective of this study is to evaluate clinical and patient reported outcomes of different bleaching products. Thirty participants were randomly divided into three bleaching groups (n = 10). Bleaching was performed with high concentrations of hydrogen peroxide (HP) - Boost (40%) and Dash (30%), and with prefabricated splints Bite&White (6% HP). Tooth colour was measured before, immediately after, and 1 and 6 months after the bleaching by using classical shade guide and spectrophotometer. Tooth hypersensitivity was self-rated by patients on the Wong-Baker's face scale. Patient satisfaction was evaluated on a 7-point Likert-type scales that measured perceived performance and importance of different characteristics of bleaching treatment. All products were effective in teeth colour change (ΔE > 3.3), which was significantly higher for Boost (p = .016) and Dash (p = .024) than Bite&White treatment. Perception of hypersensitivity was the highest in Boost group, followed by Dash and Bite&White treatment. Most of the patients were satisfied with final tooth colour, length and comfort during treatment, but were dissatisfied with the stability of bleached tooth colour. Materials with the higher concentrations of bleaching agent demonstrated greater bleaching effectiveness than at-home bleaching product, but also a greater hypersensitivity. Lengthening the treatment process, but achieving a more stable tooth colour may improve the perceived value of a bleaching service.

[Management and orientation of a hand laceration].

PubMed

Masmejean, Emmanuel

2013-11-01

The good management and orientation of a hand laceration by the general physician is essential. Anatomical knowledge help to judge, after examination, the opportunity for surgery exploration with local anesthesia. Serious stakes are prognostic and economics. The conclusion identifies three clinical pictures : simple superf cial wound requiring a simple clinical control 2 days follow-up, the dubious wound that need to be sent to a specialized center, and the wound requiring care in an emergency hand unit. Extremely urgent wounds are devascularization, amputation and the pressure injection . Bites and wounds on a tendon way require surgical exploration. Bandage should be as simple as possible in order to allow early motion. No antibiotic is given preventively exept for bite, open fractures and/or delay of treatment. Outpatient surgery under loca anesthesia simplifies management.

European viper envenomation recorded by French poison control centers: A clinical assessment and management study.

PubMed

Jollivet, V; Hamel, J F; de Haro, L; Labadie, M; Sapori, J M; Cordier, L; Villa, A; Nisse, P; Puskarczyk, E; Berthelon, L; Harry, P; Boels, D

2015-12-15

Immunotherapy is the gold standard treatment for patients bitten by European vipers in France; it significantly decreases morbidity, frequency and severity of complications and length of stay. A national prospective study was performed by all Poison Control Centers (PCC) to validate the emergency protocol for viper envenomations. This prospective study included all cases of viper bites in France, treated or not with Viperfav(®) in 2013. In 2013, 277 cases of viper bites were collected: ratio M/F 2.1; mean aged 43 years (<15 years 25% 15-65 63% > 65 12%). The final severity was divided into 68 grades 0, 58 grades I, 62 grades IIA, 71 grades IIB and 18 grades III. One death was reported. Five patients had neurological signs. For the 114 patients who received Viperfav(®), all systemic signs disappeared in 5 h and in 24 h for biological and neurological signs. No severe anaphylactic reaction with Viperfav(®) was reported. Late Viperfav(®) administration increased the risk of functional impairment 15 days after the bite (OR = 3.21 p = 0.043). The administration of Low Molecular Weight Heparin (LMWH) increased the frequency of functional impairment to 15 days after the bite (OR = 6.38 p = 0.064), although Viperfav(®) was given in the first 18 h. This study confirms the efficiency, safety and recommendation of an early administration of a single dose of Viperfav(®), LMWH should not be used. It also shows the extension of neurotoxic venom of vipers in France. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of Pelican single-use multibite biopsy forceps and traditional double-bite forceps: evaluation in a porcine model.

PubMed

Zaidman, Jeffrey S; Frederick, William G; Furth, Emma E; Su, Chinyu G; Ginsberg, Gregory G

2006-10-01

The multibite biopsy forceps is intended for consecutive acquisition of numerous tissue specimens with a single pass. The Pelican multibite forceps is equipped with a sleeve for tissue retention that allows up to 6 specimens to be obtained with each pass of the device through the accessory channel. Reducing the need for device exchange could decrease the total procedure time for colon cancer surveillance in patients with longstanding inflammatory bowel disease (IBD). The aim of this study was to evaluate a new multibite biopsy forceps in comparison with a standard double-bite forceps. Prospective randomized animal model trial. Multicenter university and community hospitals. By using a live porcine model, multiple colonoscopic biopsy specimens were obtained with both the Pelican multibite forceps and the Radial Jaw 3 (RJ3) double-bite forceps to mimic colorectal cancer surveillance in patients with IBD. Six biopsy specimens were obtained with each of 6 passes when using the Pelican forceps, and 2 biopsy specimens were obtained with each of 18 passes when using the RJ3 forceps. All trials were timed. Two independent pathologists blinded to the forceps used evaluated the specimens. Tissue acquisition when using the Pelican multibite forceps was significantly faster than with a standard double-bite forceps. The devices compared equivalently for specimen retention and quality. The operator could not be blinded to the devices used. This study uses an animal model to extrapolate how the devices might perform in human use. These findings support the evaluation of the Pelican forceps for colon cancer surveillance in patients with longstanding IBD.

In Vitro Activity of Pexiganan and 10 Comparator Antimicrobials against 234 Isolates, Including 93 Pasteurella Species and 50 Anaerobic Bacterial Isolates Recovered from Animal Bite Wounds

PubMed Central

Citron, Diane M.; Tyrrell, Kerin L.; Leoncio, Eliza S.

2017-01-01

ABSTRACT Animal bite wounds affect more than 5 million Americans annually, resulting in 300,000 emergency department visits, 10,000 hospitalizations, and an untold number of physician office visits. Various forms of topical therapy are empirically self-employed by many patients prior to seeking medical attention. Pexiganan, a 22-amino-acid synthetic cationic analogue of the peptide magainin II, acts by selectively damaging bacterial cell membranes. We determined the MICs for pexiganan and other antimicrobial agents often used for treatment of bite wounds. Most isolates were from U.S. patients, and ∼10% were from European and Canadian patients. The comparator antimicrobials studied were penicillin, amoxicillin-clavulanate, piperacillin-tazobactam, meropenem, clindamycin, doxycycline, moxifloxacin, ceftriaxone, linezolid, and metronidazole. The MIC90s of pexiganan were 32 μg/ml (against Pasteurella multocida subsp. multocida), 16 μg/ml (P. multocida subsp. septica, Pasteurella canis, and Pasteurella dagmatis), 8 μg/ml (Pasteurella stomatis), 8 μg/ml (Eikenella corrodens), 2 μg/ml (Neisseria weaveri, Neisseria zoodegmatis, and Moraxella canis-Moraxella lacunata group), 16 μg/ml (Bergeyella zoohelcum), 64 μg/ml (Bacteroides pyogenes), 4 μg/ml (Fusobacterium russii), 32 μg/ml (Fusobacterium canifelinum), and 64 μg/ml (Prevotella heparinolytica). The concentration of pexiganan in the cream used was 8,000 μg/ml, more than 60 to 100 times the highest MIC obtained. Pexiganan exhibited a broad range of antimicrobial activity, showing potential for treating animal bite infections. A clinical trial seems warranted. PMID:28373186

Superolateral dislocation of the intact mandibular condyle associated with panfacial fracture: a case report and literature review.

PubMed

Amaral, Márcio Bruno; Bueno, Sebastião Cristian; Silva, Alice Araújo Ferreira; Mesquita, Ricardo Alves

2011-06-01

Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15-year-old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three-dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well-documented cases of SDIMC. The patients' mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases. © 2011 John Wiley & Sons A/S.

Human rabies: still a neglected preventable disease in Nigeria.

PubMed

Eke, C B; Omotowo, I B; Ukoha, O M; Ibe, B C

2015-01-01

Adequate surveillance and monitoring of dog bite incidents are veritable tools in the determination of the epidemiology of human rabies infections. There is a paucity of data with regards to rabies in Nigeria. Hence, this study was aimed at describing the pattern and outcomes of dog bites and rabies infections among patients presenting to University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. This was a 10-year (January 1, 2004 to December 31, 2013) observational retrospective study. Case definition of rabies was based on ICD 10 criteria, while relevant clinical data were retrieved from individual folders of registered victims using a semi-structured questionnaire. Data were analyzed using SPSS version 17.0 while the level of statistical significance was set at P < 0.05. A total of 149 cases of dog bites were reported during the period under review, of which 6 (4.0%) had confirmed rabies. Ninety-six (64.4%) cases presented more than 24 h after the bites. Majority of the offending dogs were stray dogs 86 (57.7%), which attacked their victims unprovoked, in 54.6% of cases. Furthermore, most of the bites were from dogs with unknown history of rabies vaccination 72 (52.3%), while the case fatality rate was 100%. All the cases of rabies reported were as a result of bites from stray dogs with unknown history of rabies vaccinations, and the outcome was 100% fatality in all cases. Efforts should be made to create and strengthen awareness campaigns on control of rabies infections through responsible dog ownership including their regular vaccinations as well as provision and use of prompt postexposure prophylaxis in human cases of dog bites at all levels of health care.

Open season: select the best 'beast' for each skin lesion.

PubMed

Uber, Marjorie; Robl, Renata; Carvalho, Vania Oliveira; Abagge, Kerstin Taniguchi; Valério, Talita Sana; Marinoni, Leide Parolin; Cosechen Rosvailer, Mayara Schulze

2015-10-01

Animal bites can cause skin lesions that suggest other conditions, and therefore diagnosis can be a challenge. Four cases of skin injuries caused by arthropods are presented below. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Hugh Alistair Reid OBE MD: investigation and treatment of snake bite.

PubMed

Hawgood, B J

1998-03-01

Alistair Reid was an outstanding clinician, epidemiologist and scientist. At the Penang General Hospital, Malaya, his careful observation of sea snake poisoning revealed that sea snake venoms were myotoxic in man leading to generalized rhabdomyolysis, and were not neurotoxic as observed in animals. In 1961, Reid founded and became the first Honorary Director of the Penang Institute of Snake and Venom Research. Effective treatment of sea snake poisoning required specific antivenom which was produced at the Commonwealth Serum Laboratories in Melbourne from Enhydrina schistosa venom supplied by the Institute. From the low frequency of envenoming following bites, Reid concluded that snakes on the defensive when biting man seldom injected much venom. He provided clinical guidelines to assess the degree of envenoming, and the correct dose of specific antivenom to be used in the treatment of snake bite in Malaya. Reid demonstrated that the non-clotting blood of patients bitten by the pit viper, Calloselasma rhodostoma [Ancistrodon rhodostoma] was due to venom-induced defibrination. From his clinical experience of these patients, Reid suggested that a defibrinating derivative of C. rhodostoma venom might have a useful role in the treatment of deep vein thrombosis. This led to Arvin (ancrod) being used clinically from 1968. After leaving Malaya in 1964, Alistair Reid joined the staff of the Liverpool School of Tropical Medicine, as Senior Lecturer. Enzyme-linked immunosorbent assay (ELISA) for detecting and quantifying snake venom and venom-antibody was developed at the Liverpool Venom Research Unit: this proved useful in the diagnosis of snake bite, in epidemiological studies of envenoming patterns, and in screening of antivenom potency. In 1977, Dr H. Alistair Reid became Head of the WHO Collaborative Centre for the Control of Antivenoms based at Liverpool.

Dentoskeletal modifications in Class II deep bite malocclusion treatment with anterior bite plane functional appliance

PubMed Central

Ciavarella, Domenico; Laurenziello, Michele; Guida, Laura; Montaruli, Graziano; Gallo, Crescenzio; Lo Muzio, Lorenzo

2017-01-01

Background A treatment modality for Class II division 1 malocclusion is discussed. Orthodontic treatment of patients with deep bite and Class II malocclusion is an important challenge in clinical practice. The aim of this work is to compare the efficacy of anterior bite plane functional appliance (ABPFA) by assessing the changes in different times with untreated patients by literature. Material and Methods The study group comprised 22 subjects with Class II division 1 malocclusion and hypo-divergent. Eligibility criteria for this study were: dental Class II division 1 malocclusion, hypo-divergent skeletal pattern, late mixed or permanent dentition. We analyzed with the use of stable bone structure (ASCB) at two different times: pre-treatment (T0) and post-treatment (T1) after 24 months. Inter-group differences were evaluated with paired samples t-test at the P<0.05 level. Results No statistical significant differences were found in cephalometric skeletal measurements, whereas dental parameters showed a significant different overjet, which was significantly reduced (6 mm at T0 vs. 5 mm at T1) in our series. Conclusions In ABPFA group, the treatment effects were reduce mainly Class II malocclusion, overjet and overbite alteration. This appliance seems to suggest a significant beneficial effect in mandible displacement by reducing the counter clockwise rotation of the mandible, which is further confirmed by the almost absence of modifications of ArGoMe and SNGoMe angles. The ABPFA is particularly suitable to reduce the non-desirable dental effects represented by lower incisors pro inclination, and upper incisors retro-inclination. Key words:Orthodontics, Functional orthodontics, Class II malocclusion, Anterior bite plane functional appliance. PMID:28936295

Clinico-epidemiology of arthropod stings and bites in primary hospitals of North Western province of Sri Lanka.

PubMed

Kularatne, Senanayake A M; Shahmy, Seyed; Rathnayake, Shantha S; Dawson, Andrew H

2018-03-06

Arthropod stinging and bites are common environmental hazards in Sri Lanka. However, their medical importance has not been fully evaluated yet. This study aims to study the burden, epidemiology, and outcome of stings and bites in primary hospitals in the Kurunegala district in North Western Province (NWP) of Sri Lanka. The study was conducted one year from 25th May 2013 to 25th May 2014. Details of all stings and bites admissions and their outcomes were retrospectively extracted from hospital records in all 44 primary hospitals in the district. There were 623 stings and bites with population incidence of 38/100,000 (95% CI 27-52). There were no deaths. Median age was 38 years (IQR: 19-53 years), and 351 (56%) were males. Most of stings and bites (75%) occurred in the daytime. Median time to hospital arrival was 55 minutes (IQR: 30 min to 2 h). The offending arthropods had been identified in 557 (89%) cases, of them, 357 (57%) were Hymenoptera (hornet and bees), 99 centipedes, 61 spiders and 40 scorpions. Local pain occurred in 346 (56%) cases - centipede 69 (70%), Scorpion 24 (60%), spider 36 (59%), Hymenoptera 187 (52%) and unidentified 30 (45%). Hymenoptera stings and spider bites occurred between 06 am to 12 noon, and scorpion stings and centipede bites mostly occurred between 06 pm to 12 midnight. Mild, moderate to severe anaphylaxis reactions occurred in 173 (28%) patients including 110 Hymenoptera stings - mild 39, moderate 62 and severe 9. From primary hospitals, 53(9%) cases had been transferred to tertiary care units for further management. Of them, 41 cases were Hymenoptera stings and 24 (58%) of them had mild, moderate to severe anaphylaxis. In the entire group, 27% severe cases received adrenaline. The primary hospitals in NW province of Sri Lanka manage large numbers of arthropod stings and bites. These include Hymenoptera (hornet and bee), centipedes, spiders, and scorpions. Pain, swellings and anaphylactic reactions were the most common adverse effects.

[A case of favourable outcome of severe acute intoxication with an animal poison after a bite by the monocled cobra].

PubMed

Livanov, G A; Batotsyrenkov, B V; Lodiagin, A N; Andrianov, A Iu; Kuznetsov, O A; Loladze, A T; Baranov, D V

2014-01-01

This paper reports a case of severe acute intoxication with an animal poison after a bite by the monocled cobra. Combined treatment including artificial lung ventilation, infusion-detoxication and desensitizing (hormonal) therapy, hemosorption, correction of metabolic disorders with cytoflavin, antibacterial therapy had positive effect on the patient's condition and ensured the favourable outcome ofpotentially lethal poisoning without the use ofa specific anti-snake venom serum.

Skin lesions and inoculation eschars at the tick bite site in spotted fever group rickettsioses: experience from a patient series in eastern crete, Greece.

PubMed

Germanakis, Antonis; Chochlakis, Dimosthenis; Angelakis, Emmanouil; Tselentis, Yannis; Psaroulaki, Anna

2014-01-01

The main clinical signs and symptoms caused by a rickettsial infection typically begin 6-10 days after the bite and are accompanied by nonspecific findings such as fever, headache and muscle pain. The diagnosis is mainly based on serological tests, however antibody presentation may be delayed, at least at the early stages of the disease, while seroconversion is usually detected 10-15 days after disease onset. Culture is difficult, requires optimized facilities and often proves negative. Under this scope, the presence of a characteristic inoculation eschar at the bite site may prove a useful clinical tool towards the early suspicion and diagnosis/differential diagnosis of tick-borne rickettsioses, even before the onset of rash and fever or serological confirmation. We describe herein the presence of skin lesions and/or an inoculation eschar at the tick bite site in 17 patients diagnosed, by molecular means, as suffering from spotted fever group rickettsioses. The detection of the pathogen's DNA in biopsy samples proved to be a useful means for early rickettsiae detection and identification. Moreover, the presence of an infiltrated erythema always seemed to precede the appearance of an eschar by 2-5 days and the initiation of fever by 1-10 days; these two signs might also prove useful in the context of the final diagnosis. © 2014 S. Karger AG, Basel.

Resorption of maxillary incisors after orthodontic treatment--clinical study of risk factors.

PubMed

Elhaddaoui, Rajae; Benyahia, Hicham; Azeroual, Mohamed-Faouzi; Zaoui, Fatima; Razine, Rachid; Bahije, Loubna

2016-03-01

External apical root resorption (EARR) is one of the major problems associated with orthodontic treatment. Such lesions represent an iatrogenic risk that must be detected as early as possible, with regular radiological follow-up and appropriate therapeutic precautions. The causes and mechanisms leading to susceptibility to root resorption following the application of an orthodontic force are often not clear and are generally said to be of multifactorial origin. The aim of this clinical study was to analyze the factors linked to the occurrence of moderate to severe resorption (MSR) of upper incisors during orthodontic treatment in a group of Moroccan patients treated in the Dento-Facial Orthopedic Department of the Dental Consultation and Treatment Center (Centre de consultation et de traitements dentaires [CCTD]) in Rabat. A total of 82 patients (28% males, 72% females) aged between 12 and 27, with various malocclusions, who had been treated with fixed appliances for at least 1 year and for whom panoramic X-rays at the start, during and at the end of treatment were available, were selected randomly. The reduction in maxillary incisor root length was evaluated using resorption scores. The factors studied in relation to the risk of occurrence of MSR were: age, sex, treatment duration, extraction or non-extraction, type of malocclusion (Class I arch-length discrepancy, Class II, Class III), the vertical diagnosis (normal, supraocclusion, open bite), presence of dysfunction, impacted canines and root morphology. Statistical analysis was performed using SPSS software, version 18.0. Statistical tests used were: Kaplan-Meier analysis and the univariate and multivariate Cox models for the study of factors associated with MSR. The threshold of significance adopted was 0.05. The factors that were significantly associated with the occurrence of MSR at the level of the upper incisors were: tooth type, with a greater risk for the lateral incisor (HR=3.2 95% CI [2.3-4.5] P<0.001), treatments with extraction (HR=1.64 95% CI [1.16-2.33] P<0.05), the presence of supraocclusion (HR=2.17 95% CI [1.33-3.53] P<0.05) or open bite (HR=3.12 95% CI [1.66-5.86] P<0.001) and root malformation (HR=1.5 95% CI [1.09-2.07] P<0.05). Age, sex, type of malocclusion, dysfunction and impaction of canines were not associated at a statistically significant level with the risk of occurrence of MSR of the upper incisors. EARR is difficult to avoid; the orthodontist's role remains crucial in identifying risk factors so as to adopt a treatment strategy taking these factors into account. In our population, the risk of MSR in the upper incisors appeared to increase in treatments with extraction, situations of supraocclusion or open bite, and in the presence of root abnormalities. Finally, clinical recommendations for the prevention of the occurrence of MSR of the maxillary incisors are proposed, taking into account all the risk factors identified. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

Miniplate with a bendable C-tube head allows the clinician to alter biomechanical advantage without physically moving the skeletal anchorage device.

PubMed

Seo, Kyung-Won; Ahn, Hyo-Won; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

2014-01-01

This article introduces a binary function of a miniplate with a bendable C-tube head used in corticotomy-assisted segment intrusion. The advantage of the device is that the point of force application can be altered without having to move the miniplate or place an additional anchorage device. Cases for this study were selected from patients who received perisegmental corticotomy with compression osteogenesis (Speedy Surgical Orthodontics) for segmental intrusion. For the skeletal anchorage on patients who received Speedy Surgical Orthodontics for posterior segment intrusion to improve on severe open bite correction, the C-tube was placed on the buccal wall of the maxilla for traction of orthopedic force as a temporary skeletal anchorage. The C-tube head portion is made with titanium grade II, which makes bending easy with a Weingart plier. This adjustment regains distance and range needed to continue intrusion of posterior segment. As an alternative to orthognathic surgery to correct a severe open bite, perisegmental corticotomy combined with orthopedic force application from a temporary skeletal anchorage device can be used. The corticotomy-assisted segment intrusion is a 2-stage procedure: first, the corticotomy is performed in the palate and 2 weeks later in the buccal alveolus. A C-plate was placed in the midpalatal area, and a C-tube was placed apical to the buccal corticotomy site. Elastics were used with orthopedic forces to induce compression osteogenesis. As the intrusion took place, the elastic stretched, and resultant force and range in the buccal segment decreased. The C-tube head was adjusted by bending to gain more distance, reviving the elastic force on the posterior segment until desired intrusion was accomplished. The miniplate with a bendable C-tube head serves for temporary skeletal anchorage of orthopedic traction force to achieve segmental intrusion and has the advantage that the bendable head can be adjusted to improve the force application for intrusion without having to move or place another temporary skeletal anchorage device.

A randomized controlled trial of fresh frozen plasma for coagulopathy in Russell's viper (Daboia russelii) envenoming.

PubMed

Isbister, G K; Jayamanne, S; Mohamed, F; Dawson, A H; Maduwage, K; Gawarammana, I; Lalloo, D G; de Silva, H J; Scorgie, F E; Lincz, L F; Buckley, N A

2017-04-01

Essentials Russell's viper envenoming is a major health issue in South Asia and causes coagulopathy. We studied the effect of fresh frozen plasma and two antivenom doses on correcting coagulopathy. Fresh frozen plasma did not hasten recovery of coagulopathy. Low-dose antivenom did not worsen coagulopathy. Background Russell's viper (Daboia russelii) envenoming is a major health issue in South Asia and causes venom-induced consumption coagulopathy (VICC). Objectives To investigate the effects of fresh frozen plasma (FFP) and two antivenom doses in correcting VICC. Methods We undertook an open-label randomized controlled trial in patients with VICC at two Sri Lankan hospitals. Patients with suspected Russell's viper bites and coagulopathy were randomly allocated (1 : 1) to high-dose antivenom (20 vials) or low-dose antivenom (10 vials) plus 4 U of FFP. The primary outcome was the proportion of patients with an International Normalized Ratio (INR) of < 2 at 6 h after antivenom administration. Secondary outcomes included anaphylaxis, major hemorrhage, death, and clotting factor recovery. Results From 214 eligible patients, 141 were randomized: 71 to high-dose antivenom, and 70 to low-dose antivenom/FFP; five had no post-antivenom blood tests. The groups were similar except for a delay of 1 h in antivenom administration for FFP patients. Six hours after antivenom administration, 23 of 69 (33%) patients allocated to high-dose antivenom had an INR of < 2, as compared with 28 of 67 (42%) allocated to low-dose antivenom/FFP (absolute difference 8%; 95% confidence interval - 8% to 25%). Fifteen patients allocated to FFP did not receive it. Severe anaphylaxis occurred equally frequently in each group. One patient given FFP developed transfusion-related acute lung injury. Three deaths occurred in low-dose antivenom/FFP patients, including one intracranial hemorrhage. There was no difference in recovery rates of INR or fibrinogen, but there was more rapid initial recovery of factor V and FX in FFP patients. Conclusion FFP after antivenom administration in patients with Russell's viper bites did not hasten recovery of coagulopathy. Low-dose antivenom/FFP did not worsen VICC, suggesting that low-dose antivenom is sufficient. © 2017 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

Cheek Plumper: An Innovative Anti-cheek Biting Appliance

PubMed Central

Srivastava, Nikhil; Kaushik, Noopur; Panthri, Prerna

2016-01-01

ABSTRACT One of the most challenging tasks for a pediatric dentist is the management of deleterious oral habits which adversely affect the dentofacial complex. However, if these habits can be intercepted and diagnosed well in time, they can save the patient from the psychological impact of undergoing long treatment therapies. One such rare deleterious oral habit is cheek biting that affects the buccal mucosa. Presented here is a case report which describes the interception of this deleterious habit in a 15-year-old female child who was a bilateral cheek biter with the help of an innovative intraoral appliance: The cheek plumper. How to cite this article: Rana V, Srivastava N, Kaushik N, Panthri P. Cheek Plumper: An Innovative Anti-cheek Biting Appliance. Int J Clin Pediatr Dent 2016;9(2):146-148. PMID:27365937

Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014-15: a retrospective follow-up survey.

PubMed

Etheart, Melissa Dominique; Kligerman, Maxwell; Augustin, Pierre Dilius; Blanton, Jesse D; Monroe, Benjamin; Fleurinord, Ludder; Millien, Max; Crowdis, Kelly; Fenelon, Natael; Wallace, Ryan MacLaren

2017-10-01

Haiti has an integrated bite case management (IBCM) programme to counsel animal-bite victims on the risk of rabies and appropriate treatment, as well as the Haiti Animal Rabies Surveillance Program (HARSP) to examine the animals. We assessed the usefulness of the IBCM programme to promote best practices for rabies prophylaxis after exposure in a low-income rabies-endemic setting. We did a retrospective follow-up survey of randomly selected bite victims who were counselled by Haiti's IBCM programme between May 15, 2014, and Sept 15, 2015. We classified participants by HARSP decisions of confirmed, probable, suspected, or non-rabies exposures. We compared health-care outcomes in people who sought medical care before IBCM counselling with those in people who sought care after counselling. We used decision trees to estimate the probability of actions taken in the health-care system, and thereby human deaths. During the study period, 1478 dog bites were reported to HARSP for assessment. 37 (3%) were confirmed exposures, 76 (5%) probable exposures, 189 (13%) suspected exposures, and 1176 (80%) non-rabies exposures. 115 of these cases were followed up in the survey. IBCM counselling was associated with a 1·2 times increase in frequency of bite victims seeking medical care and of 2·4 times increase in vaccination uptake. We estimated that there would be four human rabies deaths among the 1478 people assessed by IBCM during the survey period, and 11 in the absence of this programme, which would equate to a 65% decrease in rabies deaths. Among three people dead at the time of the follow-up survey, one was deemed to be due to rabies after a probable rabies exposure. Adherence to medical providers' recommendations might be improved through counselling provided by IBCM programmes. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

BiteStrip analysis of the effect of fluoxetine and paroxetine on sleep bruxism.

PubMed

Isa Kara, M; Ertaş, Elif Tarım; Ozen, Emrullah; Atıcı, Meral; Aksoy, Selami; Erdogan, Muharrem Serif; Kelebek, Seyfi

2017-08-01

The relationship between sleep bruxism (SB) and selective serotonin reuptake inhibitors (SSRIs) is still under debate because of the lack of well-designed objective studies. The current study investigates possible effects of SSRIs, fluoxetine, and paroxetine on SB in patients with anxiety and depression. Thirty users of SSRIs for treatment of depression or anxiety were enrolled in the study. After clinical and anamnestic examination, 15 fluoxetine and 15 paroxetine users were included. For an objective evaluation of SB, a single-use disposable home screening device, BiteStrip, was used prior to the first SSRI intake and was repeated on the 7th and 15th days. Patients' self-reported data also were obtained for assessment of patient awareness. BiteStrip scores were significantly higher on the 7th and 15th days than the first measurement (p<0.01). There was an increase in 26 (86.6%) patients' bruxism scores on the 7th day. There was also an increase in 27 (90%) patients' bruxism scores on the 15th day. But according to patients' self-reports, only 6 patients had an awareness that bruxism symptoms were initiated or exacerbated 15days after starting fluoxetine or paroxetine. Fluoxetine and paroxetine, SSRIs used for the treatment of anxiety and depression, may initiate or aggravate SB. Clinicians should consider that SSRIs may be the cause of SB when SSRI users are referred to dental clinics for SB symptoms. As there is a shortage of researches on this subject, further studies are necessary to confirm the existence of SSRI-induced SB. Copyright © 2016. Published by Elsevier Ltd.

Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome.

PubMed

Teo, Ken G; Anavekar, Namrata S; Yazdabadi, Anosha; Ricketts, Sophie

2012-07-29

We report a case of asplenic fulminant sepsis in Australia following a dog bite which was complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome (TENS/SJS). Capnocytophaga canimorsus, the infective organism, is a rare cause of septicaemia: a high degree of suspicion of this unusual organism and its early aggressive management is paramount. The diagnostic and management difficulties of TENS/SJS in the context of a patient with fulminant sepsis, DIC and on inotropes are also highlighted.

Orthodontic findings in the deciduous and early mixed dentition--inferences for a preventive strategy.

PubMed

Stahl, Franka; Grabowski, Rosemarie

2003-11-01

The aim of the present epidemiologic study was to obtain representative basic data on the frequency, extent and age-dependence of malocclusions in the deciduous and early mixed dentition. The developmental tendencies of specific malocclusions were investigated from the aspect of orthodontic prevention. The collective comprised 8,864 preschool and school-aged children, of whom 1,225 were in the deciduous dentition (mean age 4.5 years) and 7,639 in the mixed dentition (mean age 8.9 years). The orthodontic data were clinically assessed as sagittal, transversal, or vertical single-arch and occlusal findings. In addition, the malocclusions were classified according to their primary symptoms. Early infantile habits, tongue dysfunctions, speech defects and incompetent lip closure were registered separately. 57% of the children were found to have malocclusions, with the frequency rising statistically significantly in dependence on age from the deciduous to the mixed dentition (p < or = 0.001). The mean extent of excessive overjet increased significantly from the deciduous to the mixed dentition. Crossbite with mandibular midline discrepancies were observed significantly more frequently in the deciduous dentition. Although the frequency of anterior open bite underwent a significant decline from the deciduous to the mixed dentition, open bite was the malocclusion most frequently associated with dysfunction in both groups. The significant increase in traumatic deep bite in the mixed dentition indicates an unfavorable developmental tendency in this anomaly until after the eruption of the permanent incisors. The need for preventive orthodontic therapy and for the intensified application of interceptive and early treatment measures is stressed in view of the high number of malalignments and malocclusions in the deciduous and mixed dentition and the tendency for some forms of malocclusion to deteriorate as the dentition develops.

Oral habits as risk factors for anterior open bite in the deciduous and mixed dentition - cross-sectional study.

PubMed

Urzal, V; Braga, A C; Ferreira, A P

2013-12-01

Anterior open bite (AOB) is an occlusal anomaly commonly associated with oral habits (OH). The aim of this study was to determine the prevalence of OH as a risk factor for the AOB. A group of children aged between 3 and 12 years were observed. The statistical methodology included independent chi-square test, Fisher's exact test and binary logistic regression. The frequency of oral habits was of 43.5% in the deciduous dentition and 54.2% in the mixed dentition. There was a statistically significant association of pacifier sucking: 61.7 and 16.1 odd ratios (OR), and tongue thrust: 3.9 and 9.2 OR with AOB in both groups, respectively. Thumb sucking occurred only in the deciduous dentition with 5.6 OR. OH and AOB have a high frequency in children. They hinder the normal development of dental and skeletal structures. As OH are risk factors for AOB, the damaging habits most frequently associated are: pacifier sucking, thumb sucking, and tongue thrust. Due to the correlation between the prevalence of AOB and OH, prevention strategies incorporating psychological data related to children should be integrated into a national public health programme.

Bites by the colubrid snake Philodryas patagoniensis: a clinical and epidemiological study of 297 cases.

PubMed

de Medeiros, Carlos R; Hess, Priscila L; Nicoleti, Alessandra F; Sueiro, Leticia R; Duarte, Marcelo R; de Almeida-Santos, Selma M; França, Francisco O S

2010-11-01

We retrospectively analyzed 297 proven cases of Philodryas patagoniensis bites admitted to Hospital Vital Brazil (HVB), Butantan Institute, São Paulo, Brazil, between 1959 and 2008. Only cases in which the causative animal was brought and identified were included. Part of the snakes brought by the patients was still preserved in the collection maintained by the Laboratory of Herpetology. Of the 297 cases, in 199 it was possible to describe the gender of the snake, and seventy three (61.3%) of them were female. The length of snakes (snout-vent length) ranged from 160 to 1080 mm. In 117 snakes their state of preservation enabled the dissection and examination of their stomach contents. The stomach was empty in 106 snakes (89.1%). Most bites occurred in the seasons of spring and summer (n = 196, 66.0%) and during warmer periods of the day. The mean age of the victims was 24.1 +/- 15.1 years old and 206 (69.4%) patients were men. Around 92% of the patients sought medical care within 6 h after the bite. Both lower (n = 188, 63.3%) and upper limbs (n = 102, 34.3%) were most frequently bitten, especially the feet and hands (n = 205, 69.0%). The local clinical manifestations were pain (n = 151, 50.8%), transitory bleeding (n = 106, 35.7%), erythema (n = 47, 15.8%) and edema (n = 39, 13.1%). Ecchymosis was not observed. Only 7 (2.4%) patients reported systemic symptoms characterized by mild dizziness and 88 patients (29.6%) showed no evidence of envenoming. The whole blood clotting time was performed in 76 (25.6%) patients on admission and all of them had coagulable blood. Supportive treatment was offered to only 13.4% of patients, namely administration of antihistamines (n = 19, 6.4%) and analgesics (n = 12, 4.1%). Eight patients (2.7%) were mistreated with Bothrops antivenom before their admission to HVB. No sequels or relevant complications were observed in patients, and the prognostic was benign. Therefore, although P. patagoniensis accidents can cause mild local symptomatology, it is very important that health professionals know how to make the correct diagnosis to avoid unnecessary use of antivenom. (c) 2010 Elsevier Ltd. All rights reserved.

[The problem of intoxication in the population of the Republic of Guinea due to venomous snake bites].

PubMed

Bal'de, M S; Konstantinov, O K; Kamara, S K

2006-01-01

Intoxication of the population of Guinea due to venomous snake bites (100-150 intoxications per 100,000 with an 18% mortality rate) is a serious public health problem in the Republic of Guinea. Guinea's fauna of venomous snakes is diverse and numbers 20 species that are dangerous to human beings. The representatives of the family Elapidae (cobras and mambas) whose venom is highly toxic (LD50 5-12 mg) are responsible for the bulk (59.6%) of their bites. There has been recently an increase in the number of deaths from venomous snake bites, as high as 60% of the patients consulting a doctor being notified in one of the prefectures. At the same time the situation associated with the availability of antisnake serum is critical in the country due to its minute amount and to the inaccessibility of its high prices. By taking into account the great demand for the serum in Guinea, as everywhere over West Africa (thousands of doses every year), its manufacture may be profitable for potential investors and partners of the Pasteur Institute of Guinea.

Time series analysis and mortality model of dog bite victims presented for treatment at a referral clinic for rabies exposure in Monrovia, Liberia, 2010-2013.

PubMed

Olarinmoye, Ayodeji O; Ojo, Johnson F; Fasunla, Ayotunde J; Ishola, Olayinka O; Dakinah, Fahnboah G; Mulbah, Charles K; Al-Hezaimi, Khalid; Olugasa, Babasola O

2017-08-01

We developed time trend model, determined treatment outcome and estimated annual human deaths among dog bite victims (DBVs) from 2010 to 2013 in Monrovia, Liberia. Data obtained from clinic records included victim's age, gender and site of bite marks, site name of residence of rabies-exposed patients, promptness of care sought, initial treatment and post-exposure-prophylaxis (PEP) compliance. We computed DBV time-trend plot, seasonal index and year 2014 case forecast. Associated annual human death (AHD) was estimated using a standardized decision tree model. Of the 775 DBVs enlisted, care seeking time was within 24h of injury in 328 (42.32%) DBVs. Victim's residential location, site of bite mark, and time dependent variables were significantly associated with treatment outcome (p< 0.05). The equation X^ t =28.278-0.365t models the trend of DBVs. The high (n=705, 90.97%) defaulted PEP and average 155 AHD from rabies implied urgent need for policy formulation on national programme for rabies prevention in Liberia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimation of Dog-Bite Risk and Related Morbidity Among Personnel Working With Military Dogs.

PubMed

Schermann, H; Eiges, N; Sabag, A; Kazum, E; Albagli, A; Salai, M; Shlaifer, A

Soldiers serving in the Israel Defense Force Military Working Dogs (MWD) Unit spend many hours taming dogs' special skills, taking them on combat missions, and performing various dogkeeping activities. During this intensive work with the aggressive military dogs, bites are common, and some of them result in permanent disability. However, this phenomenon has not been quantified or reported as an occupational hazard. This was a retrospective cohort study based on self-administered questionnaires. Information was collected about soldiers' baseline demographics, duration of the experience of working with dogs, total number of bites they had, circumstances of bite events, and complications and medical treatment of each bite. Bite risk was quantified by incidence, mean time to first bite, and a Cox proportional hazards model. Rates of complications and the medical burden of bites were compared between combat soldiers and noncombat dogkeepers. Bite locations were presented graphically. Seventy-eight soldiers participated and reported on 139 bites. Mean time of working with dogs was 16 months (standard deviation, ±9.4 months). Overall bite incidence was 11 bites per 100 person-months; the mean time to first bite event was 6.3 months. The Cox proportional hazards model showed that none of baseline characteristics significantly increased bite hazard. About 90% of bites occurred during routine activities, and 3.3% occurred on combat missions. Only in 9% of bite events did soldiers observed the safety precautions code. Bite complications included fractures, need for intravenous antibiotic treatment and surgical repair, prominent scarring, diminished sensation, and stiffness of proximal joints. Bite complications were similar between combat soldiers and dogkeepers. Most bites (57%) were located on hands and arms. MWD bites are an occupational hazard resulting in significant medical burden. Hands and arms were most common bite locations. Observance of safety precautions may be the most appropriate first-line preventive intervention. Barrier protection of upper extremities may reduce bite severity and complication rates. 2017.

A data platform to improve rabies prevention, Sri Lanka.

PubMed

De Silva, A Pubudu; Harischandra, Pa Lionel; Beane, Abi; Rathnayaka, Shriyananda; Pimburage, Ruwini; Wijesiriwardana, Wageesha; Gamage, Dilanthi; Jayasinghe, Desika; Sigera, Chathurani; Gunasekara, Amila; Cadre, Mizaya; Amunugama, Sarath; Athapattu, Priyantha L; Jayasinghe, K Saroj A; Dondorp, Arjen M; Haniffa, Rashan

2017-09-01

In Sri Lanka, rabies prevention initiatives are hindered by fragmented and delayed information-sharing that limits clinicians' ability to follow patients and impedes public health surveillance. In a project led by the health ministry, we adapted existing technologies to create an electronic platform for rabies surveillance. Information is entered by trained clinical staff, and both aggregate and individual patient data are visualized in real time. An automated short message system (SMS) alerts patients for vaccination follow-up appointments and informs public health inspectors about incidents of animal bites. The platform was rolled out in June 2016 in four districts of Sri Lanka, linking six rabies clinics, three laboratories and the public health inspectorate. Over a 9-month period, 12 121 animal bites were reported to clinics and entered in the registry. Via secure portals, clinicians and public health teams accessed live information on treatment and outcomes of patients started on post-exposure prophylaxis (9507) or receiving deferred treatment (2614). Laboratories rapidly communicated the results of rabies virus tests on dead mammals (328/907 positive). In two pilot districts SMS reminders were sent to 1376 (71.2%) of 1933 patients whose contact details were available. Daily SMS reports alerted 17 public health inspectors to bite incidents in their area for investigation. Existing technologies in low-resource countries can be harnessed to improve public health surveillance. Investment is needed in platform development and training and support for front-line staff. Greater public engagement is needed to improve completeness of surveillance and treatment.

Self-inflicted finger injury in individuals with spinal cord injury: an analysis of 5 cases.

PubMed

Frost, Frederick S; Mukkamala, Sridevi; Covington, Edward

2008-01-01

To describe the occurrence of finger autophagia in 5 persons with traumatic spinal cord injury and to present a discussion of putative causes and potential treatments. Minor self-mutilating actions, such as nail biting and hair pulling, are common in humans and usually benign. In some circumstances, these behaviors are associated with obsessive-compulsive personality traits. In humans, self-injurious biting behaviors are well described in the setting of mental retardation and psychosis and in persons with Lesch-Nyhan syndrome. Rare cases of human autophagia in persons with intact cognition have been reported, most commonly in the setting of acquired nervous system lesions. After spinal cord injury, it has been suggested that this behavior constitutes a human variant of animal autotomy and a response to neuropathic pain. Case presentation narrative. Photographic and radiological study, administration of Yale-Brown Obsessive-Compulsive Scale (YBOCS). In 5 patients with complete tetraplegia, pain in the hands was present in only one instance. The severity of autoamputation varied from minor to extreme. In all cases, damage was confined to analgesic body parts. In 3 cases, autophagia behavior was discovered in progress. Treatments included pharmacotherapy, counseling, and behavioral therapy, with mixed results. All patients were intelligent, willing to discuss their issues, and able to identify conditions of stress and isolation in their lives. Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal. On the YBOCS, only 1 patient scored in a range indicative of mild obsessive-compulsive symptomatology. This group exhibited heterogeneous medical, social, and cultural characteristics. A link between pain and self-injurious behavior could not be demonstrated. This behavior may be viewed as an extreme variant of nail biting, with potential ominous complications. Treatment strategies have been employed with mixed results.

Performance of the 20-minute whole blood clotting test in detecting venom induced consumption coagulopathy from Russell's viper (Daboia russelii) bites.

PubMed

Ratnayake, Indira; Shihana, Fathima; Dissanayake, Dhammika M; Buckley, Nicholas A; Maduwage, Kalana; Isbister, Geoffrey K

2017-02-28

The 20-minute whole blood clotting test (WBCT20) is used as a bedside diagnostic test for coagulopathic snake envenoming. We aimed to assess the performance of the WBCT20 in diagnosis of venom induced consumption coagulopathy (VICC) in Russell's viper envenoming. Adult patients admitted with suspected snake bites were recruited from two hospitals. WBCT20 and prothrombin time (PT) test were performed on admission. WBCT20 was done by trained clinical research assistants using 1 ml whole blood in a 5 ml borosilicate glass tube with a 10 mm internal diameter. The PT was measured by a semi-automated coagulation system and international normalised ratio (INR) calculated. VICC was defined as present if the INR was >1.4. The diagnostic utility of WBCT20 was determined by calculating the sensitivity and specificity of the WBCT20 on admission for detecting VICC. There were 987 snake bites where both WBCT20 and PT were done on admission samples. This included 79 patients (8 %) with VICC. The WBCT20 was positive in 65/79 patients with VICC (sensitivity 82 %; 95 % confidence interval [CI]: 72-90 %) and was falsely positive in 13/908 with no coagulopathy. The WBCT20 was negative in 895/908 snake bites with no coagulopathy (specificity: 98 % 95 % CI: 97-99 %) and was falsely negative in 14/79 with VICC. Using trained clinical staff, the WBCT20 test had a relatively good sensitivity for the detection of VICC, but still missed almost one fifth of cases where antivenom was potentially indicated.

[Thumbsucking and malocclusion--presentation of a clinical case].

PubMed

Estripeaut, L E; Henriques, J F; de Almeida, R R

1989-01-01

The digital sucking habit have been significantly related with the malocclusions. These problems can be observed as in the deciduous and mixed as in the permanent dentition. Frequency, length, and intensity of the habit generate as a consequence: anterior open bite, retrusion of the mandible, protrusion of the maxilla, excessive overjet, labial version of the upper incisors, uprighting of the lower incisors, posterior cross bites, sometimes associated to a ogival palate, diastema between the upper incisors, and any others facial characteristics. According to various authors, when the habit persist for an extended period after the age of four years, is considered how malocclusion cause. In this case is requered the professional interference. The presentation of this study has the objective to show the clinic conduct for preventive orthodontics in face to cases who exhib harmful habits.

Management of facial soft tissue injuries in children.

PubMed

Vasconez, Henry C; Buseman, Jason L; Cunningham, Larry L

2011-07-01

Pediatric facial trauma can present a challenge to even the more experienced plastic surgeon. Injuries to the head and neck may involve bone and soft tissues with an assortment of specialized organs and tissue elements involved. Because of the active nature of children, facial soft tissue injuries can be diverse and extensive as well as some of the more common injuries a plastic surgeon is asked to treat. In 2007, approximately 800,000 patients younger than 15 years presented to emergency departments around the country with significant open wounds of the head that required treatment.In this review, we present the different types and regions of pediatric soft tissue facial trauma, as well as treatment options and goals of plastic surgery wound management. Special aspects, such as bite wounds, burns, pediatric analgesia, and antibiotic therapy, are also discussed.

Texas coral snake (Micrurus tener) bites.

PubMed

Morgan, David L; Borys, Douglas J; Stanford, Rhandi; Kjar, Dean; Tobleman, William

2007-02-01

The clinical features of bites from Texas coral snakes (Micrurus tener) have not been well studied. Our goal was to review the largest number of victims of Texas coral snakebites to determine their characteristics, effects, treatment, and outcome. Retrospective case series of Micrurus tener exposures reported to the Texas Poison Center Network from 2000 to 2004. Eighty-two patients were included in the analysis. Most (57.3%) were 18 to 49-year-old men. Almost 90% had local swelling, pain, erythema, or paresthesias. Only 7.3% had systemic effects, and none of these were severe. Over half received coral snake antivenin, and 15.9% were given opioids for pain. No patient died and no patient required mechanical ventilation due to hypoventilation from the snakebite. There were more local findings and less severe systemic effects than previously reported. Antivenin is not needed for most of these patients, and opioids may be administered safely.

A new modified tandem appliance for management of developing Class III malocclusion.

PubMed

Sukh, Ram; Singh, Gyan P; Tandon, Pradeep

2013-10-01

Most developing Class III patients display a retruded maxilla. Early intervention in mixed dentition is associated with better patient compliance and possibly a better orthopedic response, which can produce favorable results. The aim of this article is to present the fabrication of the new modified tandem appliance and its use in management of developing Class III malocclusion. The therapeutic results of a new modified tandem appliance are presented in an 8 year-old male patient with anterior cross bite and retrognathic maxilla at the mixed dentition stage. Anterior cross bite was corrected in 3 months and the positive overjet of 4 mm after continued use of the appliance for 1 year. There was a significant improvement in profile of the patient. The use of this appliance in this type of malocclusion enabled the correction of malocclusion in a few months and encouraging favorable skeletal growth in the future.

Tick-borne disease.

PubMed

Bratton, Robert L; Corey, Ralph

2005-06-15

Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially affecting the palms and soles of the feet is associated with Rocky Mountain spotted fever, whereas erythema migrans (annular macule with central clearing) is associated with Lyme disease. Various other rashes or skin lesions accompanied by fever and influenza-like illness also may signal the presence of a tick-borne disease. Early, accurate diagnosis allows treatment that may help prevent significant morbidity and possible mortality. Because 24 to 48 hours of attachment to the host are required for infection to occur, early removal can help prevent disease. Treatment with doxycycline or tetracycline is indicated for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. In patients with clinical findings suggestive of tick-borne disease, treatment should not be delayed for laboratory confirmation. If no symptoms follow exposure to tick bites, empiric treatment is not indicated. The same tick may harbor different infectious pathogens and transmit several with one bite. Advising patients about prevention of tick bites, especially in the summer months, may help prevent exposure to dangerous vector-borne diseases.

Hypopituitarism following envenoming by Russell's vipers (Daboia siamensis and D. russelii) resembling Sheehan's syndrome: first case report from Sri Lanka, a review of the literature and recommendations for endocrine management.

PubMed

Antonypillai, C N; Wass, J A H; Warrell, D A; Rajaratnam, H N

2011-02-01

Russell's vipers (Daboia russelii and D. siamensis) inhabit 10 South and South East Asian countries. People envenomed by these snakes suffer coagulopathy, bleeding, shock, neurotoxicity, acute kidney injury and local tissue damage leading to severe morbidity and mortality. An unusual complication of Russell's viper bite envenoming in Burma (D. siamensis) and southern India (D. russelii) is hypopituitarism but until now it has not been reported elsewhere. Here, we describe the first case of hypopituitarism following Russell's viper bite in Sri Lanka, review the literature on this subject and make recommendations for endocrine investigation and management. A 49-year-old man was bitten and seriously envenomed by D. russelii in 2005. He was treated with antivenom but although he recovered from the acute effects he remained feeling unwell. Hypopituitarism, with deficiencies of gonadal, steroid and thyroid axes, was diagnosed 3 years later. He showed marked improvement after replacement of anterior pituitary hormones. We attribute his hypopituitarism to D. russelii envenoming. Russell's viper bite is known to cause acute and chronic hypopituitarism and diabetes insipidus, perhaps through deposition of fibrin microthrombi and haemorrhage in the pituitary gland resulting from the action of venom procoagulant enzymes and haemorrhagins. Forty nine cases of hypopituitarism following Russell's viper bite have been described in the English language literature. Patients with acute hypopituitarism may present with hypoglycaemia and hypotension during the acute phase of envenoming. Those with chronic hypopituitarism seem to have recovered from envenoming but present later with features of hypopituitarism. Over 85% of these patients had suffered acute kidney injury immediately after the bite. Steroid replacement in acute hypopituitarism is life saving. All 11 patients with chronic hypopituitarism in whom the outcome of treatment was reported, showed marked improvement with hormone replacement. Unrecognized acute hypopituitarism is potentially fatal while chronic hypopituitarism can be debilitating. Physicians should therefore be aware of this complication of severe envenoming by Russell's vipers, especially in Burma and South India, so that the diagnosis may be made without delay and replacement started with essential hormones such as hydrocortisone and thyroxine.

Animal bites - self-care

MedlinePlus

Bites - animals - self-care ... Most animal bites come from pets. Dog bites are common and most often happen to children. Cat bites are ... which can cause deeper puncture wounds. Most other animal bites are caused by stray or wild animals, ...

A fatal mongoose bite.

PubMed

Tumram, Nilesh Keshav; Bardale, Rajesh Vaijnathrao; Dixit, Pradeep Gangadhar; Deshmukh, Ashutosh Yashwant

2012-11-19

Animal bite is a bite wound from a pet, farm or wild animal. Dog bites make up 80-85% of all reported incidents. Cats amount for about 10% of reported bites and other animals such as rodents, rabbits, horses, raccoons, bats and monkeys amount to 5-10%. Bites by mongoose are uncommon. Here, we present a case of fatal mongoose bite to an elderly woman who died as a complication of streptococcal infection at the bite site.

Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

PubMed Central

2010-01-01

Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs). However, a recent report described a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP) as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI) and the Helkimo Clinical Dysfunction Index (CDI) before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p < 0.001). The changes in the mean HOP-BPOP differences on the x-axis (mediolateral) and the y-axis (anteroposterior) were significant (p < 0.05), whereas the change on the z-axis (superoinferior) was not significant (p > 0.1). Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted. PMID:20346167

Bites by coral snakes (Micrurus spp.) in Campinas, State of São Paulo, Southeastern Brazil.

PubMed

Bucaretchi, Fábio; Hyslop, Stephen; Vieira, Ronan José; Toledo, Adriana Safioli; Madureira, Paulo Roberto; de Capitani, Eduardo Mello

2006-01-01

Coral snakes (Micrurus spp.) are the main representatives of the Elapidae in South America. However, bites by these snakes are uncommon. We retrospectively reviewed the data from 11 individuals bitten by coral snakes over a 20-year period; four were confirmed (snake brought for identification) and seven were highly suspected (neuromuscular manifestations) cases of elapid envenoming. The cases were classified as dry-bite (n = 1, caused by M. lemniscatus; did not receive antivenom), mild (n = 2, local manifestations with no acute myasthenic syndrome; M. frontalis and Micrurus spp.), moderate (n = 5, mild myasthenia) or severe (n = 3, important myasthenia; one of them caused by M. frontalis). The main clinical features upon admission were paresthesia (local, n = 9; generalized, n = 2), local pain (n = 8), palpebral ptosis (n = 8), weakness (n = 4) and inability to stand up (n = 3). No patient developed respiratory failure. Antivenom was used in ten cases, with mild early reactions occurring in three. An anticholinesterase drug was administered in the three severe cases, with a good response in two. No deaths were observed. Despite the high toxicity of coral snake venoms, the prognosis following envenoming is good. In serious bites by M. frontalis or M. lemniscatus, the venom of which acts postsynaptically, anticholinesterases may be useful as an ancillary measure if antivenom is unavailable, if there is a delay in obtaining a sufficient amount, or in those patients given the highest recommended doses of antivenom without improvement of the paralysis or with delayed recovery.

A Surgery-first approach in surgical-orthodontic treatment of mandibular prognathism--a case report.

PubMed

Yu, Chung-Chih; Chen, Po-Hsun; Liou, Eric J W; Huang, Chiung-Shing; Chen, Yu-Ray

2010-01-01

The conventional approach in orthodontic surgery treatment of dentofacial anomalies requires a varied period of pre-surgical orthodontic treatment. This presurgical period is considered to be important for adequate surgical treatment and stable results. This period is usually long bothersome for patients because dental decompensation is required and there is consequent deterioration of aesthetics and function, especially in cases of skeletal Class III occlusion. At Chang Gung Craniofacial Center, a surgery-first approach (SFA), i.e. minimal pre-surgical orthodontics, is one of the treatment choices for Class III patients. In this report, we present a 19-year-old man with mandibular prognathism, an anterior open bite and severe dental crowding treated with SFA. The patient received orthognathic surgery a week after bracing of the teeth. The operation and recovery were uneventful as well as the following orthodontic treatment. The total treatment time was only four months, much shorter than with the conventional approach. The patient benefitted from immediate improvement of the facial profile after surgery, and a much shorter total treatment, and the results were not compromised. We believe in selected cases, SFA is a good and effective treatment alternative.

Jaw Function in Smilodon fatalis: A Reevaluation of the Canine Shear-Bite and a Proposal for a New Forelimb-Powered Class 1 Lever Model

PubMed Central

Brown, Jeffrey G.

2014-01-01

The jaw function of Smilodon fatalis has long been a source of debate. Although modern-day lions subdue large prey through the use of a suffocating throat bite, the dramatically elongated maxillary canines of S. fatalis suggest an alternative bite mechanism. The current literature favors a “canine shear-bite,” in which the depression of the cranium by the ventral neck flexors assists the mandibular adductors in closing the jaws. Although the model makes intuitive sense and appears to be supported by scientific data, the mechanical feasibility of “neck-powered” biting has not been experimentally demonstrated. In the present study, the computer-assisted manipulation of digitized images of a high-quality replica of an S. fatalis neck and skull shows that a rotation of the cranium by the ventral neck flexors will not result in jaw closure. Instead, the cranium and mandible rotate ventrally together (at the atlantooccipital joint), and the jaws remain in an open configuration. The only manner by which rotation of the cranium can simultaneously result in jaw closure is by an anterior rotation at the temporomandibular joint. Based on this finding, the author proposes a new Class 1 lever mechanism for S. fatalis jaw function. In this model, the mandible is immobilized against the neck of the prey and a dorsally directed force from the extension of the forelimbs rotates the cranium anteriorly at the temporomandibular joint. The maxillary canines pierce the prey’s neck and assist in clamping the ventral neck structures. The model is based on a maximum gape angle of approximately 90° and incorporates a secondary virtual point of rotation located slightly anteroventral to the temporomandibular joint. The Class 1 Lever Model is mechanically feasible, consistent with current data on S. fatalis anatomy and ecology, and may provide a basis for similar studies on other fossil taxa. PMID:25272032

Epidemiology of animal bites and other potential rabies exposures and anti-rabies vaccine utilization in a rural area in Southern Ethiopia.

PubMed

Ramos, José M; Melendez, Napoleón; Reyes, Francisco; Gudiso, Ganamo; Biru, Dejene; Fano, Gamadi; Aberra, Gulelat; Tessema, Dalu; Tesfamariam, Abraham; Balcha, Seble; Gutiérrez, Félix

2015-01-01

The presented report describes the epidemiology of potential rabies exposures and examines the utilization of anti-rabies vaccine in a rural area of Ethiopia during a period of 43 months. A total of 683 persons (51.1% females, 73% children) with animal- related bites were included in the retrospective, registry-based study. The most common site of exposure was the leg (66.8%). In children under 8 years of age the face was more often involved than in adults (9.5% vs. 4.8%; p=0.03). The main type of exposure was a bite with bleeding (66.3%) followed by contamination of mucous membranes with saliva (19.7%). The primary sources were dogs (93.4%) followed by cats (2.6%). Children under 15 years were more likely to be exposed to dogs (94.9%) than adults (88.7%) (p=0.01). The most common way of coming in contact with animals was 'walking by' (83.9%). Children came in contact with animals while 'playing with' (10.7%) more often than adults (1.1%) (p<0.001). All the patients received an anti-rabies nervous-tissue vaccine, 99% of whom completed the vaccination course. Animal bites continue to be a problem in rural Ethiopia, mainly among children. Efforts to protect children against animal bites must be of paramount importance in preventing rabies in this population.

Cat and Dog Bites

MedlinePlus

... Wellness Staying Healthy Pets and Animals Cat and Dog Bites Cat and Dog Bites Share Print Cat and dog bites are common injuries. A family pet or ... bites. Path to safety If a cat or dog bites you, you should: Wash the wound gently ...

Association Between Harmful Oral Habits and Sign and Symptoms of Temporomandibular Joint Disorders Among Adolescents.

PubMed

Motghare, Vaibhav; Kumar, Jayaprakash; Kamate, Shivalingesh; Kushwaha, Sumedha; Anand, Richa; Gupta, Neha; Gupta, Bhuvandeep; Singh, Ishan

2015-08-01

Temporomandibular disorder (TDM) is defined as a heterogenous group of psychophysiological disorders commonly characterised by orofacial pain, chewing dysfunction or both. Various Epidemiological studies had shown occurrence of TMD in all age groups including children. Also research had shown that non nutritional oral habits to be associated with TMD. Present study aimed to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Greater Noida. Schools in Gautam Buddha district and descriptive study. Cross sectional study was carried out among 240 adolescents (10 - 19 years) studying in schools of Greater Noida. Study population were selected by random sampling to whom screening questionnaires recommended by American Academy of Orofacial Pain (AAOP) were distributed. Patient history and clinical examination was used to determine harmful oral habits. Data analysis was done in SPSS version 21 and Chi-square test was applied. Sixty one participants (25.4%) displayed no sign and symptoms of TMD, 34 (14.2%) responded affirmatively to atleast one item on the questionnaire and 108(46%) gave at least three affirmative responses. Headache, Neckpain and Toothache were most frequent reported sign and symptoms of TMD (46.2%). There was statistically significant association between gender and sign and symptoms of TMD on three items of the questionnaire (p < 0.05). Nail Biting (45.8%), Biting Lips/objects (37%) were most common habits among the study group. There was statistically significant association between Nail Biting (p = 0.001), Lip Biting/ object biting (p=0.001), Grinding of teeth (p = 0.01) and sign and symptoms of TMD. A statistically significant association was found between nail biting, lip/ object biting and grinding of teeth with signs and/or symptoms of TMD. Thus there is need for preventive dental treatment and community dental education so that young adults realize importance of early diagnosis and treatment of TMJ disorders.

Three-dimensional force measurements with mandibular overdentures connected to implants by ball-shaped retentive anchors. A clinical study.

PubMed

Mericske-Stern, R

1998-01-01

The purpose of this in vivo study was to determine maximum and functional forces simultaneously in three dimensions on mandibular implants supporting overdentures. The anchorage system for overdenture connection was the ball-shaped retentive anchor. Five edentulous patients, each with two mandibular ITI implants, were selected as test subjects. A novel miniaturized piezo-electric force transducer was developed for specific use with ITI implants. Force magnitudes and directions were registered under various test conditions by means of electrostatic plotter records. The test modalities were maximum biting in centric occlusion, maximum biting on a bite plate, grinding, and chewing bread. Maximum forces measured in centric occlusion and on the ipsilateral implant when using a bite plate were slightly increased in vertical and backward-forward dimension (z-, y-axis) compared to the lateral-medial direction (x-axis). On the contralateral implant, equally low values were found in all three dimensions. This may be the effect of a nonsplinted anchorage device. With the use of a bite plate, force magnitudes on the ipsilateral implant were significantly higher on the z- and y-axis than mean maximum forces in centric occlusion (P < .001). Chewing and grinding resulted in lower forces compared to maximum biting, particularly in the vertical direction. The transverse force component in backward-forward direction, however, reached magnitudes that exceeded the vertical component by 100% to 300% during chewing function. This chewing pattern had not been observed in previous investigations with bars and telescopes, and therefore appears to be specific for retentive ball anchors. The prevalent or exclusive force direction registered on both implants in the vertical direction was downward under all test conditions. In the transverse direction during maximum biting the forward direction was more frequently registered, while no obvious prevalence of transverse force direction was observed during chewing and grinding.

Dog and cat bites: epidemiologic analyses suggest different prevention strategies.

PubMed Central

Patrick, G R; O'Rourke, K M

1998-01-01

OBJECTIVE: To examine the characteristics of reported dog and cat bite incidents in El Paso, Texas, and their implications for local bite prevention programs. METHODS: The authors reviewed a random sample of reported dog bites and all reported cat bites in El Paso, Texas, in 1995 using existing animal control surveillance data. RESULTS: The majority of cat bites (89.4%) were provoked, with females (57.5%) and adults (68.3%) more likely to be victims than males or children. In contrast, just under half of dog bites (44.6%) were provoked, with males (65.6%) and children (63%) more likely to be victims than females or adults. Dogs that had not been vaccinated for rabies were involved in 65% of dog bites and cats that had not been vaccinated for rabies were involved in 92% of cat bites. CONCLUSION: Effective bite prevention programs should address the finding that both restrained and unrestrained dogs may bite even when unprovoked and that unrestrained cats usually bite when provoked. PMID:9633872

Sub-acute neuropathy in patients with African tick bite fever.

PubMed

Jensenius, Mogens; Fournier, Pierre-Edouard; Fladby, Tormod; Hellum, Kjell Block; Hagen, Tormod; Priø, Tine; Christiansen, Merete Skovdal; Vene, Sirkka; Raoult, Didier; Myrvang, Bjørn

2006-01-01

African tick bite fever (ATBF) caused by Rickettsia africae is an emerging health problem in travellers to sub-Saharan Africa. We here present 6 patients with evidence of long-lasting sub-acute neuropathy following ATBF contracted during safari trips to southern Africa. Three patients developed radiating pain, paresthaesia and/or motor weakness of extremities, 2 had hemi-facial pain and paresthaesia, and 1 developed unilateral sensorineural hearing loss. When evaluated 3-26 months after symptom onset, cerebrospinal fluid samples from 5 patients were negative for R. africae PCR and serology, but revealed elevated protein content in 3 and mild pleocytosis in 1 case. Despite extensive investigations, no plausible alternative causes of neuropathy could be identified. Treatment with doxycycline in 2 patients had no clinical effect. Given the current increase of international safari tourism to sub-Saharan Africa, more cases of sub-acute neuropathy following ATBF may well be encountered in Europe and elsewhere in the y to come.

Cause, setting and ownership analysis of dog bites in Bay County, Florida from 2009 to 2010.

PubMed

Matthias, J; Templin, M; Jordan, M M; Stanek, D

2015-02-01

Emergency room and hospital discharge data have been used to describe the risk factors and public health impact of dog bites. These data sets are based on financial charges for severe bites and underestimates dog bite burdens within communities. This study expands both the source of information and risk factor data collected to provide demographic analysis of dog bite injury risk factors reported in Bay County, Florida in 2009-2010. Extended data for dog bites reported by various sources from January 1, 2009 to December 31, 2010 were collected by Florida Department of Health in Bay County. Data collected included bite victim's age and gender, primary reported cause of bite, setting, dog's restraint status and relationship between the victim and the dog. A total of 799 bites were reported. Most bites (55%) were reported first by healthcare practitioners, particularly bites involving children<6 years. Bites involving unfamiliar dogs and dogs off the owner's property were more likely to be reported by other sources. Boys aged 6-14 years accounted for 2.24 times more bites than same-aged females (P<0.001) and had the highest incidence with 424 bites per 100,000 persons per year. Persons 6 years or older were 3.6 times more likely to be bitten by an unfamiliar dog. Inappropriate behaviour management was the most common cause of bites (26%), followed by protective behaviour (24%). Bites of unknown cause were 2.5 times more likely in children<6 years. Separating dog fights was the most common cause of bites for persons 15 years or older (24%); females were significantly more likely to be bit than males (P=0.01). Bites by unrestrained dogs off the owner's property (32% of all bites) most commonly involved males. Estimates based solely on healthcare discharge data significantly underestimate dog bite burden within a community. Characterizing these risks by age group or gender provides an opportunity to implement targeted interventions to prevent dog bites. © 2014 Blackwell Verlag GmbH.

No evidence of Borrelia mayonii in an endemic area for Lyme borreliosis in France.

PubMed

Boyer, Pierre H; De Martino, Sylvie J; Hansmann, Yves; Zilliox, Laurence; Boulanger, Nathalie; Jaulhac, Benoît

2017-06-05

Borrelia mayonii is currently the latest species belonging to the Borrelia burgdorferi (sensu lato) complex to be discovered. Interestingly it is involved in human pathology causing a high fever. We looked for its presence in post- tick bite febrile patients as well as in Ixodes ricinus ticks in an endemic area of France. After ensuring that our molecular technics correctly detected B. mayonii, 575 patients and 3,122 Ixodes ricinus nymphs were tested. Neither B. mayonii nor another species of the B. burgdorferi (s.l.) complex previously not reported in Europe has been identified. For now, B. mayonii seems to be an epiphenomenon. However, its discovery broadens the etiology of post-Ixodes bite febrile syndromes.

The diagnostic challenge of nonburrowing mite bites. Cheyletiella yasguri.

PubMed

Shelley, E D; Shelley, W B; Pula, J F; McDonald, S G

1984-05-25

Endemic pruritus in a family of four proved to be caused by the "bite and run" habits of the Cheyletiella yasguri mites that lived on the family dog. The mystery was solved only after the 6-year-old daughter experienced an explosive attack of pruritic papules after taking a nap in the dog's sleeping box. Virtually invisible ectoparasites remain a common cause of endemic pruritus within families. Since these patients show no acarologic, clinical, or laboratory evidence for the cause fo their itch, a good rule remains, cherchez le chien.

The role of anxiety in vulnerability for self-injurious behaviour: studies in a rodent model.

PubMed

Yuan, X; Devine, D P

2016-09-15

Self-injurious behaviour (SIB) is a debilitating characteristic that is highly prevalent in autism and other neurodevelopmental disorders. Pathological anxiety is also common, and there are reports of comorbid anxiety and self-injury in some children. We have investigated potential interactions between anxiety and self-injury, using a rat model of pemoline-induced self-biting. In one experiment, rats were pre-screened for trait anxiety by measuring expression of anxiety-related behaviour on the elevated plus maze and open field emergence test. The rats were then treated with pemoline once daily for ten days, and vulnerability for pemoline-induced self-injury was evaluated. This revealed modest correlations between innate levels of anxiety-related behaviour in the open field test (time in the start box, and latency to enter the open field), and vulnerability for pemoline-induced self-biting (total duration of self-injurious oral contact, and total size of tissue injury). Measures in the elevated plus maze were not significantly correlated with vulnerability for pemoline-induced self-injury. In a second experiment, rats were treated with the beta-carboline FG 7142 twice daily, during 5days of treatment with pemoline. The rats that were treated with this anxiogenic drug exhibited greater duration of self-injurious oral contact, and larger injuries than vehicle-treated controls did. Overall, these results suggest that anxiety may contribute to the etiology and/or expression of self-injurious behaviour, and indicate that further research is warranted. Published by Elsevier B.V.

Roles of TRPV1 and TRPA1 in Spontaneous Pain from Inflamed Masseter Muscle.

PubMed

Wang, Sheng; Brigoli, Benjamin; Lim, Jongseuk; Karley, Alisha; Chung, Man-Kyo

2018-06-08

Craniofacial muscle pain, such as spontaneous pain and bite-evoked pain, are major symptoms in patients with temporomandibular disorders and infection. However, the underlying mechanisms of muscle pain, especially mechanisms of highly prevalent spontaneous pain, are poorly understood. Recently, we reported that transient receptor potential vanilloid 1 (TRPV1) contributes to spontaneous pain but only marginally contributes to bite-evoked pain during masseter inflammation. Here, we investigated the role of transient receptor potential ankyrin 1 (TRPA1) in spontaneous and bite-evoked pain during masseter inflammation, and dissected the relative contributions of TRPA1 and TRPV1. Masseter inflammation increased mouse grimace scale (MGS) scores and face wiping behaviors. Pharmacological or genetic inhibition of TRPA1 significantly attenuated MGS but not face wiping behaviors. MGS scores were also attenuated by scavenging putative endogenous ligands for TRPV1 or TRPA1. Simultaneous inhibition of TRPA1 by AP18 and TRPV1 by AMG9810 in masseter muscle resulted in robust inhibition of both MGS and face wiping behaviors. Administration of AP18 or AMG9810 to masseter muscle induced conditioned place preference (CPP). The extent of CPP following simultaneous administration of AP18 and AMG9810 was greater than that induced by the individual antagonists. In contrast, inflammation-induced reduction of bite force was not affected by the inhibition of TRPA1 alone or in combination with TRPV1. These results suggest that simultaneous inhibition of TRPV1 and TRPA1 produces additive relief of spontaneous pain, but does not ameliorate bite-evoked pain during masseter inflammation. Our results provide further evidence that distinct mechanisms underlie spontaneous and bite-evoked pain from inflamed masseter muscle. Copyright © 2018. Published by Elsevier Ltd.

[The analysis of epidemiology, clinical symptoms, serological tests in the course of borreliosis].

PubMed

Biesiada, Grazyna; Czepiel, Jacek; Leśniak, Maciej; Garlicki, Aleksander; Mach, Tomasz

2010-01-01

Lyme disease is an animal-borne disease, caused by spirochetes of the Borrelia burgdorferi (Bb). The infection is transmitted by ticks of the Ixodes ricinus species. Humans are infected through a tick bite to the skin. The aim of the study was evaluation of epidemiology, symptoms and serologic factors in Lyme disease. We have enrolled 39 patients from Malopołska region in the study treated for Lyme borreliosis. History of tick biting, clinical signs and symptoms and serological tests were evaluated. The most common symptoms were headaches and pain of the large joints. Patients with untreated erithema migrans (EM) more often developed symptoms from nervous system (83%) than joints (54%). We found abnormalities which confirmed inflammation in CSF in 24.3% of patients. Patients with positive IgG antibodies against Bb in CSF and confirmed their intrathecal synthesis had never had EM in the past. There is low percentage of the patients who were treated due to EM. Patients with untreated EM more often developed symptoms from nervous system than joints. The most common symptoms among our patients were headaches and pain of large joints.

Field evaluation of the Off! Clip-on Mosquito Repellent (metofluthrin) against Aedes albopictus and Aedes taeniorhynchus (Diptera: Culicidae) in northeastern Florida.

PubMed

Xue, Rui-De; Qualls, Whitney A; Smith, Michael L; Gaines, Marcia K; Weaver, James H; Debboun, Mustapha

2012-05-01

Repellent efficacy of the Off! Clip-on Mosquito Repellent device (S. C. Johnson and Son, Inc., Racine, WI) containing Metofluthrin was evaluated on six human volunteers against the container-breeding mosquito Aedes albopictus (Skuse) and the salt marsh mosquito Aedes taeniorhynchus (Wiedemann) at two field locations in northeastern Florida. The device repelled mosquitoes by releasing a vaporized form of the pyrethroid insecticide metofluthrin ([AI] 31.2%) and provided 70% protection from Ae. albopictus bites for > 3 h. For the second field trial, a repellent device that was used in the first trial was tested after being open for >1 wk. This device provided 79% protection from Ae. taeniorhynchus bites for 3 h. Our field results showed that the repellent device was 70 and 79% effective at repelling Ae. albopictus and Ae. taeniorhynchus from human test subjects in both field locations in northeastern Florida.

Local extinction of the Asian tiger mosquito (Aedes albopictus) following rat eradication on Palmyra Atoll

PubMed Central

McLaughlin, John P.; Bogar, Taylor A.; Bui, An; Childress, Jasmine N.; Espinoza, Magaly; Forbes, Elizabeth S.; Johnston, Cora A.; Klope, Maggie; Miller-ter Kuile, Ana; Lee, Michelle; Plummer, Katherine A.; Weber, David A.; Young, Ronald T.

2018-01-01

The Asian tiger mosquito, Aedes albopictus, appears to have been extirpated from Palmyra Atoll following rat eradication. Anecdotal biting reports, collection records, and regular captures in black-light traps showed the species was present before rat eradication. Since then, there have been no biting reports and no captures over 2 years of extensive trapping (black-light and scent traps). By contrast, the southern house mosquito, Culex quinquefasciatus, was abundant before and after rat eradication. We hypothesize that mammals were a substantial and preferred blood meal for Aedes, whereas Culex feeds mostly on seabirds. Therefore, after rat eradication, humans and seabirds alone could not support positive population growth or maintenance of Aedes. This seems to be the first documented accidental secondary extinction of a mosquito. Furthermore, it suggests that preferred host abundance can limit mosquito populations, opening new directions for controlling important disease vectors that depend on introduced species like rats. PMID:29491026

Interactive relationship between the mechanical properties of food and the human response during the first bite.

PubMed

Dan, Haruka; Kohyama, Kaoru

2007-05-01

Biting is an action that results from interplay between food properties and the masticatory system. The mechanical factors of food that cause biting adaptation and the recursive effects of modified biting on the mechanical phenomena of food are largely unknown. We examined the complex interaction between the bite system and the mechanical properties. Nine subjects were each given a cheese sample and instructed to bite it once with their molar teeth. An intra-oral bite force-time profile was measured using a tactile pressure-measurement system with a sheet sensor inserted between the molars. Time, force, and impulse for the first peak were specified as intra-oral parameters of the sample fracture. Mechanical properties of the samples were also examined using a universal testing machine at various test speeds. Besides fracture parameters, initial slope was also determined as a mechanical property possibly sensed shortly after bite onset. The bite profile was then examined based on the mechanical parameters. Sample-specific bite velocities were identified as characteristic responses of a human bite. A negative correlation was found between bite velocity and initial slope of the sample, suggesting that the initial slope is the mechanical factor that modifies the consequent bite velocity. The sample-specific bite velocity had recursive effects on the following fracture event, such that a slow velocity induced a low bite force and high impulse for the intra-oral fracture event. We demonstrated that examination of the physiological and mechanical factors during the first bite can provide valuable information about the food-oral interaction.

Death Adder Envenoming Causes Neurotoxicity Not Reversed by Antivenom - Australian Snakebite Project (ASP-16)

PubMed Central

Johnston, Christopher I.; O'Leary, Margaret A.; Brown, Simon G. A.; Currie, Bart J.; Halkidis, Lambros; Whitaker, Richard; Close, Benjamin; Isbister, Geoffrey K.

2012-01-01

Background Death adders (Acanthophis spp) are found in Australia, Papua New Guinea and parts of eastern Indonesia. This study aimed to investigate the clinical syndrome of death adder envenoming and response to antivenom treatment. Methodology/Principal Findings Definite death adder bites were recruited from the Australian Snakebite Project (ASP) as defined by expert identification or detection of death adder venom in blood. Clinical effects and laboratory results were collected prospectively, including the time course of neurotoxicity and response to treatment. Enzyme immunoassay was used to measure venom concentrations. Twenty nine patients had definite death adder bites; median age 45 yr (5–74 yr); 25 were male. Envenoming occurred in 14 patients. Two further patients had allergic reactions without envenoming, both snake handlers with previous death adder bites. Of 14 envenomed patients, 12 developed neurotoxicity characterised by ptosis (12), diplopia (9), bulbar weakness (7), intercostal muscle weakness (2) and limb weakness (2). Intubation and mechanical ventilation were required for two patients for 17 and 83 hours. The median time to onset of neurotoxicity was 4 hours (0.5–15.5 hr). One patient bitten by a northern death adder developed myotoxicity and one patient only developed systemic symptoms without neurotoxicity. No patient developed venom induced consumption coagulopathy. Antivenom was administered to 13 patients, all receiving one vial initially. The median time for resolution of neurotoxicity post-antivenom was 21 hours (5–168). The median peak venom concentration in 13 envenomed patients with blood samples was 22 ng/mL (4.4–245 ng/mL). In eight patients where post-antivenom bloods were available, no venom was detected after one vial of antivenom. Conclusions/Significance Death adder envenoming is characterised by neurotoxicity, which is mild in most cases. One vial of death adder antivenom was sufficient to bind all circulating venom. The persistent neurological effects despite antivenom, suggests that neurotoxicity is not reversed by antivenom. PMID:23029595

Death adder envenoming causes neurotoxicity not reversed by antivenom--Australian Snakebite Project (ASP-16).

PubMed

Johnston, Christopher I; O'Leary, Margaret A; Brown, Simon G A; Currie, Bart J; Halkidis, Lambros; Whitaker, Richard; Close, Benjamin; Isbister, Geoffrey K

2012-01-01

Death adders (Acanthophis spp) are found in Australia, Papua New Guinea and parts of eastern Indonesia. This study aimed to investigate the clinical syndrome of death adder envenoming and response to antivenom treatment. Definite death adder bites were recruited from the Australian Snakebite Project (ASP) as defined by expert identification or detection of death adder venom in blood. Clinical effects and laboratory results were collected prospectively, including the time course of neurotoxicity and response to treatment. Enzyme immunoassay was used to measure venom concentrations. Twenty nine patients had definite death adder bites; median age 45 yr (5-74 yr); 25 were male. Envenoming occurred in 14 patients. Two further patients had allergic reactions without envenoming, both snake handlers with previous death adder bites. Of 14 envenomed patients, 12 developed neurotoxicity characterised by ptosis (12), diplopia (9), bulbar weakness (7), intercostal muscle weakness (2) and limb weakness (2). Intubation and mechanical ventilation were required for two patients for 17 and 83 hours. The median time to onset of neurotoxicity was 4 hours (0.5-15.5 hr). One patient bitten by a northern death adder developed myotoxicity and one patient only developed systemic symptoms without neurotoxicity. No patient developed venom induced consumption coagulopathy. Antivenom was administered to 13 patients, all receiving one vial initially. The median time for resolution of neurotoxicity post-antivenom was 21 hours (5-168). The median peak venom concentration in 13 envenomed patients with blood samples was 22 ng/mL (4.4-245 ng/mL). In eight patients where post-antivenom bloods were available, no venom was detected after one vial of antivenom. Death adder envenoming is characterised by neurotoxicity, which is mild in most cases. One vial of death adder antivenom was sufficient to bind all circulating venom. The persistent neurological effects despite antivenom, suggests that neurotoxicity is not reversed by antivenom.

Electromyographic and cephalometric correlation with the predominant masticatory movement.

PubMed

Coelho-Ferraz, Maria Julia P; Berzin, Fausto; Amorim, Cesar Ferreira; Romano, Fabio Lourenco; de Paula Queluz, Dagmar

2010-01-01

This study aimed to evaluate the chewing muscular dynamics and correlate the side of the masticatory movement that is more vertical and/or more horizontal established by the photomeasurement Masticatory Functional Angle (MFA) to the muscular activity behavior, showed in the surface electromyography and in the radiographic images. Seventeen people were selected of both genders, with the average age of 25 years, without signs or apparent symptoms of masticatory muscular disorders. The teleradiographies were done in lateral norm and surface electromyography of the masseter muscles, anterior portion of temporal and supra-hyoids in rest position and maximal bite. The bite force measured with a metallic transducer that was connected to a force sensor (Strain Gauge) to measure the deformation of the material model SF4 (EMG SYSTEM DO BRASIL). A mandibular goniometer of the EMG System of Brazil was used to measure the opening size. The comparison and correlation were established between the groups with MFA>5 degrees and MFA<5 degrees by the test "t" of Student or test of Mann-Whitney conform the distribution was normal or not, respectively. The results showed significant differences between groups, although without sexual dimorphism, to masseter muscle in maximal bite. In conclusion, the anatomic-physiological aspects of temporomandibular disorders are related to the asymmetrical mandible function.

Monkey bites among US military members, Afghanistan, 2011.

PubMed

Mease, Luke E; Baker, Katheryn A

2012-10-01

Bites from Macaca mulatta monkeys, native to Afghanistan, can cause serious infections. To determine risk for US military members in Afghanistan, we reviewed records for September-December 2011. Among 126 animal bites and exposures, 10 were monkey bites. Command emphasis is vital for preventing monkey bites; provider training and bite reporting promote postexposure treatment.

Effect of ebastine on mosquito bites.

PubMed

Reunala, T; Brummer-Korvenkontio, H; Petman, L; Palosuo, T; Sarna, S

1997-07-01

Mosquito bites usually cause wealing and delayed bite papules. Cetirizine decreases wealing, bite papules and pruritus but the effect of other antihistamines on mosquito bites is unknown. We studied the effect of ebastine in 30 mosquito bite-sensitive adult subjects. Ebastine 10 mg or 20 mg and placebo were given for 4 days in a cross-over fashion. Aedes aegypti bites were given on forearms. The size of the bite lesions and pruritus (visual analogue score) were measured at 15 min, 2, 6, and 24 h after the bites. Twenty-five subjects were evaluable in the study. At 15 min ebastine decreased significantly the size of the bite lesion (p = 0.0017) and pruritus (p<0.0001). The effects of 10 mg and 20 mg of ebastine were similar. No significant effect was found at 2, 6 or 24 h, but when the measurements at all four time points were compiled the size of the bite lesion and pruritus score decreased significantly. Sedation occurred during ebastine treatment in 6 (21%) and during placebo treatment in 2 (7%) subjects. The present results show that prophylactically given ebastine is effective against immediate mosquito bite symptoms.

Predictive Factors for Death After Snake Envenomation in Myanmar.

PubMed

Aye, Kyi-Phyu; Thanachartwet, Vipa; Soe, Chit; Desakorn, Varunee; Chamnanchanunt, Supat; Sahassananda, Duangjai; Supaporn, Thanom; Sitprija, Visith

2018-06-01

Factors predictive for death from snake envenomation vary between studies, possibly due to variation in host genetic factors and venom composition. This study aimed to evaluate predictive factors for death from snake envenomation in Myanmar. A prospective study was performed among adult patients with snakebite admitted to tertiary hospitals in Yangon, Myanmar, from May 2015 to August 2016. Data including clinical variables and laboratory parameters, management, and outcomes were evaluated. Multivariate regression analysis was performed to evaluate factors predictive for death at the time of presentation to the hospital. Of the 246 patients with snake envenomation recruited into the study, 225 (92%) survived and 21 (8%) died during hospitalization. The snake species responsible for a bite was identified in 74 (30%) of the patients; the majority of bites were from Russell's vipers (63 patients, 85%). The independent factors predictive for death included 1) duration from bite to arrival at the hospital >1 h (odds ratio [OR]: 9.0, 95% confidence interval [CI]: 1.1-75.2; P=0.04); 2) white blood cell counts >20 ×10 3 cells·μL -1 (OR: 8.9, 95% CI: 2.3-33.7; P=0.001); and 3) the presence of capillary leakage (OR: 3.7, 95% CI: 1.2-11.2; P=0.02). A delay in antivenom administration >4 h increases risk of death (11/21 deaths). Patients who present with these independent predictive factors should be recognized and provided with early appropriate intervention to reduce the mortality rate among adults with snake envenomation in Myanmar. Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Estimating maximum bite performance in Tyrannosaurus rex using multi-body dynamics

PubMed Central

Bates, K. T.; Falkingham, P. L.

2012-01-01

Bite mechanics and feeding behaviour in Tyrannosaurus rex are controversial. Some contend that a modest bite mechanically limited T. rex to scavenging, while others argue that high bite forces facilitated a predatory mode of life. We use dynamic musculoskeletal models to simulate maximal biting in T. rex. Models predict that adult T. rex generated sustained bite forces of 35 000–57 000 N at a single posterior tooth, by far the highest bite forces estimated for any terrestrial animal. Scaling analyses suggest that adult T. rex had a strong bite for its body size, and that bite performance increased allometrically during ontogeny. Positive allometry in bite performance during growth may have facilitated an ontogenetic change in feeding behaviour in T. rex, associated with an expansion of prey range in adults to include the largest contemporaneous animals. PMID:22378742

Estimating maximum bite performance in Tyrannosaurus rex using multi-body dynamics.

PubMed

Bates, K T; Falkingham, P L

2012-08-23

Bite mechanics and feeding behaviour in Tyrannosaurus rex are controversial. Some contend that a modest bite mechanically limited T. rex to scavenging, while others argue that high bite forces facilitated a predatory mode of life. We use dynamic musculoskeletal models to simulate maximal biting in T. rex. Models predict that adult T. rex generated sustained bite forces of 35 000-57 000 N at a single posterior tooth, by far the highest bite forces estimated for any terrestrial animal. Scaling analyses suggest that adult T. rex had a strong bite for its body size, and that bite performance increased allometrically during ontogeny. Positive allometry in bite performance during growth may have facilitated an ontogenetic change in feeding behaviour in T. rex, associated with an expansion of prey range in adults to include the largest contemporaneous animals.

Factors Associated with Tick Bite Preventive Practices among Farmworkers in Malaysia

PubMed Central

Wong, Li Ping; Tay, Sun Tee; Bulgiba, Awang; Zandi, Keivan; Kho, Kai Ling; Koh, Fui Xian; Ong, Bee Lee; Jaafar, Tariq; Hassan Nizam, Quaza Nizamuddin

2016-01-01

Background Farmworkers are at high-risk for tick bites, which potentially transmit various tick-borne diseases. Previous studies show that personal prevention against tick bites is key, and certain factors namely, knowledge, experience of tick bites, and health beliefs influence compliance with tick bites preventive behaviour. This study aimed to assess these factors and their associations with tick bite preventive practices among Malaysian farmworkers. Methods A total of eight cattle, goat and sheep farms in six states in Peninsular Malaysia participated in a cross-sectional survey between August and October 2013 Results A total of 151 (72.2%) out of 209 farmworkers answered the questionnaire. More than half of the farmworkers (n = 91) reported an experience of tick bites. Farms with monthly acaricide treatment had significantly (P<0.05) a low report of tick bites. Tick bite exposure rates did not differ significantly among field workers and administrative workers. The mean total knowledge score of ticks for the overall farmworkers was 13.6 (SD±3.2) from 20. The mean total tick bite preventive practices score for all farmworkers was 8.3 (SD±3.1) from 15. Fixed effect model showed the effects of four factors on tick bite prevention: (1) farms, (2) job categories (administrative workers vs. field workers), (3) perceived severity of tick bites, and (4) perceived barriers to tick bite prevention. Conclusions A high proportion of farmworkers, including administrative workers, reported an experience of tick bites. The effectiveness of monthly acaricide treatment was declared by low reports of tick bites on these farms. Tick bite preventive practices were insufficient, particularly in certain farms and for administrative workers. Our findings emphasise the need to have education programmes for all farmworkers and targeting farms with low prevention practices. Education and health programmes should increase the perception of the risk of tick bites and remove perceived barriers of tick bite prevention. PMID:27341678

Same dog bite and different outcome in two cases - case report.

PubMed

Rd, Gadekar; Vk, Domple; If, Inamdar; Nr, Aswar; Mk, Doibale

2014-06-01

There is still no cure for rabies and survival from clinical rabies is extremely rare. It is a preventable disease if the post exposure prophylaxis is initiated in time and administered as per WHO guidelines including administration of rabies immunoglobulin. The role of passive rabies immunization products is to provide the immediate availability of neutralizing antibodies at the site of the exposure before it is physiologically possible for the patient to begin producing his or her own antibodies after vaccination. In this case report, the same dog has bitten to a boy and to an adult. Local wound treatment and use of human rabies immunoglobulin as well as gluteal region as a site of bite were the probable reasons for survival of the boy. On the other hand no local wound treatment, no use of rabies immunoglobulin and finger as a site of bite are the probable reasons for death of an adult due to rabies.

Prophylaxis of Human Hydrophobia in South Korea

PubMed Central

2014-01-01

Domestic human hydrophobia has not been reported since the one case of 2004 in South Korea, but still a few animal rabies occur persistently since the reemerging stage of rabies from 1993. The government has made efforts to control animal rabies in many aspects, but whether prophylactic strategy for human hydrophobia is performed adequately is in question. The rate of proper post-exposure prophylaxis for animal bite case in 'high-risk region' of rabies is very low with 20% between 2011 and 2013. The National Animal Bite Patient Surveillance targeting 'high-risk region' is missing out animal bite cases who visit directly to hospitals in 'suspect-risk region' of rabies. Little data seems to exist for pre-exposure prophylaxis of domestic hydrophobia. Danger of reoccurrence of human hydrophobia always remain in South Korea. The medical personnel needs to have greater interest on the matter and the government strengthen the management system. PMID:25298903

Ulceroglandular tularemia in a toddler in Germany after a mosquito bite.

PubMed

Hanke, Christof A; Otten, Joerg-Elard; Berner, Reinhard; Serr, Annerose; Splettstoesser, Wolf; von Schnakenburg, Christian

2009-08-01

Although tularemia is a long-known disease, its significance had diminished over the last decades in Middle Europe. However, over the past years, there is new evidence suggesting that tularemia has re-emerged in Germany. In 2007, the highest number of human cases for almost 50 years has been notified. Beside typical vectors, new ways of transmission seem to gain significance. So far, mosquito bite-transmitted tularemia has only been known from Scandinavia but not from Middle Europe. We report the first case of a 1-year-old toddler from Southwestern Germany with mosquito bite-associated ulceroglandular tularaemia. The new and interesting features of this case are the young age of the patient and the unusual transmission route. The available data suggesting changes in the epidemiology for tularemia in Germany are reviewed. This is an interesting case of infantile tularemia with a very unusual transmission route, highlighting ongoing changes in the epidemiology of tularemia in Germany.

Human rabies: a descriptive observation of 21 children in Kinshasa, the Democratic Republic of Congo.

PubMed

Muyila, Delphin I; Aloni, Michel N; Lose-Ekanga, Marie Josée; Nzita, Jules M; Kalala-Mbikay, Alexandre; Bongo, Henri L; Esako, Mathilde N; Malonga-Biapi, Jean Pierre; Mputu-Dibwe, BenoÎt; Aloni, Muriel L; Ekila, Mathilde B

2014-10-01

Human rabies has recently emerged as a significant public health threat in Kinshasa, Democratic Republic of Congo (DRC). However, there is little epidemiological information on human rabies especially in children. We performed at Pediatrics Department of General Reference hospital of Kinshasa between December 2008 and July 2009, a retrospective study to assess the incidence and to describe their clinical aspects and outcome. A total of 21 cases were observed, rather three cases per month. There were 12 boys (57·1%) and 9 girls (42·9%). Biting animal was found to be dog in all cases (100%). The dog was not immunized in all of cases. On admission, all patients (100%) showed furious rabies manifestations. Only two (9·5%) had their wounds treated and received an anti-rabies vaccine (ARV) after the bite incident. Two (9·5%) patients received rabies immunoglobulin (RIG). The case-fatality rate was 100%. The disease emerges as a new major public health problem because of a lack of knowledge regarding rabies risk, the poor management of dog bites. Preventative vaccination for rabies should be recommended in the population of Kinshasa, area at high risk to contract rabies, particularly in children.

Applicability of Berry's index in bite mark analysis

PubMed Central

Antony, Palathottungal Joseph; Pillai, Karthigakannan Subramanian; George, Giju Baby; Varghese, Thomas; Puthalath, Mohammed Shibin; Arakkal, Leena Johnson

2015-01-01

Objectives: This study attempts to highlight the usefulness of applying Berry's Index as an adjuvant to support and aid in bite analysis. Materials and Methods: This study was conducted among 100 students between the ages of 18–30 from Mar Baselios Dental Collage, Kothamangalam. Out of the 100 subjects, there were 50 males and 50 females. The data obtained was tabulated and analyzed using Statistical Package for Social Sciences, Version 16 (SPSS). Results: The mean value of the width of the upper central incisor for male and female was 0.7602 cm and 0.7765 cm respectively. The mean value of the bizygomatic width for male and female was 12.54 cm and 12.42 cm respectively. The correlation between the upper central incisor width and the bizygomatic width was inferred to have a good positive correlation with a value 0f 0.613. Pearson correlation coefficient with greater correlation between the upper central incisor width and the bizygomatic width in female patient (r = 0.678) compared with male patient (r = 0. 525). Conclusion: Berry's Index can be a useful adjuvant to bite analysis by providing a means of determining the facial proportions of an individual from the width of the central incisors. PMID:25709316

Spontaneous correction of anterior crossbite by RPE anchored on deciduous teeth in the early mixed dentition.

PubMed

Rosa, M; Lucchi, P; Mariani, L; Caprioglio, A

2012-09-01

The purpose of this study was to evaluate the effectiveness of Haas RPE anchored on deciduous teeth in the early mixed dentition, for inducing the spontaneous correction of permanent incisor's crossbite, without compliance, without post bite-plane and no involvement of the permanent teeth. The sample group comprised 50 consecutive patients (mean age 8y 5m, SD 2y 1m), 31 males, 19 females. They showed a cross-bite affecting one or more permanent incisors, for a total of 70 teeth. The patients were treated with Haas RPE appliance anchored on second deciduous molars and bonded on deciduous canines. No direct forces were applied on the permanent teeth. Anterior crossbite self-corrected 'spontaneously' in 84% of the cases. Lateral incisors had a higher rate of self-correction than central incisors. All hyper-divergent subjects showed a spontaneous crossbite self-correction. The early maxillary expansion by Haas RPE anchored on deciduous teeth is an efficient and effective procedure to induce the anterior crossbite self-correction in the early mixed dentition without the need of a bite-plane, no involvement of the permanent teeth and without compliance.

Human Bites in the Classroom: Incidence, Treatment, and Complications

ERIC Educational Resources Information Center

Conlon, Helen Acree

2007-01-01

It has been estimated that at least one half of the population will experience some type of bite in their lifetime. Human bites are the third leading cause of all bites seen in hospital emergency departments after dog and cat bites. Human bites can be the source of exposure to body fluids, transmission of communicable diseases, infections ranging…

Monkey Bites among US Military Members, Afghanistan, 2011

PubMed Central

Baker, Katheryn A.

2012-01-01

Bites from Macaca mulatta monkeys, native to Afghanistan, can cause serious infections. To determine risk for US military members in Afghanistan, we reviewed records for September–December 2011. Among 126 animal bites and exposures, 10 were monkey bites. Command emphasis is vital for preventing monkey bites; provider training and bite reporting promote postexposure treatment. PMID:23017939

Neuromuscular orthotics in the treatment of craniomandibular dysfunction and the effects on patients with multiple sclerosis: a pilot study.

PubMed

Heit, Tammarie

2011-01-01

The purpose of this pilot study was to identify, measure and document an effect on the subjective multiple sclerosis symptoms and compare it to any objective data changes in the neuromuscular system of the head and neck, following the correction of the jaw position using a neuromuscular orthotic. The hope is to provide clinical evidence of improvement in the disease long-term without relying on the subjective evidence of remissions and exacerbations reported by the patient. The evidence found in the current pilot study measured improvement of head position, jaw position, jaw function, and airway in the neuromuscular bite position, which correlated with the improvement of subjective symptoms of craniomandibular dysfunction and multiple sclerosis. Studies show that the bite affects blood flow in the brain, which may explain the improvement of the patients in the current study.

Effects of simultaneous palatal expansion and mandibular advancement in a child suffering from OSA.

PubMed

Galeotti, A; Festa, P; Pavone, M; De Vincentiis, G C

2016-08-01

This clinical report describes a child suffering from obstructive sleep apnoea (OSA) and class II skeletal malocclusion with maxillary contraction and anterior open bite. He presented moderate obstructive sleep apnoea with large impact on quality of life of patient and parents. He was treated using an innovative orthodontic device (Sleep Apnea Twin Expander) to simultaneously carry out palatal expansion and mandibular advancement. After orthodontic therapy, the OSA-18 questionnaire demonstrated an improvement of the main respiratory symptoms, while cardiorespiratory sleep study revealed a reduction in obstructive sleep apnoea events. Post-treatment, clinical assessment and cephalometric analysis showed a reduction of sagittal maxillary discrepancy and an extension of upper airway space. In conclusion, this case report suggests that orthodontic treatment might be a valuable alternative treatment in children with obstructive sleep apnoea related to craniofacial anomalies. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

Comparison of digital and conventional impression techniques: evaluation of patients’ perception, treatment comfort, effectiveness and clinical outcomes

PubMed Central

2014-01-01

Background The purpose of this study was to compare two impression techniques from the perspective of patient preferences and treatment comfort. Methods Twenty-four (12 male, 12 female) subjects who had no previous experience with either conventional or digital impression participated in this study. Conventional impressions of maxillary and mandibular dental arches were taken with a polyether impression material (Impregum, 3 M ESPE), and bite registrations were made with polysiloxane bite registration material (Futar D, Kettenbach). Two weeks later, digital impressions and bite scans were performed using an intra-oral scanner (CEREC Omnicam, Sirona). Immediately after the impressions were made, the subjects’ attitudes, preferences and perceptions towards impression techniques were evaluated using a standardized questionnaire. The perceived source of stress was evaluated using the State-Trait Anxiety Scale. Processing steps of the impression techniques (tray selection, working time etc.) were recorded in seconds. Statistical analyses were performed with the Wilcoxon Rank test, and p < 0.05 was considered significant. Results There were significant differences among the groups (p < 0.05) in terms of total working time and processing steps. Patients stated that digital impressions were more comfortable than conventional techniques. Conclusions Digital impressions resulted in a more time-efficient technique than conventional impressions. Patients preferred the digital impression technique rather than conventional techniques. PMID:24479892

Funnel-web spider bite: a systematic review of recorded clinical cases.

PubMed

Isbister, Geoffrey K; Gray, Michael R; Balit, Corrine R; Raven, Robert J; Stokes, Barrie J; Porges, Kate; Tankel, Alan S; Turner, Elizabeth; White, Julian; Fisher, Malcolm McD

2005-04-18

To investigate species-specific envenoming rates and spectrum of severity of funnel-web spider bites, and the efficacy and adverse effects of funnel-web spider antivenom. Cases were identified from a prospective study of spider bite presenting to four major hospitals and three state poisons information centres (1999-2003); museum records of spider specimens since 1926; NSW Poisons Information Centre database; MEDLINE and EMBASE search; clinical toxinology textbooks; the media; and the manufacturer's reports of antivenom use. Patient age and sex, geographical location, month, expert identification of the spider, clinical effects and management; envenoming was classified as severe, mild-moderate or minor/local effects. 198 potential funnel-web spider bites were identified: 138 were definite (spider expertly identified to species or genus), and 77 produced severe envenoming. All species-identified severe cases were attributed to one of six species restricted to NSW and southern Queensland. Rates of severe envenoming were: Hadronyche cerberea (75%), H. formidabilis (63%), Atrax robustus (17%), Hadronyche sp. 14 (17%), H. infensa (14%) and H. versuta (11%). Antivenom was used in 75 patients, including 22 children (median dose, 3 ampoules; range, 1-17), with a complete response in 97% of expertly identified cases. Three adverse reactions were reported, all in adults: two early allergic reactions (one mild and one with severe systemic effects requiring adrenaline), and one case of serum sickness. Severe funnel-web spider envenoming is confined to NSW and southern Queensland; tree-dwelling funnel webs (H. cerberea and H. formidabilis) have the highest envenoming rates. Funnel-web spider antivenom appears effective and safe; severe allergic reactions are uncommon.

[Tarantism in Spain in the eighteen century: latrodectism and suggestion].

PubMed

Corral-Corral, I; Corral-Corral, C

2016-10-16

Tarantism is the disease caused by the bite of the tarantula, in which the music tarantella triggers an involuntary dance. It is known in Italy since the sixteenth century. To analyze the tarantism reported in Spain at the end of the eighteenth century, with special attention to its neurological aspects, and to propose its medical and psychopathological explanation. An epidemic of people affected by the tarantula bite occurred in Spain in 1782. Spanish doctors described appropriately the clinical effects, identical to those produced by the bite of the spider black widow (Latrodectus tredecimguttatus), which was at that time identified as a tarantula. The cases reported by Francisco Xavier Cid cured with the involuntary dance triggered by the tarantella, as was described in Italy since the sixteenth century. Our interpretation is that this curative effect of dance in Spain was induced by suggestion. In Spanish patients there were no behavioral disturbances, periodic recurrences or collective involvement as those reported by Italian authors, which suggest an hysterical phenomenon, probably a continuation of the dancing mania of the Middle Age. Tarantism reported in Spain in the eighteenth century includes two different phenomena: the systemic symptoms produced by the tarantula bite, which is actually latrodectism, and the curative effect of the tarantella, explained by suggestion. The psychiatric disturbances, with a hysterical nature, falsely associated to the tarantula bite, observed in Italy, were not present among the Spanish cases of tarantism in the eighteenth century.

Dog bite injuries to humans and the use of breed-specific legislation: a comparison of bites from legislated and non-legislated dog breeds.

PubMed

Creedon, Nanci; Ó'Súilleabháin, Páraic S

2017-01-01

The primary objective of this study was to investigate if differences in dog bite characteristics exist amongst legislated and non-legislated dog breeds listed under breed-specific legislation in Ireland (age when bitten, anatomical bite locations, triggers for biting, victim's relationship with the dog, geographical location and owner presence, history of aggression, reporting bite incident to authorities, medical treatment required following the bite, and type of bite inflicted). A second objective of the current study was to investigate dog control officer's enforcement and perceptions of current legislation. Data for statistical analyses were collated through a nationally advertised survey, with Pearson Chi-square and Fisher's Exact Test statistical methods employed for analyses. A total of 140 incident surveys were assessed comprising of non-legislated ( n  = 100) and legislated ( n  = 40) dog bite incidents. Legislated breeds were significantly more likely to be perceived as aggressive and less fearful as triggers for biting compared to non-legislated breeds ( P  = 0.003). Non-legislated breeds were more likely to inflict a bite with the owner present on own property and on a business premises compared to legislated breeds ( P  = 0.036). Non-legislated breeds were more likely to not be reported to the authorities before ( P  = 0.009), and after ( P  = 0.032) the bite occurred compared to legislated breeds. There were no significant differences observed between both groups for; age when the victim was bitten, bite location, relationship with the dog, history of aggression, outcome for the dog, if the dog bit again, and seeing a professional trainer or behaviourist. No significant difference was observed between both legislated and non-legislated groups for medical treatment required following the bite, and the type of bite inflicted. The present study results did not observe evidence of any differences between legislated and non-legislated for both the medical treatment to victims required following the bite, and the type of bite inflicted. The significant differences in bites being reported to authorities, perceived triggers for biting, and biting locations suggests distinctly differing perceptions relating to risk between legislated and non-legislated dog breeds. Further consequences relating to the introduction of breed-specific legislation in Ireland are discussed.

Feeding biomechanics and theoretical calculations of bite force in bull sharks (Carcharhinus leucas) during ontogeny.

PubMed

Habegger, Maria L; Motta, Philip J; Huber, Daniel R; Dean, Mason N

2012-12-01

Evaluations of bite force, either measured directly or calculated theoretically, have been used to investigate the maximum feeding performance of a wide variety of vertebrates. However, bite force studies of fishes have focused primarily on small species due to the intractable nature of large apex predators. More massive muscles can generate higher forces and many of these fishes attain immense sizes; it is unclear how much of their biting performance is driven purely by dramatic ontogenetic increases in body size versus size-specific selection for enhanced feeding performance. In this study, we investigated biting performance and feeding biomechanics of immature and mature individuals from an ontogenetic series of an apex predator, the bull shark, Carcharhinus leucas (73-285cm total length). Theoretical bite force ranged from 36 to 2128N at the most anterior bite point, and 170 to 5914N at the most posterior bite point over the ontogenetic series. Scaling patterns differed among the two age groups investigated; immature bull shark bite force scaled with positive allometry, whereas adult bite force scaled isometrically. When the bite force of C. leucas was compared to those of 12 other cartilaginous fishes, bull sharks presented the highest mass-specific bite force, greater than that of the white shark or the great hammerhead shark. A phylogenetic independent contrast analysis of anatomical and dietary variables as determinants of bite force in these 13 species indicated that the evolution of large adult bite forces in cartilaginous fishes is linked predominantly to the evolution of large body size. Multiple regressions based on mass-specific standardized contrasts suggest that the evolution of high bite forces in Chondrichthyes is further correlated with hypertrophication of the jaw adductors, increased leverage for anterior biting, and widening of the head. Lastly, we discuss the ecological significance of positive allometry in bite force as a possible "performance gain" early in the life history of C. leucas. Copyright © 2012 Elsevier GmbH. All rights reserved.

Fulminant infection by uncommon organisms in animal bite wounds.

PubMed

Dutta, J K

1998-10-01

In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in India. Among them were two children infected by uncommon organisms, i.e., Capnocytophaga canimorsus and Pasteurella multocida; the patients recovered with appropriate antibiotic therapy.

21 CFR 872.3150 - Articulator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DENTAL DEVICES Prosthetic Devices § 872.3150 Articulator. (a) Identification. An articulator is a mechanical device intended to simulate movements of a patient's upper and lower jaws. Plaster casts of the patient's teeth and gums are placed in the device to reproduce the occlusion (bite) and articulation of...

Distalization of maxillary arch and correction of Class II with mini-implants: A report of two cases

PubMed Central

Tekale, Pawankumar Dnyandeo; Vakil, Ketan K.; Vakil, Jeegar K.; Gore, Ketan A.

2015-01-01

This article reports the successful use of mini-screws in the maxilla to treat two patients of age 21-year and 17-year-old girls. Both the patients had a skeletal Class II malocclusion with protrusive maxillary teeth and angels Class II mal-occlusion. Temporary anchorage devices (TADs) in the posterior dental region between maxillary second premolar and maxillary first molar teeth on both sides were used as anchorage for the retraction and intrusion of her maxillary anterior teeth. Those appliances, combined with a compensatory curved maxillary archwire, eliminated spacing, deep bite, forwardly placed and proclined upper front teeth and the protrusive profile, corrected the molar relationship from Class II to Class I. With no extra TADs in the anterior region for intrusion, the treatment was workable and simple. The patient received a satisfactory occlusion and an attractive smile. This technique requires minimal compliance and is particularly useful for correcting Class II patients with protrusive maxillary front teeth and dental deep bite. PMID:26097360

Management of pediatric mandibular fractures using bioresorbable plating system - Efficacy, stability, and clinical outcomes: Our experiences and literature review.

PubMed

Singh, Mahinder; Singh, R K; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

2016-01-01

The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients.

Molecular Detection of Tick-Borne Pathogens in Humans with Tick Bites and Erythema Migrans, in the Netherlands

PubMed Central

Jahfari, Setareh; Hofhuis, Agnetha; Fonville, Manoj; van der Giessen, Joke; van Pelt, Wilfrid; Sprong, Hein

2016-01-01

Background Tick-borne diseases are the most prevalent vector-borne diseases in Europe. Knowledge on the incidence and clinical presentation of other tick-borne diseases than Lyme borreliosis and tick-borne encephalitis is minimal, despite the high human exposure to these pathogens through tick bites. Using molecular detection techniques, the frequency of tick-borne infections after exposure through tick bites was estimated. Methods Ticks, blood samples and questionnaires on health status were collected from patients that visited their general practitioner with a tick bite or erythema migrans in 2007 and 2008. The presence of several tick-borne pathogens in 314 ticks and 626 blood samples of this cohort were analyzed using PCR-based methods. Using multivariate logistic regression, associations were explored between pathogens detected in blood and self-reported symptoms at enrolment and during a three-month follow-up period. Results Half of the ticks removed from humans tested positive for Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis, Rickettsia helvetica, Rickettsia monacensis, Borrelia miyamotoi and several Babesia species. Among 92 Borrelia burgdorferi s. l. positive ticks, 33% carried another pathogen from a different genus. In blood of sixteen out of 626 persons with tick bites or erythema migrans, DNA was detected from Candidatus Neoehrlichia mikurensis (n = 7), Anaplasma phagocytophilum (n = 5), Babesia divergens (n = 3), Borrelia miyamotoi (n = 1) and Borrelia burgdorferi s. l. (n = 1). None of these sixteen individuals reported any overt symptoms that would indicate a corresponding illness during the three-month follow-up period. No associations were found between the presence of pathogen DNA in blood and; self-reported symptoms, with pathogen DNA in the corresponding ticks (n = 8), reported tick attachment duration, tick engorgement, or antibiotic treatment at enrolment. Conclusions Based on molecular detection techniques, the probability of infection with a tick-borne pathogen other than Lyme spirochetes after a tick bite is roughly 2.4%, in the Netherlands. Similarly, among patients with erythema migrans, the probability of a co-infection with another tick-borne pathogen is approximately 2.7%. How often these infections cause disease symptoms or to what extend co-infections affect the course of Lyme borreliosis needs further investigations. PMID:27706159

Comminuted mandibular fracture in child victim of dog bite.

PubMed

de Carvalho, Matheus Furtado; Hardtke, Luiz Augusto Paixão; de Souza, Max Filipe Cota; de Oliveira Araujo, Vasco

2012-08-01

Dog bites represent lesions commonly found in Hospital Emergency Clinic. This type of lesion may cause severe harm to patients, but it rarely affects the underlying bone structure causes facial fracture. This study aims to illustrate a rare clinical case in which a pediatric patient presented a comminuted fracture in the mandible which evolved into a unilateral avulsion of the mandibular condyle, body fractures as well as a mandibular ramus and hemiface that had been deformed, with multiple lacerations and loss of soft-tissue mass. Intermaxillary fixation was performed using the Ivy method, followed by internal rigid fixation using miniplates and screws in attempt to reconstruct the child's mandible. After 2 years of follow-up, a satisfactory esthetics and functional results could be observed. © 2011 John Wiley & Sons A/S.

Injecting rabies immunoglobulin (RIG) into wounds only: A significant saving of lives and costly RIG.

PubMed

Bharti, Omesh Kumar; Madhusudana, Shampur Narayan; Wilde, Henry

2017-04-03

An increasing number of dog bite victims were being presented to public hospitals in Himachal Pradesh in 2014 amidst virtual non availability of any rabies immunoglobulin (RIG). Only a small quantity of equine rabies immunoglobulin (eRIG) was available from the government owned Central Research Institute (CRI) Kasauli. This available eRIG was used in 269 patients as an emergency response and only for local infiltration of severe bite wounds by suspected rabid dogs. This was followed by rabies vaccination, using the WHO approved intra-dermal Thai Red Cross Society vaccination schedule. A subgroup of 26 patients were later identified who had been severely bitten by laboratory confirmed rabid dogs. They were followed for more than one year and all were found to be alive.

Descriptive epidemiology of animal bites in Indiana, 1990-92--a rationale for intervention.

PubMed Central

Sinclair, C L; Zhou, C

1995-01-01

Animal bites are a reality of life throughout the world. They arise out of an imperfect relationship with domestic animals and wildlife. Most bite injuries are preventable. The principal approaches to community-wide bite prevention programs include reducing the number of domestic animals roaming in the community (animal control) and teaching people to refrain from behaviors likely to provoke bites. This article addresses the epidemiologic basis and justification for a bite prevention program targeted toward children. Animal bite data from Indiana for the years 1990, 1991, and 1992 were analyzed for trends that might suggest opportunities for preventive intervention. Bites inflicted by humans were not included in this data base. Children of all age groups were disproportionately affected, with the highest incidence in the 5-9 year age group. The dog and the cat were the most commonly reported biting animals. Wild and pet rodents were the next most frequent biting group. The bites most frequently reported from nonrodent wild animals were inflicted by raccoons. The incidence of animal bites in children peaked during the spring (April-June). Boys were bitten at a higher rate than girls, but this difference between the sexes narrows with age and was not noted in the adult population. Residents of urban counties (population greater than 100,000) had higher reported bite rates than residents of nonurban counties. PMID:7838946

A novel sensor for bite force determinations.

PubMed

Fernandes, Cláudio P; Glantz, Per Olof J; Svensson, Stig A; Bergmark, Anders

2003-03-01

The clinical usefulness, accuracy and precision of a novel bite force sensor based on force sensing resistors were tested in six subjects wearing maxillary removable partial dentures retained by conical crowns. The surfaces of the sensor were manufactured in a silicone material that had mechanical properties similar to those of tough foodstuffs. In two separate series of standardized bite force tests, submaximum force levels were recorded with the sensor and with a strain gaged bite fork. Subjects were assisted in the loading tests with visual feedback instrumentation. Reliability estimates for the bite force sensor were calculated in order to show their reproducibility. Strain gages attached to the prostheses were used to determine the pattern of force distribution during loading tests. The bite force results obtained with the new bite force sensor and with the bite fork were analyzed with ANOVA and Scheffés tests. The strain patterns registered with strain gages were analyzed with F-test. The bite force sensor and the bite fork transducer showed no statistically significant differences in respect of intra-individual bite force levels (range 50-300N). The bite forces registered with the new sensor were dependent on the loading position (p<0.05), sex (p<0.05) and test subject (p<0.05). The reliability of the new sensor for submaximum bite forces was calculated to be 93%. Strain gage results showed that the new sensor generated strain patterns of less variance (p<0.05) than the bite fork and therefore allowed for higher precision during biting tests. The presented instrument has such clinical merits, as to favor its use in experimental clinical studies on the biomechanics of prosthetic appliances.

Pre-orbital gland opening during aggressive interactions in rusa deer (Rusa timorensis).

PubMed

Ceacero, Francisco; Pluháček, Jan; Komárková, Martina; Zábranský, Martin

2015-02-01

The opening of the preorbital gland in cervids has a visual meaning and is frequently associated with agonistic and/or stress related situations. Apart from in red deer, this behaviour has scarcely been studied and the range of situations when it may occur remains unclear. In this study we report the unusual case of preorbital gland opening in rusa deer, Rusa timorensis, associated to direct aggressive agonistic interaction (biting/kicking) between two adult hinds. This case observed in Tierpark Berlin (Germany) is the first one ever recorded in female-female interactions in cervids. Preorbital gland opening was also studied in 116 social interactions in Plzeň Zoo (Czech Republic). Preorbital gland opening by the dominant adult male was twice observed with relation to alert behaviour, which is also rare. In order to contextualise our observations we summarise the current knowledge about the behaviour associated with preorbital gland opening in R. timorensis and in cervids in general. Copyright © 2014 Elsevier B.V. All rights reserved.

Studies on victims of bite by a dog in Delhi.

PubMed

Sehgal, S; Bhattacharya, D; Bhardwaj, M; Parsi, V

1994-01-01

Ninety persons were bitten by a single rabid dog on 23rd January, 1992 in Central Delhi area. All patients were given immediate first-aid, prophylactic tetanus toxoid injection and post-exposure antirabies treatment i.e., hyperimmune antirabies serum (ARS) and antirabies vaccination in different Hospitals of Delhi. Fifteen (15) patients received tissue culture antirabies vaccine (Rabipur or Verorab) and rest 75 patients were given nervous tissue vaccine. ARS was given to all patients as all had severe (Class-III) bite. Altogether there were 76 male and 14 female and 80 adult and 10 children bitten by the dog. All patients well tolerated the vaccines excepting a few, who developed very minor side-effects. Investigation regarding post-exposure antirabies antibody assessment were carried out in twenty-four patients at WHO Collaborative Centre for Rabies. Epidemiology for South-east Asia at National Institute of Communicable Diseases, Delhi. Paired blood samples were obtained from these patients and all of them had protective antibody titre (0.5 IU/ml) with mean titre of 1.81 IU/ml and 2.11 IU/ml in first and second samples, respectively. All patients were followed after six months and there were no death or vaccine failure reported.

Bite force measurements with hard and soft bite surfaces.

PubMed

Serra, C M; Manns, A E

2013-08-01

Bite force has been measured by different methods and over a wide variety of designs. In several instruments, the fact that bite surface has been manufactured with stiff materials might interfere in obtaining reliable data, by a more prompt activation of inhibitory reflex mechanisms. The purpose of this study was to compare the maximum voluntary bite force measured by a digital occlusal force gauge (GM10 Nagano Keiki, Japan) between different opponent teeth, employing semi-hard or soft bite surfaces. A sample of 34 young adults with complete natural dentition was studied. The original semi-hard bite surface was exchanged by a soft one, made of leather and rubber. Maximum voluntary bite force recordings were made for each tooth group and for both bite surfaces. Statistical analyses (Student's t-test) revealed significant differences, with higher scores while using the soft surface across sexes and tooth groups (P < 0·05). Differential activation of periodontal mechanoreceptors of a specific tooth group is mainly conditioned by the hardness of the bite surface; a soft surface induces greater activation of elevator musculature, while a hard one induces inhibition more promptly. Thus, soft bite surfaces are recommended for higher reliability in maximum voluntary bite force recordings. © 2013 John Wiley & Sons Ltd.

Bite Forces and Their Measurement in Dogs and Cats.

PubMed

Kim, Se Eun; Arzi, Boaz; Garcia, Tanya C; Verstraete, Frank J M

2018-01-01

Bite force is generated by the interaction of the masticatory muscles, the mandibles and maxillae, the temporomandibular joints (TMJs), and the teeth. Several methods to measure bite forces in dogs and cats have been described. Direct in vivo measurement of a bite in dogs has been done; however, bite forces were highly variable due to animal volition, situation, or specific measurement technique. Bite force has been measured in vivo from anesthetized dogs by electrical stimulation of jaw adductor muscles, but this may not be reflective of volitional bite force during natural activity. In vitro bite forces have been estimated by calculation of the force produced using mechanical equations representing the jaw adductor muscles and of the mandible and skull structure Bite force can be estimated in silico using finite element analysis (FEA) of the computed model of the anatomical structures. FEA can estimate bite force in extinct species; however, estimates may be lower than the measurements in live animals and would have to be validated specifically in domestic dogs and cats to be reliable. The main factors affecting the bite forces in dogs and cats are body weight and the skull's morphology and size. Other factors such as oral pain, TMJ disorders, masticatory muscle atrophy, and malocclusion may also affect bite force. Knowledge of bite forces in dogs and cats is essential for various clinical and research fields such as the development of implants, materials, and surgical techniques as well as for forensic medicine. This paper is a summary of current knowledge of bite forces in dogs and cats, including the effect of measurement methods and of other factors.

Oral Health Status among Children with Cerebral Palsy in Dubai, United Arab Emirates

PubMed Central

Al Hashmi, Haifa; Kowash, Mawlood; Hassan, Amar; Al Halabi, Manal

2017-01-01

Objectives: The purpose of this study was to assess the oral health status of children with cerebral palsy (CP) in Dubai, United Arab Emirates (UAE). Materials and Methods: Eighty-four CP and 125 healthy children were recruited from special needs centers and private/public schools in Dubai. A dental examination for decayed-missing-filled teeth in primary dentition (dmft)/Decayed-Missing-Filled teeth in permanent dentition (DMFT) indices, simplified oral hygiene index, calculus index (CI), and oral debris index was conducted. In addition, assessments of occlusal, dentofacial, soft tissue anomalies and erosion were conducted. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results: DMFT/dmft scores were comparable in both groups. CI was significantly higher among children with CP. CP patients had a significantly higher proportion of anterior open bite, anterior spacing, Class II molar Angle malocclusion, trauma, high-arched palate, tongue thrust, lymphadenopathy, angular cheilitis, macroglossia, drooling, and erosion as compared to controls. Conclusions: The study highlighted peculiar characteristics and needs for the CP patients in Dubai, UAE. PMID:29285470

Six fatal cases of classical rabies virus without biting incidents, Iran 1990-2010.

PubMed

Simani, Susan; Fayaz, Ahmad; Rahimi, Pooneh; Eslami, Naser; Howeizi, Nader; Biglari, Peyvand

2012-07-01

Rabies is an endemic fatal zoonotic disease, commonly transmitted to humans through contact (bites and scratches) with infected animals. During the years 1990-2010, six patients with the clinical symptoms of rabies (fever, tinnitus, buzzing, delirium and hydrophobia), with no history of a bite, were diagnosed by physicians in Iran. To obtain laboratory confirmation of rabies infection, different clinical specimens from each patient were sent to the World Health Organisation (WHO) Collaborating Center for Reference and Research on Rabies, Pasteur Institute of Iran. The first case was a 39-year-old male veterinary technician who entered his uncovered scratched hand into the mouth of a rabid bovine and became infected. Two years later, a herd of sheep being tended by a shepherd and his two sons were attacked by a rabid wolf. All three individuals were infected when they applied burnt thorny wool to the sheep's wounds as a bandage. Their hands were scratched and then infected through contact with the remaining saliva of the rabid wolf on the sheep's wounds. In 1994, two other human cases occurred through corneal transplantation from the same donor who had died with the clinical signs of food poisoning (according to his hospital record), which probably was a misdiagnosis of rabies infection. This is a case series study that describes human rabies cases without biting incidents. According to the WHO recommendation, human rabies cases are notifiable, therefore, in Iran, a rabies surveillance system has been established to follow these cases. During the last decade, six patients with no 'history of a bite' were hospitalised with growing symptoms of rabies. The data were collected from each patient by the physicians and transferred to the Ministry of Health and Medical Education of Iran, and to the WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute of Iran as the only testing laboratory. Thus, they came to the attention of the surveillance system. Ante-mortem diagnosis was performed on saliva, cerebrospinal fluid and blood samples that were collected from the first patient by the physicians. Fresh brain specimens from all patients were kept in a mixture of 50% glycerol in phosphate-buffered saline and transported on ice to the WHO Collaborating Center for Reference and Research on Rabies. For the first patient, rabies virus was investigated in saliva using the rapid tissue cell inoculation test (RTCIT) and the mouse inoculation test (MIT). Anti-rabies antibodies in this patient's serum and cerebrospinal fluid (CSF) were examined using the mouse neutralisation test (MNT). Fresh brain specimens from all patients were examined using the fluorescence antibody test (FAT) as recommended by the WHO laboratory manual in rabies as the post-mortem diagnostic test for rabies. Rabies infection was confirmed in all of the deceased patients. Anti-rabies antibodies were identified only in one patient's serum specimen. Testing also showed that the rabies virus isolated was the classic rabies virus (serotype 1), which is widespread in Iran. Prevention and control of this fatal disease require a sensitive surveillance system to follow 'suspected' animal and human rabies cases thoroughly through the improved reporting system, which contains the history of exposure, clinical examinations, symptoms and laboratory results. This study describes some notable human rabies infections and their transmission modes to prevent occupational accidents. Copyright © 2012 Elsevier B.V. All rights reserved.

Anterior Crossbite Correction in Early Mixed Dentition Period Using Catlan's Appliance: A Case Report

PubMed Central

Prakash, Prashanth; Durgesh, B. H.

2011-01-01

Single tooth anterior dental crossbite is the commonly encountered malocclusion during the development of occlusion in children. Various treatment options such as removable and fixed appliances have been suggested by different authors in the past literature. This paper presents two cases of anterior crossbite corrected using the standard Catlan's appliance (Lower Inclined Bite Plane) in a short period of three weeks without any damage to the tooth or the periodontium. This fixed appliance is a simple and traditional method which does not depend on patient cooperation to reverse the bite. PMID:21991464

Fulminant infection by uncommon organisms in animal bite wounds.

PubMed Central

Dutta, J. K.

1998-01-01

In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in India. Among them were two children infected by uncommon organisms, i.e., Capnocytophaga canimorsus and Pasteurella multocida; the patients recovered with appropriate antibiotic therapy. PMID:10211359

Self-Inflicted Finger Injury in Individuals With Spinal Cord Injury: An Analysis of 5 Cases

PubMed Central

Frost, Frederick S; Mukkamala, Sridevi; Covington, Edward

2008-01-01

Objective: To describe the occurrence of finger autophagia in 5 persons with traumatic spinal cord injury and to present a discussion of putative causes and potential treatments. Background: Minor self-mutilating actions, such as nail biting and hair pulling, are common in humans and usually benign. In some circumstances, these behaviors are associated with obsessive-compulsive personality traits. In humans, self-injurious biting behaviors are well described in the setting of mental retardation and psychosis and in persons with Lesch-Nyhan syndrome. Rare cases of human autophagia in persons with intact cognition have been reported, most commonly in the setting of acquired nervous system lesions. After spinal cord injury, it has been suggested that this behavior constitutes a human variant of animal autotomy and a response to neuropathic pain. Design: Case presentation narrative. Main Outcome Measures: Photographic and radiological study, administration of Yale-Brown Obsessive-Compulsive Scale (YBOCS). Findings: In 5 patients with complete tetraplegia, pain in the hands was present in only one instance. The severity of autoamputation varied from minor to extreme. In all cases, damage was confined to analgesic body parts. In 3 cases, autophagia behavior was discovered in progress. Treatments included pharmacotherapy, counseling, and behavioral therapy, with mixed results. All patients were intelligent, willing to discuss their issues, and able to identify conditions of stress and isolation in their lives. Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal. On the YBOCS, only 1 patient scored in a range indicative of mild obsessive-compulsive symptomatology. Conclusions: This group exhibited heterogeneous medical, social, and cultural characteristics. A link between pain and self-injurious behavior could not be demonstrated. This behavior may be viewed as an extreme variant of nail biting, with potential ominous complications. Treatment strategies have been employed with mixed results. PMID:18533422

Dog bites in a U.S. county: age, body part and breed in paediatric dog bites.

PubMed

Ramgopal, Sriram; Brungo, Lauren Bealafeld; Bykowski, Michael R; Pitetti, Raymond D; Hickey, Robert W

2018-05-01

To compare characteristics of gender, age, body part and breed in dog bites. We reviewed 14 956 dog bites (4195 paediatric) reported to the Allegheny County Health Department, USA, between 2007 and 2015. Using predefined age groups, we performed linear regression to assess for subject age and bite frequency and used binary logistic regression to evaluate for differences in gender and body part. We used chi-squared test with Bonferroni correction to evaluate for differences in reported breeds with age. There was a negative correlation (-0.80, r 2 = 0.64) between age and bite frequency. Children 0-3 years had a higher odds ratio (OR) of bites to the face [21.12, 95% confidence interval (CI): 17.61-25.33] and a lower OR of bites to the upper (OR: 0.14, 95% CI: 0.12-0.18) and lower (OR: 0.19, 95% CI: 0.14-0.27) extremities. 'Pit bulls' accounted for 27.2% of dog bites and were more common in children 13-18 years (p < 0.01). Shih-Tzu bites were more common in children three years of age and younger (p < 0.01). Dog bites occur with higher frequency at younger ages, and head and neck injuries are more common in younger children. Pit bull bites are more common in adolescents and Shih-Tzu bites more common in younger children. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Effects of Bite Count Feedback from a Wearable Device and Goal Setting on Consumption in Young Adults.

PubMed

Jasper, Phillip W; James, Melva T; Hoover, Adam W; Muth, Eric R

2016-11-01

New technologies are emerging that may help individuals engage in healthier eating behaviors. One paradigm to test the efficacy of a technology is to determine its effect relative to environment cues that are known to cause individuals to overeat. The purpose of this work was to independently investigate two questions: How does the presence of a technology that provides bite count feedback alter eating behavior? and, How does the presence of a technology that provides bite count feedback paired with a goal alter eating behavior? Two studies investigated these research questions. The first study tested the effects of a large and small plate crossed with the presence or absence of a device that provided bite count feedback on intake. The second study tested the effects of a bite count goal with bite count feedback, again crossed with plate size, on intake. Both studies used a 2×2 between-subjects design. In the first study, 94 subjects (62 women aged 19.0±1.6 years with body mass index [BMI] 23.04±3.6) consumed lunch in a laboratory. The second study examined 99 subjects (56 women aged 18.5±1.5 years with BMI 22.73±2.70) under the same conditions. In both studies subjects consumed a single-course meal, using either a small or large plate. In the first study participants either wore or did not wear an automated bite counting device. In the second study all participants wore the bite counting device and were given either a low bite count goal (12 bites) or a high bite count goal (22 bites). Effect of plate size, feedback, and goal on consumption (grams) and number of bites taken were assessed using 2×2 analyses of variance. As adjunct measures, the effects of serving size, bite size (grams per bite), postmeal satiety, and satiety change were also assessed. In the first study there was a main effect of plate size on grams consumed and number of bites taken such that eating from a large plate led to greater consumption (P=0.001) and a greater number of bites (P=0.001). There was also a main effect of feedback on consumption and number of bites taken such that those who received feedback consumed less (P=0.011) and took fewer bites (P<0.001). In the second study there was a main effect of plate size on consumption such that those eating from a large plate consumed more (P=0.003) but did not take more bites. Further analysis revealed a main effect of goal on number of bites taken such that those who received the low goal took fewer bites (P<0.001) but did not consume less. Providing feedback on the number of bites taken from a wearable intake monitor can reduce overall intake during a single meal. Regarding the first research question, providing feedback significantly reduced intake in both plate size groups and reduced the overall number of bites taken. Regarding the second research question, participants were successful in eating to their goals. However, individuals in the low goal condition appeared to compensate for the restricted goal by taking larger bites, leading to comparable levels of consumption between the low and high goal groups. Hence, the interaction of technology with goals should be considered when introducing a health intervention. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus.

PubMed

Wi, Yu Mi; Woo, Hye In; Park, Dahee; Lee, Keun Hwa; Kang, Cheol-In; Chung, Doo Ryeon; Peck, Kyong Ran; Song, Jae-Hoon

2016-11-01

To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus-endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry.

PubMed

Ruha, Anne-Michelle; Kleinschmidt, Kurt C; Greene, Spencer; Spyres, Meghan B; Brent, Jeffrey; Wax, Paul; Padilla-Jones, Angela; Campleman, Sharan

2017-12-01

The American College of Medical Toxicology established the North American Snakebite Registry (NASBR), a national database of detailed, prospectively collected information regarding snake envenomation in the United States, in 2013. This report describes the epidemiology, clinical course, and management of snakebites in the NASBR. All cases entered into the NASBR between January 1, 2013 and December 31, 2015 were identified. Descriptive statistics are used to report results. Fourteen sites in 10 states entered 450 snakebites. Native species comprised 99% of cases, almost all of which were pit viper bites. 56.3% were identified as rattlesnakes and 29.4% as copperheads. 69.3% were male and 28.2% were children age 12 and under. Fifty-four percent of bites were on the lower extremity. Twenty-seven percent of patients with lower extremity bites were not wearing shoes. Common tissue findings associated with envenomation were swelling, ecchymosis, and erythema. Systemic effects and hematologic toxicity were more common in rattlesnake than copperhead or cottonmouth envenomations. Crotalidae Polyvalent Immune Fab antivenom was given to 84% of patients. Twelve patients (4.3%) were re-admitted to the hospital after completion of treatment. Eight were re-treated with antivenom. The NASBR gathers detailed data on venomous snakebites across the US. In its initial years, useful information has already been gained. Data regarding footwear will inform public health interventions and education, and information regarding the clinical presentation may help physicians better anticipate effects and manage snakebite. As the number of cases in the NASBR grows, associations between patient-related factors and outcomes may be studied.

Bacteria isolated from conspecific bite wounds in Norway and black rats: implications for rat bite-associated infections in people.

PubMed

Himsworth, Chelsea G; Zabek, Erin; Tang, Patrick; Parsons, Kirbee L; Koehn, Martha; Jardine, Claire M; Patrick, David M

2014-02-01

Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound-related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species.

Annual incidence of snake bite in rural bangladesh.

PubMed

Rahman, Ridwanur; Faiz, M Abul; Selim, Shahjada; Rahman, Bayzidur; Basher, Ariful; Jones, Alison; d'Este, Catherine; Hossain, Moazzem; Islam, Ziaul; Ahmed, Habib; Milton, Abul Hasnat

2010-10-26

Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4/100,000 person years (95% C I 513.4-789.2/100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted.

A placebo controlled clinical trial investigating the efficacy of a homeopathic after-bite gel in reducing mosquito bite induced erythema.

PubMed

Hill, N; Stam, C; Tuinder, S; van Haselen, R A

1995-01-01

A randomised, placebo controlled clinical trial was conducted to examine the efficacy of a homeopathic after-bite gel in the symptomatic relief of mosquito bites. Sixty eight healthy volunteers were bitten under laboratory conditions by Aedes aegypti mosquitoes at three spots, on the ventral aspect of the forearm. One bite was treated with the homeopathic after-bite gel, another bite with a placebo gel which was identical in appearance and smell to the homeopathic after-bite gel, and the third bite remained untreated. Immediately after the bites and 1, 3, 6, 26 and 31 hours post-bite, the length and width of the erythema were measured with a calliper, and photographs were taken of the bite sites from which the size of the erythema was subsequently determined. This was followed by assessment of the extent of itching with a verbal analogue scale, and finally treatment took place. For each spot the total erythema was calculated as the area under the plotted curve of the erythema at different time points (mm2*h) and the total sum of the itch scores was determined. For the bites treated with the homeopathic after-bite gel the median total erythema was 10.500 mm2*h. For the spots treated with the placebo gel and the untreated spots the median total erythema was 12.900 mm2*h and 13.300 mm2*h, respectively. The difference between the spots treated with the homeopathic after-bite gel and the untreated spots came close to significance (two-tailed P = 0.06), which was not the case for the difference between the spots treated with the homeopathic after-bite gel and the spots treated with placebo gel (P = 0.13). After pooling the data of a very similar previous pilot study and the present study (ntotal = 83), the homeopathic after-bite gel was significantly superior to no treatment (two-tailed P = 0.003) as well as to placebo gel (two-tailed P = 0.03). Comparing itching after the three treatments, no significant differences could be demonstrated. The extent of itching was positively correlated with the area of the erythema (r = 0.63). Treatment of mosquito bites with the homeopathic after-bite gel will reduce the erythema compared to no treatment. Comparison with the placebo gel suggests it is the plant extracts which are the active components of this gel.

Surgical Orthodontic Treatment of a Patient Affected by Type 1 Myotonic Dystrophy (Steinert Syndrome)

PubMed Central

Cacucci, Laura; Ricci, Beatrice; Moretti, Maria; Gasparini, Giulio; Pelo, Sandro

2017-01-01

Myotonic dystrophy, or Steinert's disease, is the most common form of muscular dystrophy that occurs in adults. This multisystemic form involves the skeletal muscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. The weakness of the facial muscles causes a characteristic facial appearance frequently associated with malocclusions. Young people with myotonic dystrophy, who also have severe malocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient's need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient's quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases. PMID:28642828

Surgical Orthodontic Treatment of a Patient Affected by Type 1 Myotonic Dystrophy (Steinert Syndrome).

PubMed

Cacucci, Laura; Ricci, Beatrice; Moretti, Maria; Gasparini, Giulio; Pelo, Sandro; Grippaudo, Cristina

2017-01-01

Myotonic dystrophy, or Steinert's disease, is the most common form of muscular dystrophy that occurs in adults. This multisystemic form involves the skeletal muscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. The weakness of the facial muscles causes a characteristic facial appearance frequently associated with malocclusions. Young people with myotonic dystrophy, who also have severe malocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient's need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient's quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases.

[Comparison of bite marks and teeth features using 2D and 3D methods].

PubMed

Lorkiewicz-Muszyńska, Dorota; Glapiński, Mariusz; Zaba, Czesław; Łabecka, Marzena

2011-01-01

The nature of bite marks is complex. They are found at the scene of crime on different materials and surfaces - not only on human body and corpse, but also on food products and material objects. Human bites on skin are sometimes difficult to interpret and to analyze because of the specific character of skin--elastic and distortable--and because different areas of human body have different surfaces and curvatures. A bite mark left at the scene of crime can be a highly helpful way to lead investigators to criminals. The study was performed to establish: 1) whether bite marks exhibit variations in the accuracy of impressions on different materials, 2) whether it is possible to use the 3D method in the process of identifying an individual based on the comparison of bite marks revealed at the scene, and 3D scans of dental casts, 3) whether application of the 3D method allows for elimination of secondary photographic distortion of bite marks. The authors carried out experiments on simulated cases. Five volunteers bit various materials with different surfaces. Experimental bite marks were collected with emphasis on differentiations of materials. Subsequently, dental impressions were taken from five volunteers in order to prepare five sets of dental casts (the maxilla and mandible. The biting edges of teeth were impressed in wax to create an imprint. The samples of dental casts, corresponding wax bite impressions and bite marks from different materials were scanned with 2D and 3D scanners and photographs were taken. All of these were examined in detail and then compared using different methods (2D and 3D). 1) Bite marks exhibit variations in accuracy of impression on different materials. The most legible reproduction of bite marks was seen on cheese. 2) In comparison of bite marks, the 3D method and 3D scans of dental casts are highly accurate. 3) The 3D method helps to eliminate secondary photographic distortion of bite marks.

A concept to transfer a therapeutic splint position into permanent occlusion with a customized lingual appliance.

PubMed

Sachse, Tina; Schwestka-Polly, Rainer; Flieger, Stefanie; Wiechmann, Dirk

2012-05-21

The role of occlusion concerning temporomandibular disorder is still unclear but seems to be the only component of the stomathognathic system dentists are able to change morphologically. The aim of the paper is to describe the orthodontist's approach for transferring and maintaining a therapeutic splint position into permanent occlusion using a fully customized lingual appliance. Fixed acrylic bite planes on lower molars were used to maintain a symptom-free condyle position prior to orthodontic treatment. Silicone impressions of the arches including the fixed bite planes were used for the Incognito laboratory procedure. Two digital setups were made. One setup represents the target occlusion. A second setup including the bite planes was used to fabricate an additional set of lower molar brackets. In the leveling stage all teeth except the lower molars were settled to maintain the therapeutic condyle position. Finally, the fixed bite planes were stepwise removed and molar brackets were replaced to establish the permanent occlusion planned with the first setup. The advantage of an individual lingual appliance consists in the high level of congruence between the fabricated setups and the final clinical result. Both the individual scope for design and the precision of the appliance were vitally important in the treatment of a patient with a functional disorder of the masticatory system.

[Canine and human rabies in Conakry: epidemiology and preventive aspects].

PubMed

Youla, A S; Traore, F A; Sako, F B; Feda, R M; Emeric, M A

2014-02-01

In Guinea, stray dogs are present in large numbers in public places and around landfills. The objectives of this study were to determine the frequency of human exposure to rabies risk, the cases of human and canine rabies and to describe the epidemiological profile of the cases. This retrospective and descriptive study was conducted in health and veterinarian facilities within the city of Conakry. All records of patients admitted in these facilities because of animal bites and veterinary records for aggression by domestic animals from 2002 to 2012, so, during an 11-year period, were collected. During the study period, 7 994 people were concerned by domestic animal bites. Males were the most affected with 60.4% of all cases. Students represented the higher class with 36.0%, followed by workers (18%). The majority of injuries were to the lower limbs (54.4%). The dog has been implicated in the attacks in 98.8% of cases. Among the 2 916 biting dogs which were placed under observation, 14 developed clinical rabies. Among those assaulted, 11 cases of rabies were reported. From 7 994 victims of domestic animal bites, 2 634 received post-exposure prophylaxis and the dropout rate was 51%. Rabies is a real risk in Conakry. Provisions in terms of public health strategy must be taken to minimize it.

Stomatognathic function in Duchenne muscular dystrophy: a case-control study.

PubMed

Ferreira, Bruno; Da Silva, Gabriel Pádua; Gonçalves, Camila Rosa; Arnoni, Veridiana Wanshi; Siéssere, Selma; Semprini, Marisa; Verri, Edson Donizetti; Chaves, Thais Cristina; Regalo, Simone Cecilio Hallak

2016-05-01

This study aimed to analyse electromyographic activity, masticatory efficiency, muscle thickness, and bite force of individuals with Duchenne muscular dystrophy (DMD). Forty males aged 4-15 years, 20 with DMD and 20 healthy age-, height-, and weight-matched controls, underwent electromyography and ultrasonography of temporalis, masseter, and sternocleidomastoid muscles during postural control of the jaw, mastication, and maximal molar bite force. The normalized electromyography signals showed higher activity in masseter and temporal muscles at rest, during protrusion, left and right laterality, and fatigue condition in the group with DMD than in the comparison group (p≤0.05). For masticatory efficiency of cycles, in analysis of non-habitual chewing of flavourless gum, and habitual chewing of peanuts and raisins, the group with DMD presented lower averages (p≤0.05). For the muscle thickness, the results showed that there was a lower muscle thickness in the group with DMD for all muscles during the rest and maximal voluntary contraction, except for masseter and sternocleidomastoid in the maximal voluntary contraction. In the maximal molar bite force, the group with DMD presented higher values for both sides than the comparison group (p≤0.05). Patients with DMD show muscle changes related to the stomatognathic system, in their activity, bite force, and muscle thickness. © 2016 Mac Keith Press.

THE INCIDENCE OF JACKAL BITES AND INJURIES IN THE ZAGREB ANTI RABIES CLINIC DURING THE 1995-2014 PERIOD.

PubMed

Vodopija, Radovan; Racz, Aleksandar; Pahor, Đana

2016-03-01

Rabies is a zoonotic disease (a disease transmitted to humans from animals) that is caused by a virus. The disease affects domestic and wild animals, and is spread to people through close contact with infectious material, usually saliva, via bites or scratches. Rabies is present on all continents with the exception of Antarctica, but more than 95% of human deaths occur in Asia and Africa. Once the symptoms of the disease have developed, rabies is nearly always fatal. People are usually infected following deep bite or scratch by an infected animal. Dogs are the main host and transmitter of rabies. They are the source of infection in all of the estimated 55 000 human rabies deaths annually in Asia and Africa. Bats are the source of most human rabies deaths in the Americas. Bat rabies has also recently emerged as a public health threat in Australia and Western Europe. Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses and other wild carnivore host species are very rare. In the Zagreb Anti Rabies Clinic, from 1995 to 2014, there were 18,094 patients bitten by various animals, but only 2 cases were caused by jackals. One was imported (from France), and the other was from Croatia. The incidence of jackal injuries during the observed period was extremely low, accounting for 0.011% of all animals. When the imported case is excluded, the incidence was 0.0055%. Accordingly, it is concluded that jackal bites and injuries are exceptionally low and that they pose no risk for patients who present routinely to the Zagreb Anti Rabies Clinic. Therefore, it is justified that jackal as an animal species be classified in the group of 'other animals', when officially reported.

Determination of the diagnostic value of the Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in predicting difficult intubation: A prospective descriptive study.

PubMed

Mahmoodpoor, Ata; Soleimanpour, Hassan; Golzari, Samad Ej; Nejabatian, Arezoo; Pourlak, Tannaz; Amani, Masoumeh; Hajmohammadi, Saeed; Hosseinzadeh, Hamzeh; Esfanjani, Robab Mehdizadeh

2017-02-01

Difficult intubation is a significant cause of mortality and morbidity related to anesthesia. We decided to evaluate the value of Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in the prediction of difficult intubation. In a prospective descriptive study, data from 132 patients who were candidates for elective maxillofacial surgeries under general anesthesia were gathered. Facial Angles were measured by a maxillofacial surgeon according to cephalometry. The Modified Mallampati Score and Upper Lip Bite Test were first measured by an anesthesiologist and then another anesthesiologist was assigned to record the Cormack and Lehane score during the intubation. Grades 3 and 4 were considered as difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and Youden index were calculated for all tests. Difficult intubation was reported in 12% of the patients. Facial Angle≤82.5° can predict difficult intubation with 87.5% sensitivity and 88.8% specificity. Among the three tests, a high Modified Mallampati Score had the highest specificity (94.5%) and a high Modified Mallampati Score and Facial Angle (FA≤82.5°) had the highest sensitivity (87.5%). The highest NPV, sensitivity and Youden index were observed when using Facial Angle with the Modified Mallampati Score or with Upper Lip Bite Test. Facial Angle has a high sensitivity, NPV and Youden index for the prediction of difficult intubation, but the best result is achieved when Facial Angle is used in combination with either the Modified Mallampati Score or Upper Lip Bit Test. Copyright © 2017 Elsevier Inc. All rights reserved.

Rabies viral encephalitis: clinical determinants in diagnosis with special reference to paralytic form.

PubMed

Gadre, Girish; Satishchandra, P; Mahadevan, Anita; Suja, M S; Madhusudana, S N; Sundaram, C; Shankar, S K

2010-07-01

Rabies is an important public health problem in developing countries such as India where an alarmingly high incidence of the infection is reported every year despite the availability of highly effective, potent and safe vaccines. In clinical practice, diagnosis of the furious (encephalitic) form of rabies poses little difficulty. In contrast, the paralytic form poses a diagnostic dilemma, to distinguish it from Guillain-Barré syndrome. The problem is further compounded in the absence of a history of dog bite, clinical features resembling a psychiatric syndrome. The present study analysed the spectrum of neurological manifestations in 47 cases of rabies encephalitis (34 paralytic, six encephalitic, and seven psychiatric manifestations) from two hospitals in south India, confirmed at post-mortem by demonstration of a viral antigen in the brain. A history of dog bite was elicited in 33 patients and fox bite in one. Twenty-two patients received postexposure prophylaxis. The incubation period ranged from 7 days to 4 years. Clinical features were analysed, looking for any clinical pointers that provide clues to a diagnosis of paralytic rabies. Fever, distal paresthaesias, fasciculation, alteration in sensorium, rapid progression of symptoms and pleocytosis in cerebrospinal fluid should alert the neurologist to consider rabies encephalomyelitis. Detection of the viral antigen in the corneal smear and a skin biopsy from the nape of the neck had limited usefulness in the ante-mortem diagnosis. Although a few clinical signs may help indicate rabies encephalomyelitis antemortem, confirmation requires neuropathological/neurovirological assistance. The preponderance of atypical/paralytic cases in this series suggests that neurologists and psychiatrists need to have a high index of clinical suspicion, particularly in the absence of a history of dog bite.

Spine deviations and orthodontic treatment of asymmetric malocclusions in children

PubMed Central

2012-01-01

Background The aim of this randomized clinical trial was to assess the effect of early orthodontic treatment for unilateral posterior cross bite in the late deciduous and early mixed dentition using orthopedic parameters. Methods Early orthodontic treatment was performed by initial maxillary expansion and subsequent activator therapy (Münster treatment concept). The patient sample was initially comprised of 80 patients with unilateral posterior cross bite (mean age 7.3 years, SD 2.1 years). After randomization, 77 children attended the initial examination appointment (therapy = 37, control = 40); 31 children in the therapy group and 35 children in the control group were monitored at the follow-up examination (T2). The mean interval between T1 and T2 was 1.1 years (SD 0.2 years). Rasterstereography was used for back shape analysis at T1 and T2. Using the profile, the kyphotic and lordotic angle, the surface rotation, the lateral deviation, pelvic tilt and pelvic torsion, statistical differences at T1 and T2 between the therapy and control groups were calculated (t-test). Our working hypothesis was, that early orthodontic treatment can induce negative therapeutic changes in body posture through thoracic and lumbar position changes in preadolescents with uniltaral cross bite. Results No clinically relevant differences between the control and the therapy groups at T1 and T2 were found for the parameters of kyphotic and lordotic angle, the surface rotation, lateral deviation, pelvic tilt, and pelvic torsion. Conclusions Our working hypothesis was tested to be not correct (within the limitations of this study). This randomized clinical trial demonstrates that in a juvenile population with unilateral posterior cross bite the selected early orthodontic treatment protocol does not affect negatively the postural parameters. Trial registration DRKS00003497 on DRKS PMID:22906114

First report of clinical presentation of a bite by a running spider, Philodromus sp. (Araneae: Philodromidae), with recommendations for spider bite management.

PubMed

Coetzee, Maureen; Dippenaar, Ansie; Frean, John; Hunt, Richard H

2017-06-30

This article describes the clinical progression of symptoms over a period of 5 days of a bite inflicted by a Philodromus sp. spider. Commonly known as 'running spiders', these are not considered to be harmful to humans. This report, however, is the first description of an actual bite by a member of this group of spiders showing cytotoxic envenomation. Management of the bites should be as recommended for other cytotoxic spider bites.

Novel System for Bite-Force Sensing and Monitoring Based on Magnetic Near Field Communication

PubMed Central

Lantada, Andres Diaz; Bris, Carlos González; Morgado, Pilar Lafont; Maudes, Jesús Sanz

2012-01-01

Intraoral devices for bite-force sensing have several applications in odontology and maxillofacial surgery, as bite-force measurements provide additional information to help understand the characteristics of bruxism disorders and can also be of help for the evaluation of post-surgical evolution and for comparison of alternative treatments. A new system for measuring human bite forces is proposed in this work. This system has future applications for the monitoring of bruxism events and as a complement for its conventional diagnosis. Bruxism is a pathology consisting of grinding or tight clenching of the upper and lower teeth, which leads to several problems such as lesions to the teeth, headaches, orofacial pain and important disorders of the temporomandibular joint. The prototype uses a magnetic field communication scheme similar to low-frequency radio frequency identification (RFID) technology (NFC). The reader generates a low-frequency magnetic field that is used as the information carrier and powers the sensor. The system is notable because it uses an intra-mouth passive sensor and an external interrogator, which remotely records and processes information regarding a patient's dental activity. This permits a quantitative assessment of bite-force, without requiring intra-mouth batteries, and can provide supplementary information to polysomnographic recordings, current most adequate early diagnostic method, so as to initiate corrective actions before irreversible dental wear appears. In addition to describing the system's operational principles and the manufacture of personalized prototypes, this report will also demonstrate the feasibility of the system and results from the first in vitro and in vivo trials. PMID:23112669

[Management of the yellow fever epidemic in 2010 in Séguéla (Côte d'Ivoire): value of multidisciplinary investigation].

PubMed

Konan, Yao Lucien; Coulibaly, Zanakoungo Ibrahima; Allali, Kouadio Bernard; Tétchi, Sopi Mathilde; Koné, Atioumounan Blaise; Coulibaly, Daouda; Ekra, Kouadio Daniel; Doannio, Julien Marie Christian; Oudéhouri-Koudou, Paul

2014-01-01

In August 2010, five positive cases of yellow fever were reported in the region of Séguéla, in the northwest of Côte d'Ivoire, affected by an armed conflict since 2002. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a multidisciplinary investigation was carried out by the Côte-d'Ivoire Ministry of Health and Public Hygiene. Theses investigations were conducted in the villages of confirmed cases and the outpatient and hospitalization centers attended by infected patients, two weeks after the reactive immunization campaign performed in order to stop the spread of the epidemic. The search for suspects identified 16 cases, including 4 cases and 2 deaths in hospital registers and 12 cases during community interviews, including 6 deaths. Stegomyiens indices were relatively low. Aedes aegypti was present among adult mosquitoes. In addition, three wild vectors, varying in number from one locality to another, were detected: Ae. africanus, Ae. luteocephalus and Ae. vittatus with average biting rates of 0.3; 0.1 and 0.05 bite/man/twilight, respectively, at Soba, Ae. africanus and Ae. vittatus with average biting rates of 0.25 and 0.3 bite/man/twilight, respectively, at Yaokro and Ae. luteocephalus with one bite/man/twilight at Kaborékro. Unfortunately, the vaccine response conducted before investigations did not stop progression of the epidemic which broke out three months later in the Worofla health area, close to the Magrékros encampment.

Reconstruction with different free flaps in oro-facial cancer patients.

PubMed

Bhathena, H M; Savant, D N; Kavarana, N M; Parikh, D M; Sanghvi, V D

1996-01-01

In 75 patients following ablative surgery of head and neck cancer, reconstruction was attempted with free tissue transfer techniques under magnification. It was possible to do free tissue transfers in 69 cases. In 6 cases it was not possible to harvest free flaps successfully and alternative reconstructive procedure was carried out due to unavoidable circumstances and various reasons: 1. unsuitable venous drainage, as in Anterior Rib Osteomyocutaneous Composite Flap, AROCF (2 cases), 2. injury to vessels during flap harvest, as in parascapular flap (1 case), 3. residual disease unable to excise (2 cases) and 4. unsuitable proposition (1 case), due to emergency curfew imposed suddenly. These 6 cases were not included in the study. Free tissue transfer was successful in 64 cases (92.7%) and there was a total failure in 5 cases where delayed secondary salvage surgery was performed. Out of 69 cases, in 65 cases reconstructions were carried out immediately, primarily as one-stage operative procedure. Their functional, cosmetic results and complications during the operative and post-operative period are analyzed and discussed. Inter-maxillary fixation was never used to maintain the bite alignment. All cases were given a bite guide prosthesis in the early post-operative period, to improve the bite alignment when it was necessary.

Maintenance requirements associated with mandibular implant overdentures: clinical results after first year of service.

PubMed

Bilhan, Hakan; Geckili, Onur; Mumcu, Emre; Bilmenoglu, Caglar

2011-12-01

The aim of this clinical study was to evaluate the prosthodontic maintenance requirements during the first year of service of mandibular overdentures supported by interforaminal implants and to assess the influence of attachment type, implant number, and bite force on these requirements. Fifty-nine patients treated with mandibular implant overdentures between the years 2004 and 2009 and appearing in the 12th-month recall were included in this study. The overdentures constituted 4 groups: 2 single interforaminal implants (1 group with locator and 1 group with ball attachments), 3 single interforaminal implants, 3 splinted interforaminal implants (bar), and 4 splinted interforaminal implants (bar). During the examination, prosthetic parameters such as occlusion, tissue adaptation, condition of the retentive mechanism (matrice and patrice), and the condition of the denture-bearing tissues were evaluated and recorded. No statistically significant relation was found between attachment type, bite force values, implant number, and the occurring complications except the need for relining, which was found significantly more in the ball attachments than in other attachment groups (P  =  .03). After 12 months following the overdenture insertion, there seems to be no relation between occurring complications and patient-related factors, such as maximum bite force, age, and gender, as well as factors related to the overdentures such as number and type of attachments.

Chewing efficiency and maximum bite force with different attachment systems of implant overdentures: a crossover study.

PubMed

Elsyad, Moustafa Abdou; Khairallah, Ahmed Samir

2017-06-01

This crossover study aimed to evaluate and compare chewing efficiency and maximum bite force (MBF) with resilient telescopic and bar attachment systems of implant overdentures in patients with atrophied mandibles. Ten participants with severely resorbed mandibles and persistent denture problems received new maxillary and mandibular conventional dentures (control, CD). After 3 months of adaptation, two implants were inserted in canine region of the mandible. In a quasi-random method, overdentures were connected to the implants with either bar overdentures (BOD) or resilient telescopic overdentures (TOD) attachment systems. Chewing efficiency in terms of unmixed fraction (UF) was measured using chewing gum (after 5, 10, 20, 30 and 50 strokes), and MBF was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses: CD, BOD and TOD. Chewing efficiency and MBF increased significantly with BOD and TOD compared to CD. As the number of chewing cycles increased, the UF decreased. TOD recorded significant higher chewing efficiency and MBF than BOD. Resilient telescopic attachments are associated with increased chewing efficiency and MBF compared bar attachments when used to retain overdentures to the implants in patients with atrophied mandibles. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Human bites - self-care

MedlinePlus

... this page: //medlineplus.gov/ency/patientinstructions/000736.htm Human bites - self-care To use the sharing features ... at higher risk for infection. How to Prevent Human Bites Prevent bites by: Teaching young children not ...

Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial.

PubMed

Noordman, Bo Jan; Wijnhoven, Bas P L; Lagarde, Sjoerd M; Boonstra, Jurjen J; Coene, Peter Paul L O; Dekker, Jan Willem T; Doukas, Michael; van der Gaast, Ate; Heisterkamp, Joos; Kouwenhoven, Ewout A; Nieuwenhuijzen, Grard A P; Pierie, Jean-Pierre E N; Rosman, Camiel; van Sandick, Johanna W; van der Sangen, Maurice J C; Sosef, Meindert N; Spaander, Manon C W; Valkema, Roelf; van der Zaag, Edwin S; Steyerberg, Ewout W; van Lanschot, J Jan B

2018-02-06

Neoadjuvant chemoradiotherapy (nCRT) plus surgery is a standard treatment for locally advanced oesophageal cancer. With this treatment, 29% of patients have a pathologically complete response in the resection specimen. This provides the rationale for investigating an active surveillance approach. The aim of this study is to assess the (cost-)effectiveness of active surveillance vs. standard oesophagectomy after nCRT for oesophageal cancer. This is a phase-III multi-centre, stepped-wedge cluster randomised controlled trial. A total of 300 patients with clinically complete response (cCR, i.e. no local or disseminated disease proven by histology) after nCRT will be randomised to show non-inferiority of active surveillance to standard oesophagectomy (non-inferiority margin 15%, intra-correlation coefficient 0.02, power 80%, 2-sided α 0.05, 12% drop-out). Patients will undergo a first clinical response evaluation (CRE-I) 4-6 weeks after nCRT, consisting of endoscopy with bite-on-bite biopsies of the primary tumour site and other suspected lesions. Clinically complete responders will undergo a second CRE (CRE-II), 6-8 weeks after CRE-I. CRE-II will include 18F-FDG-PET-CT, followed by endoscopy with bite-on-bite biopsies and ultra-endosonography plus fine needle aspiration of suspected lymph nodes and/or PET- positive lesions. Patients with cCR at CRE-II will be assigned to oesophagectomy (first phase) or active surveillance (second phase of the study). The duration of the first phase is determined randomly over the 12 centres, i.e., stepped-wedge cluster design. Patients in the active surveillance arm will undergo diagnostic evaluations similar to CRE-II at 6/9/12/16/20/24/30/36/48 and 60 months after nCRT. In this arm, oesophagectomy will be offered only to patients in whom locoregional regrowth is highly suspected or proven, without distant dissemination. The main study parameter is overall survival; secondary endpoints include percentage of patients who do not undergo surgery, quality of life, clinical irresectability (cT4b) rate, radical resection rate, postoperative complications, progression-free survival, distant dissemination rate, and cost-effectiveness. We hypothesise that active surveillance leads to non-inferior survival, improved quality of life and a reduction in costs, compared to standard oesophagectomy. If active surveillance and surgery as needed after nCRT leads to non-inferior survival compared to standard oesophagectomy, this organ-sparing approach can be implemented as a standard of care.

[Tourism, imported parasitic diseases, and their prevention].

PubMed

Tumol'skaia, N I; Zavoĭkin, V D; Mazmanian, M V; Plakhotnaia, G A; Kurbatova, I V; Zelia, O P; Gutova, V P

2012-01-01

The paper gives the results of observations of 1558 patients before and after tourist travels to tropical countries and 368 individuals visiting the north areas of the Russian Federation. Different conditions (malaria, amebiasis, leishmaniasis, intestinal and tissue helminthiasis, insect bites, venomous fish pricks, medusa burn, tick bites, etc.) were found in 402 persons. Prophylactic immunization included vaccination against hepatitis A and B viruses, meningitis, typhus, yellow fever, tick-borne encephalitis in more than 2500 patients (not including influenza vaccination in the epidemic season). The performed observations reinforce the statement that imported pathology is urgent to Russia and suggest that it is necessary to develop this section of medicine and to set up a network of health care facilities with a necessary therapeutic and diagnostic base to render skilled care to tourists. It is essential to improve medical staff training in travel medicine.

Management of Lyme Disease in European Children: a Review for Practical Purpose.

PubMed

D'Alessandro, Matteo; Loy, Anna; Castagnola, Elio

2017-08-01

Lyme disease is a tick-borne zoonosis transmitted through a bite of a tick carrying a spirochete belonging to Borrelia species. In the last 20 years, the reported incidence of Lyme disease is increased by three times in Europe. Clinically, the illness develops through a primary stage with a typical skin rash (erythema marginatum), then a secondary stage with possible neurologic or cardiac involvement. The last stage (chronic Lyme disease) is mainly represented by arthritis or late neurological complications but nowadays is rarely seen due to precocious antibiotic use. The diagnosis of Lyme disease is essentially based on history in agreement with tick exposure (living/recent traveling in endemic area or tick bite) and clinical findings compatible with the disease. At present, no laboratory diagnostic tool available can neither establish nor exclude the diagnosis of Lyme disease. The management of Lyme disease should comprise a prophylactic administration of antibiotic in selected population (patients exposed to a tick bite in endemic regions) in which the typical signs of Lyme disease are not yet appeared; conversely, patients with current signs of Lyme disease should undergo a standard therapeutic course. First-line therapy should be oral tetracycline or oral penicillin/cephalosporin (in pediatric populations, beta-lactamic drugs are preferred). In severe courses, intravenous route should be preferred. The aim of this review is to provide an updated guide to the management of pediatric Lyme patients, from prophylaxis to first- and second-line therapy in European setting.

Update on human rabies in a dog- and fox-rabies-free country.

PubMed

Stahl, J-P; Gautret, P; Ribadeau-Dumas, F; Strady, C; Le Moal, G; Souala, F; Maslin, J; Fremont, B; Bourhy, H

2014-07-01

Rabies is responsible for 50,000 deaths per year worldwide. Mainland France has been officially freed from rabies in non-flying animals since 2001. We wanted to provide an update on the French situation, using published data, and describe possible options since official guidelines are lacking. Post-exposure prophylaxis (PEP) (early and careful cleaning and dressing of the wound, vaccination, and in case of high-risk exposure, injection of specific anti-rabies immunoglobulins) is known to be efficient except in rare cases. It is recommended after grade II contact (+specific immunoglobulins in immunodepressed patients), or grade III contact (vaccination+immunoglobulins). Mainland France being rabies-free, 3 options may be considered in case of bite by a dog or a cat that cannot be monitored in France: (a) consider the risk of rabies as null, so no PEP should be administrated, whatever the severity of bites; (b) consider there is a weak but lethal risk, so the international recommendations should be applied, using immunoglobulins in some cases; (c) consider that the risk is extremely low but cannot be excluded, and that the patient should be vaccinated to be protected, but without adding immunoglobulins (whether in case of grade II or III bites). There are no national guidelines for rabies in France, and so the physician managing the patient is the one who will decide to treat or not. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A randomized controlled trial to assess the pain associated with the debond of orthodontic fixed appliances

PubMed Central

Mangnall, Louise A R; Dietrich, Thomas; Scholey, John M

2013-01-01

Objective: To determine patient experience of pain during treatment with fixed orthodontic appliances, expectations of pain during debond and whether biting on a soft acrylic wafer during debond decreases pain experience. Design: Multicentre randomized controlled trial. Setting: Three UK hospital based orthodontic departments: Mid-Staffordshire NHS Foundation Trust, Birmingham Dental Hospital and University Hospital of North Staffordshire. Materials and methods: Ninety patients were randomly allocated to either the control (n = 45) or wafer group (n = 45). A visual analogue scale-based questionnaire was completed pre-debond to determine pain experience during treatment and expectations of pain during debond. The appliances were debonded and those in the wafer group bit on a soft acrylic wafer. A second questionnaire was completed post-debond to assess the pain experienced. Results: Biting on an acrylic wafer significantly reduced the pain experienced when debonding the posterior teeth (P≤0·05). Thirty-nine per cent found the lower anterior teeth the most painful. The expected pain was significantly greater than that actually experienced (P≤0·0001). Greater pain during treatment correlated with increased expectations and increased actually experienced pain (P≤0·0001). Conclusions: Biting on a soft acrylic wafer during debond of the posterior teeth reduces the pain experienced. The lower anterior teeth are the most painful. The pain expected is significantly greater than actually experienced. Patients who had greater pain during treatment expected and experienced greater pain at debond. PMID:24009318

Bites and Scratches (For Parents)

MedlinePlus

... pet (in kids, most animal bites are from dogs ) or a creature from the wild, scratches and ... First Aid: Animal Bites Cat Scratch Disease Preventing Dog Bites Rabies Cuts, Scratches, and Abrasions Dogs and ...

Insect Bites and Stings

MedlinePlus

Most insect bites are harmless, though they sometimes cause discomfort. Bee, wasp, and hornet stings and fire ant bites usually hurt. Mosquito and flea bites usually itch. Insects can also spread diseases. In the United States, ...

Spider Bites (For Parents)

MedlinePlus

... Videos for Educators Search English Español First Aid: Spider Bites KidsHealth / For Parents / First Aid: Spider Bites ... rare. Signs and Symptoms Of a brown recluse spider bite: red blister in the center with surrounding ...

Case profile, volume analysis, and dropout rate of antirabies vaccination regimens among animal bite victims in Gujarat.

PubMed

Dhaduk, Kishor M; Unadkat, Sumit V; Katharotiya, Pooja R; Mer, Ankit R; Chaudhary, Monika C; Prajapati, Mrudul M

2016-01-01

Rabies is a preventable neglected public health problem and associated with multiple cultural, religious, and social practices, myths in our country. There is a lack of organized surveillance system to measure the incidence of animal bite and human rabies as well as to evaluate cost-saving of different routes, regimen, and types of antirabies vaccines (ARV)/immunoglobulin available in India. The objective of this study is to know dropout rate in intradermal (i.d.) ARV regimen among animal bite and to analyze the utilized volume of ARV by a different route of vaccine administration. A total of 250 animal bite victims were followed up at ARV Clinic (ARVC). Volume utilization of i.d. route over intramuscular (i.m.) route was analyzed among the patients who attended ARVC during the past 2 years. Total dropout and delayed compliance rates of ARV regimen among different group were compared by Chi-square test. The i.d. route was about five times more volume and cost-saving than i.m. route. The majority of victims belonged to 15-30 years (27.60%) and children <15 years (26.40%) and had wound at their lower limbs (85%) mainly bitten by dogs (98%). Thirty-four percent total dropout and 31.5% delayed compliance observed particularly during the last dose of i.d. regimen. There was no significant difference in dropout rates among different demographic groups. Half of the victims practiced wound toilet on the same day of bite. Only 68% received the first dose of ARV within 24 h of the exposure. Children and young adults are at higher risk of having dog bite. I.d. ARV regimen is more volume and cost-saving than i.m. one and proper counseling and follow-up should be arranged to complete the vaccination schedule.

Occlusal factors are not related to self-reported bruxism.

PubMed

Manfredini, Daniele; Visscher, Corine M; Guarda-Nardini, Luca; Lobbezoo, Frank

2012-01-01

To estimate the contribution of various occlusal features of the natural dentition that may identify self-reported bruxers compared to nonbruxers. Two age- and sex-matched groups of self-reported bruxers (n = 67) and self-reported nonbruxers (n = 75) took part in the study. For each patient, the following occlusal features were clinically assessed: retruded contact position (RCP) to intercuspal contact position (ICP) slide length (< 2 mm was considered normal), vertical overlap (< 0 mm was considered an anterior open bite; > 4 mm, a deep bite), horizontal overlap (> 4 mm was considered a large horizontal overlap), incisor dental midline discrepancy (< 2 mm was considered normal), and the presence of a unilateral posterior crossbite, mediotrusive interferences, and laterotrusive interferences. A multiple logistic regression model was used to identify the significant associations between the assessed occlusal features (independent variables) and self-reported bruxism (dependent variable). Accuracy values to predict self-reported bruxism were unacceptable for all occlusal variables. The only variable remaining in the final regression model was laterotrusive interferences (P = .030). The percentage of explained variance for bruxism by the final multiple regression model was 4.6%. This model including only one occlusal factor showed low positive (58.1%) and negative predictive values (59.7%), thus showing a poor accuracy to predict the presence of self-reported bruxism (59.2%). This investigation suggested that the contribution of occlusion to the differentiation between bruxers and nonbruxers is negligible. This finding supports theories that advocate a much diminished role for peripheral anatomical-structural factors in the pathogenesis of bruxism.

Same Dog Bite and Different Outcome in Two Cases – Case Report

PubMed Central

VK, Domple; IF, Inamdar; NR, Aswar; MK, Doibale

2014-01-01

There is still no cure for rabies and survival from clinical rabies is extremely rare. It is a preventable disease if the post exposure prophylaxis is initiated in time and administered as per WHO guidelines including administration of rabies immunoglobulin. The role of passive rabies immunization products is to provide the immediate availability of neutralizing antibodies at the site of the exposure before it is physiologically possible for the patient to begin producing his or her own antibodies after vaccination. In this case report, the same dog has bitten to a boy and to an adult. Local wound treatment and use of human rabies immunoglobulin as well as gluteal region as a site of bite were the probable reasons for survival of the boy. On the other hand no local wound treatment, no use of rabies immunoglobulin and finger as a site of bite are the probable reasons for death of an adult due to rabies. PMID:25121007

MALARIA VECTORS IN SAN JOSÉDEL GUAVIARE, ORINOQUIA, COLOMBIA

PubMed Central

JIMÉNEZ, IRENE P.; CONN, JAN E.; BROCHERO, HELENA

2015-01-01

This study was conducted to determine Anopheles species composition and their natural infectivity by human Plasmodium in 2 localities with the highest malaria transmission in San Jose del Guaviare, Guaviare, Colombia. A total of 1,009 Anopheles mosquitoes were collected using human landing catches during 8 months in 2010. Anopheles darlingi was the most abundant (83.2%) followed by An. albitarsis s.l. (8.6%), Anopheles braziliensis (3.8%), An. oswaldoi s.l. (1%), and An. rangeli (0.3%). Anopheles darlingi showed the highest human biting rate, and it was found naturally infected with Plasmodium vivax VK210 (0.119%) using enzyme-linked immunosorbent assays. All species were collected biting both indoors and outdoors. Anopheles darlingi showed biting activity overnight with an indoor peak between 1200–0100 h. Therefore, we recommend that malaria prevention strategies focus on 1) insecticide-treated nets to reduce human–vector contact when people are most exposed and unprotected; 2) accurate diagnoses; 3) adequate treatment for patients; 4) more timely epidemiological notification; and 5) improved entomological surveillance. PMID:25102591

Bite force measurement based on fiber Bragg grating sensor

NASA Astrophysics Data System (ADS)

Padma, Srivani; Umesh, Sharath; Asokan, Sundarrajan; Srinivas, Talabattula

2017-10-01

The maximum level of voluntary bite force, which results from the combined action of muscle of mastication, joints, and teeth, i.e., craniomandibular structure, is considered as one of the major indicators for the functional state of the masticatory system. Measurement of voluntary bite force provides useful data for the jaw muscle function and activity along with assessment of prosthetics. This study proposes an in vivo methodology for the dynamic measurement of bite force employing a fiber Bragg grating (FBG) sensor known as bite force measurement device (BFMD). The BFMD developed is a noninvasive intraoral device, which transduces the bite force exerted at the occlusal surface into strain variations on a metal plate. These strain variations are acquired by the FBG sensor bonded over it. The BFMD developed facilitates adjustment of the distance between the biting platform, which is essential to capture the maximum voluntary bite force at three different positions of teeth, namely incisor, premolar, and molar sites. The clinically relevant bite forces are measured at incisor, molar, and premolar position and have been compared against each other. Furthermore, the bite forces measured with all subjects are segregated according to gender and also compared against each other.

Bacteria Isolated from Conspecific Bite Wounds in Norway and Black Rats: Implications for Rat Bite–Associated Infections In People

PubMed Central

Zabek, Erin; Tang, Patrick; Parsons, Kirbee L.; Koehn, Martha; Jardine, Claire M.; Patrick, David M.

2014-01-01

Abstract Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound–related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species. PMID:24528094

Rat Bite Fever

MedlinePlus

... Rat Bite Fever Health Issues Listen Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who have been bitten by an infected rat ...

Insect Repellents: Protect Your Child from Insect Bites

MedlinePlus

... Print Share Choosing an Insect Repellent for Your Child Page Content Mosquitoes, biting flies, and tick bites ... container with you. Other Ways to Protect Your Child from Insect Bites While you can’t prevent ...

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.

PubMed

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-09-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions - the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.

A possible mechanism of NK cell-lineage granular lymphocyte proliferative disorder (NK-GLPD) in a patient with chronic active Epstein-Barr virus infection (CAEBV) and severe hypersensitivity to mosquito bites (SHMB).

PubMed

Ohshima, Shiro; Ishii, Masaru; Asada, Hideo; Tatekawa, Toyoshi; Yamaguchi, Norihiko; Kobayashi, Hideyuki; Ishii, Taeko; Mima, Toru; Kawase, Ichiro; Saeki, Yukihiko

2002-08-01

We report the case of a young female patient with chronic active Epstein-Barr virus infection (CAEBV) and severe hypersensitivity to mosquito bites (SHMB). She showed a marked increase of NK cell population in peripheral blood. The NK cell population was suggested to be infected with EBV, and to be oligoclonal by Southern blotting using an EBV genome terminal-repeat probe. The NK cells aberrantly expressed CD25, a high affinity receptor for IL-2, and showed an augmented in vitro proliferative response to IL-2. Moreover, they also showed enhanced expression of both Fas-ligand and Bcl-2, and resistance to in vitro Fas-induced apoptotic cell death (Fas-ACD). Taken together, these observations suggested that both the augmentation of proliferative response to IL-2 and the decrease in Fas-ACD may cause NK cell lineage granular lymphocyte proliferative disorder (NK-GLPD) in patients with CAEBV and SHMB.

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease

PubMed Central

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-01-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1–13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols. PMID:25077519

Masseter muscle fatigue during sustained clenching in subjects with complete dentures, implant-supported prostheses, and natural teeth.

PubMed

Jacobs, R; van Steenberghe, D

1993-03-01

A sustained submaximal (50%) clenching effort was performed in four patient groups to establish whether implant-supported prosthetic reconstructions influence myoelectrical signal parameters. The first group consisted of patients with natural teeth in both jaws. The other three groups consisted of patients who were edentulous in both jaws: one group had complete dentures; one had an overdenture in the mandible on two implants connected by a bar; and the third had an implant-supported fixed prosthesis in either the maxilla or the mandible. Surface electromyography indicated an increased myoelectrical output level that paralleled a higher bite force level for implant-supported reconstructions compared with complete dentures. Power spectrum analysis revealed a downward shift of the mean power frequency during sustained clenching in all groups except the implant-supported fixed prosthesis. The absence of a spectral shift in the latter group probably reflected a fear of biting too hard and fracturing the prosthesis.

Annual Incidence of Snake Bite in Rural Bangladesh

PubMed Central

Rahman, Ridwanur; Faiz, M. Abul; Selim, Shahjada; Rahman, Bayzidur; Basher, Ariful; Jones, Alison; d'Este, Catherine; Hossain, Moazzem; Islam, Ziaul; Ahmed, Habib; Milton, Abul Hasnat

2010-01-01

Background Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. Methodology/Principal Findings We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4–789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. Conclusions/Significance Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted. PMID:21049056

Contribution of jaw muscle size and craniofacial morphology to human bite force magnitude.

PubMed

Raadsheer, M C; van Eijden, T M; van Ginkel, F C; Prahl-Andersen, B

1999-01-01

The existence of an interaction among bite force magnitude, jaw muscle size (e.g., cross-sectional area, thickness), and craniofacial morphology is widely accepted. Bite force magnitude depends on the size of the jaw muscles and the lever arm lengths of bite force and muscle forces, which in turn are dictated by craniofacial morphology. In this study, the relative contributions of craniofacial morphology and jaw muscle thickness to the bite force magnitude were studied. In 121 adult individuals, both magnitude and direction of the maximal voluntary bite force were registered. Craniofacial dimensions were measured by anthropometrics and from lateral radiographs. The thicknesses of the masseter, temporal, and digastric muscles were registered by ultrasonography. After a factor analysis was applied to the anthropometric and cephalometric dimensions, the correlation between bite force magnitude, on the one hand, and the "craniofacial factors" and jaw muscle thicknesses, on the other, was assessed by stepwise multiple regression. Fifty-eight percent of the bite force variance could be explained. From the jaw muscles, only the thickness of the masseter muscle correlated significantly with bite force magnitude. Bite force magnitude also correlated significantly positively with vertical and transverse facial dimensions and the inclination of the midface, and significantly negatively with mandibular inclination and occlusal plane inclination. The contribution of the masseter muscle to the variation in bite force magnitude was higher than that of the craniofacial factors.

Rat-bite fever in children: case report and review.

PubMed

Ojukwu, Ifeoma C; Christy, Cynthia

2002-01-01

We report 2 cases of rat-bite fever (RBF), a multisystem zoonosis, in children and review the literature. RBF is caused by I of 2 Gram-negative organisms: Streptobacillus moniliformis or, less commonly, Spirillum minus. Both of our cases developed in school-aged girls with a history of rat exposure who presented with a multisystem illness consisting of fever, petechial and purpuric rash, arthralgia and polyarthritis. Both responded promptly to antibiotic treatment. An additional 10 cases from a MEDLINE review (1960-2000) are reviewed. RBF must be included in the differential diagnosis of febrile patients with rashes and a history of exposure to rats.

Cimex lectularius ("Bed Bugs"): Recognition, Management, and Eradication.

PubMed

McMenaman, Kathryn S; Gausche-Hill, Marianne

2016-11-01

Reports of bed bug infestations in major cities in the United States and abroad have been in the public press. Physicians and other clinicians who care for children need to be able to recognize bed bug bites and understand the social, psychological, and medical implications that this diagnosis will have on patients and their families. In this article, a case presentation serves to guide discussion regarding establishing the diagnosis, differential diagnosis, and the management of bed bug bites and their complications. Integrated pest management programs involving housing managers, residents, and professional pest exterminators provide both chemical and nonchemical solutions for eradication of bed bug infestations.

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

PubMed Central

Stapelmann, Henrike; Türp, Jens C

2008-01-01

Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening. PMID:18662411

Local extinction of the Asian tiger mosquito (Aedes albopictus) following rat eradication on Palmyra Atoll.

PubMed

Lafferty, Kevin D; McLaughlin, John P; Gruner, Daniel S; Bogar, Taylor A; Bui, An; Childress, Jasmine N; Espinoza, Magaly; Forbes, Elizabeth S; Johnston, Cora A; Klope, Maggie; Miller-Ter Kuile, Ana; Lee, Michelle; Plummer, Katherine A; Weber, David A; Young, Ronald T; Young, Hillary S

2018-02-01

The Asian tiger mosquito, Aedes albopictus, appears to have been extirpated from Palmyra Atoll following rat eradication. Anecdotal biting reports, collection records, and regular captures in black-light traps showed the species was present before rat eradication. Since then, there have been no biting reports and no captures over 2 years of extensive trapping (black-light and scent traps). By contrast, the southern house mosquito, Culex quinquefasciatus, was abundant before and after rat eradication. We hypothesize that mammals were a substantial and preferred blood meal for Aedes , whereas Culex feeds mostly on seabirds. Therefore, after rat eradication, humans and seabirds alone could not support positive population growth or maintenance of Aedes This seems to be the first documented accidental secondary extinction of a mosquito. Furthermore, it suggests that preferred host abundance can limit mosquito populations, opening new directions for controlling important disease vectors that depend on introduced species like rats. © 2018 The Authors.

Local extinction of the Asian tiger mosquito (Aedes albopictus) following rat eradication on Palmyra Atol

USGS Publications Warehouse

Lafferty, Kevin D.; McLaughlin, John P.; Gruner, Daniel S.; Bogar, Taylor A.; Bui, An; Childress, Jasmine N.; Espinoza, Magaly; Forbes, Elizabeth S.; Johnston, Cora A.; Klope, Maggie; Kuile, Ana Miller-ter; Lee, Michelle; Plummer, Katherine A.; Weber, David A.; Young, Ronald T.; Young, Hillary S.

2018-01-01

The Asian tiger mosquito, Aedes albopictus, appears to have been extirpated from Palmyra Atoll following rat eradication. Anecdotal biting reports, collection records, and regular captures in black-light traps showed the species was present before rat eradication. Since then, there have been no biting reports and no captures over 2 years of extensive trapping (black-light and scent traps). By contrast, the southern house mosquito, Culex quinquefasciatus, was abundant before and after rat eradication. We hypothesize that mammals were a substantial and preferred blood meal for Aedes, whereas Culex feeds mostly on seabirds. Therefore, after rat eradication, humans and seabirds alone could not support positive population growth or maintenance of Aedes. This seems to be the first documented accidental secondary extinction of a mosquito. Furthermore, it suggests that preferred host abundance can limit mosquito populations, opening new directions for controlling important disease vectors that depend on introduced species like rats.

A qualitative investigation of the perceptions of female dog-bite victims and implications for the prevention of dog bites.

PubMed

Westgarth, Carri; Watkins, Francine

2015-01-01

Preventing dog bites is an increasingly important public health and political issue with implications for both human and animal health and welfare. Expert opinion is that most bites are preventable. Intervention materials have been designed to educate people on how to assess the body language of dogs, evaluate risk, and take appropriate action. The effectiveness of this approach is rarely evaluated and the incidence of dog bites is thought to be increasing. Is the traditional approach to dog bite prevention working as well as it should? In this novel, small scale qualitative study, the perceptions of victims regarding their dog bite experience were explored in-depth. The study recruited 8 female participants who had been bitten by a dog in the past 5 years. In-depth, one-to-one interviews were conducted, transcribed, and analyzed using thematic analysis. The findings indicate that dog bites may not be as easily preventable as previously presumed, and that education about dog body language may not prevent some types of dog bites. The reasons participants were bitten were multifaceted and complex. In some cases, there was no interaction with the dog before the bite so there was no opportunity to assess the situation and modify behavior around the dog accordingly. Identifying who was to blame, and had responsibility for preventing the bite, was straightforward for the participants in hindsight. Those bitten blamed themselves and/or the dog owner, but not the dog. Most participants already felt they had a theoretical knowledge that would allow them to recognize dog aggression before the dog bite, yet participants, especially those who worked regularly with dogs, routinely believed, "it would not happen to me." We also identified an attitude that bites were "just one of those things," which could also be a barrier prevention initiatives. Rather than being special to the human-canine relationship, the attitudes discovered mirror those found in other areas of injury prevention. A new approach to dog-bite prevention may now be required, drawing on other injury prevention strategies including awareness-raising and minimizing the damage caused by a bite when it happens.

Epidemiological profile of snake-bite cases from Haryana: A five year (2011-2015) retrospective study.

PubMed

Bhargava, Saurabh; Kaur, Ramanjeet; Singh, Rajvinder

2018-02-01

Varieties of venomous snakes inhabit in the world which accidentally take thousands of human lives every year. This severe medical emergency constantly persuades national and international health agencies to look at efficient epidemiological profiling of snake-bite cases for the proper management of this sympathetic problem. Establishing the accurate database of snake-bite in humans from different localities of India may perhaps lack certainty due to few inevitable reasons such as consideration of this problem as less emergent problem in disparity to pesticide poisoning, difficulty in the accessibility to rural and tribal areas where chances of snake-bite remain ceiling, lack of inspiring models of snake-bite management training, reduced reporting system, and pitiable maintenance of hospital data in India. Therefore, the present modest study was carried out to explore valuable information regarding snake-bite problem in Haryana. Factual data on snake-bite incidences happened from 2011 to 2015 were collected from government hospitals and medical institutes of Haryana. This retrospective study disclosed a few characteristic points related to the frequency of snake-bite cases, gender involved, anti-snake venom (ASV) treatment, and numbers of deaths with snake-bite. Records revealed a total of 6555 cases of snake-bite including 130 deaths reported in Haryana during the study period. A significant variation in the occurrence of snake-bite cases was also recorded in different areas of Haryana. There was a huge database of recorded snake-bite cases from government medical institute but district wise survey disclosed the maximum number of snake-bite incidences, especially amongst males from Panchkula. The present study has provided a more updated and comprehensive record of snake-bite from Haryana during 2011-2015. A huge burden of snake-bite amongst human was found in Haryana; hence, the findings of this study purposely enlighten people about the size of this problem in the selected region. However, this study also remained limited due to lack of information on a few important parameters and availability of homogeneous data. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Epidemiology of severe and fatal rattlesnake bites published in the American Association of Poison Control Centers' Annual Reports.

PubMed

Walter, Frank G; Stolz, Uwe; Shirazi, Farshad; McNally, Jude

2009-08-01

No study has focused on the nationwide epidemiology of severe and fatal rattlesnake bites during the last 25 years. We examined rates and temporal trends of severe and fatal rattlesnake bites across the United States. Our hypothesis was that nationwide annual rates of both severe and fatal outcomes from rattlesnake bites have remained unchanged over time. This study retrospectively analyzed all human rattlesnake bites published in the Annual Reports of the American Association of Poison Control Centers from 1983 through 2007. Annual rates of severe (major) and fatal rattlesnake bites were calculated using the annual number of major outcomes and fatalities as respective numerators and the total annual number of single rattlesnake bites (exposures) as denominators. Negative binomial and Poisson regressions were used to examine trends of severe and fatal rattlesnake bites over time. Annually, from 1985 to 2007, the incidence rate of major outcomes decreased by 2% per year (incidence rate ratio = 0.980; CI = 0.967-0.993), corresponding to an absolute annual rate decrease of two major outcomes per 1,000 bites per year. Annual rates of fatalities showed no statistically significant change from 1983 through 2007. This is the first study to examine rates and trends of published severe and fatal rattlesnake bites across the United States over the past 25 years. Annual rates of severe rattlesnake bites, derived from the published Annual Reports of the American Association of Poison Control Centers, have significantly decreased over time, whereas rates of fatal rattlesnake bites have remained unchanged.

Management of pediatric mandibular fractures using bioresorbable plating system – Efficacy, stability, and clinical outcomes: Our experiences and literature review

PubMed Central

Singh, Mahinder; Singh, R.K.; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

2015-01-01

Aims The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Methods Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). Conclusion 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients. PMID:27195206

Vertical control in the Class III compensatory treatment.

PubMed

Sobral, Márcio Costa; Habib, Fernando A L; Nascimento, Ana Carla de Souza

2013-01-01

Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patient's treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who present with a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extraoral appliances on the lower dental arch (J-hook), until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

Analysis of factors associated with cracked teeth.

PubMed

Seo, Deog-Gyu; Yi, Young-Ah; Shin, Su-Jung; Park, Jeong-Won

2012-03-01

The purpose of this study was to analyze the characteristics, distribution, and associated factors of longitudinal fractured teeth according to the well-defined criteria of the American Association of Endodontists (AAE). One hundred seven teeth with longitudinal fracture from 103 patients were diagnosed and analyzed. The patients' signs, symptoms, age, and sex were noted as well as the tooth number, dental arch, filling materials, size/classification of restoration, crack direction, pulp vitality, whether the patient had undergone endodontic treatment, bite test results, percussion test results, wear facet, and periodontal pocket depth. Eighty-seven teeth were diagnosed with a cracked tooth (81.3%), 14 were diagnosed with vertical root fracture (VRF, 13.1%), 4 had a split tooth (3.7%), and 2 had a fractured cusp (1.9%); 82.2% showed a sensitive reaction on the bite test. Longitudinal tooth fractures were observed most frequently in patient in their 40s. The upper first molar (28.0%) was most frequently cracked, followed by the lower first molar (25.2%), the lower second molar (20.6%), and the upper second molar (16.8%). Most longitudinal tooth fractures (72.0%) occurred mainly in restored teeth, whereas only 28.0% were found in intact teeth. Compared with resin (4.7%) or porcelain (0.9%), the use of nonbonded inlay restoration materials such as gold (20.5%) or amalgam (18.7%) increased the occurrence of longitudinal tooth fractures. Out of 107 of longitudinal fractured teeth, 33 (30.8%) were treated endodontically and 74 (69.2%) were not. VRF was associated with endodontic treatment. The bite test is most reliable for reproducing symptoms. The combined use of various examination methods is recommended for detecting cracks and minutely inspecting all directions of a tooth. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Investigation of mucosa-induced residual ridge resorption under implant-retained overdentures and complete dentures in the mandible.

PubMed

Ahmad, Rohana; Chen, Junning; Abu-Hassan, Mohamed I; Li, Qing; Swain, Michael V

2015-01-01

This study aimed to investigate and compare the residual ridge resorption (RRR) induced by an implant-retained overdenture (IRO) and associative biomechanics and by a conventional complete denture (CD) without implants. Cone beam computed tomography was used to quantify RRR in a three-dimensional (3D) manner before and after 1 year of treatment with either IROs or CDs. Twenty patients were treated with IROs, and nine patients were treated with CDs in the mandible. Their maximum bite forces were recorded. The same sets of high-resolution scan images were used to create patient-specific 3D finite element analysis models. The hydrostatic stresses, contact surface deformation, and strain energy absorption in soft tissue mucosa were correlated with the changes in RRR for patients with and without implants. With the IROs, contact surface deformation on the mucosa was two times greater than with CDs (0.32 ± 0.23 mm vs 0.16 ± 0.06 mm) and was in agreement with the amount of RRR measured, which was also two times higher for the IRO than the CD (-3.8% ± 4.5% vs -1.9% ± 0.4%). Taking into account the differences in bite forces with and without implants, which again were twice as high with IROs, the hydrostatic stress within the mucosa was found to correlate well to the RRR map measured over the 1-year interval of treatment. IROs resulted in at least twice the RRR as CDs. This could be caused by the higher hydrostatic stress and less effective energy absorption capabilities of the mucosa underneath the IRO. While implants associated with the IRO provide stronger bite force, they could potentially concentrate hydrostatic stress and cause greater RRR compared to a conventional CD.

A season of snakebite envenomation: presentation patterns, timing of care, anti-venom use, and case fatality rates from a hospital of southcentral Nepal

PubMed Central

Pandey, Deb P; Vohra, Rais; Stalcup, Philip; Shrestha, Bhola R

2016-01-01

Snakebite envenomation affects thousands of people annually in Nepal. Published hospital-based studies of snakebite treatment in Nepal are scarce. Here we present the results of the first prospective, cross-sectional study of hospitalized envenomed snakebite cases in southcentral Nepal, a region characterized by poor pre-hospital care of snakebites, limited supply and excessive use of antivenom, and a high case/fatality ratio. We seek to identify clinical management problems and suggest potential interventions to improve treatment of snakebites. Out of the 342 patients presented with snakebites to an urban emergency department in the Terai region of Nepal between April and September of 2007, 39 patients were enrolled based on development of ptosis or swelling of bitten body parts. We collected patient demographic information and documented circumstances of snakebite, prehospital care, hospital care, and development of complications. Among 39 envenomated patients admitted to Bharatpur Hospital enrolled in the study 34 (92%) exhibited features of clinically significant neurotoxicity and were treated with antivenom. Antivenom use ranged from 4 to 98 vials of Polyspecific Indian Antivenom per patient. Each of victims (n=34) received antivenom an average of 4.3 (median) ±0.73 (standard error of mean) hours after receiving the snakebite. The overall case fatality rate was 21%. Neurotoxicity developed up to 25.8hr after suspected elapid snakebites. This was not observed for viperid snake bites. No enrolled patients received any of the currently recommended first aid for snake bite. The prevalence of nocturnal elapid snake bites, the practice of inappropriate first aid measures and highly variable administration of antivenom were identified as major challenges to appropriate care in this study. To address these issues we suggest development of a comprehensive checklist for identification of snake species, management of envenomation, and an educational program which teaches proper care at all stages of snakebite treatment. PMID:26998219

A comparative study between xerographic, computer-assisted overlay generation and animated-superimposition methods in bite mark analyses.

PubMed

Tai, Meng Wei; Chong, Zhen Feng; Asif, Muhammad Khan; Rahmat, Rabiah A; Nambiar, Phrabhakaran

2016-09-01

This study was to compare the suitability and precision of xerographic and computer-assisted methods for bite mark investigations. Eleven subjects were asked to bite on their forearm and the bite marks were photographically recorded. Alginate impressions of the subjects' dentition were taken and their casts were made using dental stone. The overlays generated by xerographic method were obtained by photocopying the subjects' casts and the incisal edge outlines were then transferred on a transparent sheet. The bite mark images were imported into Adobe Photoshop® software and printed to life-size. The bite mark analyses using xerographically generated overlays were done by comparing an overlay to the corresponding printed bite mark images manually. In computer-assisted method, the subjects' casts were scanned into Adobe Photoshop®. The bite mark analyses using computer-assisted overlay generation were done by matching an overlay and the corresponding bite mark images digitally using Adobe Photoshop®. Another comparison method was superimposing the cast images with corresponding bite mark images employing the Adobe Photoshop® CS6 and GIF-Animator©. A score with a range of 0-3 was given during analysis to each precision-determining criterion and the score was increased with better matching. The Kruskal Wallis H test showed significant difference between the three sets of data (H=18.761, p<0.05). In conclusion, bite mark analysis using the computer-assisted animated-superimposition method was the most accurate, followed by the computer-assisted overlay generation and lastly the xerographic method. The superior precision contributed by digital method is discernible despite the human skin being a poor recording medium of bite marks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Analysis of the bite force and mechanical design of the feeding mechanism of the durophagous horn shark Heterodontus francisci.

PubMed

Huber, Daniel R; Eason, Thomas G; Hueter, Robert E; Motta, Philip J

2005-09-01

Three-dimensional static equilibrium analysis of the forces generated by the jaw musculature of the horn shark Heterodontus francisci was used to theoretically estimate the maximum force distributions and loadings on its jaws and suspensorium during biting. Theoretical maximum bite force was then compared with bite forces measured (1) voluntarily in situ, (2) in restrained animals and (3) during electrical stimulation of the jaw adductor musculature of anesthetized sharks. Maximum theoretical bite force ranged from 128 N at the anteriormost cuspidate teeth to 338 N at the posteriormost molariform teeth. The hyomandibula, which connects the posterior margin of the jaws to the base of the chondrocranium, is loaded in tension during biting. Conversely, the ethmoidal articulation between the palatal region of the upper jaw and the chondrocranium is loaded in compression, even during upper jaw protrusion, because H. francisci's upper jaw does not disarticulate from the chondrocranium during prey capture. Maximum in situ bite force averaged 95 N for free-swimming H. francisci, with a maximum of 133 N. Time to maximum force averaged 322 ms and was significantly longer than time away from maximum force (212 ms). Bite force measurements from restrained individuals (187 N) were significantly greater than those from free-swimming individuals (95 N) but were equivalent to those from both theoretical (128 N) and electrically stimulated measurements (132 N). The mean mass-specific bite of H. francisci was greater than that of many other vertebrates and second highest of the cartilaginous fishes that have been studied. Measuring bite force on restrained sharks appears to be the best indicator of maximum bite force. The large bite forces and robust molariform dentition of H. francisci correspond to its consumption of hard prey.

Severe human Babesia divergens infection in Norway.

PubMed

Mørch, K; Holmaas, G; Frolander, P S; Kristoffersen, E K

2015-04-01

Human babesiosis is a rare but potentially life-threatening parasitic disease transmitted by ixodid ticks, and has not previously been reported in Norway. We report a case of severe babesiosis that occurred in Norway in 2007. The patient had previously undergone a splenectomy. He was frequently exposed to tick bites in an area endemic for bovine babesiosis in the west of Norway. The patient presented with severe haemolysis and multiorgan failure. Giemsa-stained blood smears revealed 30% parasitaemia with Babesia spp. He was treated with quinine in combination with clindamycin, apheresis, and supportive treatment with ventilatory support and haemofiltration, and made a complete recovery. This is the first case reported in Norway; however Babesia divergens seroprevalence in cattle in Norway is high, as is the risk of Ixodes ricinus tick bite in the general population. Babesiosis should be considered in the differential diagnosis of unexplained febrile haemolytic disease. Copyright © 2015. Published by Elsevier Ltd.

Piezocision as an adjunct to orthodontic treatment of unilateral posterior crossbite

PubMed Central

Bakathir, Manal A.; Hassan, Ali H.; Bahammam, Maha A.

2017-01-01

Piezocision (corticotomy) is a minimally invasive approach that involves micro-incisions, piezoelectric incisions, and selective tunnelling for soft or hard tissue grafting. Piezocision has many uses in orthodontics, but its uses in cross-bite cases are limited. This case report illustrates the outcomes of a 19-year-old female patient with unilateral cross-bite that was treated with a minimally invasive piezocision with bone grafting in the affected side. In addition, she also had a functional shift, severe crowding, and mid-line shift. Therefore, the shift was eliminated using a quad helix expansion, she was treated with a fixed appliance, and a bimaxillary extraction of the first premolars was performed. The patient followed-up at 18 months, and the occlusion was stable with a pleasant profile. Piezocision can be used as an adjunct to the orthodontic treatment of adults to facilitate the treatment of complicated cases. PMID:28397951

Airway physical examination tests for detection of difficult airway management in apparently normal adult patients.

PubMed

Roth, Dominik; Pace, Nathan L; Lee, Anna; Hovhannisyan, Karen; Warenits, Alexandra-Maria; Arrich, Jasmin; Herkner, Harald

2018-05-15

The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities. We performed this individually for each of the four descriptors of the difficult airway: difficult face mask ventilation, difficult laryngoscopy, difficult tracheal intubation, and failed intubation. We searched major electronic databases including CENTRAL, MEDLINE, Embase, ISI Web of Science, CINAHL, as well as regional, subject specific, and dissertation and theses databases from inception to 16 December 2016, without language restrictions. In addition, we searched the Science Citation Index and checked the references of all the relevant studies. We also handsearched selected journals, conference proceedings, and relevant guidelines. We updated this search in March 2018, but we have not yet incorporated these results. We considered full-text diagnostic test accuracy studies of any individual index test, or a combination of tests, against a reference standard. Participants were adults without obvious airway abnormalities, who were having laryngoscopy performed with a standard laryngoscope and the trachea intubated with a standard tracheal tube. Index tests included the Mallampati test, modified Mallampati test, Wilson risk score, thyromental distance, sternomental distance, mouth opening test, upper lip bite test, or any combination of these. The target condition was difficult airway, with one of the following reference standards: difficult face mask ventilation, difficult laryngoscopy, difficult tracheal intubation, and failed intubation. We performed screening and selection of the studies, data extraction and assessment of methodological quality (using QUADAS-2) independently and in duplicate. We designed a Microsoft Access database for data collection and used Review Manager 5 and R for data analysis. For each index test and each reference standard, we assessed sensitivity and specificity. We produced forest plots and summary receiver operating characteristic (ROC) plots to summarize the data. Where possible, we performed meta-analyses to calculate pooled estimates and compare test accuracy indirectly using bivariate models. We investigated heterogeneity and performed sensitivity analyses. We included 133 (127 cohort type and 6 case-control) studies involving 844,206 participants. We evaluated a total of seven different prespecified index tests in the 133 studies, as well as 69 non-prespecified, and 32 combinations. For the prespecified index tests, we found six studies for the Mallampati test, 105 for the modified Mallampati test, six for the Wilson risk score, 52 for thyromental distance, 18 for sternomental distance, 34 for the mouth opening test, and 30 for the upper lip bite test. Difficult face mask ventilation was the reference standard in seven studies, difficult laryngoscopy in 92 studies, difficult tracheal intubation in 50 studies, and failed intubation in two studies. Across all studies, we judged the risk of bias to be variable for the different domains; we mostly observed low risk of bias for patient selection, flow and timing, and unclear risk of bias for reference standard and index test. Applicability concerns were generally low for all domains. For difficult laryngoscopy, the summary sensitivity ranged from 0.22 (95% confidence interval (CI) 0.13 to 0.33; mouth opening test) to 0.67 (95% CI 0.45 to 0.83; upper lip bite test) and the summary specificity ranged from 0.80 (95% CI 0.74 to 0.85; modified Mallampati test) to 0.95 (95% CI 0.88 to 0.98; Wilson risk score). The upper lip bite test for diagnosing difficult laryngoscopy provided the highest sensitivity compared to the other tests (P < 0.001). For difficult tracheal intubation, summary sensitivity ranged from 0.24 (95% CI 0.12 to 0.43; thyromental distance) to 0.51 (95% CI 0.40 to 0.61; modified Mallampati test) and the summary specificity ranged from 0.87 (95% CI 0.82 to 0.91; modified Mallampati test) to 0.93 (0.87 to 0.96; mouth opening test). The modified Mallampati test had the highest sensitivity for diagnosing difficult tracheal intubation compared to the other tests (P < 0.001). For difficult face mask ventilation, we could only estimate summary sensitivity (0.17, 95% CI 0.06 to 0.39) and specificity (0.90, 95% CI 0.81 to 0.95) for the modified Mallampati test. Bedside airway examination tests, for assessing the physical status of the airway in adults with no apparent anatomical airway abnormalities, are designed as screening tests. Screening tests are expected to have high sensitivities. We found that all investigated index tests had relatively low sensitivities with high variability. In contrast, specificities were consistently and markedly higher than sensitivities across all tests. The standard bedside airway examination tests should be interpreted with caution, as they do not appear to be good screening tests. Among the tests we examined, the upper lip bite test showed the most favourable diagnostic test accuracy properties. Given the paucity of available data, future research is needed to develop tests with high sensitivities to make them useful, and to consider their use for screening difficult face mask ventilation and failed intubation. The 27 studies in 'Studies awaiting classification' may alter the conclusions of the review, once we have assessed them.

Cat scratches, not bites, are associated with unipolar depression--cross-sectional study.

PubMed

Flegr, Jaroslav; Hodný, Zdeněk

2016-01-05

A recent study performed on 1.3 million patients showed a strong association between being bitten by a cat and probability of being diagnosed with depression. Authors suggested that infection with cat parasite Toxoplasma could be the reason for this association. A cross sectional internet study on a non-clinical population of 5,535 subjects was undertaken. The subjects that reported having been bitten by a dog and a cat or scratched by a cat have higher Beck depression score. They were more likely to have visited psychiatrists, psychotherapists and neurologists in past two years, to have been previously diagnosed with depression (but not with bipolar disorder). Multivariate analysis of models with cat biting, cat scratching, toxoplasmosis, the number of cats at home, and the age of subjects as independent variables showed that only cat scratching had positive effect on depression (p = 0.004). Cat biting and toxoplasmosis had no effect on the depression, and the number of cats at home had a negative effect on depression (p = 0.021). Absence of association between toxoplasmosis and depression and five times stronger association of depression with cat scratching than with cat biting suggests that the pathogen responsible for mood disorders in animals-injured subjects is probably not the protozoon Toxoplasma gondii but another organism; possibly the agent of cat-scratched disease - the bacteria Bartonella henselae.

Efficacy and safety of topical Trikatu preparation in, relieving mosquito bite reactions: a randomized controlled trial.

PubMed

Maenthaisong, Ratree; Chaiyakunapruk, Nathorn; Tiyaboonchai, Waree; Tawatsin, Apiwat; Rojanawiwat, Archawin; Thavara, Usavadee

2014-02-01

Trikatu is composed of dried fruits of Piper nigrum L and Piper retrofractum Vahl, and dried rhizomes of Zingiber officinale R. Although this preparation has been used to relieve pruritis, pain, and inflammation for a long time, there is no clinical evidence to confirm its efficacy and safety. Therefore, we performed a double-blind, within person-randomized controlled study of 30 healthy volunteers to determine efficacy and safety of topical Trikatu on mosquito bite reactions. All subjects were bitten by Aedes aegypti laboratory mosquitoes on their forearms and they were randomly assigned arms to apply either Trikatu or reference product on the mosquito bite papule. The main outcome was the difference of papule size reduction at 30 min, measured by a caliper, between the Trikatu and reference arms. Pruritis, redness, pain, and patient satisfaction were assessed at 15, 30, 60, 180, and 360 min as secondary outcomes. There were no significant differences between treatment and reference arms on any outcome at any time of measurement. Trikatu did not show additional effects for relieving mosquito bite reaction as compared with the reference product containing camphor, menthol, and eucalyptus. For further study, it is very important to consider a proper selection of subjects, comparator product, and concentration of extract when Trikatu preparation is investigated. Copyright © 2013 Elsevier Ltd. All rights reserved.

Airway injury associated with cervical bite wounds in dogs and cats: 56 cases.

PubMed

Jordan, C J; Halfacree, Z J; Tivers, M S

2013-01-01

To investigate the frequency of airway injury and damage to other vital structures associated with cervical bite wounds in dogs and cats and the implications for management and outcome. A retrospective search of electronic patient records was used to identify dogs and cats suffering cervical bite wounds that were presented to a large multidisciplinary veterinary hospital over a four year period. Complete records were available for 55 animals, with one animal suffering two separate injuries. Fourteen animals (25%) had injuries to vital structures, including airway injury in nine (17%) which was surgically confirmed and treated in six (11%). Airway injuries were associated with either subcutaneous or mediastinal emphysema in all affected animals. Other structures injured included the jugular vein, pharynx, oesophagus and spine. Airway injuries were treated with primary repair in five animals and a fasciomuscular patch in one. Temporary tracheostomy was performed in three animals. Median duration of hospitalisation was one day (0-19) with 53 animals (54 cases) (96%) surviving to discharge. Long-term follow-up (16-114 months) revealed that 43 of 49 animals were alive with six that died due to unrelated reasons. Cervical bite wounds are associated with significant injury to vital structures. Up to 17% of animals may have injury to their airway. Identification and treatment of airway injury is vital and was associated with an excellent outcome in six animals.

Malocclusions in young children: Does breast-feeding really reduce the risk? A systematic review and meta-analysis.

PubMed

Doğramacı, Esma J; Rossi-Fedele, Giampiero; Dreyer, Craig W

2017-08-01

Researchers have purported that breast-feeding can decrease the risk of malocclusions. The authors studied the relationship of breast-feeding on malocclusions in young children by means of conducting a systematic review of association (etiology). The authors used a 3-step search strategy, including electronic searches. They considered studies whose investigators included healthy children with primary dentition with a history of breast-feeding and in which the study investigators had assessed specific malocclusion outcomes to be eligible for inclusion in this review. The authors considered prospective and retrospective (longitudinal) studies, case-control studies, and analytical cross-sectional studies. Two of the authors, using standardized instruments, independently assessed the methodological quality and extracted data from the included studies. For situations for which there were a sufficient number of studies, the authors conducted meta-analyses using the random-effects model, supplemented with the fixed-effects model in situations for which statistical heterogeneity was 50% or less, assessed using the I 2 statistic. The authors identified 7 studies that were included in the review. They found that children who had breast-fed suboptimally had an increased risk of developing malocclusions and that a strong and significant association existed between a shorter duration of breast-feeding (less than 12 months) and the development of an anterior open bite (n = 1,875; risk ratio, 3.58; 95% confidence interval, 2.55 to 5.03; P < .00001) and a class II canine relationship (n = 1,203; risk ratio, 1.65; 95% confidence interval, 1.38 to 1.97; P < .00001). Young children with a history of suboptimal breast-feeding have a higher prevalence and risk ratio for malocclusions. These children have an increased risk of developing a class II canine relationship, posterior crossbite, and anterior open bite. Dental health care professionals should continue to encourage and promote breast-feeding; however, patients should be aware that children still can develop malocclusions, despite having received optimal breast-feeding, owing to the multifactorial etiology of malocclusions. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

Proximate determinants of bite force in Anolis lizards.

PubMed

Wittorski, Antoine; Losos, Jonathan B; Herrel, Anthony

2016-01-01

Performance measures associated with the vertebrate jaw system may provide important insights into vertebrate ecology and evolution because of their importance in many ecologically relevant tasks. Previous studies have shown that in many taxa, evolution toward higher bite force has gone hand in hand with the evolution of larger body size. However, independent of differences in overall body size, bite force may vary depending on head size and shape as well. Moreover, the underlying musculature may also drive variation in bite force. Here, we investigate the proximate determinants of bite force in lizards of the genus Anolis. We dissected the jaw muscles and quantified muscle mass, fibre length, and cross-sectional area. Data were analysed for both sexes independently given the sexual dimorphism detected in the dataset. Our results show that the traits that explain bite force are similar in both males and females with overall body size and muscle mass being the principal determinants. Among the different muscles examined, the adductor externus and the pseudotemporalis groups were the best determinants of bite force. However, models run for males predicted the variation in bite force better than models for females, suggesting that selection on morphology improving bite force may be stronger in males. © 2015 Anatomical Society.

Clinical effects and antivenom use for snake bite victims treated at three US hospitals in Afghanistan.

PubMed

Heiner, Jason D; Bebarta, Vikhyat S; Varney, Shawn M; Bothwell, Jason D; Cronin, Aaron J

2013-12-01

Annually, more than 100,000 US and international military and civilian personnel work in Afghanistan within terrain harboring venomous snakes. Current literature insufficiently supports Afghan antivenom treatment and stocking guidelines. We report the clinical course and treatments for snakebite victims presenting to US military hospitals in Afghanistan. All snakebite victims presenting to 3 US military emergency departments between July 2010 and August 2011 in northern and southern Afghanistan were examined via chart review. Case information included patient demographics, snake description, bite details and complications, laboratory results, antivenom use and adverse effects, procedures performed, and hospital course. Of 17 cases, median patient age was 20 years (interquartile range [IQR], 12-30), 16 were male, and 82% were Afghans. All bites were to an extremity, and median time to care was 2.8 hours (IQR, 2-5.8). On arrival, 8 had tachycardia and none had hypotension or hypoxia. A viper was implicated in 5 cases. Ten cases received at least 1 dose of polyvalent antivenom, most commonly for coagulopathy, without adverse effects. Six received additional antivenom, 6 had an international normalized ratio (INR) > 10, and none developed delayed coagulopathy. Three received blood transfusions. Hospital stay ranged from 1 to 4 days. None required vasopressors, fasciotomy, or other surgery, and none died. All had resolution of marked coagulopathies and improved swelling and pain on discharge. We report the largest series of snake envenomations treated by US physicians in Afghanistan. Antivenom was tolerated well with improvement of coagulopathy and symptoms. All patients survived with minimal advanced interventions other than blood transfusion. Published by Elsevier Inc.

Validity of the Bite Counter device in a controlled laboratory setting.

PubMed

Desendorf, Jenna; Bassett, David R; Raynor, Hollie A; Coe, Dawn P

2014-08-01

Body-borne sensors may be useful in assessing eating behaviors and have the potential to overcome some of the limitations of self-report instruments. The Bite Counter is a new commercial device, worn on the wrist that purports to track the number of bites taken per day. It contains a tri-axial accelerometer that detects an upward, arcing motion from the table to the mouth, known as a wrist roll. To examine the validity of the Bite Counter device for measuring bites in individuals while consuming various foods and beverages. 15 adults (23-58 years old) wore the device on the wrist of their dominant hand. They were presented with a meal consisting of foods/beverages, each consumed with different utensils: meat (knife and fork), side items (fork), soup (spoon), pizza (hands), can of soda (hands), and a smoothie (straw). Each food or drink was consumed by itself, in consecutive order. A researcher observed them through a one-way mirror and counted the number of bites taken. The percentage of actual bites taken varied as follows: Meat (127%), side items (82.6%), soup (60.2%), pizza (87.3%), soda (81.7%), and smoothie (57.7%). The overall mean was 81.2% of bites taken. The results indicate that the Bite Counter holds promise for being able to count the number of hand-to-mouth movements. In general, it underestimated hand-to-mouth movements, but some types of hand movements caused overestimation of bites. Future studies should be undertaken to improve the sensitivity and specificity of the Bite Counter device. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of the Elastic Properties of Thirteen Silicone Interocclusal Recording Materials

PubMed Central

Zietek, Marek

2016-01-01

Background. Addition silicones are popular as dental impression materials and are used in bite registration procedures. Objective. This study aimed to compare the postsetting elasticities and other mechanical properties of thirteen addition silicone interocclusal recording materials. Materials and Methods. The following materials were investigated: Colorbite D, Futar D, Genie Bite, Jet Blue Bite fast, Memoreg 2, O-Bite, Occlufast Rock, Omni-Bite Plus, Regidur i, Registrado X-tra, Regofix transparent, StoneBite, and Variotime Bite. Thirty specimens of each material were tested. The elasticities and strengths of the materials were measured with a universal testing machine, and computer software was used to determine the E-moduli, ultimate tensile strengths, and ultimate elongations of the specimens. Results. The results were subjected to statistical analysis using the Kruskal-Wallis test (p ≤ 0.05). The statistics revealed that the mean E-modulus values varied significantly across the materials (p = 0.000) and were highest for the StoneBite and Registrado X-tra and lowest for the Regofix transparent. The ultimate tensile strengths were highest for the Regofix transparent and Registrado X-tra (p = 0.000) and lowest for the Jet Blue Bite fast and Memoreg 2 (p = 0.000). The elongation percentages at the point of breaking varied significantly across the materials (p = 0.000); the lowest value was observed for the StoneBite, whereas the Regofix transparent nearly doubled original length. Conclusions. The authors concluded that materials with the high E-moduli and great ultimate tensile strengths may be most useful clinically. Registrado X-tra and StoneBite best met these criteria. PMID:27747239

Consumer perception of salt-reduced breads: Comparison of single and two-bites evaluation.

PubMed

Antúnez, Lucía; Giménez, Ana; Alcaire, Florencia; Vidal, Leticia; Ares, Gastón

2017-10-01

Salt-reduction in processed products has been proposed as a high-impact intervention for reducing the sodium intake at population level. A major limitation for this approach is its potential negative impact on the sensory characteristics of products. The current practice in sensory and consumer science involves single sip/bite evaluations, which may not properly reflect the sensory experience that occurs during product consumption. In this context, the aim of the present work was to compare single and two bite evaluations of consumer sensory and hedonic perception of salt-reduced breads. Five studies with a total of 499 consumers were carried out, in which overall-liking scores of five salt-reduced bread samples were collected after the first and the second bite evaluation. In one of the studies consumers also answered a CATA (check-all-that-apply) question after the first and the second bite. Neither bite nor the interaction between samples and bite had a significant effect on hedonic scores. However, when hedonic scores were analysed separately for each bite, the overall liking scores from the second bite evaluation better reflected differences among samples according to their salt content in two of the five studies. The sensory characterization of the samples did not largely vary between the first and the second bite. Results suggest that consumers' perception of salt reduced bread samples did not largely vary between a single and a two bites evaluation. Further research is warranted in this regard, in particular considering more complex products. Copyright © 2017 Elsevier Ltd. All rights reserved.

21 CFR 882.5070 - Bite block.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bite block. 882.5070 Section 882.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5070 Bite block. (a) Identification. A bite block...

21 CFR 882.5070 - Bite block.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bite block. 882.5070 Section 882.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5070 Bite block. (a) Identification. A bite block...

STS-35 crewmembers eat meal on the middeck of Columbia, OV-102

NASA Technical Reports Server (NTRS)

1990-01-01

Enjoying a meal on the middeck of Columbia, Orbiter Vehicle (OV) 102, are STS-35 Mission Specialist (MS) Robert A.R. Parker (foreground), Payload Specialist Ronald A. Parise (center), and Commander Vance D. Brand. Parker spoons up bite from his food container as Parise lets a spoonful freefloat into his open mouth and Brand balances his meal tray assembly. The forward lockers, the shuttle treadmill, and the starboard side sleep station are seen in the view.

Orthodontic camouflage in the case of a skeletal class III malocclusion.

PubMed

Costa Pinho, Teresa M; Ustrell Torrent, Josep M; Correia Pinto, João G R

2004-01-01

To describe the clinical problem of a male patient, 15 years of age, who had a dolichofacial biotype and a Class III skeletal type at the beginning of treatment, manifesting itself at the dental level. To resolve the dental problems, orthodontic camouflage (dentoalveolar compensation) with the extraction of two mandibular premolars was performed. This procedure allowed a more harmonious occlusal relationship at the canine level and provided better occlusal stability of the final result. The procedure choice was based on the fact that some cephalometric values were favorable to attenuation of the skeletal Class III. For example, according to the analyses of Björk and Jarabak, these values are the total sum of 1, 2, 3 (sella angle, articular angle, and gonial angles) and the anterior/posterior facial height (S-Go/Na-Me). However, the same cephalometric data indicate a possible worsening of the existing open bite, which might be corrected with dental extractions and the use of intermaxillary elastics.

Equine allergy therapy: update on the treatment of environmental, insect bite hypersensitivity, and food allergies.

PubMed

Marsella, Rosanna

2013-12-01

Allergies are common in horses. It is important to identify and correct as many factors as possible to control pruritus and make the patient comfortable. Culicoides hypersensitivity is a common component in allergic horses. The main treatment continues to be rigorous fly control and avoidance of insect bites. Environmental allergies are best addressed by early identification of the offending allergens and formulation of allergen-specific immunotherapy to decrease the need for rescue medications. Food allergy is best managed with food avoidance. Urticaria is one of the manifestations of allergic disease wherein detection of the triggering cause is essential for management. Copyright © 2013 Elsevier Inc. All rights reserved.

Verified spider bites in Oregon (USA) with the intent to assess hobo spider venom toxicity.

PubMed

McKeown, Nathanael; Vetter, Richard S; Hendrickson, Robert G

2014-06-01

This study compiled 33 verified spider bites from the state of Oregon (USA). The initial goal was to amass a series of bites by the hobo spider to assess whether it possesses toxic venom, a supposition which is currently in a contested state. None of the 33 bites from several spider species developed significant medical symptoms nor did dermonecrosis occur. The most common biters were the yellow sac spider, Cheiracanthium mildei (N = 10) and orb-weavers of the genus Araneus (N = 6). There were 10 bites from three genera of funnel web spiders of the family Agelenidae including one hobo spider bite and one from the congeneric giant house spider which is readily confused as a hobo spider. The hobo spider bite resulted in pain, redness, twitching in the calf muscle and resolved in 12 h. Also generated from this study were possibly the first records of bites from spiders of the genera Callobius (Amaurobiidae) and Antrodiaetus (Antrodiaetidae), both with minor manifestations. Published by Elsevier Ltd.

Comparison of cetirizine, ebastine and loratadine in the treatment of immediate mosquito-bite allergy.

PubMed

Karppinen, A; Kautiainen, H; Petman, L; Burri, P; Reunala, T

2002-06-01

People frequently experience whealing and delayed papules from mosquito bites. Whealing is mediated by antisaliva immunoglobulin (Ig)E antibodies and histamine. Cetirizine, ebastine and loratadine have earlier shown effects on mosquito-bite reactions but no comparative studies exist. A double-blind, placebo-controlled, cross-over study was performed with cetirizine 10 mg, ebastine 10 mg and loratadine 10 mg in 29 mosquito-bite-sensitive adults exposed to Aedes aegypti mosquito-bites. The size of the bite lesion and the intensity of pruritus (visual analog scale) were measured at 15 min and 2, 6 and 24 h. Cetirizine and ebastine, but not loratadine, decreased significantly the size of whealing (P < 0.01) and accompanying pruritus (P < 0.001) compared to placebo. Cetirizine was most effective on pruritus but caused more often sedation than ebastine or loratadine. The delayed bite symptoms remained too faint for any statistical comparison. This comparative study in mosquito-bite-sensitive adults shows that cetirizine and ebastine decrease significantly whealing and accompanying pruritus, and that cetirizine seems to be the most effective against pruritus.

Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 2. Side effects of oral appliances in obstructive sleep apnea patients.

PubMed

Chen, Hui; Lowe, Alan A; de Almeida, Fernanda Riberiro; Fleetham, John A; Wang, Bangkang

2008-09-01

Oral appliances (OAs) are widely prescribed for the treatment of obstructive sleep apnea (OSA). The occlusal changes that occur after long term OA treatment have not been well described based on detailed computerized three-dimensional (3D) assessment. Seventy patients with OSA (mean age, 50.0 years) who had been treated with an OA were identified for this study. A MicroScribe-3DX dental study model analysis system was used to make 3D measurements on baseline and follow-up (88.4 +/- 26.7 months) study models. The following dental measurements showed significant changes (P <0.05) with long-term use of an OA: mandibular arch width increased more than maxillary arch width, crowding decreased in both arches, the curve of Spee became flat in the premolar area, the mandibular canine to second molar segment moved forward in relation to the maxillary arch, the bite opened and the overjet decreased except in some molar areas. A variety of occlusal changes occur with long-term OA treatment for OSA. The changes could be regarded as either adverse or beneficial depending upon the baseline characteristics.

Noninvasive and multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta: a pediatric case report.

PubMed

de Souza, Juliana Feltrin; Fragelli, Camila Maria Bullio; Paschoal, Marco Aurélio Benini; Campos, Edson Alves; Cunha, Leonardo Fernandes; Losso, Estela Maris; Cordeiro, Rita de Cássia Loiola

2014-01-01

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

PubMed Central

Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

Feeding performance of king Mackerel, Scomberomorus cavalla.

PubMed

Ferguson, Amber R; Huber, Daniel R; Lajeunesse, Marc J; Motta, Philip J

2015-08-01

Feeding performance is an organism's ability to capture and handle prey. Although bite force is a commonly used metric of feeding performance, other factors such as bite pressure and strike speed are also likely to affect prey capture. Therefore, this study investigated static bite force, dynamic speeds, and predator and prey forces resulting from ram strikes, as well as bite pressure of the king mackerel, Scomberomorus cavalla, in order to examine their relative contributions to overall feeding performance. Theoretical posterior bite force ranged from 14.0-318.7 N. Ram speed, recorded with a rod and reel incorporated with a line counter and video camera, ranged from 3.3-15.8B L/s. Impact forces on the prey ranged from 0.1-1.9 N. Bite pressure, estimated using theoretical bite forces at three gape angles and tooth cross-sectional areas, ranged from 1.7-56.9 MPa. Mass-specific bite force for king mackerel is relatively low in comparison with other bony fishes and sharks, with relatively little impact force applied to the prey during the strike. This suggests that king mackerel rely on high velocity chases and high bite pressure generated via sharp, laterally compressed teeth to maximize feeding performance. © 2015 Wiley Periodicals, Inc.

Is extreme bite performance associated with extreme morphologies in sharks?

PubMed

Huber, Daniel R; Claes, Julien M; Mallefet, Jérôme; Herrel, Anthony

2009-01-01

As top predators in many oceanic communities, sharks are known to eat large prey and are supposedly able to generate high bite forces. This notion has, however, largely gone untested due to the experimental intractability of these animals. For those species that have been investigated, it remains unclear whether their high bite forces are simply a consequence of their large body size or the result of diet-related adaptation. As aquatic poikilotherms, sharks can grow very large, making them ideal subjects with which to investigate the effects of body size on bite force. Relative bite-force capacity is often associated with changes in head shape because taller or wider heads can, for example, accommodate larger jaw muscles. Constraints on bite force in general may also be released by changes in tooth shape. For example, more pointed teeth may allow a predator to penetrate prey more effectively than blunt, pavementlike teeth. Our analyses show that large sharks do not bite hard for their body size, but they generally have larger heads. Head width is the best predictor of bite force across the species included in our study as indicated by a multiple regression model. Contrary to our predictions, sharks with relatively high bite forces for their body size also have relatively more pointed teeth at the front of the tooth row. Moreover, species including hard prey in their diet are characterized by high bite forces and narrow and pointed teeth at the jaw symphysis.

Effect of gender, facial dimensions, body mass index and type of functional occlusion on bite force.

PubMed

Koç, Duygu; Doğan, Arife; Bek, Bülent

2011-01-01

Some factors such as gender, age, craniofacial morphology, body structure, occlusal contact patterns may affect the maximum bite force. Thus, the purposes of this study were to determine the mean maximum bite force in individuals with normal occlusion, and to examine the effect of gender, facial dimensions, body mass index (BMI), type of functional occlusion (canine guidance and group function occlusion) and balancing side interferences on it. Thirty-four individuals aged 19-20 years-old were selected for this study. Maximum bite force was measured with strain-gauge transducers at first molar region. Facial dimensions were defined by standardized frontal photographs as follows: anterior total facial height (ATFH), bizygomathic facial width (BFW) and intergonial width (IGW). BMI was calculated using the equation weight/height². The type of functional occlusion and the balancing side interferences of the subjects were identified by clinical examination. Bite force was found to be significantly higher in men than women (p<0.05). While there was a negative correlation between the bite force and ATFH/BFW, ATFH/IGW ratios in men (p<0.05), women did not show any statistically significant correlation (p>0.05). BMI and bite force correlation was not statistically significant (p>0.05). The average bite force did not differ in subjects with canine guidance or group function occlusion and in the presence of balancing side interferences (p>0.05). Data suggest that bite force is affected by gender. However, BMI, type of functional occlusion and the presence of balancing side interferences did not exert a meaningful influence on bite force. In addition, transverse facial dimensions showed correlation with bite force in only men.

Bone-breaking bite force of Basilosaurus isis (Mammalia, Cetacea) from the late Eocene of Egypt estimated by finite element analysis.

PubMed

Snively, Eric; Fahlke, Julia M; Welsh, Robert C

2015-01-01

Bite marks suggest that the late Eocence archaeocete whale Basilosaurus isis (Birket Qarun Formation, Egypt) fed upon juveniles of the contemporary basilosaurid Dorudon atrox. Finite element analysis (FEA) of a nearly complete adult cranium of B. isis enables estimates of its bite force and tests the animal's capabilities for crushing bone. Two loadcases reflect different biting scenarios: 1) an intitial closing phase, with all adductors active and a full condylar reaction force; and 2) a shearing phase, with the posterior temporalis active and minimized condylar force. The latter is considered probable when the jaws were nearly closed because the preserved jaws do not articulate as the molariform teeth come into occulusion. Reaction forces with all muscles active indicate that B. isis maintained relatively greater bite force anteriorly than seen in large crocodilians, and exerted a maximum bite force of at least 16,400 N at its upper P3. Under the shearing scenario with minimized condylar forces, tooth reaction forces could exceed 20,000 N despite lower magnitudes of muscle force. These bite forces at the teeth are consistent with bone indentations on Dorudon crania, reatract-and-shear hypotheses of Basilosaurus bite function, and seizure of prey by anterior teeth as proposed for other archaeocetes. The whale's bite forces match those estimated for pliosaurus when skull lengths are equalized, suggesting similar tradeoffs of bite function and hydrodynamics. Reaction forces in B. isis were lower than maxima estimated for large crocodylians and carnivorous dinosaurs. However, comparison of force estimates from FEA and regression data indicate that B. isis exerted the largest bite forces yet estimated for any mammal, and greater force than expected from its skull width. Cephalic feeding biomechanics of Basilosaurus isis are thus consistent with habitual predation.

[Pre-hospital treatment of ophidian accidents: review, update, and current problems].

PubMed

Gil-Alarcón, Guillermo; Sánchez-Villegas, María Del Carmen; Hugo Reynoso, Víctor

2011-01-01

Mythic, out-dated, ambiguous and sometimes iatrogenic procedures, still remain in pre-hospital and hospital ophidian accident treatment. Errors, omissions and ignorance make ophidian accidents appear more dangerous than they truly are, resulting in a general public contempt toward snakes. Here we present an updated review of current knowledge on pre-hospital and hospital treatment of ophidian bite incidents, including indications, recommendations and logic errors. We describe an appropriate treatment for native Mexican poisonous snakebites using fabotherapics, based on our experience. Adequate initial pre-hospital and hospital management is crucial for a successful outcome of this medical emergency. We describe the state of the art in snake bite research discussing those procedures where research is needed to implement them either by the patient, first responders, paramedics and doctors. We suggest proposals to achieve even more efficient management of fabotherapics based on support networks. Finally, we emphasize prevention as the main subject of venom bite treatment, as it is always more adequate and economic to invest in prevention than to spend on mitigation during emergency and recovery.

Snake poisoning in rural Zimbabwe--a prospective study.

PubMed

Nhachi, C F; Kasilo, O M

1994-01-01

Over a period of 2 years (January 1991 to December 1992) 274 cases of snake bite were admitted to hospital in the eight provinces of Zimbabwe. Of these patients, 54% were males and 88% belonged to the 6-40-year age group. Five deaths (1.8% of the total cases) were reported. The majority of snake bites (63%) occurred at night (between 6.30 p.m. and midnight) and over 74% took place during the hot rainy season, i.e. between November and April. In over 58% of the cases the victim accidentally stepped on the snake, the snake being cobra in 37%, puff adder in 20% and the black and green mamba in 18% of the cases. Most of the bites occurred on the leg, below the knee. Treatment of snake envenomation consisted mainly of the administration of antibiotics (151 cases), analgesics (144 cases), antivenom tropical snake polyvalent (ATT) (89 cases), antitoxoid tetanus (TT) (61 cases), antihistamines (47 cases) and traditional medicines (43 cases). This study indicates that snake envenomation in rural Zimbabwe is common but fatalities are relatively rare.

Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

PubMed Central

2014-01-01

Background Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India. Methods In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented. Results A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC. Conclusions This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients. PMID:24965875

The examination and identification of bite marks in foods using 3D scanning and 3D comparison methods.

PubMed

Naether, Silvio; Buck, Ursula; Campana, Lorenzo; Breitbeck, Robert; Thali, Michael

2012-01-01

Bite mark analysis offers the opportunity to identify the biter based on the individual characteristics of the dentitions. Normally, the main focus is on analysing bite mark injuries on human bodies, but also, bite marks in food may play an important role in the forensic investigation of a crime. This study presents a comparison of simulated bite marks in different kinds of food with the dentitions of the presumed biter. Bite marks were produced by six adults in slices of buttered bread, apples, different kinds of Swiss chocolate and Swiss cheese. The time-lapse influence of the bite mark in food, under room temperature conditions, was also examined. For the documentation of the bite marks and the dentitions of the biters, 3D optical surface scanning technology was used. The comparison was performed using two different software packages: the ATOS modelling and analysing software and the 3D studio max animation software. The ATOS software enables an automatic computation of the deviation between the two meshes. In the present study, the bite marks and the dentitions were compared, as well as the meshes of each bite mark which were recorded in the different stages of time lapse. In the 3D studio max software, the act of biting was animated to compare the dentitions with the bite mark. The examined food recorded the individual characteristics of the dentitions very well. In all cases, the biter could be identified, and the dentitions of the other presumed biters could be excluded. The influence of the time lapse on the food depends on the kind of food and is shown on the diagrams. However, the identification of the biter could still be performed after a period of time, based on the recorded individual characteristics of the dentitions.

Dental changes evaluated with a 3D computer-assisted model analysis after long-term tongue retaining device wear in OSA patients.

PubMed

Chen, Hui; Lowe, Alan A; Strauss, Arthur M; de Almeida, Fernanda Riberiro; Ueda, Hiroshi; Fleetham, John A; Wang, Bangkang

2008-05-01

Oral appliances (OAs) have been used to treat obstructive sleep apnea (OSA) patients for decades. However, detailed dental side effects in long-term OA cases analyzed with an accurate three-dimensional (3D) measurement tool have seldom been reported. The purpose of this study is to evaluate dental side effects in five OSA patients, who had used a tongue retaining device (TRD) (with occasional other OA wear) for an average of 6 years and 4 months. The baseline and follow-up orthodontic study models were measured with a newly developed MicroScribe-3DX analysis system. High compliance of TRD wear was confirmed in all cases and different patterns and amounts of dental changes were observed. The most common appliance-induced dental changes included anterior and/or unilateral posterior open-bites and reduced anterior overjets. It was hypothesized that there might be two possible mechanisms for the TRD side effects--one is the forward pressure of the tongue upon the anterior dental arch and the other is the lateral pressure of the tongue upon the posterior arch. Considerations to correct the TRD dental side effects should be guided by these different mechanisms of the tongue on the dental arch. Possible solutions to minimize occlusal changes and maximize the benefits for OSA patients are also discussed.

Field assessment of a novel spatial repellent for malaria control: a feasibility and acceptability study in Mondulkiri, Cambodia.

PubMed

Liverani, Marco; Charlwood, Jacques Derek; Lawford, Harriet; Yeung, Shunmay

2017-10-13

Large-scale use of insecticide-treated nets and indoor residual spraying have contributed to a significant decrease in malaria transmission worldwide. Further reduction and progress towards elimination, however, require complementary control measures which can address the remaining gaps in protection from mosquito bites. Following the development of novel pyrethroids with high knockdown effects on malaria vectors, programmatic use of spatial repellents has been suggested as one potential strategy to fill the gaps. This report explores social and contextual factors that may influence the relevance, uptake and sustainable use of a spatial repellent in two remote villages in Mondulkiri province, Cambodia, with endemic malaria transmission. The repellent consisted of polyethylene emanators, held in an open plastic frame and impregnated with 10% metofluthrin. In a baseline survey, 90.9% of households in Ou Chra (n = 30/33) and 96.6% in Pu Cha (n = 57/59) were interviewed. Behavioural data were collected for all household occupants (n = 448). In both villages, there were times and places in which people remained exposed to mosquito bites. Prior to the installation of the repellent, 50.6 and 59.5% of respondents noted that bites occurred "very often" inside the house and in the outdoor area surrounding the house, respectively. Indoor biting was reported to occur more frequently in the evening, followed by at night, while outdoor biting occurred more frequently in the early morning. In a follow-up survey, spatial repellents were well received in both villages, although 63.2% of respondents would not replace bed nets with repellents. Most participants (96.6%) were willing to use the product again; the mean willingness to pay was US$ 0.3 per unit. A preference for local procurement methods emerged. Widespread use of spatial repellents would not fill all protective gaps, but, if their entomological efficacy can be ascertained, outdoor application has the potential to enhance vector control strategies in Cambodia. Successful implementation would require subsidisation and integration with the existing national malaria control strategy. It is hoped that this study, while contributing to a better understanding of the social contexts of residual malaria transmission, will generate further interest in the evaluation of spatial repellents for malaria control.

Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network.

PubMed

Hilton, Thomas J; Funkhouser, Ellen; Ferracane, Jack L; Gordan, Valeria V; Huff, Kevin D; Barna, Julie; Mungia, Rahma; Marker, Timothy; Gilbert, Gregg H

2018-03-01

The objective of this study was to determine which patient traits, behaviors, external tooth and/or crack characteristics correlate with the types of symptoms that teeth with visible cracks exhibit, namely pain on biting, pain due to cold stimuli, or spontaneous pain. Dentists in the National Dental Practice-Based Research Network enrolled a convenience sample of subjects each of whom had a single, vital posterior tooth with at least one observable external crack (cracked teeth); 2858 cracked teeth from 209 practitioners were enrolled. Data were collected at the patient-, tooth-, and crack-level. Generalized estimating equations were used to obtain significant (p < .05) independent odds ratios (OR) associated with teeth that were painful for 10 outcomes based on types of pain and combinations thereof. Overall, 45% of cracked teeth had one or more symptoms. Pain to cold was the most common symptom, which occurred in 37% of cracked teeth. Pain on biting (16%) and spontaneous pain (11%) were less common. Sixty-five percent of symptomatic cracked teeth had only one type of symptom, of these 78% were painful only to cold. No patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Positive associations for various combinations of pain symptoms were present with cracks that: (1) were on molars; (2) were in occlusion; (3) had a wear facet through enamel; (4) had caries; (5) were evident on a radiograph; (6) ran in more than one direction; (7) blocked transilluminated light; (8) connected with another crack; (9) extended onto the root; (10) extended in more than one direction; or (11) were on the distal surface. Persons who were <65 yo or who clench, grind, or press their teeth together also were more likely to have pain symptoms. Pain was less likely in teeth with stained cracks or exposed roots, or in non-Hispanic whites. Although pain to cold was the most commonly noted pain associated with symptomatic cracked teeth, no patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Characteristics were only associated with pain on biting and/or spontaneous pain with or without pain to cold. Although often considered the most reliable diagnosis for a cracked tooth, pain on biting is not the most common symptom of a tooth with a visible crack, but rather pain to cold. Copyright © 2017 Elsevier Ltd. All rights reserved.

Necrotizing Soft-Tissue Infections: Clinical Guidelines

DTIC Science & Technology

2009-10-01

viscus, liposuction , infected arteriovenous grafts, and invasive cancer. As many as half of these patients may not be able to identify a previous lesion...Fractures Liposuction Seawater, seafood Surgery Spider bite Childbirth, C section Burns NSTI, necrotizing soft-tissue infection; GI, gastrointestinal; HIV

Tick-borne Diseases: The Big Two | NIH MedlinePlus the Magazine

MedlinePlus

... been a tick bite. Photo: CDC/James Gathany Lyme disease Lyme disease is the most common tick-borne disease in ... nervous system can develop in patients with late Lyme disease. Lyme disease has different stages. The rash is ...

Bite Force Recording Devices - A Review

PubMed Central

Kumathalli, Kanteshwari Iranagouda; Jain, Vinay; Kumar, Rajesh

2017-01-01

In dental research, bite force serves as a valuable parameter to evaluate the efficacy of masticatory system. A variety of devices with different design and working principle have been used to record bite force, but no single device is capable to record all the required forces. One may find it difficult to choose a device that will fulfil the purpose of recording bite force for research. So, the present review aims to report and compare the wide range of devices and will help in describing their uses for recording bite force. PMID:29207848

Polymicrobial tenosynovitis with Pasteurella multocida and other Gram negative bacilli after a Siberian tiger bite

PubMed Central

Isotalo, P; Edgar, D; Toye, B

2000-01-01

Mammalian bites present a considerable clinical problem because they are often associated with bacterial infections. Pasteurella multocida is a microorganism that commonly infects both canine and small feline bites. Zoonotic infections developing after large feline bites have been recognised, although their reports are limited. We describe a 35 year old man who was bitten by a Siberian tiger and who developed infectious tenosynovitis secondary to P multocida, Bergeyella (Weeksella) zoohelcum, and Gram negative bacteria most like CDC group EF-4b and comamonas species. The latter three bacteria have not been isolated previously from large feline bite wounds. Key Words: animal bite • zoonotic infection • Pasteurella multocida • Bergeyella zoohelcum PMID:11127273

How to train your T cell: genetically engineered chimeric antigen receptor T cells versus bispecific T-cell engagers to target CD19 in B acute lymphoblastic leukemia.

PubMed

Ruella, Marco; Gill, Saar

2015-06-01

Antigen-specific T cell-based immunotherapy is getting its day in the sun. The contemporaneous development of two potent CD19-specific immunotherapeutic modalities for the treatment of B-cell malignancies provides exciting opportunities for patients, physicians and scientists alike. Patients with relapsed, refractory or poor-risk B-cell acute lymphoblastic leukemia (ALL) previously had few therapeutic options and now have two potential new lifelines. Physicians will have the choice between two powerful modalities and indeed could potentially enroll some patients on trials exploring both modalities if needed. For scientists interested in tumor immunology, the advent of chimeric antigen receptor T-cell therapy and of bispecific T-cell engagers (BiTEs) provides unprecedented opportunities to explore the promise and limitations of antigen-specific T-cell therapy in the context of human leukemia. In this article, we compare chimeric antigen receptor T cells and BiTEs targeting CD19 in B-cell ALL in the setting of the available clinical literature.

Pain control in orthodontics using a micropulse vibration device: A randomized clinical trial.

PubMed

Lobre, Wendy D; Callegari, Brent J; Gardner, Gary; Marsh, Curtis M; Bush, Anneke C; Dunn, William J

2016-07-01

To investigate the relationship between a micropulse vibration device and pain perception during orthodontic treatment. This study was a parallel group, randomized clinical trial. A total of 58 patients meeting eligibility criteria were assigned using block allocation to one of two groups: an experimental group using the vibration device or a control group (n  =  29 for each group). Patients used the device for 20 minutes daily. Patients rated pain intensity on a visual analog scale at appropriate intervals during the weeks after the separator or archwire appointment. Data were analyzed using repeated measures analysis of variance at α  =  .05. During the 4-month test period, significant differences between the micropulse vibration device group and the control group for overall pain (P  =  .002) and biting pain (P  =  .003) were identified. The authors observed that perceived pain was highest at the beginning of the month, following archwire adjustment. The micropulse vibration device significantly lowered the pain scores for overall pain and biting pain during the 4-month study period.

Modified SARME (Surgically Assisted Rapid Maxillary Expansion) in Conjunction with Orthodontic Treatment-A Case Report.

PubMed

Dahiya, Sagar; Chitra, Prasad; Rao, Sadam Srinivas; Bindra, Sukhvinder

2015-10-01

Transverse maxillary hypoplasia or maxillary constriction in conjunction with unilateral or bilateral posterior cross bites is a common finding in cleft palate patients. These situations are also commonly encountered in adults who have not had recourse to orthodontic treatment in childhood. In adults, after ossification of the mid palatal suture is complete, the accepted means of correcting transverse skeletal discrepancies is by Surgically Assisted Rapid Maxillary Expansion (SARME). The disadvantage of this technique in the Indian scenario is reduced patient acceptance and increased treatment costs. Le Fort-I down fracture and mid palatal suture sectioning requires hospitalization and increases morbidity. A case of a 21-year-old non-cleft male who presented with Class I malocclusion with transverse skeletal discrepancy and bilateral posterior cross bites is presented. A modified SAARME technique was performed without pterygomaxillary disjunction, as an outpatient procedure. The results obtained were satisfactory and the desired amount of transverse skeletal correction was achieved. The patient was discharged the same day. The technique can be used to successfully treat a large number of patients in India with maxillary skeletal transverse problems with increased predictability, reduced costs and morbidity and higher rates of acceptance.

Ecomorphology of the moray bite: relationship between dietary extremes and morphological diversity.

PubMed

Mehta, Rita S

2009-01-01

The pharyngeal jaws of moray eels function exclusively to transport prey from the oral jaws into the esophagus. This functional innovation in the moray pharyngeal jaw system occurred through the loss of some ancestral functions that presumably included prey processing. Therefore, the oral jaws of morays are used to capture and process prey. Dietary accounts suggest that morays can be categorized as either piscivorous or durophagous in feeding habits. These extreme feeding specializations that select for conflicting biomechanical demands on the oral jaws should result in two discrete clusters of cranial form and diet in morphospace. When functional characters underlying the oral jaws were examined for 10 muraenid species, piscivorous and durophagous morays occupied distinct areas of morphospace. Piscivores exhibited longer jaws, narrower heads, and long recurved teeth, while durophagous morays exhibited shorter jaws, greater dentary depths, and short blunt teeth. Durophagous morays process prey in their oral jaws, and their jaw-opening and jaw-closing ratios, along with their enlarged adductors, revealed jaws modified for force transmission. Pharyngeal jaw characters also separated moray species into different areas of morphospace. For example, Gymnomuraena zebra, a molluscivore, had more teeth on its pharyngobranchials than all other morays, and these teeth were long and thin compared with those of piscivores. The overall patterns of morphological variation corresponded well with moray dietary breadth. In addition, the range of jaw-opening and jaw-closing ratios revealed that for a clade of obligate carnivores, morays exhibit diverse biting behaviors.

Prevalence of traumatic dental injuries and associated factors among 8 to 12-years-old schoolchildren in Diyarbakir, Turkey.

PubMed

Tumen, E C; Yavuz, I; Kaya, S; Uysal, E; Tümen, D S; Ay, Y; Başaran, G; Adıgüzel, Ö; Değer, Y; Laçin, N

2017-10-01

This study aimed to assess the prevalence of traumatic injuries of the permanent incisors in public primary schoolchildren from 8 to 12 years old in South-Eastern Anatolia, Turkey. Additionally, the relationship between traumatic dental injuries, parents' education level, family income, size of incisal overjet and the presence of anterior open bite were examined. Data were collected through oral examinations and structured interviews, and included socio-economic indicators. A total of 2907 children of both genders (1498 boys, 1409 girls) were included in the study. The response rate was 97%. The prevalence of dental injuries was 4.6% (n = 135). The highest frequency of trauma in permanent teeth was observed at the age of 12 (8%). Boys experienced more dental injuries than girls, 5.9% and 3.3% (p = 0.001), respectively. The most commonly reported cause of injuries to the permanent incisors was falls (71.8%), followed by collision with objects or people (17.8%). Maxillary central incisors were the most affected by dental injuries (154, 84.6%). The most common crown fracture was in enamel only (67.58%) followed by crown fracture of enamel and dentin (22.52%). Socio-economic indicators and parents' level of education were not statistically significantly associated with the occurrence of traumatic dental injuries. Factors associated with increased risk of dental injuries in permanent teeth were age, gender, having an incisal overjet greater than 5mm and anterior open bite.

Influence of maxillary posterior discrepancy on upper molar vertical position and facial vertical dimensions in subjects with or without skeletal open bite

PubMed Central

Aliaga-Del Castillo, Aron; Pérez-Vargas, Luis Fernando; Flores-Mir, Carlos

2016-01-01

Summary Objectives: To determine the influence of maxillary posterior discrepancy on upper molar vertical position and dentofacial vertical dimensions in individuals with or without skeletal open bite (SOB). Materials and methods: Pre-treatment lateral cephalograms of 139 young adults were examined. The sample was divided into eight groups categorized according to their sagittal and vertical skeletal facial growth pattern and maxillary posterior discrepancy (present or absent). Upper molar vertical position, overbite, lower anterior facial height and facial height ratio were measured. Independent t-test was performed to determine differences between the groups considering maxillary posterior discrepancy. Principal component analysis and MANCOVA test were also used. Results: No statistically significant differences were found comparing the molar vertical position according to maxillary posterior discrepancy for the SOB Class I group or the group with adequate overbite. Significant differences were found in SOB Class II and Class III groups. In addition, an increased molar vertical position was found in the group without posterior discrepancy. Limitations: Some variables closely related with the individual’s intrinsic craniofacial development that could influence the evaluated vertical measurements were not considered. Conclusions and implications: Overall maxillary posterior discrepancy does not appear to have a clear impact on upper molar vertical position or facial vertical dimensions. Only the SOB Class III group without posterior discrepancy had a significant increased upper molar vertical position. PMID:26385786

Influence of maxillary posterior discrepancy on upper molar vertical position and facial vertical dimensions in subjects with or without skeletal open bite.

PubMed

Arriola-Guillén, Luis Ernesto; Aliaga-Del Castillo, Aron; Pérez-Vargas, Luis Fernando; Flores-Mir, Carlos

2016-06-01

To determine the influence of maxillary posterior discrepancy on upper molar vertical position and dentofacial vertical dimensions in individuals with or without skeletal open bite (SOB). Pre-treatment lateral cephalograms of 139 young adults were examined. The sample was divided into eight groups categorized according to their sagittal and vertical skeletal facial growth pattern and maxillary posterior discrepancy (present or absent). Upper molar vertical position, overbite, lower anterior facial height and facial height ratio were measured. Independent t-test was performed to determine differences between the groups considering maxillary posterior discrepancy. Principal component analysis and MANCOVA test were also used. No statistically significant differences were found comparing the molar vertical position according to maxillary posterior discrepancy for the SOB Class I group or the group with adequate overbite. Significant differences were found in SOB Class II and Class III groups. In addition, an increased molar vertical position was found in the group without posterior discrepancy. Some variables closely related with the individual's intrinsic craniofacial development that could influence the evaluated vertical measurements were not considered. Overall maxillary posterior discrepancy does not appear to have a clear impact on upper molar vertical position or facial vertical dimensions. Only the SOB Class III group without posterior discrepancy had a significant increased upper molar vertical position. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Cheek-biting disorder: another stereotypic movement disorder?

PubMed

Sarkhel, Sujit; Praharaj, Samir Kumar; Akhtar, Sayeed

2011-12-01

Recurrent cheek biting, a form of self-injurious behavior is a rare entity which presents mostly to dentists and dermatologists. We report a case of recurrent severe cheek biting in an adult male leading to mucosal ulceration. The stereotypic pattern of cheek biting and associated behavior bears striking resemblance to other impulse control disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Measurement of bite force variables related to human discrimination of left-right hardness differences of silicone rubber samples placed between the incisors.

PubMed

Dan, Haruka; Azuma, Teruaki; Hayakawa, Fumiyo; Kohyama, Kaoru

2005-05-01

This study was designed to examine human subjects' ability to discriminate between spatially different bite pressures. We measured actual bite pressure distribution when subjects simultaneously bit two silicone rubber samples with different hardnesses using their right and left incisors. They were instructed to compare the hardness of these two rubber samples and indicate which was harder (right or left). The correct-answer rates were statistically significant at P < 0.05 for all pairs of different right and left silicone rubber hardnesses. Simultaneous bite measurements using a multiple-point sheet sensor demonstrated that the bite force, active pressure and maximum pressure point were greater for the harder silicone rubber sample. The difference between the left and right was statistically significant (P < 0.05) for all pairs with different silicone rubber hardnesses. We demonstrated for the first time that subjects could perceive and discriminate between spatially different bite pressures during a single bite with incisors. Differences of the bite force, pressure and the maximum pressure point between the right and left silicone samples should be sensory cues for spatial hardness discrimination.

Functional near-infrared spectroscopy study on primary motor and somatosensory cortex response to biting and finger clenching.

PubMed

Shibusawa, Mami; Takeda, Tomotaka; Nakajima, Kazunori; Jun, Handa; Sekiguchi, Shinichi; Ishigami, Keiichi; Sakatani, Kaoru

2010-01-01

The purpose of this study was to compare the influence of biting and finger clenching intensity on the concentration of oxygenated hemoglobin (OxyHb) in regional cerebral blood flow (rCBF) as an indicator of brain activity in the primary motor (MI) and somatosensory (SI) cortices. Functional near-infrared spectroscopy (fNIRS) was used in 8 healthy subjects. Subjects were required to do biting (bite) and finger clenching (fclench) at 20, 50 and 80% of maximum force. To minimize the effect of temporal muscle activity on the working side of the jaw, the fNIRS probes were positioned contralaterally, in the left temporal region. Activation of MI and SI cortices with bite and fclench was noted in all subjects, irrespective of the intensity of bite and fclench. A significant increase was observed in OxyHb in MI and SI between 20% and both 50 and 80% intensity. In MI cortex, OxyHb showed a significant increase between 80% and both 20 and 50% fclench intensity. The results suggest that intensity of bite and fclench influences activation levels in MI and SI. Further, an activation was more obvious with bite than fclench.

Comparative evaluation of light-trap catches, electric motor mosquito catches and human biting catches of Anopheles in the Three Gorges Reservoir.

PubMed

Duo-quan, Wang; Lin-hua, Tang; Zhen-cheng, Gu; Xiang, Zheng; Man-ni, Yang; Wei-kang, Jiang

2012-01-01

The mosquito sampling efficiency of light-trap catches and electric motor mosquito catches were compared with that of human biting catches in the Three Gorges Reservoir. There was consistency in the sampling efficiency between light-trap catches and human biting catches for Anopheles sinensis (r = 0.82, P<0.01) and light-trap catches were 1.52 (1.35-1.71) times that of human biting catches regardless of mosquito density (r = 0.33, P>0.01), while the correlation between electric motor mosquito catches and human biting catches was found to be not statistically significant (r = 0.43, P>0.01) and its sampling efficiency was below that of human biting catches. It is concluded that light-traps can be used as an alternative to human biting catches of Anopheles sinensis in the study area and is a promising tool for sampling malaria vector populations.

Comparative Evaluation of Light-Trap Catches, Electric Motor Mosquito Catches and Human Biting Catches of Anopheles in the Three Gorges Reservoir

PubMed Central

Duo-quan, Wang; Lin-hua, Tang; Zhen-cheng, Gu; Xiang, Zheng; Man-ni, Yang; Wei-kang, Jiang

2012-01-01

The mosquito sampling efficiency of light-trap catches and electric motor mosquito catches were compared with that of human biting catches in the Three Gorges Reservoir. There was consistency in the sampling efficiency between light-trap catches and human biting catches for Anopheles sinensis (r = 0.82, P<0.01) and light-trap catches were 1.52 (1.35–1.71) times that of human biting catches regardless of mosquito density (r = 0.33, P>0.01), while the correlation between electric motor mosquito catches and human biting catches was found to be not statistically significant (r = 0.43, P>0.01) and its sampling efficiency was below that of human biting catches. It is concluded that light-traps can be used as an alternative to human biting catches of Anopheles sinensis in the study area and is a promising tool for sampling malaria vector populations. PMID:22235256

«Surgery first» or two stage complex rehabilitation plan for patients with malocclusions.

PubMed

Andreishchev, A R; Kavrayskaya, A Yu; Nikolaev, A V

2016-01-01

The article considers stages of complex rehabilitation treatment plans of patients with bite anomalies. The study included 515 patients with various complex malocclusions. Two and conventional three stage treatment plans are described. The article suggests indications for the two stage treatment protocol. The evaluation of efficiency and stability of achieved treatment results obtained with a help of the system of quantitative analysis of dentooralfacial disorders is presented.

Functional (psychogenic) stereotypies.

PubMed

Baizabal-Carvallo, José Fidel; Jankovic, Joseph

2017-07-01

Functional (psychogenic) movement disorders (FMDs) may present with a broad spectrum of phenomenology including stereotypic movements. We aimed to characterize the phenomenology of functional stereotypies and compare these features with those observed in 65 patients with tardive dyskinesia (TD). From a cohort of 184 patients with FMDs, we identified 19 (10.3%) with functional stereotypies (FS). There were 15 women and 4 men, with a mean age at onset of 38.6 ± 17.4 years. Among the patients with FS, there were 9 (47%) with orolingual dyskinesia/stereotypy, 9 (47%) with limb stereotypies, 6 (32%) with trunk stereotypies, and 2 (11%) with respiratory dyskinesia as part of orofacial-laryngeal-trunk stereotypy. These patients showed signs commonly seen in FMDs such as sudden onset (84%), prominent distractibility (58%), and periods of unexplained improvement (84%) that were not reported in patients with TD. Besides a much lower frequency of exposure to potential offending drugs, patients with FS differed from those with classic TD by a younger age at onset, lack of self-biting, uncommon chewing movements, more frequent lingual movements without mouth dyskinesia, and associated functional tremor and abnormal speech. Lack of self-biting showed the highest sensitivity (1.0) and abnormal speech showed the highest specificity (0.9) for the diagnosis of functional orolingual dyskinesia. FS represent part of the clinical spectrum of FMDs. Clinical and demographic features are helpful in distinguishing patients with FS from those with TD.

Human bites (image)

MedlinePlus

Human bites present a high risk of infection. Besides the bacteria which can cause infection, there is ... the wound extends below the skin. Anytime a human bite has broken the skin, seek medical attention.

Integrating 3D facial scanning in a digital workflow to CAD/CAM design and fabricate complete dentures for immediate total mouth rehabilitation

PubMed Central

Greven, Marcus; Wismeijer, Daniel

2017-01-01

PURPOSE To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes. PMID:29142646

Ticks and Tick Bites Presenting as "Funny Moles": A Review of Different Presentations and a Focus on Tick-borne Diseases.

PubMed

Kallini, Joseph R; Khachemoune, Amor

2017-03-01

Purpose: To describe a man with an adherent tick mimicking a melanoma, summarize the salient features of this condition, and review other cases of ticks mistaken for dermatoses. Background: Ticks are obligatory ectoparasites. Disease-causing ticks belong to two families: Ixodidae (hard ticks) and Argasidae (soft ticks). Ticks thrive by consuming blood from animal hosts, and the transfer of infected blood from one host to the next is the method by which ticks spread disease. Materials and methods: The authors describe a man who presented to their dermatology clinic in New York with an unusual black pigmented lesion on the right zygomatic region of his face. He was worried about how rapidly the lesion had developed and the tingling of the skin surrounding it. Since the patient had a history of nonmelanoma skin cancer, he was concerned that the lesion was a melanoma. An excisional biopsy of the lesion revealed a non- Ixodes tick with a surrounding tick-bite reaction. Results: Ticks cause cutaneous manifestations through physical trauma and their salivary contents. A number of reports describe a similar phenomenon of a persistent tick being mistaken for a nodule or tumor. Management includes complete removal of a tick, either mechanically or surgically, along with the appropriate work-up for tick-borne diseases in the relevant geographic location. The decision to test for systemic disease depends on the clinical presentation of the patient and geographic location of the tick bite. Conclusion: A patient presented to the authors' dermatology clinic with a pigmented lesion suspicious for a melanoma, but the lesion was actually an adherent non- Ixodes tick. This case illustrates the importance of keeping insects and arthropods in the differential diagnosis of a sudden- and recent-onset pigmented skin lesion.