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Sample records for severe bruxism group

  1. Clinical significance of sleep bruxism on several occlusal and functional parameters.

    PubMed

    Ommerborn, Michelle A; Giraki, Maria; Schneider, Christine; Fuck, Lars Michael; Zimmer, Stefan; Franz, Matthias; Raab, Wolfgang Hans-michael; Schaefer, Ralf

    2010-10-01

    The aim of this study was to evaluate the association between various functional and occlusal parameters and sleep bruxism. Thirty-nine (39) sleep bruxism patients and 30 controls participated in this investigation. The assessment of sleep bruxism was performed using the Bruxcore Bruxism-Monitoring Device (BBMD) combined with a new computer-based analyzing method. Sixteen functional and/or occlusal parameters were recorded. With a mean slide of 0.95 mm in the sleep bruxism group and a mean slide of 0.42 mm in the control group (Mann Whitney U test; p<0.003), results solely demonstrated a significant group difference regarding the length of a slide from centric occlusion to maximum intercuspation. The results suggest that the slightly pronounced slide could be of clinical importance in the development of increased wear facets in patients with current sleep bruxism activity. Following further evaluation including polysomnographic recordings, the BBMD combined with this new analyzing technique seems to be a clinically feasible instrument that allows the practitioner to quantify abrasion over a short period.

  2. Risk factors for bruxism among Croatian navy employees.

    PubMed

    Alajbeg, I Z; Zuvela, A; Tarle, Z

    2012-09-01

    The aim of the study was to evaluate the relationship between bruxism, and sociodemographic parameters, symptoms of temporomandibular disorders (TMD), personality and war experience among Croatian navy employees. The sample included 1092 subjects, aged 20-60 years (mean age 37·06 ± 7·85). An individual's bruxism status was based on clinical oral examination and participants' report of bruxism. Subjects with bruxism index values ≥ 90th percentile were included in severe bruxism group (n = 111), and those with scores below 90th percentile were labelled as negligible bruxism group (n = 981). No differences were found in gender distribution between the two groups. The proportion of military personnel presenting with bruxism is double the proportion of administrative employees with bruxism. A total of 23·34% subjects in negligible bruxism group and 48·65% in severe bruxism group participated in the war. Subjects in severe bruxism group presented more TMD-related signs and symptoms than those in negligible bruxism group. Higher prevalence of neuroticism and psychoticism was found in severe bruxism group. According to logistic regression, the probability of severe bruxism was significantly associated with marital status [Odds ratio (OR) 6·859, 95% confidence interval (CI) 3·869-12·158 P < 0·001], neuroticism (OR 2·842, 95% CI 1·434-5·632 P = 0·003), psychoticism (OR 2·618, 95% CI 1·193-5·746 P = 0·016), military duty (OR 1·828, 95% CI 1·013-3·298 P = 0·045) and masticatory muscles tenderness (OR 9·372, 95% CI 4·923-17·841 P < 0·001). Smokers had a 2·72-fold (95% CI 1·706-4·335 P < 0·001) higher risk of bruxism than non-smokers. Subjects who participated in war were more represented in severe bruxism group. Further studies, including other potential risk factors, are required to clarify these relationships. © 2012 Blackwell Publishing Ltd.

  3. The phenotype, psychotype and genotype of bruxism

    PubMed Central

    Cruz-Fierro, Norma; Martínez-Fierro, Margarita; Cerda-Flores, Ricardo M.; Gómez-Govea, Mayra A.; Delgado-Enciso, Iván; Martínez-De-Villarreal, Laura E.; González-Ramírez, Mónica T.; Rodríguez-Sánchez, Irám Pablo

    2018-01-01

    Bruxism is a jaw muscle activity that involves physio-pathological, psycho-social, hereditary and genetic factors. The purpose of this study was to determine the associations between self-reported bruxism, anxiety, and neuroticism personality trait with the rs6313 polymorphism in the gene HTR2A. A sample of 171 subjects of both sexes (14–53 years of age) was included. The control group (group 1, n=60) exhibited no signs or symptoms of bruxism. The case group had signs and symptoms of bruxism (n=112) and was subdivided into group 2, bruxism during sleep (n=22); group 3, awake bruxism (n=44); and group 4 combined bruxism (n=46). As diagnostic tools, the Self-Reported Bruxism Questionnaire (SBQ), the Beck Anxiety Inventory (BAI) and the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) were used. HTR2A (rs6313) SNPs were determined by qPCR for all the participants. The packages SPSS, maxLik and EPI-INFO were used for data analysis. The combined bruxism group reported higher scores in bruxism symptoms, mean = 32.21; anxiety symptoms, mean = 14.80; and neuroticism, mean = 3.26. Combined bruxism was associated with a higher degree of neuroticism (OR=15.0; CI 1.52–148.32) and anxiety in grade 3-moderate (OR=3.56; CI 1.27–10.03), and grade 4-severe (OR=8.40; CI 1.45–48.61), as determined using EPISODE computer software. Genotypic homogeneity analysis revealed no significant differences in allele frequency (P=0.612) among the four groups. The population was in Hardy-Weinberg equilibrium (maxLik package). In conclusion, the three instruments confirm traits of bruxism, anxiety and neuroticism in individuals with bruxism. These data were ratified when the sample was divided by genotypic homogeneity. On the other hand, there was no significant difference between the groups in the SNPs rs6313 from the HTR2A gene. PMID:29599979

  4. The phenotype, psychotype and genotype of bruxism.

    PubMed

    Cruz-Fierro, Norma; Martínez-Fierro, Margarita; Cerda-Flores, Ricardo M; Gómez-Govea, Mayra A; Delgado-Enciso, Iván; Martínez-De-Villarreal, Laura E; González-Ramírez, Mónica T; Rodríguez-Sánchez, Irám Pablo

    2018-03-01

    Bruxism is a jaw muscle activity that involves physio-pathological, psycho-social, hereditary and genetic factors. The purpose of this study was to determine the associations between self-reported bruxism, anxiety, and neuroticism personality trait with the rs6313 polymorphism in the gene HTR2A . A sample of 171 subjects of both sexes (14-53 years of age) was included. The control group (group 1, n=60) exhibited no signs or symptoms of bruxism. The case group had signs and symptoms of bruxism (n=112) and was subdivided into group 2, bruxism during sleep (n=22); group 3, awake bruxism (n=44); and group 4 combined bruxism (n=46). As diagnostic tools, the Self-Reported Bruxism Questionnaire (SBQ), the Beck Anxiety Inventory (BAI) and the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) were used. HTR2A (rs6313) SNPs were determined by qPCR for all the participants. The packages SPSS, maxLik and EPI-INFO were used for data analysis. The combined bruxism group reported higher scores in bruxism symptoms, mean = 32.21; anxiety symptoms, mean = 14.80; and neuroticism, mean = 3.26. Combined bruxism was associated with a higher degree of neuroticism (OR=15.0; CI 1.52-148.32) and anxiety in grade 3-moderate (OR=3.56; CI 1.27-10.03), and grade 4-severe (OR=8.40; CI 1.45-48.61), as determined using EPISODE computer software. Genotypic homogeneity analysis revealed no significant differences in allele frequency (P=0.612) among the four groups. The population was in Hardy-Weinberg equilibrium (maxLik package). In conclusion, the three instruments confirm traits of bruxism, anxiety and neuroticism in individuals with bruxism. These data were ratified when the sample was divided by genotypic homogeneity. On the other hand, there was no significant difference between the groups in the SNPs rs6313 from the HTR2A gene.

  5. Current Treatments of Bruxism.

    PubMed

    Guaita, Marc; Högl, Birgit

    2016-02-01

    Despite numerous case reports, the evidence for treatment of bruxism is still low. Different treatment modalities (behavioral techniques, intraoral devices, medications, and contingent electrical stimulation) have been applied. A clinical evaluation is needed to differentiate between awake bruxism and sleep bruxism and rule out any medical disorder or medication that could be behind its appearance (secondary bruxism). A polysomnography is required only in a few cases of sleep bruxism, mostly when sleep comorbidities are present. Counselling with regard to sleep hygiene, sleep habit modification, and relaxation techniques has been suggested as the first step in the therapeutic intervention, and is generally considered not harmful, despite low evidence of any efficacy. Occlusal splints are successful in the prevention of dental damage and grinding sounds associated with sleep bruxism, but their effects on reducing bruxism electromyographic (EMG) events are transient. In patients with psychiatric and sleep comorbidities, the acute use of clonazepam at night has been reported to improve sleep bruxism, but in the absence of double-blind randomized trials, its use in general clinical practice cannot be recommended. Severe secondary bruxism interfering with speaking, chewing, or swallowing has been reported in patients with neurological disorders such as in cranial dystonia; in these patients, injections of botulinum toxin in the masticatory muscles may decrease bruxism for up to 1-5 months and improve pain and mandibular functions. Long-term studies in larger and better specified samples of patients with bruxism, comparing the effects of different therapeutic modalities on bruxism EMG activity, progression of dental wear, and orofacial pain are current gaps of knowledge and preclude the development of severity-based treatment guidelines.

  6. Bruxism and associated factors among Dutch adolescents.

    PubMed

    van Selms, Maurits K A; Visscher, Corine M; Naeije, Machiel; Lobbezoo, Frank

    2013-08-01

    To assess the prevalence rates of self-reported sleep bruxism and awake bruxism and their associations with several demographical, exogenous, and psychosocial factors among Dutch adolescents. In a cross-sectional questionnaire survey, 4285 questionnaires were completed, with an about equal gender distribution and with ages ranging from 10 to 22 years. In the group of 4235 12- to 18-year-old adolescents, sleep bruxism had a reported prevalence of 14.8% and awake bruxism of 8.7%. Logistic regression analyses revealed that sleep bruxism was associated with female gender [OR = 1.49 (95% CI = 1.23-1.81)], pain or tense feeling in the jaws upon awakening in the morning [OR = 1.47 (95% CI = 1.17-1.86)], clicking joint sounds [OR = 1.31 (95% CI = 1.03-1.65)], stress [OR = 1.25 (95% CI = 1.00-1.55)], and depressive mood [OR = 1.35 (95% CI = 1.10-1.65)]. Awake bruxism was associated with orofacial pain [OR = 1.49 (95% CI = 1.16-1.91)], clicking joint sounds [OR = 1.50 (95% CI = 1.13-1.98)], scraping joint sounds [OR = 2.03 (95% CI = 1.21-3.37)], stress [OR = 1.36 (95% CI = 1.03-1.78)], depressive mood [OR = 1.82 (95% CI = 1.42-2.35)], and smoking [OR = 1.42 (95% CI = 1.06-1.89)]. Sleep bruxism and awake bruxism are common conditions among Dutch adolescents, with self-reported prevalence rates that are slightly higher than those derived from most large-scale studies on adults. Several predictor variables were found to be exclusively associated with either form of bruxism, corroborating the common suggestion that both circadian manifestations are, at least in part, different entities. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Management of a child with autism and severe bruxism: a case report.

    PubMed

    Muthu, M S; Prathibha, K M

    2008-06-01

    Autism is a developmental disorder characterized by severe deficits in social interaction and communication. A wide spectrum of medical and behavioral symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Bruxism or forceful grinding of teeth is one of the sleep problems commonly observed in children with autism. Our patient, a 4-year-old male child with autism, presented with complaints of pain and sensitivity of the teeth. There was history of excessive grinding and clenching of teeth. Limited oral examination revealed severe attrition of all primary teeth. Treatment was planned under general anesthesia because of his poor cognitive abilities. Full-mouth rehabilitation, including placement of stainless steel crowns for all primary molars, was done. Following treatment there was a significant decrease in the grinding habit over the next 2 months. Although the communication and behavioral problems in children with autism pose challenges for the dentist, treatment with proper planning and a lot of patience can definitely make a difference.

  8. Psychopathological profile of patients with different forms of bruxism.

    PubMed

    Bayar, Gurkan Rasit; Tutuncu, Recep; Acikel, Cengizhan

    2012-02-01

    The aim of the current study was to evaluate the prevalence of psychopathological symptoms in patients who self-reported different forms of bruxism by means of clinical and anamnestic diagnostic criteria. Eighty-five participants were divided into four groups as sleep bruxers (12), awake bruxers (24), sleep-awake bruxers (33), and non-bruxers (16). A self-report symptom inventory questionnaire (Symptom Checklist-90-Revised (SCL-90-R)) was filled out by all groups to determine their psychopathological symptoms. As regards mean psychopathological scores, patients with sleep-awake bruxism endorsed the highest scores. In addition, patients with awake bruxism showed higher scores than patients with sleep bruxism and non-bruxism in most SCL-90-R subscales. Kruskal-Wallis test revealed significant differences between groups in any of the SCL-90-R subscales, except for the psychoticism subscale. Mann-Whitney test followed by Bonferroni's test correction between non-bruxer and sleep-awake bruxer groups revealed significant differences in depression, anxiety, hostility, phobic anxiety, paranoid ideation, global severity index, positive symptom distress index, and positive symptom total in all SCL-90-R subscales. Statistical analysis of our study showed that differences between groups were significant in all SCL-90-R subscales except for the psychoticism subscale. Better distinction of bruxism forms may help to develop new treatment strategies for bruxism disorder.

  9. Comparison of platelet serotonin transporter activity in subjects with severe sleep bruxism and control.

    PubMed

    Minakuchi, Hajime; Sogawa, Chiharu; Hara, Emilio Satoshi; Miki, Haruna; Maekawa, Kenji; Sogawa, Norio; Kitayama, Shigeo; Matsuka, Yoshizo; Clark, Glenn T; Kuboki, Takuo

    2014-10-01

    The aim of this study was to evaluate the correlation between sleep bruxism (SB) frequency and serotonin transporter (SERT)-driven serotonin (5-HT)-uptake in platelets. Subjects were dental trainee residents and faculty members of Okayama University Hospital who were aware of having severe or no SB. SB frequency was assessed for 3-consecutive nights by a self-contained electromyographic detector/analyzer, which indicated individual SB levels as one of four grades (score 0, 1, 2 and 3). Subjects were classified as normal control (NC) when SB scores indicated only 0 or 1 during the 3 nights, or as severe SB for scores 2 or 3. Those subjects whose scores fluctuated from 0 to 3 during the 3 nights were omitted from further analysis. Fasting peripheral venous blood samples were collected in the morning following the final SB assessment. Amounts of SERTs proteins collected from peripheral platelets were quantified using ELISA, and SERTs transport activity was assessed by uptake assay using [3H]-5-HT. Thirteen severe SB subjects and 7 NC subjects were eligible. Gender distribution, mean age, 5-HT concentration and total amounts of SERT protein in platelets showed no significant differences between NC and severe SB (p=0.85: Chi-squared test; p=0.64, 0.26, 0.46: t-test). However, [3H]-5-HT uptake by platelets was significantly greater in NC compared to severe SB subjects (12.79±1.97, 8.27±1.91 fmol/10(5) platelets/min, p<0.001, t-test). The results of this pilot study suggest a possible correlation between peripheral platelet serotonin transporter uptake ability and SB severity. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  10. Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation

    PubMed Central

    Alicia Ommerborn, Michelle; Giraki, Maria; Schneider, Christine; Michael Fuck, Lars; Handschel, Jörg; Franz, Matthias; Hans-Michael Raab, Wolfgang; Schäfer, Ralf

    2012-01-01

    This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann–Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive capacity of the stomatognathic system into future investigations. PMID:22935746

  11. Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation.

    PubMed

    Ommerborn, Michelle Alicia; Giraki, Maria; Schneider, Christine; Fuck, Lars Michael; Handschel, Jörg; Franz, Matthias; Hans-Michael Raab, Wolfgang; Schäfer, Ralf

    2012-09-01

    This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann-Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive capacity of the stomatognathic system into future investigations.

  12. Psychotropic drugs and bruxism.

    PubMed

    Falisi, Giovanni; Rastelli, Claudio; Panti, Fabrizio; Maglione, Horacio; Quezada Arcega, Raul

    2014-10-01

    Sleep and awake bruxism is defined as 'a parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth'. Some evidence suggests that bruxism may be caused by, or associated with, alterations in the CNS neurotransmission. Several classes of psychotropic drugs interfering with CNS activity may potentially contribute to bruxism. Thus, the purpose of this study was to examine relevant peer-reviewed papers to identify and describe the various classes of psychotropic substances that may cause, exacerbate or reduce bruxism as the result of their pharmacological action in CNS neurons. A literature search from 1980 to the present was performed using PubMed database. The term 'bruxism' was used in association with 'psychotropic', 'dopamine (DA)', 'serotonin', 'histamine', 'antipsychotics', 'antidepressants', 'antihistaminergics' and 'stimulants'. Studies on the effects of DA agonists (Levo-DOPA, psychostimulants) and antagonists (antipsychotics) identified a central role of DA in the pathogenesis of pharmacologically induced bruxism. Important information from studies on drugs acting on serotonin neurotransmission (antidepressants) was recognized. Other mechanisms involving different neurotransmitters are emerging. This is the case of antihistaminergic drugs which may induce bruxism as a consequence of their disinhibitory effect on the serotonergic system.

  13. Incidence of bruxism in TMD population.

    PubMed

    Chandwani, Briesh; Ceneviz, Caroline; Mehta, Noshir; Scrivani, Steven

    2011-01-01

    The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

  14. Bruxism defined and graded: an international consensus.

    PubMed

    Lobbezoo, F; Ahlberg, J; Glaros, A G; Kato, T; Koyano, K; Lavigne, G J; de Leeuw, R; Manfredini, D; Svensson, P; Winocur, E

    2013-01-01

    To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains. © 2012 Blackwell Publishing Ltd.

  15. Nocturnal bruxism and temporomandibular disorders.

    PubMed

    Rugh, J D; Harlan, J

    1988-01-01

    This chapter has discussed the important aspects of nocturnal bruxism and its relation to disorders of the masticatory system and headaches. Bruxism is believed to be a stress-related sleep disorder, occurring in both men and women, in children, and in adults. In most patients, bruxism results only in minor tooth wear; however, it can become extremely severe with damage occurring in essentially every part of the masticatory apparatus. Nocturnal bruxism should not be overlooked as an etiologic factor in muscular headaches. Short-term acute therapy may involve physical therapy, nocturnal electromyographic biofeedback, and medication to relieve anxiety and improve sleep. Long-term management usually includes some form of stress reduction, change in lifestyle, and an occlusal splint or nightguard to protect the teeth and masticatory system.

  16. Bruxism in children: effect on sleep architecture and daytime cognitive performance and behavior.

    PubMed

    Herrera, Marcela; Valencia, Ignacio; Grant, Mitzie; Metroka, David; Chialastri, Augustine; Kothare, Sanjeev V

    2006-09-01

    Sleep bruxism is an involuntary mandibular movement with tooth grinding during sleep. The prevalence of sleep bruxism in children is high and may lead to frequent arousals with altered daytime functioning. We investigated the sleep architecture, the incidence of gastroesophageal reflux, and the daytime cognitive behavioral functioning in a group of children with sleep bruxism. DESIGN-PATIENTS: This prospective pilot study included 10 children. Polysomnographic data with pH-probe analysis was compared with 10 age- and sex-matched controls. Each patient completed a dental evaluation, a nighttime polysomnogram, and cognitive behavioral tests (Kaufman Brief Intelligence Test and Achenbach Child Behavior Checklist). Eight of 10 children had clinically significant bruxism and the 2 remaining patients had recent teeth exfoliation. There was no difference on sleep architecture between patients and controls, except for a higher arousal index for the bruxism group (36.7 vs 20.7, p < .007). Sleep bruxism occurred more frequently in stage 2 and rapid eye movement sleep, with arousals in 66% of the cases. There was no relationship of bruxism to gastroesophageal reflux or intelligence. However, 40% of the patients had elevated scores on the Achenbach Child Behavior Checklist, indicating significant attention and behavior problems, and there were moderate correlations between the arousal index and several of the behavior-problem scales from the Achenbach Child Behavior Checklist (0.5 to 0.6). The data suggest that children with bruxism have a higher arousal index, which may be associated with an increased incidence of attention-behavior problems. Future studies investigating pediatric sleep bruxism will need to focus on behavior issues that may be prevalent in this population.

  17. Bruxism in craniocervical dystonia: a prospective study.

    PubMed

    Borie, Laetitia; Langbour, Nicolas; Guehl, Dominique; Burbaud, Pierre; Ella, Bruno

    2016-09-01

    Bruxism pathophysiology remains unclear, and its occurrence has been poorly investigated in movement disorders. The aim of this study was to compare the frequency of bruxism in patients with craniocervical dystonia vs. normal controls and to determine its associated clinical features. This is a prospective-control study. A total of 114 dystonic subjects (45 facial dystonia, 69 cervical dystonia) and 182 controls were included. Bruxism was diagnosed using a hetero-questionnaire and a clinical examination performed by trained dentists. Occurrence of bruxism was compared between the different study populations. A binomial logistic regression analysis was used to determine which clinical features influenced bruxism occurrence in each population. The frequency of bruxism was significantly higher in the dystonic group than in normal controls but there was no difference between facial and cervical dystonia. It was also higher in women than in men. Bruxism features were similar between normal controls and dystonic patients except for a higher score of temporomandibular jaw pain in the dystonic group. The higher frequency of bruxism in dystonic patients suggests that bruxism is increased in patients with basal ganglia dysfunction but that its nature does not differ from that seen in bruxers from the normal population.

  18. Bruxism: A Literature Review

    PubMed Central

    Reddy, S Varalakshmi; Kumar, M Praveen; Sravanthi, D; Mohsin, Abdul Habeeb Bin; Anuhya, V

    2014-01-01

    Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism. Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description. PMID:25628497

  19. Bruxism. Masticatory implications and anxiety.

    PubMed

    Alves, Anne C; Alchieri, João C; Barbosa, Gustavo A S

    2013-01-01

    In this study we investigate the phenomenon of bruxism, defined as the act of clenching and/or grinding the teeth, a habit that compromises the orofacial region. It is often associated with emotional aspects, such as anxiety and stress, and may result in alterations to orofacial structures, functional modifications and social repercussions. The aim of this study was to determine a possible association between bruxism and anxiety underscoring the primary complaints related to masticatory function. Eighty volunteers participated in the study. They were divided into bruxers (N = 40) and non-bruxers (N = 40) of both sexes. The diagnosis of bruxism was made by clinical examination. The Trait-State Anxiety Inventory was used to assess anxiety levels and a questionnaire with structured questions related to daily activities, focusing on masticatory function (for the bruxism group), was applied to evaluate psychosocial aspects. The results of the study show a significant difference in state anxiety. Mean and standard deviation of state anxiety in the bruxism and non-bruxism groups was 42.7 +/- 9.6 and 38.6 +/- 8.2 (p < or = 0.04), respectively, while trait anxiety had a mean and standard deviation of 44.5 +/- 11.0 and 40.7 +/- 9.5 (p < or = 0.11). The main complaints of bruxers during mastication were facial pain and headache while chewing as well as the presence of clicking sounds in the jaw joint. Findings demonstrate an association between emotional factors such as anxiety and bruxism, resulting in compromised masticatory function.

  20. Perceived stress and bruxism in university students.

    PubMed

    Cavallo, Pierpaolo; Carpinelli, Luna; Savarese, Giulia

    2016-12-21

    Many studies have shown the correlation between bruxism and stress that affects the quality of life of university students. The present study highlights this correlation-for the first time-in a group of university students in Italy. We have investigated the prevalence of awake and asleep bruxism and its correlation with perceived stress in a group of 278 Italian undergraduate students (117 M). A self report questionnaire was constructed using a socio-demographic test, the Perceived Stress Scale (PSS) and the item n. 8 of the Fonseca Questionnaire for presence of bruxism. The perceived stress score using PSS-10 scale was 32.2 (SD 4.6, 95% CL 31.6-32.7) for all the subjects, with significant gender difference: M = 31.2 and F = 32.9 (P = 0.0019). The prevalence for awake bruxism was 37.9% (F = 40.8%; M = 34.2%,), while for sleep bruxism was 31.8% (F = 33.3%; M = 29.1%), both without significant gender difference. A positive correlation, with significant concordance and dependence, between stress score and awake bruxism was present for male students only. University students showed higher bruxism and stress levels compared to the general population, with higher stress for females, but, even if female students show higher stress, a correlation between stress and bruxism exists only for male gender. Further studies should be performed.

  1. Are bruxism and the bite causally related?

    PubMed

    Lobbezoo, F; Ahlberg, J; Manfredini, D; Winocur, E

    2012-07-01

    In the dental profession, the belief that bruxism and dental (mal-)occlusion ('the bite') are causally related is widespread. The aim of this review was to critically assess the available literature on this topic. A PubMed search of the English-language literature, using the query 'Bruxism [Majr] AND (Dental Occlusion [Majr] OR Malocclusion [Majr])', yielded 93 articles, of which 46 papers were finally included in the present review*. Part of the included publications dealt with the possible associations between bruxism and aspects of occlusion, from which it was concluded that neither for occlusal interferences nor for factors related to the anatomy of the oro-facial skeleton, there is any evidence available that they are involved in the aetiology of bruxism. Instead, there is a growing awareness of other factors (viz. psychosocial and behavioural ones) being important in the aetiology of bruxism. Another part of the included papers assessed the possible mediating role of occlusion between bruxism and its purported consequences (e.g. tooth wear, loss of periodontal tissues, and temporomandibular pain and dysfunction). Even though most dentists agree that bruxism may have several adverse effects on the masticatory system, for none of these purported adverse effects, evidence for a mediating role of occlusion and articulation has been found to date. Hence, based on this review, it should be concluded that to date, there is no evidence whatsoever for a causal relationship between bruxism and the bite. © 2012 Blackwell Publishing Ltd.

  2. Occlusal splints for treating sleep bruxism (tooth grinding).

    PubMed

    Macedo, C R; Silva, A B; Machado, M A; Saconato, H; Prado, G F

    2007-10-17

    Sleep bruxism is an oral activity characterised by teeth grinding or clenching during sleep. Several treatments for sleep bruxism have been proposed such as pharmacological, psychological, and dental. To evaluate the effectiveness of occlusal splints for the treatment of sleep bruxism with alternative interventions, placebo or no treatment. We searched the Cochrane Oral Health Group's Trials Register (to May 2007); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1); MEDLINE (1966 to May 2007); EMBASE (1980 to May 2007); LILACS (1982 to May 2007); Biblioteca Brasileira de Odontologia (1982 to May 2007); Dissertation, Theses and Abstracts (1981 to May 2007); and handsearched abstracts of particular importance to this review. Additional reports were identified from the reference lists of retrieved reports and from article reviews about treating sleep bruxism. There were no language restrictions. We selected randomised or quasi-randomised controlled trials (RCTs), in which splint therapy was compared concurrently to no treatment, other occlusal appliances, or any other intervention in participants with sleep bruxism. Data extraction was carried out independently and in duplicate. Validity assessment of the included trials was carried out at the same time as data extraction. Discrepancies were discussed and a third review author consulted. The author of the primary study was contacted when necessary. Thirty-two potentially relevant RCTs were identified. Twenty-four trials were excluded. Five RCTs were included. Occlusal splint was compared to: palatal splint, mandibular advancement device, transcutaneous electric nerve stimulation, and no treatment. There was just one common outcome (arousal index) which was combined in a meta-analysis. No statistically significant differences between the occlusal splint and control groups were found in the meta-analyses. There is not sufficient evidence to state that the occlusal splint is

  3. To see bruxism: a functional MRI study.

    PubMed

    Yılmaz, S

    2015-01-01

    Since the pathophysiology of bruxism is not clearly understood, there exists no possible treatment. The aim of this study is to investigate the cerebral activation differences between healthy subjects and patients with bruxism on behalf of possible aetiological factors. 12 healthy subjects and 12 patients with bruxism, a total of 24 right-handed female subjects (aged 20-27 years) were examined using functional MRI during tooth-clenching and resting tasks. Imaging was performed with 3.0-T MRI scanner with a 32-channel head coil. Differences in regional brain activity between patients with bruxism and healthy subjects (control group) were observed with BrainVoyager QX 2.8 (Brain Innovation, Maastricht, Netherlands) statistical data analysis program. Activation maps were created using the general linear model: single study and multistudy multisubject for statistical group analysis. This protocol was approved by the ethics committee of medical faculty of Kirikkale University, Turkey (02/04), based on the guidelines set forth in the Declaration of Helsinki. The group analysis revealed a statistically significant increase in blood oxygenation level-dependent signal of three clusters in the control group (p<0.005), which may indicate brain regions related with somatognosis, repetitive passive motion, proprioception and tactile perception. These areas coincide with Brodmann areas 7, 31, 39 and 40. It is conceivable that there are differences between healthy subjects and patients with bruxism. Our findings indicate that there was a decrease of cortical activation pattern in patients with bruxism in clenching tasks. This indicates decreased blood flow and activation in regional neuronal activity. Bruxism, as an oral motor disorder concerns dentistry, neurology and psychiatry. These results might improve the understanding and physiological handling of sleep bruxism.

  4. To see bruxism: a functional MRI study

    PubMed Central

    2015-01-01

    Objective: Since the pathophysiology of bruxism is not clearly understood, there exists no possible treatment. The aim of this study is to investigate the cerebral activation differences between healthy subjects and patients with bruxism on behalf of possible aetiological factors. Methods: 12 healthy subjects and 12 patients with bruxism, a total of 24 right-handed female subjects (aged 20–27 years) were examined using functional MRI during tooth-clenching and resting tasks. Imaging was performed with 3.0-T MRI scanner with a 32-channel head coil. Differences in regional brain activity between patients with bruxism and healthy subjects (control group) were observed with BrainVoyager QX 2.8 (Brain Innovation, Maastricht, Netherlands) statistical data analysis program. Activation maps were created using the general linear model: single study and multistudy multisubject for statistical group analysis. This protocol was approved by the ethics committee of medical faculty of Kirikkale University, Turkey (02/04), based on the guidelines set forth in the Declaration of Helsinki. Results: The group analysis revealed a statistically significant increase in blood oxygenation level-dependent signal of three clusters in the control group (p < 0.005), which may indicate brain regions related with somatognosis, repetitive passive motion, proprioception and tactile perception. These areas coincide with Brodmann areas 7, 31, 39 and 40. It is conceivable that there are differences between healthy subjects and patients with bruxism. Conclusions: Our findings indicate that there was a decrease of cortical activation pattern in patients with bruxism in clenching tasks. This indicates decreased blood flow and activation in regional neuronal activity. Bruxism, as an oral motor disorder concerns dentistry, neurology and psychiatry. These results might improve the understanding and physiological handling of sleep bruxism. PMID:25806864

  5. A study of the temporomandibular joint during bruxism

    PubMed Central

    Commisso, María S; Martínez-Reina, Javier; Mayo, Juana

    2014-01-01

    A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue. PMID:24651655

  6. A study of the temporomandibular joint during bruxism.

    PubMed

    Commisso, María S; Martínez-Reina, Javier; Mayo, Juana

    2014-06-01

    A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.

  7. Bruxism in Movement Disorders: A Comprehensive Review.

    PubMed

    Ella, Bruno; Ghorayeb, Imad; Burbaud, Pierre; Guehl, Dominique

    2017-10-01

    Bruxism is an abnormal repetitive movement disorder characterized by jaw clenching and tooth gnashing or grinding. It is classified into two overlapping types: awake bruxism (AB) and sleep bruxism (SB). Theories on factors causing bruxism are a matter of controversy, but a line of evidence suggests that it may to some extent be linked to basal ganglia dysfunction although so far, this topic has received little attention. The purpose of this article was to review cases of bruxism reported in various movement disorders. The biomedical literature was searched for publications reporting the association of bruxism with various types of movement disorders. As a whole, very few series were found, and most papers corresponded to clinical reports. In Parkinsonian syndromes, AB was rarely reported, but seems to be exacerbated by medical treatment, whereas SB is mainly observed during non-REM sleep, as in restless leg syndrome. AB is occasionally reported in Huntington's disease, primary dystonia, and secondary dystonia; however, its highest incidence and severity is reported in syndromes combining stereotypies and cognitive impairment, such as Rett's syndrome (97%), Down syndrome (42%), and autistic spectrum disorders (32%). Taken as a whole, AB seems to be more frequent in hyperkinetic movement disorders, notably those with stereotypies, and is influenced by anxiety, suggesting an involvement of the limbic part of the basal ganglia in its pathophysiology. © 2016 by the American College of Prosthodontists.

  8. Botulinum toxin for the treatment of bruxism.

    PubMed

    Tinastepe, Neslihan; Küçük, Burcu Bal; Oral, Koray

    2015-10-01

    Botulinum toxin, the most potent biological toxin, has been shown to be effective for a variety of disorders in several medical conditions, when used both therapeutically and cosmetically. In recent years, there has been a rising trend in the use of this pharmacological agent to control bruxing activity, despite its reported adverse effects. The aim of this review was to provide a brief overview to clarify the underlying essential ideas for the use of botulinum toxin in bruxism based on available scientific papers. An electronic literature search was performed to identify publications related to botulinum toxin and its use for bruxism in PubMed. Hand searching of relevant articles was also made to identify additional studies. Of the eleven identified studies, only two were randomized controlled trials, compared with the effectiveness of botulinum toxins on the reduction in the frequency of bruxism events and myofascial pain after injection. The authors of these studies concluded that botulinum toxin could be used as an effective treatment for reducing nocturnal bruxism and myofascial pain in patients with bruxism. Evidence-based research was limited on this topic. More randomized controlled studies are needed to confirm that botulinum toxin is safe and reliable for routine clinical use in bruxism.

  9. Botulinum toxin for the treatment of bruxism.

    PubMed

    Tinastepe, Neslihan; Küçük, Burcu Bal; Oral, Koray

    2014-08-14

    Aims: Botulinum toxin, the most potent biological toxin, has been shown to be effective for a variety of disorders in several medical conditions, when used both therapeutically and cosmetically. In recent years, there has been a rising trend in the use of this pharmacological agent to control bruxing activity, despite its reported adverse effects. The aim of this review was to provide a brief overview to clarify the underlying essential ideas for the use of botulinum toxin in bruxism based on available scientific papers. Methodology: An electronic literature search was performed to identify publications related to botulinum toxin and its use for bruxism in PubMed. Hand searching of relevant articles was also made to identify additional studies. Results: Of the eleven identified studies, only two were randomized controlled trials, compared with the effectiveness of botulinum toxins on the reduction in the frequency of bruxism events and myofascial pain after injection. The authors of these studies concluded that botulinum toxin could be used as an effective treatment for reducing nocturnal bruxism and myofascial pain in patients with bruxism. Conclusion: Evidence-based research was limited on this topic. More randomized controlled studies are needed to confirm that botulinum toxin is safe and reliable for routine clinical use in bruxism.

  10. Relationship between Bruxism and Malocclusion among Preschool Children in Isfahan

    PubMed Central

    Ghafournia, Maryam; Hajenourozali Tehrani, Maryam

    2012-01-01

    Background and aims Bruxism is defined as a habitual nonfunctional forceful contact between occlusal tooth surfaces. In younger children bruxism may be a consequence of the masticatory neuromuscular system immaturity. The aim of this study was to assess the prevalence of bruxism and investigate the relationship between occlusal factors and bruxism among preschool children. Materials and methods In this cross-sectional survey, 400 3-6-year-old children were selected randomly from different preschools in Isfahan, Iran. The subjects were divided into two groups of bruxers and non-bruxers as determined by the clinical examination and their parents’ reports. The examiner recorded the primary canines (Class I, Class II, and Class III) and molars (mesial step, distal step, flash terminal plane) relationship, existence of anterior and posterior crossbite, open and deep bite. Also, rotated teeth, food impaction, sharp tooth edges, high restorations, extensive tooth caries, and painful teeth (categorized as irritating tooth conditions) were evaluated. The relationship between bruxism and occlusal factors and irritating tooth conditions was evaluated with chi-square test. Results Bruxism was seen in 12.75% of the subjects. Statistically significant relationships existed between bruxism and some occlusal factors, such as flash terminal plane (P = 0.023) and mesial step (P = 0.001) and also, between food impaction, extensive tooth caries, tooth pain, sharp tooth edge and bruxism. Conclusion The results showed significant relationship of bruxism with primary molar relationships and irritating tooth conditions among preschool children. PMID:23277860

  11. Effects of sleep bruxism related tinnitus on quality of life.

    PubMed

    Saltürk, Ziya; Özçelik, Erdinç; Kumral, Tolgar Lütfi; Çakır, Ozan; Kasımoğlu, Şeref; Atar, Yavuz; Yıldırım, Güven; Berkiten, Güler; Göker, Ayşe Enise; Uyar, Yavuz

    2015-01-01

    This study aims to analyze the subjective and objective characteristics of tinnitus in sleep bruxism patients. The study included 57 patients (12 males; 45 females; mean age 33.89±12.50 years; range 19 to 55 years) with sleep bruxism and tinnitus (sleep bruxism group) and 24 patients (6 males, 18 females; mean age 43.75±16.19 years; range 21 to 58 years) only with tinnitus (control group). Sleep bruxism was diagnosed by the diagnostic criteria of American Academy of Sleep Medicine. Patients were performed pure tone audiometry to detect hearing thresholds at standard and high frequencies. Tinnitus frequency and loudness were assessed. Subjective aspects of tinnitus were identified by tinnitus handicap inventory. The statistical analysis revealed that the sleep bruxism group had significantly lower hearing thresholds except 1000 Hz and 2000 Hz. Tinnitus frequency was between 3000 Hz and 18000 Hz in sleep bruxism group while it was between 6000 and 16000 Hz in control group with no statistically significant difference (p=0.362). Sleep bruxism group had significantly lower tinnitus loudness and tinnitus handicap inventory scores in comparison to control group (p=0.024 and p=0.000, respectively). Tinnitus caused by sleep bruxism and temporomandibular joint issues has higher frequency and lower loudness compared to patients with only tinnitus.

  12. Sleep bruxism: challenges and restorative solutions

    PubMed Central

    Mengatto, Cristiane Machado; Coelho-de-Souza, Fábio Herrmann; de Souza Junior, Oswaldo Baptista

    2016-01-01

    Bruxism is a parafunctional activity related to clenching or grinding the teeth and tooth wear can be a consequence of sleep bruxism (SB). Management of severe tooth wear due to SB is a challenging situation because of the common reduced amount of remaining dental structure and loss of vertical dimension of occlusion. Rationale for the planning of oral rehabilitation of patients with SB presenting severe tooth wear should rely on evidence-based approaches; however, few studies have discussed properties of dental materials for SB rehabilitation and how to cosmetically manage severe tooth wear. This review aimed to provide an overview into bruxism cosmetic rehabilitation and how this can be implemented with good outcomes for the patient. PMID:27217798

  13. 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

  14. Association between nocturnal bruxism and gastroesophageal reflux.

    PubMed

    Miyawaki, Shouichi; Tanimoto, Yuko; Araki, Yoshiko; Katayama, Akira; Fujii, Akihito; Takano-Yamamoto, Teruko

    2003-11-01

    To examine the relationship between nocturnal bruxism and gastroesophageal reflux. Controlled descriptive study and double-blind, placebo-controlled, clinical study. Portable pH monitoring, electromyography, and audio-video recordings were conducted during the night in the subjects' home. Ten patients with bruxism and 10 normal subjects were matched for height, weight, age, and sex. They did not have symptoms of gastroesophageal reflux disease. Medication with a proton pump inhibitor (ie, a gastric-acid-inhibiting drug). The bruxism group showed a significantly higher frequency of nocturnal rhythmic masticatory muscle activity (RMMA) episodes (mean +/- SD: 6.7 +/- 2.2 times per hour) and a higher frequency and percentage of time of gastroesophageal reflux episodes with a pH less than 4.0 and 5.0 (0.5 +/- 0.9 and 3.6 +/- 1.6 times per hour and 1.3% +/- 2.5% and 7.4% +/- 12.6%, respectively) than the control group (RMMA episodes: 2.4 +/- 0.9 times per hour; gastroesophageal reflux episodes: 0.0 +/- 0.0 and 0.1 +/- 0.3 times per hour and 0.0% +/- 0.0% and 0.0% +/- 0.0%, respectively). In the bruxism group, 100% of the gastroesophageal reflux episodes with a pH less than 3.0 and 4.0 included both an RMMA episode and an electromyographic burst, the duration of which was approximately 0.5 to 1.0 seconds, probably representing swallowing of saliva. The majority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 also included both an RMMA episode and an electromyographic burst in the control and bruxism groups (100% +/- 0.0% vs 70.7% +/- 16.5%), again probably due to swallowing of saliva. The remaining minority of gastroesophageal reflux episodes with a pH of 4.0 to 5.0 contained only an electromyographic burst (swallowing of saliva). The frequency of RMMA episodes after the release of the medication from the proton pump inhibitor, which increased the gastric and esophageal pH, was significantly lower than that after administration of the placebo in the control

  15. The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014

    PubMed Central

    Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

    2015-01-01

    Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were admitted to the Children Hospital and were divided randomly into test and control groups. The test group consisted of 88 hydroxyzine-treated children and the control group consisted of 55 children who used hot towels. Both groups were examined in some stages including the pre-test stages or the stage before starting treatments at two, four, and six weeks and four months after stopping the treatment. The effects of each treatment on reducing bruxism symptoms were assessed by a questionnaire. The data were analyzed by using SPSS in descriptive statistics, t-test, and ANOVA. Results. As far as bruxism severity was concerned, the results showed a significant difference between the test group members who received hydroxyzine and the control group members who received no medication. T-test results showed a statistically significant difference between the test and the control groups in the second post-test (four weeks later) (p. value ≤ 0.05). Mean of the scores of bruxism severity in the test group has changed significantly in the post-test (at two weeks, four weeks, and six weeks later) as compared to the pre-test. Whereas, as far as the response to the treatment, no significant difference was recorded between the control group and the test group 4 weeks after the treatment. Discussion. The results showed that prescribing hydroxyzine for 4 weeks had a considerable effect in diminishing bruxism severity between the test groups. PMID:28316738

  16. The effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital in 2013-2014.

    PubMed

    Rahmati, M; Moayedi, A; Zakery Shahvari, S; Golmirzaei, J; Zahirinea, M; Abbasi, B

    2015-01-01

    Introduction. Bruxism is to press or grind teeth against each other in non-physiologic cases, when an individual does not swallow or chew. If not treated, teeth problems, stress, mental disorders, frequent night waking, and headache is expected. This research aimed to study the effect of hydroxyzine on treating bruxism of 2- to 14-year-old children admitted to the clinic of Bandar Abbas Children Hospital. Methodology. In this clinical trial, 143 children with the ages between 4-12 years were admitted to the Children Hospital and were divided randomly into test and control groups. The test group consisted of 88 hydroxyzine-treated children and the control group consisted of 55 children who used hot towels. Both groups were examined in some stages including the pre-test stages or the stage before starting treatments at two, four, and six weeks and four months after stopping the treatment. The effects of each treatment on reducing bruxism symptoms were assessed by a questionnaire. The data were analyzed by using SPSS in descriptive statistics, t-test, and ANOVA. Results. As far as bruxism severity was concerned, the results showed a significant difference between the test group members who received hydroxyzine and the control group members who received no medication. T-test results showed a statistically significant difference between the test and the control groups in the second post-test (four weeks later) (p. value ≤ 0.05). Mean of the scores of bruxism severity in the test group has changed significantly in the post-test (at two weeks, four weeks, and six weeks later) as compared to the pre-test. Whereas, as far as the response to the treatment, no significant difference was recorded between the control group and the test group 4 weeks after the treatment. Discussion. The results showed that prescribing hydroxyzine for 4 weeks had a considerable effect in diminishing bruxism severity between the test groups.

  17. Current Concepts of Bruxism.

    PubMed

    Manfredini, Daniele; Serra-Negra, Junia; Carboncini, Fabio; Lobbezoo, Frank

    Bruxism is a common phenomenon, and emerging evidence suggests that biologic, psychologic, and exogenous factors have greater involvement than morphologic factors in its etiology. Diagnosis should adopt the grading system of possible, probable, and definite. In children, it could be a warning sign of certain psychologic disorders. The proposed mechanism for the bruxism-pain relationship at the individual level is that stress sensitivity and anxious personality traits may be responsible for bruxism activities that may lead to temporomandibular pain, which in turn is modulated by psychosocial factors. A multiple-P (plates, pep talk, psychology, pills) approach involving reversible treatments is recommended, and adult prosthodontic management should be based on a common-sense cautionary approach.

  18. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    PubMed Central

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

  19. Self-reported sleep bruxism and nocturnal gastroesophageal reflux disease in patients with obstructive sleep apnea: relationship to gender and ethnicity.

    PubMed

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups.

  20. Prevalence of sleep bruxism and awake bruxism in different chronotype profiles: Hypothesis of an association.

    PubMed

    Serra-Negra, J M; Lobbezoo, F; Martins, C C; Stellini, E; Manfredini, D

    2017-04-01

    Sleep (SB) and awake bruxism (AB) recognize a multifactorial etiology and have a relationship with several psychological factors. Psychological disorders have recently been associated also with the chronotype, which is the propensity for an individual to be especially active at a particular time during a 24-h period. Based on the chronotype, the two extreme profiles are morningness and eveningness individuals. Due to the relationship that both the chronotype and bruxism have with psychological factors and the fact that performing tasks not compatible with chronotype can trigger stress, this review presents the hypothesis that the prevalence of SB and AB can differ with the various chronotype profiles. New perspectives for the study of bruxism etiology may emerge from investigations on the topic. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Bruxism: Is There an Indication for Muscle-Stretching Exercises?

    PubMed

    Gouw, Simone; de Wijer, Anton; Creugers, Nico Hj; Kalaykova, Stanimira I

    Bruxism is a common phenomenon involving repetitive activation of the masticatory muscles. Muscle-stretching exercises are a recommended part of several international guidelines for musculoskeletal disorders and may be effective in management of the jaw muscle activity that gives rise to bruxism. However, most studies of muscle-stretching exercises have mainly focused on their influence on performance (eg, range of motion, coordination, and muscle strength) of the limb or trunk muscles of healthy individuals or individuals with sports-related injuries. Very few have investigated stretching of the human masticatory muscles and none muscle-stretching exercises in the management of (sleep) bruxism. This article reviews the literature on muscle-stretching exercises and their potential role in the management of sleep bruxism or its consequences in the musculoskeletal system.

  2. Bruxism and oral parafunctional hyperactivity in social phobia outpatients.

    PubMed

    Hermesh, H; Schapir, L; Marom, S; Skopski, R; Barnea, E; Weizman, A; Winocur, E

    2015-02-01

    Anxiety and selective serotonin reuptake inhibitors (SSRIs) are considered aggravating factors for bruxism. We examined the influence of anxiety, depression and SSRI on bruxism in social phobia (SP). Twenty-three drug naïve, 17 SSRI-treated SP patients and 33 healthy controls underwent a psychiatric assessment and completed Leibowitz Social Anxiety Scale and Beck Depression Inventory. Oral parafunctional activity (PF) was evaluated by TM-dental examination and by a questionnaire. Drug- naïve and SSRI-treated SP patients did not differ on demographic and clinical measures. Awake bruxism, 'JAW PLAY' and at least one PF were more prevalent in SP than in controls. Severity of SP predicted the presence of PF. SP, but not depression, was associated with higher risk of oral PF and awake bruxism. Chronic SSRI treatment of SP did not affect sleep and awake bruxism. Dental and anxiety screening may improve the prognosis psychiatric and dental patients. Effective treatment of SP may mitigate bruxism. © 2014 John Wiley & Sons Ltd.

  3. Bruxism: Conceptual discussion and review

    PubMed Central

    Murali, R. V.; Rangarajan, Priyadarshni; Mounissamy, Anjana

    2015-01-01

    Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures. The etiology of bruxism is unclear, but the condition has been associated with stress, occlusal disorders, allergies and sleep positioning. Due to its nonspecific pathology, bruxism may be difficult to diagnose. Unfortunately, very little data exists on the subject of a cause-and-effect relationship of bruxism to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. The present paper reviewed current concepts on bruxism, etiology, diagnosis and management, underlining its effects on dental structures in an attempt to provide clinically useful suggestions based on scientifically sound data. PMID:26015729

  4. [Bruxism and rumination in the mentally handicapped].

    PubMed

    van Lith, L G

    1991-11-01

    In 1969 we started an investigation of the dental abnormalities and treatment in a severely and profoundly mentally retarded population in The Netherlands. In this study the occurrence of bruxism, rumination and the combination of both is reported. Especially the combination is serious, since it inevitably and remedilessly ruins the dentition. The remains have to be removed already at an average age of 30 years. These patients, usually males, were not even cooperative during the daily brushing of their teeth.

  5. Self-reported bruxism mirrors anxiety and stress in adults

    PubMed Central

    Lobbezoo, Frank; Ahlberg, Kristiina; Manfredini, Daniele; Hublin, Christer; Sinisalo, Juha; Könönen, Mauno; Savolainen, Aslak

    2013-01-01

    Objectives: The aims were to analyze whether the levels of self-reported bruxism and anxiety associate among otherwise healthy subjects, and to investigate the independent effects of anxiety and stress experience on the probability of self-reported bruxism. Study Design: As part of a study on irregular shift work, a questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (number of subjects: n=750) and to an equal number of randomly selected employees in the same company with regular eight-hour daytime work. Results: The response rates were 82.3% (56.6 % men) and 34.3 % (46.7 % men), respectively. Among the 874 respondents, those aware of more frequent bruxism reported significantly more severe anxiety (p<0.001). Adjusted by age and gender, frequent bruxers were more than two times more likely to report severe stress (odds ratio 2.5; 95% confidence interval 1.5-4.2) and anxiety (odds ratio 2.2; 95% confidence interval 1.3-3.6) than non-or-mild bruxers. Conclusions: Present findings suggest that self-reported bruxism and psychological states such as anxiety or stress may be related in working age subjects. Key words:Bruxism, self-report, anxiety, stress, adult. PMID:22926484

  6. Association between respiratory problems and dental caries in children with bruxism.

    PubMed

    Motta, Lara Jansiski; Bortoletto, Carolina Carvalho; Marques, Alyne Jacques; Ferrari, Raquel Agnelli Mesquita; Fernandes, Kristianne Porta Santos; Bussadori, Sandra Kalil

    2014-01-01

    Bruxism is the habit of clenching or grinding one's teeth in non-functional activities and affects both children and adults alike. Respiratory problems, such as asthma and upper airway infections, are reported to be the etiological factors of bruxism. The aim of the present study was to determine whether there is an association between respiratory problems and dental caries in children who exhibit the habit of bruxism. An observational cross-sectional study was carried out. Patient histories were taken and clinical exams were performed on 90 children for selection and allocation to one of two groups. For the determination of bruxism, a questionnaire was administered to parents/guardians and an oral clinical exam was performed based on the criteria of the American Academy of Sleep Medicine. Thirty-three male and female children between 4 and 7 years of age participated in the study - 14 children with bruxism and 19 children without bruxism. The data were statistically analyzed using the chi-square test, with level of significance set at 5% (P < 0.05). Mean age of the participants was 5.73 years. The male gender accounted for 45.5% (n = 15) of the sample and the female gender accounted for 54.5% (n = 18). A statistically significant association was found between respiratory problems and dental caries among the children with bruxism. Seventy-seven percent of the children with bruxism had caries and 62.5% the children with respiratory problems exhibited the habit of bruxism. There seems to be an association between bruxism, respiratory problems, and dental caries in children.

  7. Prevalence of Bruxism in Hemifacial-Spasm Patients.

    PubMed

    Ella, Bruno; Guillaud, Etienne; Langbour, Nicolas; Guehl, Dominique; Burbaud, Pierre

    2017-06-01

    A previous study reported an increased prevalence of bruxism (25%) in patients with cranio-cervical dystonia (CCD) compared to normal controls (13%). CCD can affect the muscles of the head and neck. Besides the CCD affecting these muscles, hemifacial spasm (HFS) is a form of peripheral myoclonus due to a neurovascular conflict affecting the muscles of the face. The fact that they affect the same muscle regions could lead to other links in clinical manifestations such as bruxism, which is more common in patients with CCD than in the normal population. The aim was to study the prevalence of bruxism in patients with HFS. Patients with HFS were enrolled in the department of clinical neurophysiology (Bordeaux University Hospital) over a 6-month period. They were paired regarding age, the absence of neurological pathology or neuroleptics intake. To be included in the study, patients needed to have had unilateral involuntary facial muscle contractions affecting one hemiface. A hetero-questionnaire and a clinicial study were performed. The diagnostic criteria of bruxism included parafunction items such as grinding and clenching and at least one of the following clinical signs: abnormal tooth wear, temporomandibular joint (TMJ) pain, TMJ clicking, muscle hypertonia (masseter or temporal muscles). Additional epidemiological data were collected including age, sex, disease duration, stress, and sleep disorders. Stress symptoms inventory included symptoms like depression, strong heartbeat, dry mouth, anger, inability to concentrate, weakness, fatigability, insomnia, headache, and excessive sweating. The sleep disorder diagnosis included at least two of the symptoms described in the ICSD-3. All these criteria were recorded as either present (scored "1") or absent (scored "0"). The prevalence of bruxism in the two groups (normal and HFS) was not significantly different (p = 0.37). The rate was not significantly different between sleep and awake bruxism (p = 0.15) in both groups

  8. Lifestyle and oral facial disorders associated with sleep bruxism in children.

    PubMed

    Alencar, Nashalie Andrade de; Fernandes, Alline Birra Nolasco; Souza, Margareth Maria Gomes de; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

    2017-05-01

    The aim of the study was to investigate the routine, sleep history, and orofacial disorders associated with children aged 3-7 years with nocturnal bruxism. Children (n = 66) were divided into groups of parent reported nocturnal bruxism (n = 34) and those without the disorder (n = 32). Data about the child's routine during the day, during sleep and awakening, headache frequency, temporomandibular joint (TMJ), and hearing impairments were obtained through interviews with parents/caregivers. Electromyography examination was used to assess the activity of facial muscles. Multiple logistic regression (MLR), chi-square test, and t-test analyses were performed. MLR revealed association of nightmares (p = 0.002; OR = 18.09) and snoring (p = 0.013; OR = 0.14) with bruxism. Variables related to awakening revealed an association with bruxism (p < 0.05). Parents of the main group (children with nocturnal bruxism) reported more complaints of orofacial pain, facial appearance, and headache occurrence (p < 0.05). Auditory and muscle disorders were not significant variables (p > 0.05). Nightmares and snoring are associated with nocturnal bruxism in children. Bruxism in children elicits consequences such as headache, orofacial pain, and pain related to awakening.

  9. Impact of Bruxism on Ceramic Defects in Implant-Borne Fixed Dental Prostheses: A Retrospective Study.

    PubMed

    Mikeli, Aikaterini; Walter, Michael H

    2016-01-01

    Ceramic veneer fracture is a frequent complication in implant-borne fixed restorations. The retrospective clinical study assesses the effect of bruxism on this complication. A sample of 507 implant-borne fixed units inserted between 1995 and 2011 in 144 patients were examined. Any detected veneer fractures were assigned to one of four groups according to extent and position. A hypothetical correlation between bruxism and ceramic veneer fractures was examined. Of 34 patients (23.6%) with at least one ceramic veneer fracture, 24 were bruxers (70%) and 10 were nonbruxers (30%) (P = .002). Bruxism may pose a risk for ceramic fractures.

  10. Associations of sleep bruxism with age, sleep apnea, and daytime problematic behaviors in children.

    PubMed

    Tachibana, M; Kato, T; Kato-Nishimura, K; Matsuzawa, S; Mohri, I; Taniike, M

    2016-09-01

    The aims of this study were to investigate the prevalence of sleep bruxism in children in Japan, and its relationships with sleep-related factors and daytime problematic behavior. Guardians of 6023 children aged 2-12 years completed the Japanese Sleep Questionnaire. Multiple regression analysis and structural equation modeling were performed. Sleep bruxism was reported in 21.0% children (n = 1263): the prevalence was highest in the age group of 5-7 years (27.4%). Multiple regression analysis showed that sleep bruxism had significant correlations with age 5-7 years (OR: 1.72; P < 0.0001), 'Moves a lot during sleep' (OR: 1.47; P < 0.0001), 'sleeps with mouth open' (OR: 1.56; P < 0.0001), and 'snores loudly' (OR: 1.80; P < 0.0001). In structural equation modeling, sleep bruxism had a significant but weak direct effect on daytime problematic behavior, while sleep bruxism significantly correlated with obstructive sleep apnea, which had a higher direct effect on daytime problematic behavior. Sleep bruxism was reported in 21.0% of Japanese children and had independent relationships with age, movements during sleep, and snoring. A comorbidity of sleep-disordered breathing might be related to daytime problematic behavior in children with sleep bruxism. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Self-reported bruxism mirrors anxiety and stress in adults.

    PubMed

    Ahlberg, Jari; Lobbezoo, Frank; Ahlberg, Kristiina; Manfredini, Daniele; Hublin, Christer; Sinisalo, Juha; Könönen, Mauno; Savolainen, Aslak

    2013-01-01

    The aims were to analyze whether the levels of self-reported bruxism and anxiety associate among otherwise healthy subjects, and to investigate the independent effects of anxiety and stress experience on the probability of self-reported bruxism. As part of a study on irregular shift work, a questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (number of subjects: n=750) and to an equal number of randomly selected employees in the same company with regular eight-hour daytime work. The response rates were 82.3% (56.6 % men) and 34.3 % (46.7 % men), respectively. Among the 874 respondents, those aware of more frequent bruxism reported significantly more severe anxiety (p<0.001). Adjusted by age and gender, frequent bruxers were more than two times more likely to report severe stress (odds ratio 2.5; 95% confidence interval 1.5-4.2) and anxiety (odds ratio 2.2; 95% confidence interval 1.3-3.6) than non-or-mild bruxers. Present findings suggest that self-reported bruxism and psychological states such as anxiety or stress may be related in working age subjects.

  12. Treatment of chronic pain associated with nocturnal bruxism with botulinum toxin. A prospective and randomized clinical study

    PubMed Central

    Al-Wayli, Hessa

    2017-01-01

    Background To evaluate the role of botulinum toxin type A (BTX-A) in the treatment of pain associated with nocturnal bruxism. Material and Methods Fifty subjects reporting nocturnal bruxism were recruited for a randomized clinical trial. Twenty five bruxers were injected with botulinum toxin in both masseters, and twenty five were treated with traditional methods of treating bruxism. Patients were evaluated at 3rd week, 2nd and 6th month and one year after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. Results Mean pain score due to Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group A (P =0.000, highly significant). However, in the conventional treatment group, mean pain score does not show improvement with time (p>0.05). Conclusions Our results suggest that botulinum toxin injection reduced the mean pain score and number of bruxism events, most likely by decreasing the muscle activity of masseter rather than affecting the central nervous system. Key words:Temporomandibular pain, nocturnal bruxism, botulinum toxin. PMID:28149474

  13. The clinical management of awake bruxism.

    PubMed

    Goldstein, Ronald E; Auclair Clark, Wendy

    2017-06-01

    Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations. The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment. The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism. Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism. Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  14. Sleep bruxism, awake bruxism and sleep quality among Brazilian dental students: a cross-sectional study.

    PubMed

    Serra-Negra, Júnia Maria; Scarpelli, Ana Carolina; Tirsa-Costa, Débora; Guimarães, Flávia Helena; Pordeus, Isabela Almeida; Paiva, Saul Martins

    2014-01-01

    The aim of the study was to evaluate the association of sleep bruxism, awake bruxism and sleep quality among dental students of the Federal University of Minas Gerais, Belo Horizonte, Brazil. A cross-sectional study was performed including 183 Brazilian dental students aged from 17 to 46 years old. The complete course curriculum consists of 9 semesters. Students enrolled in the first semester, the middle semester and the final semester of the course participated in the survey. The PSQI-BR (the Brazilian version of the Pittsburgh Sleep Questionnaire Index) was used for data collection. The PSQI-BR was distributed during lecture classes. Sleep bruxism and awake bruxism diagnosis was based on self-reported data. Descriptive analysis, Kruskal-Wallis, Mann-Whitney and Poisson regression with robust estimator were the statistical tests used. Sleep bruxism prevalence was 21.5% and awake bruxism prevalence was 36.5%. Sleep duration components were associated with sleep bruxism (PR=1.540; 95% CI: 1.00-2.37) and awake bruxism (PR=1.344; 95% CI: 1,008-1,790). There was an association between awake bruxism and habitual sleep efficiency component (PR=1.323; 95% CI: 1.03-1.70). Sleep disturbance component and awake bruxism were associated (PR=1.533; 95% CI: 1.03-2.27). Poor sleep quality was an important factor among dental students, who reported sleep bruxism as well as among those who presented awake bruxism.

  15. 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.

  16. Childhood bruxism: Related factors and impact on oral health-related quality of life.

    PubMed

    Antunes, Lívia Azeredo Alves; Castilho, Thuanny; Marinho, Marcello; Fraga, Renato Silva; Antunes, Leonardo Santos

    2016-01-01

    This study aimed to assess childhood bruxism relating associated factors and the bruxism's impact on oral health-related quality of life (OHRQoL). A case-control study was performed with 3- to 6-year-old children obtained from public preschools in Brazil. The case and control groups had 21 and 40 children, respectively. Associations between bruxism and respiratory problems (p = 0.04, OR: 0.33, CI: 0.09 to 1.14), dental wear (p < 0.01, OR: 0.01, CI: 0.00 to 0.05), malocclusion (p < 0.01, OR: 0.06, CI: 0.01 to 0.35), and dental caries (p = 0.02, OR: 0.22, CI: 0.04 to 1.04) were observed. The OHRQoL overall mean score and subscales were relatively low independent of the evaluated group (p > 0.05). The association between presence and absence of impact with bruxism or other variables showed no statistical relationship (p > 0.05). It could be concluded that childhood bruxism is related to respiratory problems, dental wear, dental caries, and malocclusion. Despite being a topic that demands special care in dentistry, bruxism does not significantly affect the OHRQoL. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  17. Epigenetics and Bruxism: Possible Role of Epigenetics in the Etiology of Bruxism.

    PubMed

    Čalić, Aleksandra; Peterlin, Borut

    2015-01-01

    Bruxism is defined as a repetitive jaw muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting of the mandible. There are two distinct circadian phenotypes for bruxism: sleep bruxism (SB) and awake bruxism, which are considered separate entities due to the putative difference in their etiology and phenotypic variance. The detailed etiology of bruxism so far remains unknown. Recent theories suggest the central regulation of certain pathophysiological or psychological pathways. Current proposed causes of bruxism appear to be a combination of genetic and environmental (G×E) factors, with epigenetics providing a robust framework for investigating G×E interactions, and their involvement in bruxism makes it a suitable candidate for epigenetic research. Both types of bruxism are associated with certain epigenetically determined disorders, such as Rett syndrome (RTT), Prader-Willi syndrome (PWS), and Angelman syndrome (AS), and these associations suggest a mechanistic link between epigenetic deregulation and bruxism. The present article reviews the possible role of epigenetic mechanisms in the etiology of both types of bruxism based on the epigenetic pathways involved in the pathophysiology of RTT, PWS, and AS, and on other epigenetic disruptions associated with risk factors for bruxism, including sleep disorders, altered stress response, and psychopathology.

  18. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014.

    PubMed

    Jiménez-Silva, Antonio; Peña-Durán, Consuelo; Tobar-Reyes, Julio; Frugone-Zambra, Raúl

    2017-01-01

    In order to establish a relationship between bruxism and temporomandibular disorders (TMDs), a systematic review was performed. A systematic research was performed based on PubMed, Cochrane Library, Medline, Embase, BIREME, Lilacs and Scielo data bases, between 2003 and 2014 including all languages. Descriptive clinical cases were identified. Two independent authors selected the articles. PICO format was used to analyse the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. Thirty-nine studies (n = 39) were analysed in this review. According to bruxism diagnosis, articles were grouped as follows: polysomnographic diagnosis (PSG) (n = 7), clinical diagnosis (n = 11) and survey/self-report (n = 21). Thirty-three articles (n = 33) established a positive relation between bruxism and TMD and six (n = 6) did not. Quality of evidence was low to moderate. In general, the most part of the studies showed shortcomings on their design with bias risk, and also had a low sensitivity on bruxism diagnosis. The evidence based on PSG was not as conclusive as the studies that used surveys and clinical exam to diagnosis bruxism, when bruxism was related to TMD. Sleep bruxism could be associated with myofascial pain, arthralgia and joint pathology as disc displacement and joint noises. Although the evidence at present is inconclusive and does not provide information according to the type of bruxism (bruxism sleep and wakefulness), it is possible to suggest that bruxism would be associated with TMD.

  19. Epidemiology of bruxism in adults: a systematic review of the literature.

    PubMed

    Manfredini, Daniele; Winocur, Ephraim; Guarda-Nardini, Luca; Paesani, Daniel; Lobbezoo, Frank

    2013-01-01

    To perform a systematic review of the literature dealing with the prevalence of bruxism in adult populations. A systematic search of the medical literature was performed to identify all peer-reviewed English-language papers dealing with the prevalence assessment of either awake or sleep bruxism at the general population level by the adoption of questionnaires, clinical assessments, and polysomnographic (PSG) or electromyographic (EMG) recordings. Quality assessment of the reviewed papers was performed according to the Methodological evaluation of Observational REsearch (MORE) checklist, which enables the identification of flaws in the external and internal validity. Cut-off criteria for an acceptable external validity were established to select studies for the discussion of prevalence data. For each included study, the sample features, diagnostic strategy, and prevalence of bruxism in relation to age, sex, and circadian rhythm, if available, were recorded. Thirty-five publications were included in the review. Several methodological problems limited the external validity of findings in most studies, and prevalence data extraction was performed only on seven papers. Of those, only one paper had a flaw less external validity, whilst internal validity was low in all the selected papers due to their self-reported bruxism diagnosis alone, mainly based on only one or two questionnaire items. No epidemiologic data were available from studies adopting other diagnostic strategies (eg, PSG, EMG). Generically identified "bruxism" was assessed in two studies reporting an 8% to 31.4% prevalence, awake bruxism was investigated in two studies describing a 22.1% to 31% prevalence, and prevalence of sleep bruxism was found to be more consistent across the three studies investigating the report of "frequent" bruxism (12.8% ± 3.1%). Bruxism activities were found to be unrelated to sex, and a decrease with age was described in elderly people. The present systematic review described

  20. Is there enough evidence to use botulinum toxin injections for bruxism management? A systematic literature review.

    PubMed

    De la Torre Canales, Giancarlo; Câmara-Souza, Mariana Barbosa; do Amaral, Camilla Fraga; Garcia, Renata Cunha Matheus Rodrigues; Manfredini, Daniele

    2017-04-01

    The objective of the study was to conduct a systematic review of the literature assessing the effects of botulinum toxin (BoNT-A) injections in the management of bruxism. Search for articles involved the PubMed, Scopus, Web of Science, Embase, Cochrane, Scielo and Lilacs databases. Specific terms were used and the search carried out from 1980 to March 2016 by three independent researchers. Randomized controlled studies (RCTs), prospective and before-after studies that applied BoNT-A at the masseter and/or temporalis muscles were included. Three RCTs and two uncontrolled before-after studies out of 904 identified citations were included in this review. All five articles dealt with sleep bruxism and featured a small sample size. None of them was about awake bruxism. Two randomized clinical trials were double-blinded, with a control group using saline solution. Two studies used polysomnography/electromyography for sleep bruxism diagnosis, whilst others were based on history taking and clinical examination. All studies using subjective evaluations for pain and jaw stiffness showed positive results for the BoNT-A treatment. In contrast, the two studies using objective evaluations did not demonstrate any reduction in bruxism episodes, but a decrease in the intensity of muscles contractions. Despite the paucity of works on the topic, BoNT-A seems to be a possible management option for sleep bruxism, minimizing symptoms and reducing the intensity of muscle contractions, although further studies are necessary especially as far as the treatment indications for bruxism itself is concerned. BoNT-A has been increasingly diffused in dentistry over recent years, being also used for pain management in patients with bruxism. Nonetheless, there is no consensus about its effects in this disorder.

  1. Reevaluating Antidepressant Selection in Patients With Bruxism and Temporomandibular Joint Disorder.

    PubMed

    Rajan, Royce; Sun, Ye-Ming

    2017-05-01

    Temporomandibular joint disorder (TMD) is a broad pain disorder that refers to several conditions affecting the temporomandibular joint of the jaw and the muscles of mastication. As with most pain disorders, a high prevalence of depression and anxiety is associated with TMD. Research has shown that selective serotonin reuptake inhibitors (SSRIs), the first-line drug therapy for major depressive disorder, may not be suitable for TMD patients because SSRIs can induce teeth-grinding, otherwise known as bruxism. This is problematic because bruxism is believed to further exacerbate TMD. Therefore, the purpose of this literature review is to better understand the mechanism of SSRI-induced bruxism, as well as discuss alternative antidepressant options for treating depression and anxiety in patients with bruxism and TMD. Alternative classes of antidepressants reviewed include serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, atypical antidepressants, and monoamine oxidase inhibitors. Findings indicate that dopamine agonists and buspirone are currently the most effective medications to treat the side effects of SSRI-induced bruxism, but results regarding the effectiveness of specific antidepressants that avoid bruxism altogether remain inconclusive.

  2. Genetic polymorphisms in the serotonergic system are associated with circadian manifestations of bruxism.

    PubMed

    Oporto, G H; Bornhardt, T; Iturriaga, V; Salazar, L A

    2016-11-01

    Bruxism (BRX) is a condition of great interest for researchers and clinicians in dental and medical areas. BRX has two circadian manifestations; it can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, WB). However, it can be suffered together. Recent investigations suggest that central nervous system neurotransmitters and their genes could be involved in the genesis of BRX. Serotonin is responsible for the circadian rhythm, maintaining arousal, regulating stress response, muscle tone and breathing. Thus, serotonin could be associated with BRX pathogenesis. The aim of this work was to evaluate the frequency of genetic polymorphisms in the genes HTR1A (rs6295), HTR2A (rs1923884, rs4941573, rs6313, rs2770304), HTR2C (rs17260565) and SLC6A4 (rs63749047) in subjects undergoing BRX treatment. Patients included were classified according to their diagnosis in awake bruxism (61 patients), sleep bruxism (26 patients) and both (43 patients). The control group included 59 healthy patients with no signs of BRX. Data showed significant differences in allelic frequencies for the HTR2A rs2770304 polymorphism, where the C allele was associated with increased risk of SB (odds ratio = 2·13, 95% confidence interval: 1·08-4·21, P = 0·03). Our results suggest that polymorphisms in serotonergic pathways are involved in sleep bruxism. Further research is needed to clarify and increase the current understanding of BRX physiopathology. © 2016 John Wiley & Sons Ltd.

  3. Implant rehabilitation in bruxism patient

    PubMed Central

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215

  4. Functional analysis and treatment of diurnal bruxism.

    PubMed

    Lang, Russell; Davenport, Katy; Britt, Courtney; Ninci, Jennifer; Garner, Jennifer; Moore, Melissa

    2013-01-01

    An analogue functional analysis identified attention as a function for a 5-year-old boy's bruxism (teeth grinding). Functional communication training resulted in a reduction of bruxism and an increase in alternative mands for attention. Results were maintained 3 weeks following the intervention. © Society for the Experimental Analysis of Behavior.

  5. Bruxism and TMD disorders of everyday dental clinical practice.

    PubMed

    Kapusevska, Biljana; Dereban, Nikola; Popovska, Mirjana; Nikolovska, Julijana; Popovska, Lidija

    2013-01-01

    Bruxism, as an etiological factor for the development of TMD, includes different disorders of the TMJ and the masticatory muscles, exhibiting pain and disruption of the stomatognathic functions. Our goal was to study patients with bruxism and TMD from everyday dental clinical practice, in terms of diagnosis, identification of etiological factors, classification and treatment of these disorders. We treated 120 patients, divided into 2 groups of 60 patients. The first group had disorders of the TMJ, and the second of the masticatory muscles. The groups were divided into subgroups of 20 patients with dislocation of the articular disk with or without reduction and inflammation of TMJ. The second group was organized from patients with myofascial pain, myositis and muscular trismus. Our conservative treatment consisted of patient education, NSAID, myorelaxants, fabrication of prosthetics, repositioning and stabilization splints. The progress of the patients was followed immediately after the delivery of the prosthetics and the splint, after 1, 6 and 12 months. The results showed that in patients with disorders of the TMJ there were visible signs of recovery after 6 months in 68.3% patients, and in 85% after 12 months. In the second group we achieved faster results with the elimination of symptoms. Patients with afflictions of the muscles in 88.3% of cases noticed relief of symptoms even after 6 months and in 98.3% after 12 months. As therapists we concluded that timely treated complications of bruxism and TMD prevent the destruction of the TMJ, masticatory muscles and the entire stomatognatic system.

  6. Methadone treatment, bruxism, and temporomandibular disorders among male prisoners.

    PubMed

    Enguelberg-Gabbay, Judith V; Schapir, Lior; Israeli, Yair; Hermesh, Haggai; Weizman, Abraham; Winocur, Ephraim

    2016-06-01

    There is little information on bruxism related to illicit drug use. Prolonged drug use may damage the stomatognathic system via oral motor overactivity. The aim of the present study was to compare the rates of bruxism and temporomandibular disorders (TMDs) between prisoners with and without drug-use disorders, to evaluate the association between methadone treatment and bruxism and to assess the possible relationship between bruxism and pain. The sample included 152 male prisoners, 69 of whom were drug users maintained on methadone. All prisoners were examined by an experienced dentist and completed a questionnaire on their oral habits, with the aim of detecting signs or symptoms of TMD and/or bruxism. Additional data were collected from medical files. The prevalence of sleep bruxism and awake bruxism, but not of TMDs, was significantly higher among drug-user than non-drug user prisoners (52.2% vs. 34.9% for sleep bruxism, 59.7% vs. 30.1% for awake bruxism, and 46.3% vs. 25.6% for TMDs, respectively). Participants with awake bruxism were statistically more sensitive to muscle palpation compared with participants with sleep bruxism [rating scores (mean ± SD): 0.32 ± 0.21 vs. 0.19 ± 0.28, respectively]. An association was found between sleep bruxism and awake bruxism. It seems that there is a direct or an indirect association between methadone maintenance treatment and sleep bruxism or awake bruxism in male prisoners. © 2016 Eur J Oral Sci.

  7. The two main theories on dental bruxism.

    PubMed

    Behr, Michael; Hahnel, Sebastian; Faltermeier, Andreas; Bürgers, Ralf; Kolbeck, Carola; Handel, Gerhard; Proff, Peter

    2012-03-20

    Bruxism is characterized by non-functional contact of mandibular and maxillary teeth resulting in clenching or grating of teeth. Theories on factors causing bruxism are a matter of controversy in current literature. The dental profession has predominantly viewed peripheral local morphological disorders, such as malocclusion, as the cause of clenching and gnashing. This etiological model is based on the theory that occlusal maladjustment results in reduced masticatory muscle tone. In the absence of occlusal equilibration, motor neuron activity of masticatory muscles is triggered by periodontal receptors. The second theory assumes that central disturbances in the area of the basal ganglia are the main cause of bruxism. An imbalance in the circuit processing of the basal ganglia is supposed to be responsible for muscle hyperactivity during nocturnal dyskinesia such as bruxism. Some authors assume that bruxism constitutes sleep-related parafunctional activity (parasomnia). A recent model, which may explain the potential imbalance of the basal ganglia, is neuroplasticity. Neural plasticity is based on the ability of synapses to change the way they work. Activation of neural plasticity can change the relationship between inhibitory and excitatory neurons. It seems obvious that bruxism is not a symptom specific to just one disease. Many forms (and causes) of bruxism may exist simultaneously, as, for example, peripheral or central forms. Copyright © 2011 Elsevier GmbH. All rights reserved.

  8. The effectiveness of occlusal splints for sleep bruxism.

    PubMed

    Jagger, Robert

    2008-01-01

    Searches were made using the Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS (Latin American & Caribbean Health Sciences Literature), Biblioteca Brasileira de Odontologia, and Dissertations, Theses and Abstracts. Hand searches were made of abstracts of particular importance to this review. Additional reports were identified from the reference lists of retrieved reports and from article reviews about treating sleep bruxism. There were no language restrictions. Randomised controlled trials (RCT) or quasi-RCT were chosen that compared splint therapy concurrently with no treatment, other occlusal appliances, or any other intervention in participants who had sleep bruxism. Data extraction was carried out independently and in duplicate. Validity assessment of the included trials was carried out at the same time as data extraction. Discrepancies were discussed and a third review author consulted. The author of the primary study was contacted when necessary. Thirty-two potentially relevant RCT were identified of which five were eventually included. In these, use of an occlusal splint was compared with palatal splint, mandibular advancement device, transcutaneous electric nerve stimulation, and no treatment. There was just one common outcome (arousal index) which was combined in a meta-analysis. No statistically significant difference between the occlusal splint and control groups were found in meta-analysis. There is not enough evidence to state that the occlusal splint is effective for treating sleep bruxism. Indication of its use is questionable with regard to sleep outcomes, but there may be some benefit with regard to tooth wear. This systematic review suggests the need for further investigation in more controlled RCT that pay attention to method of allocation, outcome assessment, large sample size, and sufficient duration of followup. The study design must be parallel in order to eliminate

  9. Bruxism and health related quality of life in southern Italy's prison inmates.

    PubMed

    Cavallo, P; Savarese, G; Carpinelli, L

    2014-06-01

    The aim of this study was to determine the prevalence of self-assessed bruxism, the level of Health Related Quality of Life (HRQoL) and their relationship in a group of male inmates. BASIC RESEARCH DESIGN, SETTING: The present study was cross-sectional, its setting was two penal institutions in Italy. A sample of 280 male prisoners (mean age 39.7 years). Due to the very small number of female prisoners, it was not possible to study both genders. Subjects were administered a questionnaire with items investigating demographic data, self-assessed bruxism and HRQoL using EuroQoL EQ-5D instrument. Bruxism was present in 29.7% of inmates. Results for EQ-5D (in brackets are data for the general population age and gender matched) were: EQ-index 1.3 (0.8), EQ-VAS 62 (80). Percentage reporting a problem for each dimension: Mobility (MO): 7.5 (9.6), Self Care (SC): 6.1 (4.3), Usual Activities (UA): 17.9 (10.1), Pain/discomfort (PD): 43.9 (40.8), Anxiety/depression (AD): 54.6 (31.9). There was a strong correlation between bruxism and EQ-index, showing concordance and dependence and, as expected, discordance and dependence between bruxism and EQ-VAS. Bruxism prevalence is higher and HRQoL is worse in the prison population than in the general population; the presence of bruxism is correlated with lower HRQoL levels, and correlation is stronger for subjects at first prison experience and for higher education levels, thus suggesting higher effect of stress on these subjects.

  10. Is there a First Night Effect on Sleep Bruxism? A Sleep Laboratory Study

    PubMed Central

    Hasegawa, Yoko; Lavigne, Gilles; Rompré, Pierre; Kato, Takafumi; Urade, Masahiro; Huynh, Nelly

    2013-01-01

    Study Objectives: Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. Methods: A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or < 25 bursts/h) and moderate-high frequency (≥ 4 episodes/h and ≥ 25 bursts/h). Results: Overall, no first night effects were found for most sleep variables. However, total sleep time, sleep efficiency, and stage transitions showed significant time and group interactions (repeated measures ANOVAs, p ≤ 0.05). The RMMA episode index did not differ between the 2 nights, whereas the second night showed significantly higher burst index, bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. Conclusions: The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history. Citation: Hasegawa Y; Lavigne G; Rompré P; Kato T; Urade M; Huynh N. Is there a first night effect on sleep bruxism? A sleep laboratory study. J Clin Sleep Med 2013;9(11):1139-1145. PMID:24235894

  11. Weighing the potential effectiveness of various treatments for sleep bruxism.

    PubMed

    Huynh, Nelly; Manzini, Christiane; Rompré, Pierre H; Lavigne, Gilles J

    2007-10-01

    Sleep bruxism may lead to a variety of problems, but its pathophysiology has not been completely elucidated. As such, there is no definitive treatment, but certain preventive measures and/or drugs may be used in acute cases, particularly those involving pain. This article is intended to guide clinician scientists to the treatment most appropriate for future clinical studies. To determine the best current treatment, 2 measures were used to compare the results of 10 clinical studies on sleep bruxism, 3 involving oral devices and 7 involving pharmacologic therapy. The first measure, the number needed to treat (NNT), allows several randomized clinical studies to be compared and a general conclusion to be drawn. The second measure, effect size, allows evaluation of the impact of treatment relative to a placebo using different studies of similar design. Taking into account the NNT, the effect size and the power of each study, it can be concluded that the following treatments reduce sleep bruxism: mandibular advancement device, clonidine and occlusal splint. However, the first 2 of these have been linked to adverse effects. The occlusal splint is therefore the treatment of choice, as it reduces grinding noise and protects the teeth from premature wear with no reported adverse effects. The NNT could not be calculated for an alternative pharmacologic treatment, short-term clonazepam therapy, which had a large effect size and reduced the average bruxism index. However, the risk of dependency limits its use over long periods. Assessment of efficacy and safety of the most promising treatments will require studies with larger sample sizes over longer periods.

  12. Is there a first night effect on sleep bruxism? A sleep laboratory study.

    PubMed

    Hasegawa, Yoko; Lavigne, Gilles; Rompré, Pierre; Kato, Takafumi; Urade, Masahiro; Huynh, Nelly

    2013-11-15

    Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or < 25 bursts/h) and moderate-high frequency (≥ 4 episodes/h and ≥ 25 bursts/h). Overall, no first night effects were found for most sleep variables. However, total sleep time, sleep efficiency, and stage transitions showed significant time and group interactions (repeated measures ANOVAs, p ≤ 0.05). The RMMA episode index did not differ between the 2 nights, whereas the second night showed significantly higher burst index, bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history.

  13. Bruxism and prosthetic treatment: a critical review.

    PubMed

    Johansson, Anders; Omar, Ridwaan; Carlsson, Gunnar E

    2011-07-01

    Based on the findings from available research on bruxism and prosthetic treatment published in the dental literature, an attempt was made to draw conclusions about the existence of a possible relationship between the two, and its clinical relevance. MEDLINE/PubMed searches were conducted using the terms 'bruxism' and 'prosthetic treatment', as well as combinations of these and related terms. The few studies judged to be relevant were critically reviewed, in addition to papers found during an additional manual search of reference lists within selected articles. Bruxism is a common parafunctional habit, occurring both during sleep and wakefulness. Usually it causes few serious effects, but can do so in some patients. The etiology is multifactorial. There is no known treatment to stop bruxism, including prosthetic treatment. The role of bruxism in the process of tooth wear is unclear, but it is not considered a major cause. As informed by the present critical review, the relationship between bruxism and prosthetic treatment is one that relates mainly to the effect of the former on the latter. Bruxism may be included among the risk factors, and is associated with increased mechanical and/or technical complications in prosthodontic rehabilitation, although it seems not to affect implant survival. When prosthetic intervention is indicated in a patient with bruxism, efforts should be made to reduce the effects of likely heavy occlusal loading on all the components that contribute to prosthetic structural integrity. Failure to do so may indicate earlier failure than is the norm. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  14. Prevalence of bruxism in children with episodic migraine--a case-control study with polysomnography.

    PubMed

    Masuko, Alice Hatsue; Villa, Thais Rodrigues; Pradella-Hallinan, Marcia; Moszczynski, Alexander Joseph; Carvalho, Deusvenir de Souza; Tufik, Sergio; do Prado, Gilmar Fernandes; Coelho, Fernando Morgadinho Santos

    2014-05-14

    Parents of children with migraine have described a higher prevalence of sleep bruxism and other sleep disturbances in their children. The objective of this study was to use polysomnography to investigate the prevalence of bruxism during sleep in children with episodic migraine relative to controls. Controls and patients were matched by sex, age, years of formal education, presence of snoring, arousals per hour, and respiratory events per hour.A total of 20 controls, between 6 and 12 years old, with no history of headache, recruited from public schools in Sao Paulo between 2009 and 2012, and 20 patients with episodic migraine recruited from the Headache Clinic at the Federal University of Sao Paulo between 2009 and 2012 underwent polysomnography.No intervention was performed before sleep studies.Among migraine patients, 27.5% experienced aura prior to migraine onset. The sleep efficiency, sleep latency, REM sleep latency, arousals per hour, percentage of sleep stages, and breathing events per hour were similar between groups. Five children (25%) with episodic migraine exhibited bruxism during the sleep study while this finding was not observed in any control (p = 0.045). Our data demonstrate that bruxism during sleep is more prevalent in children with episodic migraine. Further prospective studies will help elucidate the underlying shared pathogenesis between bruxism and episodic migraine in children.

  15. Prevalence of bruxism in children with episodic migraine - a case–control study with polysomnography

    PubMed Central

    2014-01-01

    Background Parents of children with migraine have described a higher prevalence of sleep bruxism and other sleep disturbances in their children. The objective of this study was to use polysomnography to investigate the prevalence of bruxism during sleep in children with episodic migraine relative to controls. Findings Controls and patients were matched by sex, age, years of formal education, presence of snoring, arousals per hour, and respiratory events per hour. A total of 20 controls, between 6 and 12 years old, with no history of headache, recruited from public schools in Sao Paulo between 2009 and 2012, and 20 patients with episodic migraine recruited from the Headache Clinic at the Federal University of Sao Paulo between 2009 and 2012 underwent polysomnography. No intervention was performed before sleep studies. Among migraine patients, 27.5% experienced aura prior to migraine onset. The sleep efficiency, sleep latency, REM sleep latency, arousals per hour, percentage of sleep stages, and breathing events per hour were similar between groups. Five children (25%) with episodic migraine exhibited bruxism during the sleep study while this finding was not observed in any control (p = 0.045). Conclusions Our data demonstrate that bruxism during sleep is more prevalent in children with episodic migraine. Further prospective studies will help elucidate the underlying shared pathogenesis between bruxism and episodic migraine in children. PMID:24886343

  16. Taking the Bite out of Bruxism (For Kids)

    MedlinePlus

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Taking the Bite Out of Bruxism KidsHealth / For Kids / Taking the Bite Out of Bruxism Print Do ...

  17. Are Pain-Related Temporomandibular Disorders the Product of an Interaction Between Psychological Factors and Self-Reported Bruxism?

    PubMed

    van Selms, Maurits Ka; Muzalev, Konstantin; Visscher, Corine M; Koutris, Michail; Bulut, Melike; Lobbezoo, Frank

    2017-01-01

    To investigate whether pain-related temporomandibular disorders (TMD) are the product of an interaction between psychological factors and self-reported bruxism activities. Patients referred to a specialized clinic for complaints of orofacial pain and dysfunction completed a digital questionnaire prior to the first clinical visit. The patient sample was then split into a case group consisting of 268 patients diagnosed with TMD pain according to the Diagnostic Criteria for Temporomandibular Disorders (85.8% women; mean ± standard deviation [SD] age = 40.1 ± 14.5 years) and a control group consisting of 254 patients without any pain in the orofacial area (50.8% women; 46.9 ± 13.6 years). The possible moderating roles of six psychological factors (depression, somatic symptoms, anxiety, stress, optimism, and prior psychological treatment) on the relationship between self-reported bruxism and the clinical presence of TMD pain were examined. Patients with TMD pain reported significantly more bruxism than patients without any report of orofacial pain. Furthermore, bruxism intensity was associated with a variety of psychological factors; however, there were no significant interactions between any of the psychological factors and bruxism with respect to the clinical presence of TMD pain. These findings do not support the view that the effect of bruxism on TMD pain is stronger in patients who experience higher levels of psychological distress compared to those with lower levels of distress.

  18. [Temporomandibular joint, occlusion and bruxism].

    PubMed

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Prevalence of Sleep Bruxism in IBD Patients and Its Correlation to Other Dental Disorders and Quality of Life

    PubMed Central

    Caggiano, M.

    2018-01-01

    Background Patients with inflammatory bowel diseases could experience mouth and teeth disorders and alterations in psychological mood. Vice versa, the psychological status may influence the presence of oral diseases. Aim To evaluate in inflammatory bowel disease patients the prevalence of sleep bruxism and its correlation with the presence of oral diseases, quality of sleep, and psychological disturbances. Methods Patients were consecutively recruited in our clinic and examined for temporomandibular disorders, dental enamel disorders, sleep bruxism, and recurrent aphthous stomatitis by two dentists. Patients also underwent Pittsburgh Sleep Quality Index and Beck Depression Inventory Scale questionnaires. Results 47 patients and 46 controls were included. Sleep bruxism and enamel wear disorders were more frequent in Crohn's disease patients when compared with ulcerative colitis patients and controls (p = 0.03 and p = 0.02, resp.). Among groups, no differences were noted for enamel hypoplasia, temporomandibular disorders, recurrent aphthous stomatitis, depression, and quality of sleep. We found a positive correlation between bruxism and temporomandibular disorders (Spearman 0.6, p < 0.001) and between bruxism and pathological sleep (Pittsburgh Sleep Quality Index > 5) (Spearman 0.3, p < 0.005). Conclusion Bruxism and enamel wear disorders should be routinely searched in Crohn's disease patients. Moreover, the attention of healthcare givers to sleep disturbances should be addressed to all inflammatory bowel disease patients. PMID:29721012

  20. Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint: a pilot study

    PubMed Central

    Gu, WeiPing; Yang, Jie; Zhang, FeiMin; Yin, XinMin; Wei, XiaoLong; Wang, Chen

    2015-01-01

    Abstract The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management. The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism, compared with occlusal splint. Twenty-four volunteers with sleep bruxism were divided into two groups: the GTB group that were treated with biofeedback therapy (n  = 12) and the GTO group that were treated with occlusal splint (n  = 12). A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated. To foster the relaxation of the masticatory muscles and the nervous system, the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded. Total episodes and average duration of bruxism events during 8 hours of sleep were analyzed with the monitoring program (TRMY1.0). After 6 and 12 weeks, the episodes (P  =  0.001) and duration (P < 0.05) in the GTB group declined dramatically. In contrast, there were no significant differences in the GTO group after the treatment (P > 0.05). Furthermore, the episodes had significant differences between the GTB group and the GTO group after the same period of treatment (P  =  0.000). The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers, when compared with occlusal splint therapy. The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future. PMID:25859272

  1. Reported bruxism and restless legs syndrome in media personnel with or without irregular shift work.

    PubMed

    Ahlberg, Kristiina; Ahlberg, Jari; Könönen, Mauno; Partinen, Markku; Hublin, Christer; Savolainen, Aslak

    2005-04-01

    A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n = 750) and to an equal number of randomly selected controls in the same company with regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosocial status, stress, work satisfaction and performance, tobacco use, bruxism, and restless legs symptoms (RLS). The aim was to investigate among a multiprofessional media personnel the associations between reported bruxism and RLS, while simultaneously controlling the effects of gender, age, tobacco use, shift work, and dissatisfaction with current workshift schedule. The overall response rate was 58.3% (53.7% men). The response rate in the irregular shift work group was 82.3% (56.6% men) and in the regular daytime work group 34.3% (46.7% men). In the bivariate analyses, RLS was more prevalent in workers at either end of the studied age range (p < 0.05). Self-reported frequent bruxism was significantly associated with younger age (p < 0.05). Females reported RLS (11.4%) slightly more often than males (7.7%) (NS). In logistic regression, frequent bruxism (p < 0.05) and older age (p < 0.05) were significantly positively associated with RLS. Dissatisfaction with one's current workshift schedule (p < 0.05) and RLS (p < 0.05) were significantly positively associated with frequent bruxism, while age (p < 0.05) was significantly negatively associated. In conclusion, perceived bruxism may be a sign of a stressful situation or dissatisfaction, while RLS as a more stable trait may in itself negatively affect sleep quality and further enhance the problem.

  2. Bruxism in military pilots and non-pilots: tooth wear and psychological stress.

    PubMed

    Lurie, Orit; Zadik, Yehuda; Einy, Shmuel; Tarrasch, Ricardo; Raviv, Gil; Goldstein, Liav

    2007-02-01

    Bruxism is the diurnal or nocturnal para-functional habit of clenching or grinding the teeth and affects 5-10% of the general western population. Bruxism can cause pain and irreversible damage to the teeth, periodontium, masticatory muscles, and temporo-mandibular joint. Variables such as general stress, work-related stress, and personality traits have been increasingly considered as initiating, predisposing, and perpetuating factors for bruxism. We sought to evaluate the potential of work-related stress and personality factors to induce bruxism among military pilots and non-pilot officers. Subjects were 57 healthy male Israel Air Force officers (mean age 25.8+/-4.3 yr). Of these, 17 were jet-pilots, 18 helicopter-pilots, and 22 non-pilot officers. Tooth-wear was classified according to a six-point scale. In addition, the subjects responded to a battery of psychological questionnaires for self-assessment of stress at the workplace and their coping behavior. Bruxism of clinical importance (i.e., with dentin exposure) was found in 69% of the aircrew members but only 27% of the non-pilot group. No difference was found between groups regarding stress levels. Military aircrews may be relatively vulnerable to deleterious bruxism as well as other signs of chronic stress. Among bruxers, pilots tended to show coping strategies that were significantly more emotional and less task-oriented than non-pilots, whereas non-bruxers showed no significant differences in coping behavior. This study suggest that integrating dental and psychological preventive intervention may be helpful.

  3. Therapies most frequently used for the management of bruxism by a sample of German dentists.

    PubMed

    Ommerborn, Michelle A; Taghavi, Jalleh; Singh, Preeti; Handschel, Joerg; Depprich, Rita A; Raab, Wolfgang H M

    2011-03-01

    At present, there is little information available on how practicing dentists manage bruxism patients with respect to conservative, reversible techniques as compared to irreversible techniques. The purpose of this study was to determine the most commonly applied therapies used for the management of bruxism by German general dentists (GDs) and dental specialists. In addition, efforts were made to gather information on the knowledge and opinion of GDs and specialists regarding the role of occlusal interferences, in particular, on the development of sleep bruxism. A 13-item questionnaire was developed and mailed to all active members of the statutory dental insurance providers of the German North Rhine (n=5500; 2006 roster) and the German Westphalia-Lippe area (n=4984; 2006 roster). Group differences were statistically analyzed using chi-square tests for the qualitative variables and Mann-Whitney U tests for the quantitative variables (α=.05). Occlusal splints were by far the most frequently prescribed therapy for the management of bruxism, followed by relaxation techniques, occlusal equilibration, physiotherapy, and prosthodontic reconstruction. The occlusal stabilization splint with canine protected articulation was the splint type most often prescribed, whereas respondents used unadjusted soft splints for approximately 8% of their bruxism patients. Comparison of the opinions of all responding practicing dentists with that of experts in regard to the statement that "sleep bruxism is caused by occlusal interferences" showed a significant difference between the 2 groups (P=.021). Eighty-five percent of the experts disagreed with this statement, and only 47.7% of the practicing dentists had the same opinion as the experts. Most practicing dentists seem to concur with current scientific recommendations, and express the opinion that the management of bruxism should predominantly be conservative and reversible; however, the findings of the present survey reveal diverse

  4. [Sleep bruxism in children and adolescents].

    PubMed

    Firmani, Mónica; Reyes, Milton; Becerra, Nilda; Flores, Guillermo; Weitzman, Mariana; Espinosa, Paula

    2015-01-01

    Bruxism is a rhythmic masticatory muscle activity, characterized by teeth grinding and clenching. This is a phenomenon mainly regulated by the central nervous system and peripherally influenced. It has two circadian manifestations, during sleep (sleep bruxism) and awake states (awake bruxism). Bruxism is much more than just tooth wearing. It is currently linked to orofacial pain; headaches; sleep disorders; sleep breathing disorders, such as apnea and hypopnea sleep syndrome; behavior disorders, or those associated with the use of medications. It is also influenced by psycho-social and behavior factors, which means that oromandibular parafunctional activities, temporomandibular disorders, malocclusion, high levels of anxiety and stress, among others, may precipitate the occurrence of bruxism. Nowadays, its etiology is multifactorial. The dentist and the pediatrician are responsible for its early detection, diagnosis, management, and prevention of its possible consequences on the patients. The aim of this review is to update the concepts of this disease and to make health professionals aware of its early detection and its timely management. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Bruxism

    MedlinePlus

    ... discipline. There is no recognized TMJ specialty in dentistry. For a massage-based approach, look for a ... Updated by: Michael Kapner, DDS, general and aesthetic dentistry, Norwalk Medical Center, Norwalk, CT. Review provided by ...

  6. Sleep bruxism and myofascial temporomandibular disorders

    PubMed Central

    Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

  7. Sleep bruxism: Current knowledge and contemporary management

    PubMed Central

    Yap, Adrian U.; Chua, Ai Ping

    2016-01-01

    Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief. PMID:27656052

  8. Association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism.

    PubMed

    Yoshida, Yuya; Suganuma, Takeshi; Takaba, Masayuki; Ono, Yasuhiro; Abe, Yuka; Yoshizawa, Shuichiro; Sakai, Takuro; Yoshizawa, Ayako; Nakamura, Hirotaka; Kawana, Fusae; Baba, Kazuyoshi

    2017-08-01

    The aim of this study was to investigate the association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism. A total of 35 university students and staff members participated in this study after providing informed consent. All participants were divided into either a sleep bruxism group (n = 21) or a control group (n = 14), based on the following clinical diagnostic criteria: (1) reports of tooth-grinding sounds for at least two nights a week during the preceding 6 months by their sleep partner; (2) presence of tooth attrition with exposed dentin; (3) reports of morning masticatory muscle fatigue or tenderness; and (4) presence of masseter muscle hypertrophy. Video-polysomnography was performed in the sleep laboratory for two nights. Sleep bruxism episodes were measured using masseter electromyography, visually inspected and then categorized into phasic or tonic episodes. Phasic episodes were categorized further into episodes with or without grinding sounds as evaluated by audio signals. Sleep bruxism subjects with reported grinding sounds had a significantly higher total number of phasic episodes with grinding sounds than subjects without reported grinding sounds or controls (Kruskal-Wallis/Steel-Dwass tests; P < 0.05). Similarly, sleep bruxism subjects with tooth attrition exhibited significantly longer phasic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P < 0.05). Furthermore, sleep bruxism subjects with morning masticatory muscle fatigue or tenderness exhibited significantly longer tonic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P < 0.05). These results suggest that each clinical sign and symptom of sleep bruxism represents different aspects of jaw motor activity during sleep. © 2016 European Sleep Research Society.

  9. Does Bruxism Contribute to Dental Implant Failure? A Systematic Review and Meta-Analysis.

    PubMed

    Zhou, Yi; Gao, Jinxia; Luo, Le; Wang, Yining

    2016-04-01

    Bruxism was usually considered as a contraindication for oral implanting. The causal relationship between bruxism and dental implant failure was remained controversial in existing literatures. This meta-analysis was performed to investigate the relationship between them. This review conducted an electronic systematic literature search in MEDLINE (PubMed) and EmBase in November 2013 without time and language restrictions. Meanwhile, a hand searching for all the relevant references of included studies was also conducted. Study information extraction and methodological quality assessments were accomplished by two reviewers independently. A discussion ensued if any disagreement occurred, and unresolved issues were solved by consulting a third reviewer. Methodological quality was assessed by using the Newcastle-Ottawa Scale tool. Odds ratio (OR) with 95% confidence interval (CI) was pooled to estimate the relative effect of bruxism on dental implant failures. Fixed effects model was used initially; if the heterogeneity was high, random effects model was chosen for meta-analysis. Statistical analyses were carried out by using Review Manager 5.1. In this meta-analysis review, extracted data were classified into two groups based on different units. Units were based on the number of prostheses (group A) and the number of patients (group B). In group A, the total pooled OR of bruxers versus nonbruxers for all subgroups was 4.72 (95% CI: 2.66-8.36, p = .07). In group B, the total pooled OR of bruxers versus nonbruxers for all subgroups was 3.83 (95% CI: 2.12-6.94, p = .22). This meta-analysis was performed to evaluate the relationship between bruxism and dental implant failure. In contrast to nonbruxers, prostheses in bruxers had a higher failure rate. It suggests that bruxism is a contributing factor of causing the occurrence of dental implant technical/biological complications and plays a role in dental implant failure. © 2015 Wiley Periodicals, Inc.

  10. Bruxism force detection by a piezoelectric film-based recording device in sleeping humans.

    PubMed

    Baba, Kazuyoshi; Clark, Glenn T; Watanabe, Tatsutomi; Ohyama, Takashi

    2003-01-01

    To test the reliability and utility of a force-based bruxism detection system (Intra-Splint Force Detector [ISFD]) for multiple night recordings of forceful tooth-to-splint contacts in sleeping human subjects in their home environment. Bruxism-type forces, i.e., forceful tooth-to-splint contacts, during the night were recorded with this system in 12 subjects (6 bruxers and 6 controls) for 5 nights in their home environment; a laboratory-based nocturnal polysomnogram (NPSG) study was also performed on 1 of these subjects. All 12 subjects were able to use the device without substantial difficulty on a nightly basis. The bruxer group exhibited bruxism events of significantly longer duration than the control group (27 seconds/hour versus 7.4 seconds/hour, P < .01). A NPSG study performed on 1 subject revealed that, when the masseter muscle electromyogram (EMG) was used as a "gold standard," the ISFD had a sensitivity of 0.89. The correlation coefficient between the duration of events detected by the ISFD and the EMG was also 0.89. These results suggest that the ISFD is a system that can be used easily by the subjects and that has a reasonable reliability for bruxism detection as reflected in forceful tooth-to-splint contacts during sleep.

  11. Associations between sleep bruxism and (peri-) implant complications: a prospective cohort study

    PubMed Central

    Thymi, Magdalini; Visscher, Corine M; Yoshida-Kohno, Eiko; Crielaard, Wim; Wismeijer, Daniel; Lobbezoo, Frank

    2017-01-01

    Objectives/Aims: To describe the protocol of a prospective cohort study designed to answer the question: ‘Is sleep bruxism a risk factor for (peri-)implant complications?’. Materials and Methods: Our study is a single-centre, double-blind, prospective cohort study with a follow-up time of 2 years. Ninety-eight participants fulfilling inclusion criteria (planned treatment with implant-supported fixed suprastructure(s) and age 18 years or older) will be included. Sleep bruxism will be monitored at several time points as masticatory muscle activity during sleep by means of a portable single-channel electromyographic device. Our main outcomes are biological complications (i.e., related to peri-implant bleeding, probing depth, marginal bone height, quality of submucosal biofilm and loss of osseointegration) and technical complications (i.e., suprastructure, abutment, implant body or other). Results: The study is currently ongoing, and data are being gathered. Discussion: The results of this prospective cohort study will provide important information for clinicians treating bruxing patients with dental implants. Furthermore, it will contribute to the body of evidence related to the behaviour of dental implants and their complications under conditions of high mechanical loadings that result from sleep bruxism activity. Conclusion: The protocol of a prospective cohort study designed to investigate possible associations between sleep bruxism and (peri-) implant complications was presented. PMID:29607076

  12. Effectiveness of two physical therapy interventions, relative to dental treatment in individuals with bruxism: study protocol of a randomized clinical trial.

    PubMed

    Santos Miotto Amorim, Cinthia; Firsoff, Eliete Ferreira Osses; Vieira, Glauco Fioranelli; Costa, Jecilene Rosana; Marques, Amélia Pasqual

    2014-01-07

    Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. Participants will be randomized into one of three groups: Group 1 (n=24) intervention will consist of massage and stretching exercises; Group 2 (n=24) will consist of relaxation and imagination therapies; and Group 3 (n=24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile--14. Significance level will be determined at the 5% level. This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. The study will

  13. [Chewing on bruxism. Diagnosis, imaging, epidemiology and aetiology].

    PubMed

    Lobbezoo, F; Jacobs, R; De Laat, A; Aarab, G; Wetselaar, P; Manfredini, D

    2017-06-01

    Since the publication of a special issue on bruxism of the NTvT in July 2000, consensus has been reached on bruxism's definition as a repetitive masticatory muscle activity that is characterised by clenching and/or grinding while awake (awake bruxism) or during sleep (sleep bruxism). As yet, however, no consensus exists about the diagnosis of bruxism: sufficient evidence to establish the reliability and validity of the commonly used techniques (self-report, clinical examination, imaging, electromyography, polysomnography) has not yet been produced. Morphological factors are no longer considered important aetiological factors, while increasing evidence suggests aetiological roles for psychosocial, physiological, biological, and exogenous factors. This review paper is the first part of a diptych and is concerned with the definition, diagnostics, epidemiology and possible causes of this disorder. In the second part, that will be published in the next issue, associations of bruxism with other conditions will be discussed, along with its (purported) consequences and its management.

  14. Vitamin D Levels in Different Severity Groups of Schizophrenia.

    PubMed

    Akinlade, Kehinde Sola; Olaniyan, Oyejide Afolabi; Lasebikan, Victor Olufolahan; Rahamon, Sheu Kadiri

    2017-01-01

    Vitamin D deficiency (VDD) continues to be associated with schizophrenia, but there is the dearth of information on the relationship between the severity of schizophrenia and plasma levels of vitamin D. This study, therefore, determined the plasma levels of vitamin D in different severity groups of schizophrenia. Plasma level of vitamin D was determined in 60 patients with schizophrenia and 30 apparently healthy individuals who served as controls. Patients with schizophrenia were classified into mildly ill, moderately ill, markedly ill, and severely ill groups using the Positive and Negative Syndrome Scale (PANSS). The mean level of vitamin D was significantly lower in patients with schizophrenia compared with the controls. Similarly, there was a significant association between VDD and schizophrenia. The mean plasma levels of vitamin D were not significantly different when the mildly, moderately, markedly, and severely ill groups were compared with one another and there was no significant correlation between vitamin D level and PANSS scores. Furthermore, patients on atypical antipsychotics had an insignificantly lower level of vitamin D compared with the patients on typical antipsychotics. It could be concluded from this study that patients with schizophrenia have low plasma vitamin D level which does not appear to be associated with the severity of schizophrenia and type of antipsychotics. Therefore, regular screening for vitamin D status of patients with schizophrenia is suggested in order to allow for the institution of appropriate clinical intervention when necessary.

  15. Sleep bruxism: an updated review of an old problem.

    PubMed

    Castrillon, Eduardo E; Ou, Keng-Liang; Wang, Kelun; Zhang, Jinglu; Zhou, Xinwen; Svensson, Peter

    2016-07-01

    Objective To provide an update on what is known about bruxism and some of the major clinical highlights derived from new insights into this old problem in dentistry. Materials and methods A selective, non-systematic but critical review of the available scientific literature was performed. Results There are two main different types of bruxism, which are related to different circadian periods (sleep and awake bruxism) that may differ in terms of pathophysiology, but they share some common signs and symptoms. Approximately one out of 10 adult individuals may suffer from bruxism, but not all bruxers may need treatment. Bruxism is complicated to diagnose in the clinic and self-report of bruxism may not necessarily reflect the true presence of jaw muscle activity. Better understanding has been acquired of bruxism relationships with sleep stages, arousal responses and autonomic function with the help of polysomnography and controlled sleep studies. Meanwhile, there is still much more to learn about awake bruxism. With the available scientific knowledge it is possible to systematically assess the effects of bruxism and its potential risk factors for oral and general health. Moreover, we can be aware of the realistic possibilities to manage/treat the patient suffering from bruxism. Conclusion Bruxism is a parafunctional activity involving the masticatory muscles and probably it is as old as human mankind. Different ways have been proposed to define, diagnose, assess the impact and consequences, understand the pathophysiology and treat or manage bruxism. Despite the vast research efforts made in this field, there are still significant gaps in our knowledge.

  16. Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial.

    PubMed

    Gomes, Cid André Fidelis de Paula; El Hage, Yasmin; Amaral, Ana Paula; Politti, Fabiano; Biasotto-Gonzalez, Daniela Aparecida

    2014-01-01

    Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism. Sixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD. The inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups. Massage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and

  17. Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach.

    PubMed

    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2016-11-01

    Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P < 0·001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure. © 2016 John Wiley & Sons Ltd.

  18. Therapies for bruxism: a systematic review and network meta-analysis (protocol).

    PubMed

    Mesko, Mauro Elias; Hutton, Brian; Skupien, Jovito Adiel; Sarkis-Onofre, Rafael; Moher, David; Pereira-Cenci, Tatiana

    2017-01-13

    Bruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments (including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy) is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists? Comprehensive searches of the Cochrane Library, MEDLINE (via PubMed), Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria (Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism). The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized (i.e., GRADE). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses (PRISMA-NMA) statement. This systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is

  19. Enterotoxigenic Escherichia coli blood group A interactions intensify diarrheal severity.

    PubMed

    Kumar, Pardeep; Kuhlmann, F Matthew; Chakroborty, Subhra; Bourgeois, A Louis; Foulke-Abel, Jennifer; Tumala, Brunda; Vickers, Tim J; Sack, David A; DeNearing, Barbara; Harro, Clayton D; Wright, W Shea; Gildersleeve, Jeffrey C; Ciorba, Matthew A; Santhanam, Srikanth; Porter, Chad K; Gutierrez, Ramiro L; Prouty, Michael G; Riddle, Mark S; Polino, Alexander; Sheikh, Alaullah; Donowitz, Mark; Fleckenstein, James M

    2018-05-17

    Enterotoxigenic Escherichia coli (ETEC) infections are highly prevalent in developing countries where clinical presentations range from asymptomatic colonization to severe cholera-like illness. The molecular basis for these varied presentations, that may involve strain-specific virulence features as well as host factors, have not been elucidated. We demonstrate that when challenged with ETEC strain H10407, originally isolated from a case of cholera-like illness, blood group A human volunteers developed severe diarrhea more frequently than individuals from other blood groups. Interestingly, a diverse population of ETEC strains, including H10407, secrete a novel adhesin molecule, EtpA. As many bacterial adhesins also agglutinate red blood cells, we combined the use of glycan arrays, biolayer inferometry, and non-canonical amino acid labeling with hemagglutination studies to demonstrate that EtpA is a dominant ETEC blood group A specific lectin/hemagglutinin. Importantly, we also show that EtpA interacts specifically with glycans expressed on intestinal epithelial cells from blood group A individuals, and that EtpA-mediated bacterial-host interactions accelerate bacterial adhesion and the effective delivery both heat-labile and heat-stable toxins of ETEC. Collectively, these data provide additional insight into the complex molecular basis of severe ETEC diarrheal illness that may inform rational design of vaccines to protect those at highest risk.

  20. The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad.

    PubMed

    Smith, W A J; Marchan, S; Rafeek, R N

    2008-02-01

    Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

  1. Interepisode Sleep Bruxism Intervals and Myofascial Face Pain.

    PubMed

    Muzalev, Konstantin; Lobbezoo, Frank; Janal, Malvin N; Raphael, Karen G

    2017-08-01

    Sleep bruxism (SB) is considered as a possible etiological factor for temporomandibular disorder (TMD) pain. However, polysomnographic (PSG) studies, which are current "gold standard" diagnostic approach to SB, failed to prove an association between SB and TMD. A possible explanation could be that PSG studies have considered only limited characteristics of SB activity: the number of SB events per hour and, sometimes, the total duration of SB per night. According to the sports sciences literature, lack of adequate rest time between muscle activities leads to muscle overloading and pain. Therefore, the aim of this study was to determine whether the intervals between bruxism events differ between patients with and without TMD pain. Two groups of female volunteers were recruited: myofascial TMD pain group (n=124) and non-TMD control group (n=46). From these groups, we selected 86 (69%) case participants and 37 (80%) controls who had at least two SB episodes per night based on PSG recordings. A linear mixed model was used to compare case and control groups over the repeated observations of interepisode intervals. The duration of interepisode intervals was statistically similar in the case (mean [standard deviation {SD}] 1137.7 [1975.8] seconds)] and control (mean [SD] 1192.0 [1972.0] seconds) groups. There were also a similar number of SB episodes per hour and a total duration of SB episodes in both groups. The current data fail to support the idea that TMD pain can be explained by increasing number of SB episodes per hour of sleep or decreasing the time between SB events. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  2. Management of bruxism-induced complications in removable partial denture wearers using specially designed dentures: a clinical report.

    PubMed

    Baba, Kazuyoshi; Aridome, Kumiko; Pallegama, Ranjith Wasantha

    2008-01-01

    In patients with a limited number of remaining teeth, bruxism force can be destructive for both the remaining teeth and periodontal structures. This paper reports the successful management of four such patients with severe sleep bruxism, using conventional removable partial dentures and specially designed, splint-like removable partial dentures called a night denture. The night denture was fabricated in two different designs, which depended upon the pattern of the remaining tooth contacts. The patients were followed up for 2-6 years using a night denture in either of the two designs. Within the limitations of these four reports of clinical cases, the night denture appeared to be effective in managing the problems related to sleep bruxism.

  3. Grinding patterns in migraine patients with sleep bruxism: a case-controlled study.

    PubMed

    Kato, Momoko; Saruta, Juri; Takeuchi, Mifumi; Sugimoto, Masahiro; Kamata, Yohei; Shimizu, Tomoko; To, Masahiro; Fuchida, Shinya; Igarashi, Hisaka; Kawata, Toshitsugu; Tsukinoki, Keiichi

    2016-11-01

    Details on grinding patterns and types of contact during sleep bruxism in association with migraine headache have not yet been elucidated. This study compared the characteristics of sleep bruxism between patients with migraine and controls. The study included 80 female patients who had been diagnosed with migraine and 52 women with no history of migraine. Grinding patterns were measured using the BruxChecker® (Scheu Dental, Iserlohn, Germany). There was a significant difference between the two groups in the distribution of grinding patterns at the laterotrusive side (p < 0.001). When the anterior teeth and premolar and molar regions in the two groups were compared, the proportion of the grinding area at all sites was significantly larger in the migraine group than in the control group (p < 0.001). The BruxChecker® showed that there was substantial grinding over a large area among migraine patients, particularly in the molar region.

  4. Sleep bruxism possibly triggered by multiple sclerosis attacks and treated successfully with botulinum toxin: Report of three cases.

    PubMed

    Sevim, Serhan; Kaleağası, Hakan; Fidancı, Halit

    2015-09-01

    Sleep bruxism refers to a nocturnal parafunctional activity including the clenching, grinding or gnashing of teeth. While most of the nocturnal bruxism cases seen in the general population are apparently idiopathic, it has been reported to be associated with a range of neurological diseases such as Huntington's disease, cranio-cervical dystonia and post-anoxic brain damage, but not multiple sclerosis (MS). We describe three cases of MS patients who have had moderate to severe complaints of bruxism in the two weeks following their relevant MS attacks. None of the three patients had a diagnosis of bruxism prior to her attack. The diagnosis was confirmed in one out of three by a polysomnography. One patient did not have any complaints related to bruxism previous to her attack, whereas two had mild and infrequent complaints. The symptoms of the relevant attacks were left hemihypesthesia in all and hemiparesis in two. None of the patients had spasticity that could result in severe teeth clenching. All three patients presented with morning headaches and jaw pain or tightness and were treated successfully with botulinum toxin (Btx) injections applied to their masseter and temporalis muscles. The cause of bruxism is controversial but lesions of the cortico-basalganglia-thalamo-cotrical loops are thought to be most likely. However, acute or chronic lesions in those pathways were not demonstrated in the 3 patients. It is feasible that they had normal appearing white matter interruptions in their cortico-basalganglia-thalamocortical loops along with their relevant attack. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Understanding bruxism in children and adolescents.

    PubMed

    Saulue, Paul; Carra, Maria-Clotilde; Laluque, Jean-François; d'Incau, Emmanuel

    2015-12-01

    Screening for the various forms of bruxism in children and adolescents requires a sound knowledge of the physiopathology of this parafunction in addition to the etiologic and associated factors and comorbidities. The international literature contains various suggestions for suitable treatment. The optimal therapeutic approach often involves multidisciplinary management of these young patients. Sleep bruxism (SB) is a common sleep disorder which can cause serious problems to the stomatognathic system such as damaged teeth, headaches, muscle pain and TMD. Dental professionals are responsible for the detection and prevention of these harmful impacts on the patient's oral health. However, SB is much more than a question of worn teeth. Patients with SB consult for other medical comorbidities such as nighttime breathing problems, insomnia, attention deficit hyperactivity disorder, depression, moodiness and gastroesophogeal reflux before any course of treatment is initiated. If a comorbidity is diagnosed, the treatment approach will be aimed in the first instance at the medical disorder, while concurrently managing the repercussions of SB. On the other hand, in as far as the majority of young bruxers cease to grind their teeth before adolescence or adulthood, it is feasible to adopt wait-and-see and non-interventionist strategies for young children. However, it is preferable to have a better understanding of SB, notably on account of its potential association with psychological disorders during childhood. Daytime bruxism is characterized by teeth clenching (TC). First-line treatment involves encouraging patients to monitor their harmful parafunctional behavior and, consequently, change and cease it. This protocol is not always easy to apply, particularly in younger children. In such cases, cognitive-behavioral treatments and biofeedback techniques can also be used in daytime bruxism.

  6. Prevalence of Bruxism among Mexican Children with Down Syndrome

    ERIC Educational Resources Information Center

    Lopez-Perez, Ruben; Lopez-Morales, Patricia; Borges-Yanez, S. Aida; Maupome, Gerardo; Pares-Vidrio, Gustavo

    2007-01-01

    This study sought to determine the prevalence of bruxism in a Mexican community of children with Down syndrome, and to evaluate bruxism's relationship with age, sex, intellectual disability level, and type of chromosomal abnormality of trisomy 21. Using a cross-sectional design, 57 boys and girls (3 to 14 years old) were examined. Three approaches…

  7. Community based study of sleep bruxism during early childhood

    PubMed Central

    Insana, Salvatore P.; Gozal, David; McNeil, Daniel W.; Montgomery-Downs, Hawley E.

    2012-01-01

    Objectives The aims for this study were to determine the prevalence of sleep-bruxism among young children, explore child behavior problems that may be associated with sleep-bruxism, and identify relations among sleep-bruxism, health problems, and neurocognitive performance. Methods The current study was a retrospective analysis of parent report surveys, and behavioral and neurocognitive assessments. Parents of 1953 preschool and 2888 first grade children indicated their child’s frequency of bruxism during sleep. A subsample of preschool children (n = 249) had additional behavioral, as well as neurocognitive assessments. Among the subsample, parents also reported on their child’s health, and completed the Child Behavioral Checklist; children were administered the Differential Ability Scales, and Pre-Reading Abilities subtests of the Developmental Neuropsychological Assessment. Results 36.8% of preschoolers and 49.6% of first graders were reported to brux ≥ 1 time per week. Among the preschool subsample, bruxing was independently associated with increased internalizing behaviors (β = .17). Bruxism was also associated with increased health problems (β = .19), and increased health problems were associated with decreased neurocognitive performance (β = .22). Conclusions The prevalence of sleep-bruxism was high. A dynamic and potentially clinically relevant relation exists among sleep-bruxism, internalizing behaviors, health, and neurocognition. Pediatric sleep-bruxism may serve as a sentinel marker for possible adverse health conditions, and signal a need for early intervention. These results support the need for an interdisciplinary approach to pediatric sleep medicine, dentistry, and psychology. PMID:23219144

  8. Influence of bruxism on survival of porcelain laminate veneers.

    PubMed

    Granell-Ruíz, Maria; Agustín-Panadero, Rubén; Fons-Font, Antonio; Román-Rodríguez, Juan-Luis; Solá-Ruíz, María-Fernanda

    2014-09-01

    This study aims to determine whether bruxism and the use of occlusal splints affect the survival of porcelain laminate veneers in patients treated with this technique. Restorations were made in 70 patients, including 30 patients with some type of parafunctional habit. A total of 323 veneers were placed, 170 in patients with bruxism activity, and the remaining 153 in patients without it. A clinical examination determined the presence or absence of ceramic failure (cracks, fractures and debonding) of the restorations; these incidents were analyzed for association with bruxism and the use of splints. Analysis of the ceramic failures showed that of the 13 fractures and 29 debonding that were present in our study, 8 fractures and 22 debonding were related to the presence of bruxism. Porcelain laminate veneers are a predictable treatment option that provides excellent results, recognizing a higher risk of failure in patients with bruxism activity. The use of occlusal splints reduces the risk of fractures.

  9. Study of the relationship of psychosocial disorders to bruxism in adolescents.

    PubMed

    Katayoun, E; Sima, F; Naser, V; Anahita, D

    2008-01-01

    Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls). They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent's age and education, mother's marital status, child support status, mother's employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr) was then filled out by both groups for the evaluation of 12 psychosocial symptoms. Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P < 0.005), Conduct Disorders (P < 0.05), Antisocial Disorders (P < 0.06) as identified by YSR was significantly higher in bruxers. Significant differences between the two groups also emerged in total YSR scores (P < 0.005). The results of Odds Ratio revealed that a bruxer adolescent has 16 times greater probability for psychosocial disorders than a non-bruxer one. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. Support to the existence of an association between bruxism and psychosocial disorders has been provided.

  10. [Management of severe invasive group A streptococcal infections].

    PubMed

    Faye, A; Lorrot, M; Bidet, Ph; Bonacorsi, S; Cohen, R

    2014-11-01

    The group A streptococcus (GAS) is the 5(th) responsible pathogen of invasive infections in children in France. These particularly severe diseases are dominated in children by soft tissue infection, isolated bacteremia but also osteoarthritis. Other complications are rare in France such as lung infections, necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS). More unusual localizations such as meningitis, neonatal infections, severe ear and throat and gastrointestinal infections and vascular disorders are also described. Based on published series, mortality ranging from 0-8 % of cases, is high but still lower than that observed in adults. Probabilistic antibiotherapy includes a β-lactam with anti-SGA but also anti-staphylococcal (predominantly methi-S in France) activity such as clavulanic acid- amoxicillin followed by amoxicillin as soon as identification of SGA is performed. The addition of an anti-toxin antibiotic such as clindamycin is recommended particularly in NF or STSS or clinical signs suggestive of toxin production by the SGA (rash, gastrointestinal signs, hemodynamic disorders). The use of intravenous polyvalent immunoglobulins must also be discussed in NF and STSS. In all cases surgery should be discussed. The prognosis of these potentially very severe infections is related to their early diagnosis and treatment. A better understanding of the pathophysiology of these infections may optimize their management but also their prevention. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Interdisciplinary treatment of bruxism with an occlusal splint and cognitive behavioral therapy.

    PubMed

    Trindade, Marilene; Orestes-Cardoso, Silvana; de Siqueira, Teresa Cristina

    2015-01-01

    The etiology of bruxism is associated with exogenous factors, such as occlusal interference, stress, and anxiety, as well as endogenous factors involving neurotransmitters of the basal ganglia. Due to the multifactorial etiology of bruxism, interdisciplinary treatment involving professionals from different healthcare fields has been proposed. The aim of the present study was to compare 2 groups of patients with bruxism (11 in each group) treated with either an occlusal splint combined with cognitive behavioral therapy or an occlusal splint alone. Surface electromyography of the masseter and anterior temporal muscles at rest was performed before and after treatment. The mean amplitude of activity of all muscles was lower after treatment, except for the right anterior temporal muscle in the group treated with an occlusal splint alone. Mean amplitudes were greater in the anterior temporal muscles than in the masseter muscles. Significantly greater improvement was found in the group exposed to cognitive behavioral therapy (P < 0.05; analysis of variance and Student t tests). Therefore, the combination of occlusal splint and psychological therapy was more effective at achieving muscle relaxation than occlusal splint use alone.

  12. Self-Reported bruxism and associated factors in Israeli adolescents.

    PubMed

    Emodi Perlman, A; Lobbezoo, F; Zar, A; Friedman Rubin, P; van Selms, M K A; Winocur, E

    2016-06-01

    Little is known about the epidemiological characteristics of sleep and awake bruxism (SB and AB) in adolescents. The aims of the study were: to assess the prevalence rates of self-reported SB and AB in Israeli adolescents; to determine the associations between SB/AB and several demographical, exogenous and psychosocial factors in Israeli adolescents; and to investigate the possible concordance between SB and AB. The study made use of a questionnaire. The study population included 1000 students from different high schools in the centre of Israel. Prevalence of self-reported SB and AB in the Israeli adolescents studied was 9·2% and 19·2%, respectively. No gender difference was found regarding the prevalence of SB and AB. Multiple variable regression analysis revealed that the following predicting variables were related to SB: temporomandibular joint sounds (P = 0·002) and feeling stressed (P = 0·001). The following predicting variables were related to AB: age (P = 0·018), temporomandibular joint sounds (P = 0·002), oro-facial pain (P = 0·006), and feeling stressed (P = 0·002) or sad (P = 0·006). A significant association was found between SB and AB; that is, an individual reporting SB had a higher probability of reporting AB compared with an individual who did not report SB (odds ratio = 5·099). Chewing gum was the most common parafunction reported by adolescents. The results of this study demonstrate that self-reports of AB and SB are common in the Israeli adolescents population studied and are not related to gender. The significant correlation found between SB and AB may be a confounding bias that affects proper diagnosis of bruxism through self-reported questionnaires only. © 2016 John Wiley & Sons Ltd.

  13. Dental wear caused by association between bruxism and gastroesophageal reflux disease: a rehabilitation report.

    PubMed

    Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; Branco, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes Neto, Alfredo Júlio; Soares, Carlos José

    2007-08-01

    Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensitivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders.

  14. DENTAL WEAR CAUSED BY ASSOCIATION BETWEEN BRUXISM AND GASTROESOPHAGEAL REFLUX DISEASE: A REHABILITATION REPORT

    PubMed Central

    Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; Branco, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes, Alfredo Júlio; Soares, Carlos José

    2007-01-01

    Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders. PMID:19089153

  15. Association between sleep bruxism and gastroesophageal reflux disease.

    PubMed

    Mengatto, Cristiane Machado; Dalberto, Charlene da Silveira; Scheeren, Betina; Barros, Sérgio Gabriel Silva de

    2013-11-01

    Rhythmic masticatory muscle activity, including sleep bruxism (SB), can be induced in healthy individuals by experimental esophageal acidification, which plays an important role in the pathogenesis of gastroesophageal reflux disease (GERD). However, no robust evidence supports the association between SB and GERD. The purpose of this study was to investigate the association between SB and GERD. Forty-five individuals were eligible to participate in this observational transversal study at the Gastroenterology Service of the Clinical Hospital of Porto Alegre, Brazil. The participants were classified into 2 groups, those with and without GERD, according to the Montreal Criteria and pH-metry/endoscopy findings. The diagnosis of SB was not assessed in a sleep laboratory but was based on self-report plus clinical inspection, according to the minimal diagnostic criteria of the American Academy of Sleep Medicine. The Lipp Stress Symptom Inventory was used to evaluate self-perceived stress. Univariate and multiple logistic regression analyses were performed with SB as dependent variable and GERD, sex, age, body mass index, and stress as predictors (α=.05; 90% power). The study population included individuals with SB without GERD (13.3%) and individuals with SB with GERD (31.1%). In participants with GERD, the prevalence of SB was 73.7%. Only the variable GERD was significantly associated with SB (P=.017; odds ratio 6.58; 95% confidence interval 1.40-30.98), although adjusted for stress and age. Sleep bruxism is prevalent in GERD patients, and GERD is highly associated with SB. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  16. The relationship between bruxism, sleep quality, and headaches in schoolchildren

    PubMed Central

    Bortoletto, Carolina Carvalho; Salgueiro, Mônica da Consolação Canuto; Valio, Renata; Fragoso, Yara Dadalti; Motta, Pamella de Barros; Motta, Lara Jansiski; Kobayashi, Fernanda Yukie; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Deana, Alessandro; Bussadori, Sandra Kalil

    2017-01-01

    [Purpose] Present study aimed to evaluate the relationship between sleep bruxism and headache in school children. [Subjects and Methods] This study was conducted with 103 children aged 3–6 years. The exclusion criteria were early tooth loss, dental appliance was used, physical or psychological limitations, chronic disease and continuous medication. Sleep bruxism was diagnosed based on an indication by parents of the occurrence of teeth clenching/grinding and incisor/occlusal tooth wear, following the criteria of the American Academy of Sleep Medicine. Sleep quality was evaluated by a questionnarie, detailing the child’s sleep characteristics. [Results] Forty-nine children (47.6%) were diagnosed with sleep bruxism. Those with sleep bruxism were 3.25-fold more likely to present headache. Children whose parents were separated had a significantly greater frequency of sleep bruxism and primary headache. The relative risk of exhibiting primary headache was 13.1 among children with sleep bruxism whose parents were separated. [Conclusion] Children with SB demonstrated a greater risk of having primary headache and those whose parents were separated had a greater chance of having headache. Only sleep bruxism was associated with headache, clenching the teeth during waking hours was not correlated with primary headache. PMID:29200617

  17. Factors associated with bruxism in children with developmental disabilities.

    PubMed

    Souza, Valeska Aparecida Fernandes; Abreu, Mauro Henrique Nogueira Guimarães; Resende, Vera Lúcia Silva; Castilho, Lia Silva

    2015-01-01

    The aim of the present study was to investigate factors associated with bruxism in children aged from 1 to 13 years with developmental disabilities. A total of 389 dental records were examined. The bruxism analyzed was determined based on parental reports. The following variables were also analyzed: gender, age, International Code of Diseases (ICD), mouth breathing, history of gastroesophageal reflux, use of psychotropic drugs, gingival status, reports of xerostomia, hyperkinesis, pacifier use, thumb sucking and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without bruxism. Variables with a p-value < 0.25 in the bivariate analysis were incorporated into the logistic regression models. Females had a 0.44-fold (95%CI: 0.25 to 0.78) greater chance of exhibiting bruxism than males. Individuals with gastroesophageal reflux had a 2.28-fold (95%CI: 1.03 to 5.02) greater chance of exhibiting bruxism. Individuals with reported involuntary movements had a 2.24-fold (95%CI: 1.19 to 4.24) greater chance of exhibiting bruxism than those without such movements. Exhibiting involuntary movements, the male gender and gastroesophageal reflux are factors associated with bruxism in children with developmental disabilities.

  18. Correlation between occlusion and cervical posture in patients with bruxism.

    PubMed

    Cesar, Guilherme Manna; Tosato, Juliana de Paiva; Biasotto-Gonzalez, Daniela Ap

    2006-08-01

    The goal of this study was to evaluate head and neck posture in the rest position of patients with bruxism and patients without temporomandibular disorder signs or symptoms to further relate them with Angle's class of malocclusion. Fifty-six volunteers participated in this study, ages 18 to 27 years with an average age of 22.5 years. They were divided into 2 groups: Group B--28 subjects with parafunctions (teeth grinding or clenching); and Group C--28 subjects without parafunctional habits (control group). All participants were photographed, and their pictures were analyzed and compared with the software Alcimagem (Instrumental Concept and Movement Analysis Laboratory, Uberlândia, Minas Gerais, Brazil). The results demonstrated that variation of angular values did not present statistical difference for the studied groups. Regarding Angle's class of malocclusion, class I was predominant in Group C, and classes II and III were predominant in Group B. The mental-sternal angle calculated did not present statistical significance between the groups; however, there was a greater variation between the smaller angle and the higher angle in Group B, contrary to Group C.

  19. Polysomnography-Detected Bruxism in Children is Associated With Somatic Complaints But Not Anxiety.

    PubMed

    Alfano, Candice A; Bower, Joanne L; Meers, Jessica M

    2018-01-15

    Sleep bruxism (SB) is common in children and is associated with somatic symptoms and sleep disturbance. Etiological theories posit the role of anxiety, suggesting youth with anxiety disorders may be at high risk for SB, but empirical data are lacking. Furthermore, parent report rather than polysomnography (PSG) has been used to examine SB-anxiety relationships in children. We examined rates of PSG-detected compared to parent-reported SB in children with generalized anxiety disorder (GAD) and healthy controls. Associations among SB, somatic complaints, and sleep disturbance were also examined. Thirty-one children, aged 7-11 years, completed 1 night of PSG monitoring and 7 daily reports of somatic symptoms. Bruxism events were scored during stage R sleep, stage N1 sleep, and stage N2 sleep. Almost one-third of children showed evidence of SB based on PSG. No associations were identified between parent-reported and PSG-detected SB. Rates of SB did not differ between anxious and control groups, though children with GAD showed more tonic bruxisms during stage R sleep. Presence of SB predicted more muscle aches and stomach aches, and children with SB had more awake time after sleep onset than those without bruxism. Results indicate poor concordance between PSG-detected and parent-reported SB in children, suggesting that parent report alone is not a reliable method for detection. The lack of association between SB and anxiety status suggests that stress sensitivity rather than anxiety per se may be predictive of SB. Associations between SB, somatic symptoms, and sleep disturbance are congruent with the broader literature. © 2018 American Academy of Sleep Medicine

  20. Sound scattering by several zooplankton groups. II. Scattering models.

    PubMed

    Stanton, T K; Chu, D; Wiebe, P H

    1998-01-01

    Mathematical scattering models are derived and compared with data from zooplankton from several gross anatomical groups--fluidlike, elastic shelled, and gas bearing. The models are based upon the acoustically inferred boundary conditions determined from laboratory backscattering data presented in part I of this series [Stanton et al., J. Acoust. Soc. Am. 103, 225-235 (1998)]. The models use a combination of ray theory, modal-series solution, and distorted wave Born approximation (DWBA). The formulations, which are inherently approximate, are designed to include only the dominant scattering mechanisms as determined from the experiments. The models for the fluidlike animals (euphausiids in this case) ranged from the simplest case involving two rays, which could qualitatively describe the structure of target strength versus frequency for single pings, to the most complex case involving a rough inhomogeneous asymmetrically tapered bent cylinder using the DWBA-based formulation which could predict echo levels over all angles of incidence (including the difficult region of end-on incidence). The model for the elastic shelled body (gastropods in this case) involved development of an analytical model which takes into account irregularities and discontinuities of the shell. The model for gas-bearing animals (siphonophores) is a hybrid model which is composed of the summation of the exact solution to the gas sphere and the approximate DWBA-based formulation for arbitrarily shaped fluidlike bodies. There is also a simplified ray-based model for the siphonophore. The models are applied to data involving single pings, ping-to-ping variability, and echoes averaged over many pings. There is reasonable qualitative agreement between the predictions and single ping data, and reasonable quantitative agreement between the predictions and variability and averages of echo data.

  1. What sleep behaviors are associated with bruxism in children? A systematic review and meta-analysis.

    PubMed

    Guo, Huaqi; Wang, Tongxia; Li, Xuechao; Ma, Qiong; Niu, Xiaohong; Qiu, Jie

    2017-12-01

    The aim of this article was to assess the sleep behaviors that serve as risk factors related to bruxism in children ages 0 to 12 years by performing a systematic review and meta-analysis of published studies. Seven databases were searched to identify all peer-reviewed articles potentially relevant to the review. Data were pooled for random-effects modeling. Sleep risk factors related to bruxism in this age group are summarized using pooled odds ratios (ORs), 95% confidence intervals (CIs), and P values. Of 5637 initially identified articles, 14 met inclusion criteria. Study qualities of all case-control studies were high. Quality of cross-sectional studies was more variable. The pooled ORs, 95% CIs, and P values were as follows: snoring (2.86, 1.85-4.42, <0.0001), mouth breathing (1.51, 1.04-2.18, 0.029), restless sleep (2.31, 1.89-2.83, <0.0001), drooling (1.79, 1.07-2.97, 0.026), stomach position during sleep (1.70, 1.0-2.39, 0.003), and inadequate sleep time (2.56, 1.48-4.43, 0.001). Snoring, mouth breathing, restless sleep, drooling, stomach position during sleep, and lack of sleep were the risk factors related to bruxism in children.

  2. DNA homology among diverse spiroplasma strains representing several serological groups.

    PubMed

    Lee, I M; Davis, R E

    1980-11-01

    Deoxyribonucleic acid (DNA) homology among 10 strains of spiroplasma associated with plants and insects was assessed by analysis of DNA-DNA hybrids with single strand specific S1 nuclease. Based on DNA homology, the spiroplasmas could be divided into three genetically distinct groups (designated I, II, and III), corresponding to three separate serogroups described previously. DNA sequence homology between the three groups was less than or equal to 5%. Based on DNA homology, group I could be divided into three subgroups (A, B, and C) that corresponded to three serological subgroups of serogroup I. Subgroup A contained Spiroplasma citri strains Maroc R8A2 and C 189; subgroup B contained strains AS 576 from honey bee and G 1 from flowers; subgroup C contained corn stunt spiroplasma strains I-747 and PU 8-17. There was 27-54% DNA sequence homology among these three subgroups. Group II contained strains 23-6 and 27-31 isolated from flowers of tulip tree (Liriodendron tulipifera L.). Group III contained strains SR 3 and SR 9, other isolates from flowers of tulip tree. Based on thermal denaturation, guanine plus cytosine contents of DNA from five type strains representing all groups and subgroups were estimated to be close to 26 mol% for group I strains, close to 25 mol% for group II strains, and close to 29 mol% for group III strains. The genome molecular weights of these five type strains were all estimated to bae about 10(9).

  3. Influence of bruxism on survival of porcelain laminate veneers

    PubMed Central

    Agustín-Panadero, Rubén; Fons-Font, Antonio; Román-Rodríguez, Juan L.; Solá-Ruíz, María F.

    2014-01-01

    Objectives: This study aims to determine whether bruxism and the use of occlusal splints affect the survival of porcelain laminate veneers in patients treated with this technique. Material and Methods: Restorations were made in 70 patients, including 30 patients with some type of parafunctional habit. A total of 323 veneers were placed, 170 in patients with bruxism activity, and the remaining 153 in patients without it. A clinical examination determined the presence or absence of ceramic failure (cracks, fractures and debonding) of the restorations; these incidents were analyzed for association with bruxism and the use of splints. Results: Analysis of the ceramic failures showed that of the 13 fractures and 29 debonding that were present in our study, 8 fractures and 22 debonding were related to the presence of bruxism. Conclusions: Porcelain laminate veneers are a predictable treatment option that provides excellent results, recognizing a higher risk of failure in patients with bruxism activity. The use of occlusal splints reduces the risk of fractures. Key words:Veneer, fracture, debonding, bruxism, occlusal splint. PMID:23986018

  4. Association among stress, personality traits, and sleep bruxism in children.

    PubMed

    Serra-Negra, Junia M; Paiva, Saul M; Flores-Mendoza, Carmen E; Ramos-Jorge, Maria L; Pordeus, Isabela A

    2012-01-01

    The purpose of this study was to determine the association among stress levels, personality traits, and sleep bruxism in children. A population-based case control study (proportion=1:2) was conducted involving 120 7- to 11-year-olds with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from schools in Belo Horizonte, Minas Gerais, Brazil. The following instruments were used for data collection: questionnaire administered to parents; child stress scale; and neuroticism and responsibility scales of the big five questionnaire for children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism was diagnosed from parents' reports. The chi-square test, as well as binary and multivariate logistic regression, was applied for statistical analysis. In the adjusted logistic model, children with a high level of stress, due to psychological reactions (odds ratio=1.8; confidence interval=1.1-2.9) and a high sense of responsibility (OR=1.6; CI=1.0-2.5) vs those with low levels of these psychological traits, presented a nearly 2-fold greater chance of exhibiting the habit of sleep bruxism. High levels of stress and responsibility are key factors in the development of sleep bruxism among children.

  5. Does tooth wear status predict ongoing sleep bruxism in 30-year-old Japanese subjects?

    PubMed

    Baba, Kazuyoshi; Haketa, Tadasu; Clark, Glenn T; Ohyama, Takashi

    2004-01-01

    This study investigated whether tooth wear status can predict bruxism level. Sixteen Japanese subjects (eight bruxers and eight age- and gender-matched controls; mean age 30 years) participated in this study. From dental casts of these subjects, the tooth wear was scored by Murphy's method. Bruxism level in these subjects was also recorded for 5 consecutive nights in the subject's home environment using a force-based bruxism detecting system. The relationship between the tooth wear score and bruxism data was evaluated statistically. Correlation analysis between the Murphy's scores of maxillary and mandibular dental arch and bruxism event duration score revealed no significant relationship between tooth wear and current bruxism. Tooth wear status is not predictive of ongoing bruxism level as measured by the force-based bruxism detection system in 30-year-old Japanese subjects.

  6. Severe group A streptococcal infection and streptococcal toxic shock syndrome.

    PubMed

    Baxter, F; McChesney, J

    2000-11-01

    To review the literature on group A streptococcal toxic shock syndrome, (STSS). Medline and EMBASE searches were conducted using the key words group A streptococcal toxic shock syndrome, alone and in combination with anesthesia; and septic shock, combined with anesthesia. Medline was also searched using key words intravenous immunoglobulin, (IVIG) and group A streptococcus, (GAS); and group A streptococcus and antibiotic therapy. Other references were included in this review if they addressed the history, microbiology, pathophysiology, incidence, mortality, presentation and management of invasive GAS infections. Relevant references from the papers reviewed were also considered. Articles on the foregoing topics were included regardless of study design. Non-English language studies were excluded. Literature on the efficacy of IVIG and optimal antibiotic therapy was specifically searched. Reports of invasive GAS infections have recently increased. Invasive GAS infection is associated with a toxic shock syndrome, (STSS), in 8-14% of cases. The STSS characteristically results in shock and multi-organ failure soon after the onset of symptoms, and is associated with a mortality of 33-81%. Many of these patients will require extensive soft tissue debridement or amputation in the operating room, on an emergency basis. The extent of tissue debridement required is often underestimated before skin incision. Management of STSS requires volume resuscitation, vasopressor/inotrope infusion, antibiotic therapy and supportive care in an intensive care unit, usually including mechanical ventilation. Intravenous immunoglobulin infusion has been recommended. Further studies are needed to define the role of IVIG in STSS management and to determine optimal anesthetic management of patients with septic shock.

  7. Bruxism affects stress responses in stressed rats.

    PubMed

    Sato, Chikatoshi; Sato, Sadao; Takashina, Hirofumi; Ishii, Hidenori; Onozuka, Minoru; Sasaguri, Kenichi

    2010-04-01

    It has been proposed that suppression of stress-related emotional responses leads to the simultaneous activation of both sympathetic and parasympathetic divisions of the autonomic nervous system (ANS) and that the expression of these emotional states has a protective effect against ulcerogenesis. In the present study, we investigated whether stress-induced bruxism activity (SBA) has a physiological effect of on the stress-induced changes of the stomach, thymus, and spleen as well as blood leukocytes, cortisol, and adrenaline. This study demonstrated that SBA attenuated the stress-induced ulcer genesis as well as degenerative changes of thymus and spleen. SBA also attenuated increases of adrenaline, cortisol, and neutrophils in the blood. In conclusion, expression of aggression through SBA during stress exposure attenuates both stress-induced ANS response, including gastric ulcer formation.

  8. A vibratory stimulation-based inhibition system for nocturnal bruxism: a clinical report.

    PubMed

    Watanabe, T; Baba, K; Yamagata, K; Ohyama, T; Clark, G T

    2001-03-01

    For the single subject tested to date, the bruxism-contingent vibratory-feedback system for occlusal appliances effectively inhibited bruxism without inducing substantial sleep disturbance. Whether the reduction in bruxism would continue if the device no longer provided feedback and whether the force levels applied are optimal to induce suppression remain to be determined.

  9. Effectiveness of two physical therapy interventions, relative to dental treatment in individuals with bruxism: study protocol of a randomized clinical trial

    PubMed Central

    2014-01-01

    Background Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. Methods/Design Participants will be randomized into one of three groups: Group 1 (n = 24) intervention will consist of massage and stretching exercises; Group 2 (n = 24) will consist of relaxation and imagination therapies; and Group 3 (n = 24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile - 14. Significance level will be determined at the 5% level. Discussion This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and

  10. Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism.

    PubMed

    van der Zaag, Jacques; Lobbezoo, Frank; Wicks, Darrel J; Visscher, Corine M; Hamburger, Hans L; Naeije, Machiel

    2005-01-01

    To assess the efficacy of occlusal stabilization splints in the management of sleep bruxism (SB) in a double-blind, parallel, controlled, randomized clinical trial. Twenty-one participants were randomly assigned to an occlusal splint group (n = 11; mean age = 34.2 +/- 13.1 years) or a palatal splint (ie, an acrylic palatal coverage) group (n = 10; mean age = 34.9 +/- 11.2 years). Two polysomnographic recordings that included bilateral masseter electromyographic activity were made: one prior to treatment, the other after a treatment period of 4 weeks. The number of bruxism episodes per hour of sleep (Epi/h), the number of bursts per hour (Bur/h), and the bruxism time index (ie, the percentage of total sleep time spent bruxing) were established as outcome variables at a 10% maximum voluntary contraction threshold level. A general linear model was used to test both the effects between splint groups and within the treatment phase as well as their interaction for each outcome variable. Neither occlusal stabilization splints nor palatal splints had an influence on the SB outcome variables or on the sleep variables measured on a group level. In individual cases, variable outcomes were found: Some patients had an increase (33% to 48% of the cases), while others showed no change (33% to 48%) or a decrease (19% to 29%) in SB outcome variables. The absence of significant group effects of splints in the management of SB indicates that caution is required when splints are indicated, apart from their role in the protection against dental wear. The application of splints should therefore be considered at the individual patient level.

  11. Electromyogram biofeedback training for daytime clenching and its effect on sleep bruxism.

    PubMed

    Sato, M; Iizuka, T; Watanabe, A; Iwase, N; Otsuka, H; Terada, N; Fujisawa, M

    2015-02-01

    Bruxism contributes to the development of temporomandibular disorders as well as causes dental problems. Although it is an important issue in clinical dentistry, no treatment approaches have been proven effective. This study aimed to use electromyogram (EMG) biofeedback (BF) training to improve awake bruxism (AB) and examine its effect on sleep bruxism (SB). Twelve male participants (mean age, 26·8 ± 2·5 years) with subjective symptoms of AB or a diagnosis of SB were randomly divided into BF (n = 7) and control (CO, n = 5) groups to undergo 5-h daytime and night-time EMG measurements for three consecutive weeks. EMG electrodes were placed over the temporalis muscle on the habitual masticatory side. Those in the BF group underwent BF training to remind them of the occurrence of undesirable clenching activity when excessive EMG activity of certain burst duration was generated in week 2. Then, EMGs were recorded at week 3 as the post-BF test. Those in the CO group underwent EMG measurement without any EMG BF training throughout the study period. Although the number of tonic EMG events did not show statistically significant differences among weeks 1-3 in the CO group, events in weeks 2 and 3 decreased significantly compared with those in week 1, both daytime and night-time, in the BF group (P < 0·05, Scheffé's test). This study results suggest that EMG BF to improve AB tonic EMG events can also provide an effective approach to regulate SB tonic EMG events. © 2014 John Wiley & Sons Ltd.

  12. Bruxism: is it a new sign of the cardiovascular diseases?

    PubMed

    Atilgan, Z; Buyukkaya, R; Yaman, F; Tekbas, G; Atilgan, S; Gunay, A; Palanci, Y; Guven, S

    2011-12-01

    To determine the relationship between bruxism and cardiovascular diseases. 120 patients who referred to the Dentistry Faculty with the complaint of bruxism were selected. All patients gave informed consent for participation in the study. All of the patients were examined and bruxism was classified. And also these were examined by B-mode ultrasound to measure the Intima Media Thickness (IMT) at the far wall of the common carotid artery. A wide range of vascular risk factors including age, gender, body mass index, and previous history were surveyed. Spearman correlation analysis was performed to ascertain quantitative comparison, Mann-Whitney U and Kruskal-Wallis test were used for comparison of means There were 66 (55%) male and 54 (45%) female patients, with a female to male ratio of 1/1.2. The mean age was 35.6 +/- 1,25 years (range 18-65 years). In the analysis of bruxism classification and IMT there was a statistical significance between bruxism classification subgroup 1, 2, 3 and IMT. There was no statistical significance between bruxism classification Subgroup 4 and IMT due to the small number of the patients (n = 12). Stressful situations can cause both bruxism and cardiovascular disease such as coronary artery diseases, hypertension, arrhythmias, cardiomyopathy. The statistical analysis supported this hypothesis. However, we need to new studies with large number of samples to confirm this hypothesis. Clearly, future studies in this field will need to take into consideration the influence of the following variables: age, use of medication or drugs, smoking habits, and other sleep disorders.

  13. 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.

  14. [Bruxism, temporo-mandibular dysfunction and botulinum toxin].

    PubMed

    Chikhani, L; Dichamp, J

    2003-07-01

    Tooth grinding and tooth clenching are unvoluntary mainly nocturnal habits that result in an hypertrophy of masseter and temporalis muscles with an unbalance between opening and closing muscles of the jaw and lead to an alteration of mandibular condyles movements and to hyper pressure in the temporo-mandibular joints (TMJ) which can generate severe pain. Intra muscular injections of botulinum toxin permit to restablish the balance between closing and opening muscles, to relieve pain, to treat masseteric hypertrophy with improvement of face outline and to recover a normal cinetic of temporo-mandibular joints. Moreover, botulinum toxin injections permit to quit habits of tooth grinding and clenching and one single session of injections is curative for 2/3 of the patients. There are no side effects apart from slight diffusion to superficial muscles of the face resulting in a "fixed" smile for about 6 to 8 weeks. So injections of botulinum toxin in masseter and temporalis muscles are an efficient treatment of bruxism and TMJ dysfunction, cheap with no lasting side effect.

  15. Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls.

    PubMed

    Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Klausner, J J; Krieger, A C; Lavigne, G J

    2015-10-01

    Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of oro-facial problems, including temporomandibular disorders (TMD). As laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n = 124) and a demographically matched control group without TMD (n = 46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for the presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict the presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. © 2015 John Wiley & Sons Ltd.

  16. Validity of Self-reported Sleep Bruxism among Myofascial Temporomandibular Disorder Patients and Controls

    PubMed Central

    Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of orofacial problems, including temporomandibular disorders (TMD). Since laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n=124) and a demographically matched control group without TMD (n=46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. PMID:26010126

  17. Bruxism and genetics: a review of the literature.

    PubMed

    Lobbezoo, F; Visscher, C M; Ahlberg, J; Manfredini, D

    2014-09-01

    People who suffer from bruxism (teeth-grinding) often ask their dentists whether their condition is hereditary. The purpose of this study is to enable dentists to provide an 'evidence-based' answer to this question. The biomedical literature was searched using PubMed, and 32 publications were identified, of which nine proved relevant to the research question. The references cited by the publications identified yielded one further publication, bringing the total number of publications included in the analysis to 10. Four publications related to family studies, five related to twin studies and one related to a DNA analysis. With the exception of one of the twin studies, all the included studies concluded that bruxism appears to be (in part) genetically determined. Dentists whose patients ask them about bruxism can therefore tell them that teeth-grinding does indeed 'run in families'. © 2014 John Wiley & Sons Ltd.

  18. Digital imaging of patterns of dental wear to diagnose bruxism in children.

    PubMed

    Restrepo, C; Peláez, A; Alvarez, E; Paucar, C; Abad, P

    2006-07-01

    The aim of this study was to evaluate and compare the area, perimeter, and form (D factor and fractal dimension) of the dental wear among bruxist and nonbruxist children with mixed dentition in order to determine if the dental wear may be used as criteria to diagnose bruxism. The children were 8 to 11 years old and were classified as bruxist or nonbruxist, according to anxiety level and temporomandibular disorders. Dental casts of the upper arch were obtained for the bruxist (n = 24) and the control (n = 29) group. The dental wear was measured in digital format and processed automatically. The complete and pathological dental wear was compared between the two groups, using the Student's t-test and Mann-Whitney test. Statistically significant differences were observed between the two groups, with a higher area, perimeter, and more irregular form of the pathological dental wear among the bruxist group. Regarding complete dental wear, differences were only significant for the D factor (an un-dimensional quantitative parameter which produces a relation between the area and the perimeter of an object). Digital imaging of dental wear may be used as criteria to diagnose bruxism in children with mixed dentition after making an analysis of the area, perimeter, and irregularity of the form of pathological dental wear.

  19. Changes in the temporomandibular joint disc and temporal and masseter muscles secondary to bruxism in Turkish patients

    PubMed Central

    Garip, Hasan; Tufekcioglu, Sukran; Kaya, Emre

    2018-01-01

    Objectives: To analyze the relationships between temporalis and masseter muscle hypertrophy and temporomandibular joint (TMJ) disc displacement in patients with severe bruxism using magnetic resonance imaging (MRI). Methods: This retrospective study included 100 patients with severe bruxism, referred to the Department of Oral and Maxillofacial Surgery, University of Marmara and Istanbul Medipol University, Istanbul, Turkey, between January 2015 and December 2016. Patients underwent TMJ MRI with a 1.5-T system in open and closed mouth positions. The masseter and temporalis muscles were measured in the axial plane when the patient’s mouth was closed. Results: At its thinnest, the disc averaged was 1.11±0.24 mm. At their thickest, the masseter averaged was 13.65±2.19 mm and temporalis muscles was 12.98±2.4 mm. Of the discs, 24% were positioned normally, 74% were positioned anteriorly, and 2% were positioned posteriorly. The temporalis muscle was significantly thicker in patients with normally positioned discs than in those with anteriorly positioned discs (p=0.035). Conclusions: The temporalis muscle was significantly thicker in patients with normally positioned discs than in those with anteriorly positioned discs (p=0.035). Additional studies should be conducted to evaluate the relationships between all masticatory and surrounding muscles and disc movements in patients with bruxism. PMID:29332113

  20. Effects of clear aligners on sleep bruxism: randomized controlled trial.

    PubMed

    Castroflorio, T; Bargellini, A; Lucchese, A; Manuelli, M; Casasco, F; Cugliari, G; Cioffi, I; Deregibus, A

    2018-01-01

    The possible effects on sleep bruxism (SB) of clear aligners in orthodontics are unknown. This study was conducted to analyze the effects of clear aligners on SB. Sixty subjects needing orthodontic treatment and affected by SB (33 m, 27 f, 20±;5 years) were enrolled in the study and randomly assigned to one of the following three groups: 20 were given clear aligners (CAT) (12 m, 8 f, 19±5 years), 20 occlusal splint (MOS) (9 m, 11 f, 22±5 years) and 20 a placebo splint (PMS) (12 m, 8 f, 24±3 years). All groups were followed for 6 consecutive months and monitored for SB with a portable electromyographic-electrocardiographic (EMG-ECG) device (Bruxoff®, OT Bioelettronica, Torino, Italy). MOS subjects reduced masseter contractions after 6 months of treatment (t3) (MD=-29.11, std. error 11.74, p=0.017) but increased phasic contractions related to SB after 3 months of treatment (t2) (MD=4.73, std. error 2.36, p=0.048) and tonic contractions related to SB during all the six months of treatment (t1, t2, t3) when compared to PMS. CAT subjects increased phasic contractions related to SB during the first (t1) (MD=3.94, std. error 2.27, p=0.04) and the third month (t2) of treatment (MD=4.62, std. error 2.36, p=0.046) when compared to PMS. No significant differences were found for SB index at any time for all the three groups. Although MOS and CAT affected EMG signals during sleep time differently, they did not influence the overall SB index.

  1. Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students.

    PubMed

    Huhtela, Outi S; Näpänkangas, Ritva; Joensuu, Tiina; Raustia, Aune; Kunttu, Kristina; Sipilä, Kirsi

    2016-01-01

    To evaluate the prevalence of self-reported bruxism and symptoms of temporomandibular disorders (TMD) and to investigate their association in academic and applied science university students in Finland. The data were gathered from 4,403 Finnish students included in the Finnish Student Health Survey 2012. The comprehensive questionnaire included five questions concerning bruxism and TMD symptoms. Bivariate associations between self-reported bruxism and TMD symptoms were evaluated using chi-square tests, and logistic regression model was used with age and gender as factors. Sleep bruxism was reported by 21.0% of women and by 12.5% of men, awake bruxism by 2.0% of women and by 2.8% of men, and both sleep and awake bruxism by 7.2% of women and by 3.2% of men. TMD pain was reported by 25.9% of women and by 11.4% of men and temporomandibular joint (TMJ) pain on jaw movement by 9.6% of women and by 4.2% of men. Report of sleep bruxism increased the risk for all TMD symptoms in both genders. Among women, report of awake bruxism increased the risk for TMD pain and TMJ pain on jaw movement. Reporting stress as a perpetuating factor for TMD pain increased the risk for both sleep and awake bruxism in both genders. The logistic regression analysis (including age and gender) showed that report of sleep bruxism and/or awake bruxism was associated with TMD pain (Odds Ratio [OR] = 5.71; 95% confidence interval [CI] = 4.86-6.70), TMJ pain on jaw movement (OR = 4.49; 95% CI = 3.54-5.69), and TMJ locking (OR = 2.98; 95% CI = 2.17-4.10). Bruxism and TMD symptoms are frequent in Finnish university students. Self-reported bruxism is associated with TMD symptoms, confirming earlier findings.

  2. Sleep bruxism associated with obstructive sleep apnoea syndrome - A pilot study using a new portable device.

    PubMed

    Winck, M; Drummond, M; Viana, P; Pinho, J C; Winck, J C

    Sleep bruxism (SB) and obstructive sleep apnoea syndrome (OSAS) share common pathophysiologic pathways. We aimed to study the presence and relationship of SB in a OSAS population. Patients referred with OSAS suspicion and concomitant SB complains were evaluated using a specific questionnaire, orofacial evaluation and cardio-respiratory polygraphy that could also monitor audio and EMG of the masseter muscles. From 11 patients studied 9 had OSAS. 55.6% were male, mean age was 46.3±11.3 years, and apnea hypopnea index of 11.1±5.7/h. Through specific questionnaire 55.6% had SB criteria. Orofacial examination (only feasible in 3) confirmed tooth wear in all. 77.8% had polygraphic SB criteria (SB index>2/h). Mean SB index was 5.12±3.6/h, phasic events predominated (72.7%). Concerning tooth grinding episodes, we found a mean of 10.7±9.2 per night. All OSAS patients except two (77.8%) had more than two audible tooth-grinding episodes. These two patients were the ones with the lowest SB index (1.0 and 1.4 per hour). Only in one patient could we not detect tooth grinding episodes. There was a statistically significant positive correlation between tooth grinding episodes and SB index and phasic event index (R=0.755, p=0.019 and R=0.737, p=0.023 respectively, Pearson correlation). Mean apnoea to bruxism index was 0.4/h, meaning that only a minority of SB events were not secondary to OSAS. We could not find any significant correlation between AHI and bruxism index or phasic bruxism index (R=-0.632 and R=-0.611, p>0.05, Pearson correlation). This pilot study shows that SB is a very common phenomenon in a group of mild OSAS patients, probably being secondary to it in the majority of cases. The new portable device used may add diagnostic accuracy and help to tailor therapy in this setting. Copyright © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  3. Intricate Assessment and Evaluation of Effect of Bruxism on Long-term Survival and Failure of Dental Implants: A Comparative Study.

    PubMed

    Yadav, Kajal; Nagpal, Abhishek; Agarwal, S K; Kochhar, Aarti

    2016-08-01

    Dental implants are one of the common lines of treatment used for the treatment of missing tooth. Various risk factors are responsible for the failure of the dental implants and occurrence of postoperative complications. Bruxism is one such factor responsible for the failure of the dental implants. The actual relation between bruxism and dental implants is a subject of long-term controversy. Hence, we carried out this retrospective analysis to assess the complications occurring in dental implants in patients with and without bruxism. The present study included 1100 patients which were treated for rehabilitation by dental implant procedure at 21 dental offices of Ghaziabad (India) from 2004 to 2014. Analyzing the clinical records of the patients along with assessing the photographs of the patients was done for confirming the diagnosis of bruxism. Clinical re-evaluation of the patients, who came back for follow-up, was done to confirm the diagnosis of bruxism. Systemic questionnaires as used by previous workers were used to evaluate the patients about the self-conscience of the condition. Estimation of the mechanical complications was done only in those cases which occurred on the surfaces of the restoration of the dental implants. All the results were analyzed by Statistical Package for Social Sciences (SPSS) software. Student's t-test and Pearson's chi-square test were used to evaluate the level of significance. In both bruxer and non-bruxers, maximum number of dental implants was placed in anterior maxillary region. Significant difference was obtained while comparing the two groups for dimensions of the dental implants used. On comparing the total implant failed cases between bruxers and non-bruxers group, statistically significant result was obtained. Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit. Success of dental implant is significantly

  4. Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders.

    PubMed

    Candirli, C; Korkmaz, Y T; Celikoglu, M; Altintas, S H; Coskun, U; Memis, S

    2016-01-01

    The aim of this study was to investigate dentist's approaches to the use of splint therapy for myofascial pain, bruxism, and temporomandibular joint (TMJ) disorders and to assessment of treatment modalities. A 12-item questionnaire was developed to determine dentists' knowledge of TMJ disorders and approaches for occlusal splint treatments. The researchers spoke with each dentist included in the study at his/her clinic or by telephone to assess their immediate knowledge and approach to the TMJ disorders. Chi-squared test was performed to analyze the values. The confidence interval was set as 95%. A total of 370 dentists working in Turkey were participated in this study. The most common splint application reason for occlusal splint treatment was bruxism (77.8%) while TMJ pain was very rare (%1.4). The use of hard splint ratios for 0-5 years of professional experience was 57.0%, 42.4.0%, and 26.8% for the experience of 5-15 years and over 15 years groups, respectively (P < 0.001). While the dentists' with sufficient knowledge soft splint application rates were 11.6%, hard splint application rates were 43.4% for the dentists with sufficient knowledge. Occlusion adjustment rate of dentists who practice in all three groups was under 16.0%. The knowledge of the dentists about TMJ disorders and occlusal splint therapy were found to be insufficient. Their knowledge decreased with increasing experience.

  5. A piezoelectric film-based intrasplint detection method for bruxism.

    PubMed

    Takeuchi, H; Ikeda, T; Clark, G T

    2001-08-01

    An accurate, easy-to-use, long-term method other than EMG is needed to monitor bruxism. This article presents pilot data on the reproducibility, validity, and utility of an intrasplint piezoelectric film method. Simulated bruxism behaviors (steady-state and rhythmic clenching, grinding, and tapping) in 5 subjects were recorded with the use of both masseter EMG and an intrasplint piezoelectric film method. Correlation coefficients calculated for simulated bruxism event duration with the use of a masseter EMG or an intrasplint piezoelectric film method were 0.99 for tapping and steady-state clenching, 0.96 for rhythmic clenching, and 0.79 for grinding. Piezoelectric film has its limitations and does not faithfully capture sustained force magnitudes. However, for the target behaviors associated with bruxism (tooth grinding, clenching, and tapping), it appears to faithfully reproduce above-baseline events with durations statistically indistinguishable from those recorded with masseter EMG. Masseter EMG was poorest at detecting a simulated side-to-side grinding behavior.

  6. Patents related to the treatment and diagnosis of bruxism.

    PubMed

    Felicíssimo, Kenya; Quintella, Cristina; Stuginski-Barbosa, Juliana; Salles, Cristina; Rangel, Flora; Barreto, Leandro

    2018-06-06

    Bruxism is among the most chronic dental problems worldwide, and its perception may increase indicatively the condition of people's health, avoiding future health problems. Technologic solutions have improved considerably due to new diagnostic and treatment technologies and their automation. This review aims to assess therapeutic methods for bruxism through analysis of patent applications spanning recent decades. Areas covered: Patent families of bruxism, and products available on the market. Data were obtained through Questel Orbit from the European Patent Office on a worldwide basis using Cooperative Patent Classification (CPC), analyzing 134 patent families. The products on the market were mapped and classified as used for diagnosis, treatment or both. Expert opinion: This technological prospect has shown that the technological field of bruxism is growing toward smaller, automated devices; there is still no predominant owner of the technologies. Products are expected to provide home use with a high degree of reliability and specificity, using the Internet of Things (telemedicine associated with industry 4.0) and enabling real-time diagnosis.

  7. Sleep Bruxism in Respiratory Medicine Practice.

    PubMed

    Mayer, Pierre; Heinzer, Raphael; Lavigne, Gilles

    2016-01-01

    Sleep bruxism (SB) consists of involuntary episodic and repetitive jaw muscle activity characterized by occasional tooth grinding or jaw clenching during sleep. Prevalence decreases from 20% to 14% in childhood to 8% to 3% in adulthood. Although the causes and mechanisms of idiopathic primary SB are unknown, putative candidates include psychologic risk factors (eg, anxiety, stress due to life events, hypervigilance) and sleep physiologic reactivity (eg, sleep arousals with autonomic activity, breathing events). Although certain neurotransmitters (serotonin, dopamine, noradrenalin, histamine) have been proposed to play an indirect role in SB, their exact contribution to rhythmic masticatory muscle activity (RMMA) (the electromyography marker of SB) genesis remains undetermined. No specific gene is associated with SB; familial environmental influence plays a significant role. To date, no single explanation can account for the SB mechanism. Secondary SB with sleep comorbidities that should be clinically assessed are insomnia, periodic limb movements during sleep, sleep-disordered breathing (eg, apnea-hypopnea), gastroesophageal reflux disease, and neurologic disorders (eg, sleep epilepsy, rapid eye movement behavior disorder). SB is currently quantified by scoring RMMA recordings in parallel with brain, respiratory, and heart activity recordings in a sleep laboratory or home setting. RMMA confirmation with audio-video recordings is recommended for better diagnostic accuracy in the presence of neurologic conditions. Management strategies (diagnostic tests, treatment) should be tailored to the patient's phenotype and comorbidities. In the presence of sleep-disordered breathing, a mandibular advancement appliance or CPAP treatment is preferred over single occlusal splint therapy on the upper jaw. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  8. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms.

    PubMed

    van der Meer, Hedwig A; Speksnijder, Caroline M; Engelbert, Raoul H H; Lobbezoo, Frank; Nijhuis-van der Sanden, Maria W G; Visscher, Corine M

    2017-09-01

    The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study the influence of possible confounding factors on this association, the regression models were extended with age, sex, bruxism, stress, depression, and somatic symptoms. Of the included patients (n=203), 67.5% experienced headaches. In the subsample of patients with a painful TMD (n=58), the prevalence of self-reported headaches increased to 82.8%. The associations found between self-reported headache and (1) painful TMD and (2) function-related TMD were confounded by the presence of somatic symptoms. For probable migraine, both somatic symptoms and bruxism confounded the initial association found with painful TMD. The findings of this study imply that there is a central working mechanism overlapping TMD and headache. Health care providers should not regard these disorders separately, but rather look at the bigger picture to appreciate the complex nature of the diagnostic and therapeutic process.

  9. Effect of mandibular advancement device on sleep bruxism score and sleep quality.

    PubMed

    Solanki, Nehal; Singh, Balendra Pratap; Chand, Pooran; Siddharth, Ramashankar; Arya, Deeksha; Kumar, Lakshya; Tripathi, Suryakant; Jivanani, Hemant; Dubey, Abhishek

    2017-01-01

    The use of mandibular advancement devices (MADs) in the treatment of sleep bruxism is gaining widespread importance. However, the effects of MADs on sleep bruxism scores, sleep quality, and occlusal force are not clear. The purpose of this clinical study was to analyze the effect of MADs on sleep bruxism scores, sleep quality, and occlusal force. This uncontrolled before and after study enrolled 30 participants with sleep bruxism. Outcomes assessed were sleep quality, sleep bruxism scores (sleep bruxism bursts and sleep bruxism episodes/hour), and occlusal force before and after 15 and 30 days of using a MAD. Sleep bruxism scores were assessed by ambulatory polysomnography and sleep quality by using the Pittsburgh sleep quality index (PSQI). Occlusal force was recorded by using a digital gnathodynamometer in the first molar region on both sides. Statistical analysis was done by 1-factor repeated measures ANOVA (α=.05). Statistically significant reductions in sleep bruxism bursts/h, sleep bruxism episodes/h, and PSQI scores were found after 15 and 30 days of using a MAD (P<.001). Statistically significant reduction in occlusal force on both sides was found only after 15 days (P<.001) but not after 30 days of using a MAD (P=.292 on left side, and P=.575 on the right side). The study showed a short-term improvement in sleep bruxism scores, sleep quality, and reduction in occlusal force in sleep bruxism participants after using MADs. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. EVALUATION OF A MULTICOMPONENT INTERVENTION FOR DIURNAL BRUXISM IN A YOUNG CHILD WITH AUTISM

    PubMed Central

    Barnoy, Emily L; Najdowski, Adel C; Tarbox, Jonathan; Wilke, Arthur E; Nollet, Megan D

    2009-01-01

    Bruxism, forceful grinding of one's teeth together, can produce destructive outcomes such as wear on the teeth and damaged gums and bone structures. The current study implemented a multicomponent intervention that consisted of vocal and physical cues to decrease rates of bruxism. A partial component analysis suggested that the vocal cue was only effective at decreasing levels of bruxism when paired with a simultaneous physical cue. PMID:20514192

  11. Different association between specific manifestations of bruxism and temporomandibular disorder pain.

    PubMed

    Berger, Marcin; Szalewski, Leszek; Szkutnik, Jacek; Ginszt, Michał; Ginszt, Apolinary

    A growing body of evidence suggests that bruxism exists in two separate manifestations. However, little is known about the association between specific manifestations of bruxism and temporomandibular disorder (TMD) pain. The aim of our study was to analyze the association between TMD pain and specific diagnoses of bruxism (sleep, awake, and mixed diagnosis of sleep and awake bruxism). 508 adult patients (296 women and 212 men), aged between 18 and 64 years (mean age 34±12 years), attending to a clinic for general dental treatment. Patients were asked to fill an anonymous questionnaire, consisting of three questions, verifying the presence of TMD pain and two forms of bruxism. All questions were based on the Polish version of the Research Diagnostic Criteria for Temporomandibular Disorders patient history questionnaire. Cross tabulation was done, and χ 2 was used as a test of significance to find the association between the variables. Awake bruxism was associated with TMD pain only in men (χ 2 =7.746, p<0.05) while mixed diagnosis of bruxism was associated with TMD pain in both women (χ 2 =10.486, p<0.05) and men (χ 2 =4.314, p<0.05). There was no statistically significant association between sleep bruxism and TMD pain. Gender-related differences in the presence of all bruxism diagnoses were also statistically insignificant. Interaction between sleep and awake bruxism may increase the risk for TMD pain. We suggest considering concomitance as a confounder, when studying sleep or awake bruxism. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  12. Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation

    PubMed Central

    Shim, Young Joo; Lee, Moon Kyu; Kato, Takafumi; Park, Hyung Uk; Heo, Kyoung; Kim, Seong Taek

    2014-01-01

    Study Objectives: To investigate the effects of botulinum toxin type A (BoNT-A) injection on jaw motor episodes during sleep in patients with or without orofacial pain who did not respond to oral splint treatment. Methods: Twenty subjects with a clinical diagnosis of SB completed this study. Ten subjects received bilateral BoNT-A injections (25 U per muscle) into the masseter muscles only (group A), and the other 10 received the injections into both the masseter and temporalis muscles (group B). Video-polysomnographic (vPSG) recordings were made before and at 4 weeks after injection. Rhythmic masticatory muscle activity (RMMA) and orofacial activity (OFA) were scored and analyzed for several parameters (e.g., frequency of episodes, bursts per episode, episode duration). The peak amplitude of electromyographic (EMG) activity in the two muscles was also measured. Results: BoNT-A injection did not reduce the frequency, number of bursts, or duration for RMMA episodes in the two groups. The injection decreased the peak amplitude of EMG burst of RMMA episodes in the injected muscles (p < 0.001, repeated measure ANOVA) in both groups. At 4 weeks after injection, 9 subjects self-reported reduction of tooth grinding and 18 subjects self-reported reduction of morning jaw stiffness. Conclusions: A single BoNT-A injection is an effective strategy for controlling SB for at least a month. It reduces the intensity rather than the generation of the contraction in jaw-closing muscles. Future investigations on the efficacy and safety in larger samples over a longer follow-up period are needed before establishing management strategies for SB with BoNT-A. Citation: Shim YJ; Lee MK; Kato T; Park HU; Heo K; Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation. J Clin Sleep Med 2014;10(3):291-298. PMID:24634627

  13. A psychotherapeutic approach to task-oriented groups of severely ill patients.

    PubMed Central

    Wilson, W. H.; Diamond, R. J.; Factor, R. M.

    1985-01-01

    This paper presents a conceptual approach for leading various types of groups of chronically mentally ill patients. Although these groups may have a concrete, task-oriented purpose, with skillful leadership they also function as psychotherapy groups. The developmental deficits in ego functions, object relations, and social skills that severely impair such groups can be compensated by non-interpretative actions of the therapists. The group leader must actively work to provide for the structure, stability, and safety of the group when group members are unable to provide these for themselves. PMID:4049917

  14. Tiagabine May Reduce Bruxism and Associated Temporomandibular Joint Pain

    PubMed Central

    Kast, R. E.

    2005-01-01

    Tiagabine is an anticonvulsant gamma-aminobutyric acid reuptake inhibitor commonly used as an add-on treatment of refractory partial seizures in persons over 12 years old. Four of the 5 cases reported here indicate that tiagabine might also be remarkably effective in suppressing nocturnal bruxism, trismus, and consequent morning pain in the teeth, masticatory musculature, jaw, and temporomandibular joint areas. Tiagabine has a benign adverse-effect profile, is easily tolerated, and retains effectiveness over time. Bed partners of these patients report that grinding noises have stopped; therefore, the tiagabine effect is probably not simply antinociceptive. The doses used to suppress nocturnal bruxism at bedtime (4–8 mg) are lower than those used to treat seizures. PMID:16252740

  15. [EEG changes in symptomatic headache caused by bruxism].

    PubMed

    Wieselmann, G; Grabmair, W; Logar, C; Permann, R; Moser, F

    1987-02-20

    EEG recordings were carried out on 36 patients with the verified diagnosis of bruxism and unilateral headache. Occlusal splints were applied in the long-term management of these patients. Initial EEG recordings showed pathological changes in 56% of the patients. The EEG recordings were repeated two and six weeks later in these patients and following improvement in the clinical symptomatology pathological EEG patterns were detected in only 22% of all cases. This decrease is of statistical significance.

  16. Clinical Management of Implant Prostheses in Patients with Bruxism

    PubMed Central

    Komiyama, Osamu; Lobbezoo, Frank; De Laat, Antoon; Iida, Takashi; Kitagawa, Tsuyoshi; Murakami, Hiroshi; Kato, Takao; Kawara, Misao

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism. PMID:22701484

  17. Evaluation of a Multicomponent Intervention for Diurnal Bruxism in a Young Child with Autism

    ERIC Educational Resources Information Center

    Barnoy, Emily L.; Najdowski, Adel C.; Tarbox, Jonathan; Wilke, Arthur E.; Nollet, Megan D.

    2009-01-01

    Bruxism, forceful grinding of one's teeth together, can produce destructive outcomes such as wear on the teeth and damaged gums and bone structures. The current study implemented a multicomponent intervention that consisted of vocal and physical cues to decrease rates of bruxism. A partial component analysis suggested that the vocal cue was only…

  18. Bruxism is unlikely to cause damage to the periodontium: findings from a systematic literature assessment.

    PubMed

    Manfredini, Daniele; Ahlberg, Jari; Mura, Rossano; Lobbezoo, Frank

    2015-04-01

    This paper systematically reviews the MEDLINE and SCOPUS literature to answer the following question: Is there any evidence that bruxism may cause periodontal damage per se? Clinical studies on humans, assessing the potential relationship between bruxism and periodontal lesions (i.e., decreased attachment level, bone loss, tooth mobility/migration, altered periodontal perception) were eligible. Methodologic shortcomings were identified by the adoption of the Critical Appraisal Skills Program quality assessment, mainly concerning the internal validity of findings according to an unspecific bruxism diagnosis. The six included articles covered a high variability of topics, without multiple papers on the same argument. Findings showed that the only effect of bruxism on periodontal structures was an increase in periodontal sensation, whereas a relationship with periodontal lesions was absent. Based on the analysis of Hill criteria, the validity of causation conclusions was limited, mainly owing to the absence of a longitudinal evaluation of the temporal relationship and dose-response effects between bruxism and periodontal lesions. Despite the scarce quantity and quality of the literature that prevents sound conclusions on the causal link between bruxism and the periodontal problems assessed in this review, it seems reasonable to suggest that bruxism cannot cause periodontal damage per se. It is also important to emphasize, however, that because of methodologic problems, particularly regarding sleep bruxism assessment, more high-quality studies (e.g., randomized controlled trials) are needed to further clarify this issue.

  19. Efficacy of botulinum toxins on bruxism: an evidence-based review.

    PubMed

    Long, Hu; Liao, Zhengyu; Wang, Yan; Liao, Lina; Lai, Wenli

    2012-02-01

    The objective of this study was to assess the efficacy of botulinum toxins on bruxism. Electronic databases (PubMed, Embase and Science Citation Index), websites (Cochrane Central Register of Controlled Trials and ClinicalTrials.gov) and the literature database of SIGLE (System for Information on Grey Literature in Europe) were searched from January 1990 to April 2011 for randomised controlled trials or nonrandomised studies assessing the efficacy of botulinum toxins on bruxism. There was no language restriction. Through a predefined search strategy, we retrieved 28 studies from PubMed, 94 from Embase, 60 from the Science Citation Index, two ongoing clinical trials and two from the Cochrane Central Register of Controlled Trials. Of these, only four studies met our inclusion criteria and were finally included. Of the four included studies, two were randomised controlled trials and two were controlled before-and-after studies. These studies showed that botulinum toxin injections can reduce the frequency of bruxism events, decrease bruxism-induced pain levels and satisfy patients' self-assessment with regard to the effectiveness of botulinum toxins on bruxism. In comparison with oral splint, botulinum toxins are equally effective on bruxism. Furthermore, botulinum toxin injections at a dosage of <100 U are safe for otherwise healthy patients. Botulinum toxin injections are effective on bruxism and are safe to use. Therefore, they can be used clinically for otherwise healthy patients with bruxism. © 2012 FDI World Dental Federation.

  20. Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism

    PubMed Central

    RAPHAEL, K. G.; SANTIAGO, V.; LOBBEZOO, F.

    2017-01-01

    Summary Inspired by the international consensus on defining and grading of bruxism (Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. J Oral Rehabil. 2013;40:2), this commentary examines its contribution and underlying assumptions for defining sleep bruxism (SB). The consensus’ parsimonious redefinition of bruxism as a behaviour is an advance, but we explore an implied question: might SB be more than behaviour? Behaviours do not inherently require clinical treatment, making the consensus-proposed ‘diagnostic grading system’ inappropriate. However, diagnostic grading might be useful, if SB were considered a disorder. Therefore, to fully appreciate the contribution of the consensus statement, we first consider standards and evidence for determining whether SB is a disorder characterised by harmful dysfunction or a risk factor increasing probability of a disorder. Second, the strengths and weaknesses of the consensus statement’s proposed ‘diagnostic grading system’ are examined. The strongest evidence-to-date does not support SB as disorder as implied by ‘diagnosis’. Behaviour alone is not diagnosed; disorders are. Considered even as a grading system of behaviour, the proposed system is weakened by poor sensitivity of self-report for direct polysomnographic (PSG)-classified SB and poor associations between clinical judgments of SB and portable PSG; reliance on dichotomised reports; and failure to consider SB behaviour on a continuum, measurable and definable through valid behavioural observation. To date, evidence for validity of self-report or clinician report in placing SB behaviour on a continuum is lacking, raising concerns about their potential utility in any bruxism behavioural grading system, and handicapping future study of whether SB may be a useful risk factor for, or itself a disorder requiring treatment. PMID:27283599

  1. Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism.

    PubMed

    Raphael, K G; Santiago, V; Lobbezoo, F

    2016-10-01

    Inspired by the international consensus on defining and grading of bruxism (Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. J Oral Rehabil. 2013;40:2), this commentary examines its contribution and underlying assumptions for defining sleep bruxism (SB). The consensus' parsimonious redefinition of bruxism as a behaviour is an advance, but we explore an implied question: might SB be more than behaviour? Behaviours do not inherently require clinical treatment, making the consensus-proposed 'diagnostic grading system' inappropriate. However, diagnostic grading might be useful, if SB were considered a disorder. Therefore, to fully appreciate the contribution of the consensus statement, we first consider standards and evidence for determining whether SB is a disorder characterised by harmful dysfunction or a risk factor increasing probability of a disorder. Second, the strengths and weaknesses of the consensus statement's proposed 'diagnostic grading system' are examined. The strongest evidence-to-date does not support SB as disorder as implied by 'diagnosis'. Behaviour alone is not diagnosed; disorders are. Considered even as a grading system of behaviour, the proposed system is weakened by poor sensitivity of self-report for direct polysomnographic (PSG)-classified SB and poor associations between clinical judgments of SB and portable PSG; reliance on dichotomised reports; and failure to consider SB behaviour on a continuum, measurable and definable through valid behavioural observation. To date, evidence for validity of self-report or clinician report in placing SB behaviour on a continuum is lacking, raising concerns about their potential utility in any bruxism behavioural grading system, and handicapping future study of whether SB may be a useful risk factor for, or itself a disorder requiring treatment. © 2016 John Wiley & Sons Ltd.

  2. Association between self-reported bruxism activity and occurrence of dental attrition, abfraction, and occlusal pits on natural teeth.

    PubMed

    Tsiggos, Nikolaos; Tortopidis, Dimitrios; Hatzikyriakos, Andreas; Menexes, George

    2008-07-01

    It is unclear whether subjects who report tooth clenching and/or grinding have more noticeable clinical signs of dental attrition, abfractions, and occlusal pits on their natural teeth than subjects who do not report bruxism activity. The purpose of this study was to determine whether there was an association between self-reported (or not reported) bruxism activity and occurrence of dental attrition (anterior, posterior), abfractions, and occlusal pits on natural teeth. One hundred and two volunteer adult Greek subjects (mean age 44.6 +/-5.7 years) were classified into 2 groups (50 self-reported bruxers and 52 nonbruxers) according to 2 inquires regarding grinding and/or clenching of their teeth. Dental attrition (anterior, posterior) was assessed by 2 calibrated experienced examiners on diagnostic casts on a tooth-by-tooth basis, using a previously well established ordinal scale. Abfraction lesions (V-shaped, in the cervical region) and occlusal pits were recorded if these clinical signs were found on at least 2 natural teeth. Statistical comparisons between the 2 groups relative to the distribution of the occurrence of the 4 clinical signs were performed by means of the exact version of the chi-square test. The Fisher's exact test was used for the comparison of percentages. The intra- and interexaminer reliability was assessed by means of the Cohen's kappa coefficient (alpha=.05). The results demonstrated that there was a significant association between self-reported bruxism and occurrence of the 4 clinical signs. Although the 2 groups were significantly different according to the distribution of the 4 clinical signs, the greatest differences occurred for the anterior and posterior attrition signs. In this study, the occurrence of 4 clinical signs (posterior or anterior dental attrition, abfractions, and occlusal pits) was associated with self-reported bruxers. It is suggested that, primarily, signs of dental attrition may differentiate self-reported bruxers from

  3. Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism

    PubMed Central

    Palinkas, Marcelo; De Luca Canto, Graziela; Rodrigues, Laíse Angélica Mendes; Bataglion, César; Siéssere, Selma; Semprini, Marisa; Regalo, Simone Cecilio Hallak

    2015-01-01

    Objective: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. Methods: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. Results: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of “probable SB” were associated with the worst sensitivity (16%, 18%, 22%, respectively). Conclusions: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and—although they do not attain diagnostic values high enough to replace the current gold standard (PSG)—should be used as a screening tool to identify SB. Citation: Palinkas M, De Luca Canto G, Rodrigues LA, Bataglion C, Siéssere S, Semprini M, Regalo SC. Comparative capabilities of clinical assessment, diagnostic criteria, and polysomnography in detecting sleep bruxism. J Clin Sleep Med 2015;11(11):1319–1325. PMID:26235152

  4. GABA and glutamate levels in occlusal splint-wearing males with possible bruxism.

    PubMed

    Dharmadhikari, Shalmali; Romito, Laura M; Dzemidzic, Mario; Dydak, Ulrike; Xu, Jun; Bodkin, Cynthia L; Manchanda, Shalini; Byrd, Kenneth E

    2015-07-01

    The inhibitory neurotransmitter γ-aminobutyric acid (GABA) plays an important role in the pathophysiology of anxiety behavioural disorders such as panic disorder and post-traumatic stress disorder and is also implicated in the manifestation of tooth-grinding and clenching behaviours generally known as bruxism. In order to test whether the stress-related behaviours of tooth-grinding and clenching share similar underlying mechanisms involving GABA and other metabolites as do anxiety-related behavioural disorders, we performed a Magnetic Resonance Spectroscopy (MRS) study for accurate, in vivo metabolite quantification in anxiety-related brain regions. MRS was performed in the right hippocampus and right thalamus involved in the hypothalamic-pituitary-adrenal axis system, together with a motor planning region (dorsal anterior cingulate cortex/pre-supplementary motor area) and right dorsolateral prefrontal cortex (DLPFC). Eight occlusal splint-wearing men (OCS) with possible tooth-grinding and clenching behaviours and nine male controls (CON) with no such behaviour were studied. Repeated-measures ANOVA showed significant Group×Region interaction for GABA+ (p = 0.001) and glutamate (Glu) (p = 0.031). Between-group post hoc ANOVA showed significantly lower levels of GABA+ (p = 0.003) and higher levels of Glu (p = 0.002) in DLPFC of OCS subjects. These GABA+ and Glu group differences remained significant (GABA+, p = 0.049; Glu, p = 0.039) after the inclusion of anxiety as a covariate. Additionally, GABA and Glu levels in the DLPFC of all subjects were negatively related (Pearson's r = -0.75, p = 0.003). These findings indicate that the oral behaviours of tooth-grinding and clenching, generally known as bruxism, may be associated with disturbances in brain GABAergic and glutamatergic systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Mother's Work Status on Children's Bruxism in a Subset of Saudi Population

    PubMed Central

    Alouda, Rana; Alshehri, Maram; Alnaghmoosh, Shoog; Shafique, Maryam; Al-Khudhairy, May Wathiq

    2017-01-01

    Aims and Objectives: The aims and objectives of this study were to determine if an association exists between mothers work status and her children's incidence of bruxism and habits related to bruxism. Materials and Methods: A cross-sectional study was conducted through data collection of a questionnaire answered by 561 mothers’ about their working status and their child's habits and behaviors. The survey consisted of 5 parts with a total of 34 questions: mother's information, child's behavior, child's sleeping pattern, mother's knowledge about bruxism, and child's medical history. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05. Results: The work status of the mother was not statistically significant in increasing the incidence of a child to have bruxism. However, this study clearly elucidates that 7 of the 15 habits correlate significantly with a status of bruxism. According to this sample, a child, that is, reported to be aggressive is more than twice as likely to have nocturnal bruxism. Likewise, any child that bites their nails, complains of headaches, drools in their sleep, snores, complains of muscle cramps, and colic is more than twice as likely to be a nocturnal bruxer than a child that does not have these habits. Conclusion: The prevalence of children's bruxism in this convenient sample was 34.5% (n = 141). The concerning habits related to bruxism can serve the pediatric dentist, general dentist, general practitioner, and primary care provider of children having these red flags as indicators of bruxism. It is imperative that parents of these children be made aware these habits that may occur together, alone or even simultaneously with bruxism. PMID:29285473

  6. Group Therapy for Survivors of Severe Childhood Abuse: Repairing the Social Contract.

    ERIC Educational Resources Information Center

    Scott, Wayne

    1999-01-01

    Presents a model for conducting time-limited group therapy with adult survivors of severe childhood abuse who were diagnosed with complex post-traumatic and dissociative disorders. Group sessions are organized around verbal promises that encourage the client's active, attentive engagement. Gentle confrontation of dissociative defenses is integral…

  7. Methodological challenges in the use of focus groups with people with severe mental illness.

    PubMed

    Onocko-Campos, Rosana Teresa; Díaz, Alberto Rodolfo Giovanello; Dahl, Catarina Magalhães; Leal, Erotildes Maria; Serpa, Octavio Domont de

    2017-07-13

    This study addresses the practical, methodological and ethical challenges that were found in three studies that used focus groups with people with severe mental illness, in the context of community mental health services in Brazil. Focus groups are a powerful tool in health research that need to be better discussed in research with people with severe mental illness, in the context of community mental health facilities. This study is based on the authors' experience of conducting and analyzing focus groups in three different cities - Campinas, Rio de Janeiro and Salvador - between 2006-2010. The implementation of focus groups with people with severe mental illness is discussed in the following categories; planning, group design, sampling, recruitment, group interview guides, and conduction. The importance of connecting mental healthcare providers as part of the research context is emphasized. Ethical issues and challenges are highlighted, as well as the establishment of a sensitive and empathic group atmosphere, wherein mutual respect can facilitate interpersonal relations and enable people diagnosed with severe mental illness to make sense of the experience. We emphasize the relevance of the interaction between clinical and research teams in order to create collaborative work, achieve inquiry aims, and elicit narratives of mental health users and professionals.

  8. A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma.

    PubMed

    Yorke, Janelle; Adair, Pauline; Doyle, Anne-Marie; Dubrow-Marshall, Linda; Fleming, Sharon; Holmes, Leanne; Menzies-Gow, Andrew; Niven, Rob; Pilling, Mark; Shuldham, Caroline

    2017-06-01

    Evidence for the efficacy of Cognitive Behavioural Therapy (CBT) in asthma is developing but it is not known if this translates to benefits in severe asthma or if a group approach is acceptable to this patient group. This study aimed to assess the feasibility and acceptability of Group-CBT in severe asthma. This was a two-centre, randomised controlled parallel group feasibility study. Eligible participants (patients with severe asthma and a clinically significant diagnosis of anxiety and/or depression - Hospital Anxiety and Depression Scale (HAD) score greater than 8 for the anxiety or depression sub-scale) received Group-CBT in weekly sessions for eight consecutive weeks and usual care or usual care only. Follow-up was for 16 weeks and end points were: Asthma Quality of Life Questionnaire, Asthma Control Questionnaire, HAD, Dyspnoea-12, EuroQual-5D and EuroQuol-VAS. 51 patients were randomised: 36% (51 out of 140) consent rate and attrition at week 16 was 12. Screening logs indicated that study take-up was influenced by patients living long distances from the treatment centre and inability to commit to the weekly demands of the programme. Drop-out was higher in Group-CBT compared due to inability to commit to the weekly programme because of poor health. Participants who contributed to focus group discussions reported that Group-CBT contributed to a better understanding of their illness and related approaches to anxiety management and acceptance of their asthma condition. Although weekly face-to-face sessions were challenging, this was the preferred method of delivery for these participants. This feasibility study shows that Group-CBT warrants further investigation as a potentially promising treatment option for patients with severe asthma. It has been possible but not easy to recruit and retain the sample. Options for a less demanding intervention schedule, such as less frequent face-to-face visits and the use of web-based interventions, require careful

  9. Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers.

    PubMed

    Carvalho, Andréa Lúcia de Almeida; Cury, Altair Antoninha Del Bel; Garcia, Renata Cunha Matheus Rodrigues

    2008-01-01

    This study aimed to assess the prevalence of bruxism and emotional stress in Brazilian police officers, due to exposure to stressful situations, and to assess the relationship between the type of work done by a police officer and the presence of bruxism and emotional stress. A cross-sectional study was conducted at the Military Police of the State of São Paulo, Campinas, SP, Brazil. The final sample included 394 male police officers (mean age = 35.5 years). Bruxism was diagnosed by the presence of aligned dental wear facets associated with the presence of one of the following signs or symptoms: self-report of tooth-grinding, painful sensitivity of the masseter and temporal muscles, discomfort in the jaw musculature upon waking. The Stress Symptoms Inventory (SSI) was applied to evaluate emotional stress. The type of work done by the police was classified as organizational or operational, the latter being assumed as the more stressful since it exposes the police officer to life risk. The results showed a prevalence of bruxism of 50.2% and a prevalence of emotional stress of 45.7%. The Chi-square test indicated an association between stress and bruxism (P < .05). No significant association was found between emotional stress and type of work (P = .382) or between bruxism and work activity (P = .611). It could be concluded that emotional stress was associated with bruxism, independently of the type of work done by police officers.

  10. Bruxism in prospective studies of veneered zirconia restorations-a systematic review.

    PubMed

    Schmitter, Marc; Boemicke, Wolfgang; Stober, Thomas

    2014-01-01

    The objectives of this work were to systematically review the effect of bruxism on the survival of zirconia restorations on teeth and to assess the prevalence of nocturnal masseter muscle activity in a clinical sample. A Medline search was performed independently and in triplicate using the term "zirconia" and activating the filter "clinical trial." Furthermore, three other electronic databases were searched using the same term. Only papers published in English on prospective studies of veneered zirconia frameworks on teeth were included. To estimate the prevalence of sleep bruxism in clinical settings, subjects with no clinical signs of bruxism and who did not report grinding and/or clenching were examined by use of a disposable electromyographic device. The initial search resulted in 107 papers, of which 22 were included in the analysis. Bruxers were excluded in 20 of these articles. In 1 study bruxers were not excluded, and 1 study did not provide information regarding this issue. The methods used to identify bruxers were heterogeneous/not described, and no study used reliable, valid methods. Of 33 subjects without clinical signs of bruxism, nocturnal muscle activity exceeded predefined muscle activity for 63.8% of the subjects. There is a lack of information about the effect of bruxism on the incidence of technical failure of veneered zirconia restorations because all available studies failed to use suitable instruments for diagnosis of bruxism. Nocturnal muscle activity without clinical symptoms/report of bruxism was observed for a relevant number of patients.

  11. Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment.

    PubMed

    Gong, Ping; Luo, Song-Hui; Li, Xiao-Lin; Guo, Yuan-Lin; Zhu, Cheng-Gang; Xu, Rui-Xia; Li, Sha; Dong, Qian; Liu, Geng; Chen, Juan; Zeng, Rui-Xiang; Li, Jian-Jun

    2014-12-01

    Although the study on the relationship between ABO blood groups and coronary atherosclerosis has a long history, few data is available regarding ABO to severity of coronary atherosclerosis in a large cohort study. Therefore, the present study aimed to investigate the relation of the ABO blood groups to the severity of coronary atherosclerosis assessed by Gensini score (GS) in a large Chinese cohort undergoing coronary angiography. A total of 2919 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics and ABO blood groups were collected. The GS was calculated as 1st tertile (0-10), 2nd tertile (11-36), 3rd tertile (>36) according to angiographic results. The relation of the ABO blood groups to GS was investigated. The frequency of blood group A was significantly higher in the upper GS tertiles (24.4% vs. 28.2% vs. 29.5%, p = 0.032). Multivariable linear regression analysis revealed that blood group A was independently associated with GS (β = 0.043, p = 0.017). Likewise, multivariable logistic regression analysis showed that group A remained significantly associated with mid-high GS (OR = 1.44, 95% CI 1.16-1.80, p = 0.001), and the group O was showed as a protective factor (OR = 0.77, 95% CI = 0.65-0.92, p = 0.004). In this large Chinese cohort study, the data indicated that there was an association between ABO blood groups and the severity of coronary atherosclerosis. Moreover, the blood group A was an independent risk factor for serious coronary atherosclerosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Confrontation and Support in Group Therapy in the Residential Treatment of Severely Disturbed Adolescents.

    ERIC Educational Resources Information Center

    Siegel, Leonard Israel

    1987-01-01

    Focuses on various forms of group therapy for severely emotionally and behaviorally disturbed adolescents. Discusses eclectic theoretical frame of reference including elements of psychodynamic, object relations, and structural and strategic family therapy theory. Identifies precedents for confrontational-supportive approach to be encounter group…

  13. Botulinum Toxin Type A as Preoperative Treatment for Immediately Loaded Dental Implants Placed in Fresh Extraction Sockets for Full-Arch Restoration of Patients With Bruxism.

    PubMed

    Mijiritsky, Eitan; Mortellaro, Carmen; Rudberg, Omri; Fahn, Miri; Basegmez, Cansu; Levin, Liran

    2016-05-01

    The aim of the present report was to describe the use of Botulinum toxin type A as preoperative treatment for immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration of patients with bruxism. Patients with bruxism who were scheduled to receive immediately loaded full-arch implant supported fixed restorations were included in this retrospective clinical report. To reduce the occlusal forces applied in patients with bruxism, Botulinum toxin type A was introduced prior to the implant placement procedure. Patients were followed and implant survival as well as peri-implant bone level was assessed in each periodic follow-up visit. Adverse effects were also recorded. A control group with no use of Botulinum toxin was evaluated as well. A total of 26 patients (13 test and 13 control), with bruxism, aged 59.15 ± 11.43 years on average were included in this retrospective report and received immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration. The test group treatment preceded by Botulinum toxin type A injection. Maxillary arches were supported by 8 to 10 implants while the mandibular arch was supported by 6 implants. All surgeries went uneventfully and no adverse effects were observed. The average follow-up time was 32.5 ± 10.4 months (range, 18-51). In the test group, no implant failures were recorded. One patient presented with 1 to 2 mm bone loss around 4 of the implants; the other implants presented with stable bone level. In the control group 1 patient lost 2 implants and another demonstrated 2 mm bone loss around 3 of the implants. The preoperative use of Botulinum toxin in patients with bruxism undergoing full-arch rehabilitation using immediately loaded dental implants placed in fresh extraction sockets seems to be a technique that deserves attention. Further long-term, large-scale randomized clinical trials will help to determine the additional benefit of this suggested

  14. Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial.

    PubMed

    Salgueiro, Mônica da Consolação Canuto; Bortoletto, Carolina Carvalho; Horliana, Anna Carolina RattoTempestini; Mota, Ana Carolina Costa; Motta, Lara Jansiski; Motta, Pamella de Barros; MesquitaFerrari, Raquel Agnelli; Fernandes, Kristianne Porta Santos; Bussadori, Sandra Kalil

    2017-08-08

    Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).

  15. Identification of sleep bruxism with an ambulatory wireless recording system.

    PubMed

    Inano, Shinji; Mizumori, Takahiro; Kobayashi, Yasuyoshi; Sumiya, Masakazu; Yatani, Hirofumi

    2013-01-01

    To examine whether an ambulatory bruxism recording system, including a biologic monitor, that measures sleep variables and sympatho-vagal balance can specifically identify sleep bruxism (SB) at home. Twenty-six volunteers, including 16 SB subjects, were recruited. Each participant recorded his or her electromyogram (EMG), sympatho-vagal balance, and sound level for 3 consecutive nights using an audio-video recorder to identify SB. Data of sleep variables were compared among the 3 experimental nights. The episodes were classified into SB episodes with and without grinding and non-SB episodes. EMG patterns, amplitude, sympatho-vagal balance, and sound level of all episodes were analyzed so as to determine the appropriate thresholds to detect SB episodes and grinding sound. Then, all episodes without video-recording data were classified into SB and non-SB episodes by using the appropriate thresholds, and the sensitivity and specificity to detect SB episodes were calculated. With regard to sleep variables, there were no significant differences except for sleep latency between the first and second nights. The appropriate EMG pattern and thresholds of amplitude, sympatho-vagal balance, and sound level were phasic or mixed EMG pattern, 20% of maximum voluntary contraction, mean + 1 SD, and mean + 2 SDs, respectively. The sensitivity and specificity to detect SB episodes were 88.4% and 74.2%, respectively. The results suggest that this system enables the detection of SB episodes at home with considerably high accuracy and little interference with sleep.

  16. Family and school environmental predictors of sleep bruxism in children.

    PubMed

    Rossi, Debora; Manfredini, Daniele

    2013-01-01

    To identify potential predictors of self-reported sleep bruxism (SB) within children's family and school environments. A total of 65 primary school children (55.4% males, mean age 9.3 ± 1.9 years) were administered a 10-item questionnaire investigating the prevalence of self-reported SB as well as nine family and school-related potential bruxism predictors. Regression analyses were performed to assess the correlation between the potential predictors and SB. A positive answer to the self-reported SB item was endorsed by 18.8% of subjects, with no sex differences. Multiple variable regression analysis identified a final model showing that having divorced parents and not falling asleep easily were the only two weak predictors of self-reported SB. The percentage of explained variance for SB by the final multiple regression model was 13.3% (Nagelkerke's R² = 0.133). While having a high specificity and a good negative predictive value, the model showed unacceptable sensitivity and positive predictive values. The resulting accuracy to predict the presence of self-reported SB was 73.8%. The present investigation suggested that, among family and school-related matters, having divorced parents and not falling asleep easily were two predictors, even if weak, of a child's self-report of SB.

  17. Severity of Group B Streptococcal Arthritis in Selected Strains of Laboratory Mice

    PubMed Central

    Puliti, Manuela; Bistoni, Francesco; von Hunolstein, Christina; Orefici, Graziella; Tissi, Luciana

    2001-01-01

    The susceptibilities of C3H/HeN, BALB/c, and C57BL/6N mouse strains to group B streptococci (GBS) infection were evaluated. C3H/HeN mice developed severe polyarthitis; mild lesions and no lesions were observed in BALB/c and C57BL/6N mice, respectively. A correlation between the severity of arthritis, the number of GBS in the joints, and local interleukin-6 and interleukin-1β production was evident. PMID:11119551

  18. [Setting up of a day group service system for severely disabled children, the "Koala Club"].

    PubMed

    Ozawa, Hiroshi; Kubota, Masaya; Tanaka, Yoshiko; Atsumi, So; Arimoto, Kiyoshi; Kimiya, Satoshi

    2006-01-01

    This is a report of the setting up of a day group service system for severely disabled children, the "Koala Club". The "Koala Club" was started in 1993, and has been running outside of the hospital since 1997. A support group for the "Koala Club" was established in 1999. Currently 13 children attend the "Koala Club". The staff of the "Koala Club" consists of one coordinater, four nurses and eight care workers. The medical care is fulfilled by nurses. The "Koala Club" open two days a week. It has been supervised by a doctor and a case worker. There is an important role for physicians in the regional care of disabled children.

  19. A focus group assessment of patient perspectives on irritable bowel syndrome and illness severity.

    PubMed

    Drossman, Douglas A; Chang, Lin; Schneck, Susan; Blackman, Carlar; Norton, William F; Norton, Nancy J

    2009-07-01

    There is a growing need to understand from the patient's perspective the experience of irritable bowel syndrome (IBS) and the factors contributing to its severity; this has been endorsed by the Food and Drug Administration (FDA). Accordingly, we conducted focus groups to address this issue. A total of 32 patients with mostly moderate to severe IBS were recruited through advertising and were allocated into three focus groups based on predominant stool pattern. The focus groups were held using standard methodology to obtain a general assessment of the symptoms experienced with IBS, its impact, and of factors associated with self-perceived severity. Patients described IBS not only as symptoms (predominantly abdominal pain) but mainly as it affects daily function, thoughts, feelings and behaviors. Common responses included uncertainty and unpredictability with loss of freedom, spontaneity and social contacts, as well as feelings of fearfulness, shame, and embarrassment. This could lead to behavioral responses including avoidance of activities and many adaptations in routine in an effort for patients to gain control. A predominant theme was a sense of stigma experienced because of a lack of understanding by family, friends and physicians of the effects of IBS on the individual, or the legitimacy of the individual's emotions and adaptation behaviors experienced. This was a barrier to normal functioning that could be ameliorated through identifying with others who could understand this situation. Severity was linked to health-related quality of life (HRQOL) and was influenced by the intensity of abdominal pain and other symptoms, interference with and restrictions relating to eating, work, and social activities, and of the unpredictability of the condition. This study confirms the heterogeneous and multi-component nature of IBS. These qualitative data can be used in developing health status and severity instruments for larger-scale studies.

  20. Bruxism Is Associated With Nicotine Dependence: A Nationwide Finnish Twin Cohort Study

    PubMed Central

    Ahlberg, J.; Hublin, C.; Broms, U.; Madden, P. A. F.; Könönen, M.; Koskenvuo, M.; Lobbezoo, F.; Kaprio, J.

    2010-01-01

    Objectives: To investigate the association of smoking with bruxism while controlling for genetic and environmental factors using a co-twin-control design. Especially, the role of nicotine dependence was studied in this context. Methods: The material derives from the Finnish Twin Cohort consisting of 12,502 twin individuals who responded to a questionnaire in 1990 (response rate of 77%). All were born in 1930–1957, the mean age being 44 years. The questionnaire covered 103 multiple choice questions, 7 dealing with tobacco use and 22 with sleep and vigilance matters, including perceived bruxism. In addition, a subsample derived from the Nicotine Addiction Genetics Finland Study containing 445 twin individuals was studied. Results: In age- and gender-controlled multinomial logistic regression, both monthly and rarely reported bruxism associated with both current cigarette smoking (odds ratio [OR] = 1.74 and 1.64) and former cigarette smoking (OR = 1.64 and 1.47). Weekly bruxism associated with current smoking (OR = 2.85). Current smokers smoking 20 or more cigarettes a day reported weekly bruxism more likely (OR = 1.61–1.97) than those smoking less. Among twin pairs (N = 142) in which one twin was a weekly bruxer and the cotwin a never bruxer, there were 13 monozygotic pairs in which one twin was a current smoker and the other twin was not. In all cases, the bruxer was the smoker (p = .0003). Nicotine dependence associated significantly with bruxism. Conclusions: Our twin study provides novel evidence for a possible causal link between tobacco use and bruxism among middle-aged adults. Nicotine dependence may be a significant predisposing factor for bruxism. PMID:21041838

  1. Bruxism secondary to brain injury treated with Botulinum toxin-A: a case report

    PubMed Central

    El Maaytah, Mohammed; Jerjes, Waseem; Upile, Tahwinder; Swinson, Brian; Hopper, Colin; Ayliffe, Peter

    2006-01-01

    We report a successful treatment of bruxism in a patient with anoxic brain injury using botulinum toxin-A (BTX-A). On examination the mouth opening was 0 mm, no feeding was possible through the mouth. Botulinum toxin was injected into the masseter and temporalis; great improvement in trismus and bruxism was noted after 3 weeks. One further treatment improved the mouth opening on the following week and the patient was discharged from our care to be reviewed when required. PMID:17123443

  2. Is there an association between bruxism and intestinal parasitic infestation in children?

    PubMed

    Díaz-Serrano, Kranya Victoria; da Silva, Carolina Brunelli Alvares; de Albuquerque, Sérgio; Pereira Saraiva, Maria da Conceição; Nelson-Filho, Paulo

    2008-01-01

    Multiple factors have been considered in the etiology of bruxism in pediatric patients, among which are infestations by intestinal parasites suggested by some authors. No empirical evidence exists, however, of such association. Therefore, this study's purpose was to investigate the existence of an association between bruxism and intestinal parasitic infestation in children. Fifty-seven 6- to 11-year-olds (30 cases and 27 controls) who had not used anthelminthics 2 months before the baseline examination were enrolled in the study. A diagnosis of bruxism was based on an intraoral clinical examination performed by a single trained examiner and on the parent/guardian's report of any perceived parafunctional habits (questionnaire-based interview). Bruxism cases were defined as those children with a report of currently perceived habits of eccentric or centric bruxism (tooth-grinding and tooth-clenching, respectively) combined with clinical evidence of nonphysiologic wear facets. The volunteers were required to collect 3 fecal samples (1 every 2 to 3 days). Parasitologic analysis was performed using the spontaneous sedimentation method. Data gathered from the intraoral clinical examination, questionnaire, and parasitologic analysis were tabulated and submitted to statistical analysis using the chi-square test and student's t test. Intestinal parasitic infestation was observed in 30% (N=9) of cases and 41% (N=11) of controls, but no statistically significant association was observed (P=.40). This study's findings do not support the existence of an association between intestinal parasitic infestation and bruxism among the evaluated pediatric population.

  3. Use of electromyographic and electrocardiographic signals to detect sleep bruxism episodes in a natural environment.

    PubMed

    Castroflorio, Tommaso; Mesin, Luca; Tartaglia, Gianluca Martino; Sforza, Chiarella; Farina, Dario

    2013-11-01

    Diagnosis of bruxism is difficult since not all contractions of masticatory muscles during sleeping are bruxism episodes. In this paper, we propose the use of both EMG and ECG signals for the detection of sleep bruxism. Data have been acquired from 21 healthy volunteers and 21 sleep bruxers. The masseter surface EMGs were detected with bipolar concentric electrodes and the ECG with monopolar electrodes located on the clavicular regions. Recordings were made at the subjects' homes during sleeping. Bruxism episodes were automatically detected as characterized by masseter EMG amplitude greater than 10% of the maximum and heart rate increasing by more than 25% with respect to baseline within 1 s before the increase in EMG amplitude above the 10% threshold. Furthermore, the subjects were classified as bruxers and nonbruxers by a neural network. The number of bruxism episodes per night was 24.6 ± 8.4 for bruxers and 4.3 ± 4.5 for controls ( P < 0.0001). The classification error between bruxers and nonbruxers was 1% which was substantially lower than when using EMG only for the classification. These results show that the proposed system, based on the joint analysis of EMG and ECG, can provide support for the clinical diagnosis of bruxism.

  4. Bruxism in children and transverse plane of occlusion: is there a relationship or not?

    PubMed

    Nahás-Scocate, Ana Carla Raphaelli; Coelho, Fernando Vusberg; de Almeida, Viviane Chaves

    2014-01-01

    To assess the occurrence of bruxism in deciduous dentition and a potential association between the habit and the presence or absence of posterior crossbite. A total of 940 patient files were assessed. They were gathered from the archives of University of São Paulo City--UNICID; however, 67 patient files were dismissed for not meeting the inclusion criteria. Therefore, 873 children, males and females, comprised the study sample. They were aged between 2-6 years old and came from six different public primary schools from the east of the city of São Paulo. Data were collected through questionnaires answered by parents/guardians and by clinical examinations carried out in the school environment in order to obtain the occlusal characteristics in the transverse direction. First, a descriptive statistical analysis of all variables was performed (age, sex, race, posterior crossbite, bruxism, headache and restless sleep); then, the samples were tested by means of chi-square test with significance level set at 0.05%. A logistic regression model was applied to identify the presence of bruxism. The prevalence of this parafunctional habit was of 28.8%, with 84.5% of patients showing no posterior crossbite. Regarding the association of bruxism with crossbite, significant results were not found. Children with restless sleep have 2.1 times more chances of developing bruxism, whereas children with headache have 1.5 more chances. Transverse plane of occlusion was not associated with the habit of bruxism.

  5. Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers.

    PubMed

    Gomes, Monalisa Cesarino; Neves, Érick Tássio; Perazzo, Matheus França; Souza, Emilly Gabrielle Carlos de; Serra-Negra, Júnia Maria; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

    2018-02-05

    The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent's/caregiver's sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52-5.65) and tooth wear (OR = 2.34; 95%CI: 1.39-3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.

  6. Bruxism in children and transverse plane of occlusion: Is there a relationship or not?

    PubMed Central

    Nahás-Scocate, Ana Carla Raphaelli; Coelho, Fernando Vusberg; de Almeida, Viviane Chaves

    2014-01-01

    OBJECTIVE: To assess the occurrence of bruxism in deciduous dentition and a potential association between the habit and the presence or absence of posterior crossbite. METHODS: A total of 940 patient files were assessed. They were gathered from the archives of University of São Paulo City - UNICID; however, 67 patient files were dismissed for not meeting the inclusion criteria. Therefore, 873 children, males and females, comprised the study sample. They were aged between 2-6 years old and came from six different public primary schools from the east of the city of São Paulo. Data were collected through questionnaires answered by parents/guardians and by clinical examinations carried out in the school environment in order to obtain the occlusal characteristics in the transverse direction. First, a descriptive statistical analysis of all variables was performed (age, sex, race, posterior crossbite, bruxism, headache and restless sleep); then, the samples were tested by means of chi-square test with significance level set at 0.05%. A logistic regression model was applied to identify the presence of bruxism. RESULTS: The prevalence of this parafunctional habit was of 28.8%, with 84.5% of patients showing no posterior crossbite. Regarding the association of bruxism with crossbite, significant results were not found. Children with restless sleep have 2.1 times more chances of developing bruxism, whereas children with headache have 1.5 more chances. CONCLUSION: Transverse plane of occlusion was not associated with the habit of bruxism. PMID:25715718

  7. Cross-sectional study of anxiety symptoms and self-report of awake and sleep bruxism in female TMD patients.

    PubMed

    Tavares, Luisa Maria Faria; da Silva Parente Macedo, Leonora Cristina; Duarte, Cristina Maria Rabelais; de Goffredo Filho, Gilberto Senechal; de Souza Tesch, Ricardo

    2016-11-01

    The aim of this study was to assess the relationship between levels of anxiety symptoms and prevalence of self-report of awake and sleep bruxism in patients with temporomandibular disorders (TMD). One hundred and eighty-one female patients, aged 19-77 years, were consecutively evaluated. The patients were selected from among those who sought treatment at the TMD and Orofacial Pain Outpatient Clinic of the Petrópolis School of Medicine. All patients completed the questionnaire and underwent clinical examination, both components of the RDC/TMD, in addition to answering questions pertaining to the assessment of levels of anxiety symptoms, taken from the Symptom Check List 90 self-report instrument. The subjects were classified according to the presence of self-reported only awake bruxism, only sleep bruxism, both, or none. A logistic regression procedure was performed to evaluate the possible association through odds ratio between anxiety symptoms and self-reported awake or sleep bruxism. The cofactors for each outcome were age, self-reported bruxism during the circadian period other than the one being evaluated, and the use of selective serotonin reuptake inhibitors. It was possible to demonstrate the presence of a positive and statistically significant relationship between anxiety levels and self-reported awake bruxism. This finding was not observed in those subjects who reported sleep bruxism. A positive relationship was found between self-reported awake bruxism and levels of anxiety symptoms, but not between sleep bruxism and anxiety.

  8. Medical outcomes for adults hospitalized with severe anorexia nervosa: An analysis by age group.

    PubMed

    Gaudiani, Jennifer L; Brinton, John T; Sabel, Allison L; Rylander, Melanie; Catanach, Brittany; Mehler, Philip S

    2016-04-01

    Relatively little has been written about the outcomes of medical stabilization, analyzed specifically across the age spectrum, in adults with severe anorexia nervosa (AN). We retrospectively evaluated clinical parameters relevant to acuity of illness and outcomes of early refeeding in 142 adults with severe AN, admitted for definitive inpatient medical stabilization from October 1, 2008 to December 31, 2012. Patients were categorized into three age groups: 17 to 29, 30 to 40, and 41+ years. The study included 142 patients with median age of 28 years old (range 17-65 years). Fifty-four percent (n = 78) were under 30 years old, 23% (n = 32) between 30 and 40 years old, and 23% (n = 32) were over 40 years old. Average admission BMI did not differ among age groups, ranging from 12.7 to 13.2 kg/m(2). Of the admission parameters, only low serum albumin levels (more prevalent in older patients), high international normalized ratio (INR) levels (more prevalent in younger patients), and neutropenia (more prevalent in the <30 age group) varied with age. During hospitalization, rates of bradycardia, hypoglycemia, liver dysfunction, very low %IBW, refeeding hypophosphatemia, refeeding edema, length of stay, and discharge BMI did not differ with age. Age group was associated with rate of weekly weight gain only in patients with AN-binge purge subtype. Results demonstrate medical abnormalities and response to medical stabilization in severely ill AN patients during hospitalization were mostly similar across the age span. This information should allay fears that the effect of age will make medical stabilization more difficult. © 2015 Wiley Periodicals, Inc.

  9. Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

    PubMed

    Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

    2015-03-01

    The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.

  10. Prevalence of sleep bruxism in children: A systematic review

    PubMed Central

    Machado, Eduardo; Dal-Fabbro, Cibele; Cunali, Paulo Afonso; Kaizer, Osvaldo Bazzan

    2014-01-01

    INTRODUCTION: Prevalence of sleep bruxism (SB) in children is subject to discussions in the literature. OBJECTIVE: This study is a systematic literature review aiming to critically assess the prevalence of SB in children. METHODS: Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children. RESULTS: After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB. CONCLUSION: There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately. PMID:25628080

  11. The effect of intermittent use of occlusal splint devices on sleep bruxism: a 4-week observation with a portable electromyographic recording device.

    PubMed

    Matsumoto, H; Tsukiyama, Y; Kuwatsuru, R; Koyano, K

    2015-04-01

    This randomised controlled study investigated the effect of intermittent use of occlusal splints on sleep bruxism compared with that of continuous use by measuring masseter muscle electromyographic activity using a portable electromyographic recording system. Twenty bruxers were randomly allocated to the continuous group and intermittent group. Subjects in the continuous group wore stabilisation splints during sleep for 29 nights continuously, whereas those in the intermittent group wore splints during sleep every other week, that is they used splints on the 1st-7th, 15th-21st and 29th nights. Electromyographic activity of the masseter muscle during sleep was recorded for the following six time points: before (baseline), immediately after, and 1, 2, 3 and 4 weeks after the insertion of a stabilisation splint. The number of nocturnal masseter electromyographic events, duration and the total activity of sleep bruxism were analysed. In the continuous group, nocturnal masseter electromyographic events were significantly reduced immediately and 1 week after the insertion of the stabilisation splint, and duration was reduced immediately after the insertion (P < 0·05, Dunnett's test), but no reduction was observed at 2, 3 and 4 weeks after insertion. In the intermittent group, nocturnal masseter electromyographic events and duration were significantly reduced immediately after and also 4 weeks after insertion of the stabilisation splint (P < 0·05, Dunnett's test). The obtained results of the present exploratory trial indicate that the intermittent use of stabilisation splints may reduce sleep bruxism activity for a longer period compared with that of continuous use. © 2014 John Wiley & Sons Ltd.

  12. Is bruxism a risk factor for dental implants? A systematic review of the literature.

    PubMed

    Manfredini, Daniele; Poggio, Carlo E; Lobbezoo, Frank

    2014-06-01

    To systematically review the literature on the role of bruxism as a risk factor for the different complications on dental implant-supported rehabilitations. A systematic search in the National Library of Medicine's Medline Database was performed to identify all peer-reviewed papers in the English literature assessing the role of bruxism, as diagnosed with any other diagnostic approach (i.e., clinical assessment, questionnaires, interviews, polysomnography, and electromyography), as a risk factor for biological (i.e., implant failure, implant mobility, and marginal bone loss) or mechanical (i.e., complications or failures of either prefabricated components or laboratory-fabricated suprastructures) complications on dental implant-supported rehabilitations. The selected articles were reviewed according to a structured summary of the articles in relation to four main issues, viz., "P" - patients/problem/population, "I" - intervention, "C" - comparison, and "O" - outcome. A total of 21 papers were included in the review and split into those assessing biological complications (n = 14) and those reporting mechanical complications (n = 7). In general, the specificity of the literature for bruxism diagnosis and for the study of the bruxism's effects on dental implants was low. From a biological viewpoint, bruxism was not related with implant failures in six papers, while results from the remaining eight studies did not allow drawing conclusions. As for mechanical complications, four of the seven studies yielded a positive relationship with bruxism. Bruxism is unlikely to be a risk factor for biological complications around dental implants, while there are some suggestions that it may be a risk factor for mechanical complications. © 2012 Wiley Periodicals, Inc.

  13. Tobacco use and reported bruxism in young adults: A nationwide Finnish Twin Cohort Study

    PubMed Central

    Ahlberg, J.; Hublin, C.; Lobbezoo, F.; Rose, R. J.; Murtomaa, H.; Kaprio, J.

    2010-01-01

    Introduction: Higher levels of smoking, leading to increased levels of nicotine and dopamine release, may be more strongly related to bruxism, although this relationship has remained unclear. Thus, the aim of the present study was to investigate the possible effect of cumulative tobacco use on bruxism in a large sample of young adults. Methods: The material of the present study derives from the FinnTwin16, which consists of five birth cohorts born in 1975–1979. A total of 3,124 subjects (mean age 24 years, range 23–27 years) provided data in 2000–2002 on frequency of bruxism and tobacco use. Multinomial logistic regression was used to explore the relationships of frequency of bruxism with smoking and smokeless tobacco use while controlling covariates (alcohol intoxication, alcohol problems [Rutgers Alcohol Problem Index, RAPI], illicit drug use, psychological distress [General Health Questionnaire], and coffee use). Results: Based on subjective response and multivariate analyses, weekly bruxers were more than two times more likely to report heavy smoking than never bruxers (odds ratio [OR] 2.5, 95 % CI 1.8–3.4). The significant association between heavy smoking and bruxism held when the effects of other tobacco use and multiple covariates were controlled. In addition, the use of smokeless tobacco emerged as an independent risk factor for bruxism. Discussion: Given the observed associations with both heavy smoking and smokeless tobacco and a dose–response relationship, the present results support our hypothesis of a link between nicotine intake and bruxism. PMID:20427458

  14. Group music therapy for severe mental illness: a randomized embedded-experimental mixed methods study.

    PubMed

    Grocke, D; Bloch, S; Castle, D; Thompson, G; Newton, R; Stewart, S; Gold, C

    2014-08-01

    Music therapy is an innovative approach to support people with severe mental illness (SMI). The aim of the study was to determine whether group music therapy (GMT) positively impacted on quality of life (QoL), social enrichment, self-esteem, spirituality and psychiatric symptoms of participants with SMI and how they experienced the intervention. The primary outcome was QoL; secondary measures assessed social enrichment, self-esteem, spirituality and psychiatric symptoms. The 13-week intervention comprised singing familiar songs and composing original songs recorded in a professional studio. Qualitative data were generated from focus group interviews and song lyric analysis. Ninety-nine adults (57 female) were recruited, with an initial cohort (n = 75) randomized to either: weekly GMT followed by standard care (SC) or SC followed by GMT. Crossover occurred after 13 weeks. Measures were conducted at baseline, 13, 26 and 39 weeks. A second cohort (n = 24) could not be randomized and were assigned to GMT followed by SC. Intention-to-treat analysis showed a significant difference between GMT and SC on QoL and spirituality. This was robust to different assumptions about missing data (listwise deletion, last observation carried forward or multiple imputation). Per-protocol analysis suggested greater benefit for those receiving more sessions. Focus group interview and song lyric analyses suggested that GMT was enjoyable; self-esteem was enhanced; participants appreciated therapists and peers; and although challenges were experienced, the programme was recommended to others. Group music therapy may enhance QoL and spirituality of persons with SMI. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Is there an association between verbal school bullying and possible sleep bruxism in adolescents?

    PubMed

    Serra-Negra, J M; Pordeus, I A; Corrêa-Faria, P; Fulgêncio, L B; Paiva, S M; Manfredini, D

    2017-05-01

    The aim of this study was to determine the association between verbal school bullying and possible sleep bruxism (SB) in adolescents. A case-control study was carried out at the population level by recruiting 13- to 15-year-old participants among the attendants of schools of Itabira, Brazil. The case group was composed of 103 adolescents with possible SB (i.e. self- or parental-reported), while the control group included 206 adolescents without possible SB. All participants answered a questionnaire on the occurrence of their involvement in verbal school bullying episodes, based on the National School of Health Research (PeNSE) as well as an evaluation of their economic class according to the criteria of the Brazilian Association of Research Companies. Pearson's chi-square, McNemar test and conditional logistic regression were performed to assess the association between possible SB, verbal school bullying and economic class. There were 134 (43·3%) participants who reported involvement in verbal school bullying episodes as a victim, bully or both. The majority of them were males (90·3%). Adolescents with possible SB were more likely to have been involved in episodes of verbal school bullying (OR: 6·20; 95% CI: 3·67-10·48). Based on these findings, it can be suggested that possible SB in young teenagers is associated with a history of episodes of verbal school bullying. © 2017 John Wiley & Sons Ltd.

  16. Groups Call for Better Protection From Climate Change and Severe Weather

    NASA Astrophysics Data System (ADS)

    Fellows, Jack

    2008-11-01

    With a newly elected U.S. president taking office in January, eight leading professional organizations in the field of weather and climate have called on the next administration and Congress to better protect the United States from severe weather and climate change. The groups' ``transition document,'' which was provided to John McCain and Barack Obama, includes five recommendations to reverse declining budgets and provide tools and information that local and regional decision makers need in trying to prepare for weather- and climate-related impacts. The organizations also have been collecting from the community names that the next president should consider for key weather- and climate-related leadership positions in his administration.

  17. Respiratory disorders and the prevalence of sleep bruxism among schoolchildren aged 8 to 11 years.

    PubMed

    Drumond, Clarissa Lopes; Souza, Débora Souto; Serra-Negra, Júnia Maria; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Ramos-Jorge, Joana

    2017-03-01

    The aim of this study was to evaluate the association between respiratory disorders and sleep bruxism, with an evaluation of demographic/socioeconomic factors and childhood stress as confounding variables. A cross-sectional study was performed in the city of Diamantina, Brazil, with 448 randomly selected schoolchildren aged 8 to 11 years. The schoolchildren underwent an oral examination for the evaluation of bruxism. Parents/caregivers answered a questionnaire for the assessment of sleep bruxism; socioeconomic-demographic factors; and respiratory disorders, such as rhinitis, sinusitis, and bronchitis. The schoolchildren filled out the Children's Stress Scale. Poisson regression models were constructed separately for each respiratory disorder to determine prevalence ratios (PRs) and 95% confidence intervals (CIs). Sleep bruxism was more prevalent among children with rhinitis (PR = 1.45; 95%CI 1.08-1.93; p = 0.012) and sinusitis (PR = 1.58; 95%CI 1.06-2.36; p = 0.023). No significant association was found between sleep bruxism and bronchitis. A greater frequency of sleep bruxism was found among children whose mothers had a higher level of schooling and those who reported stress in the resistance/exhaustion phase. Rhinitis and sinusitis were associated with sleep bruxism. Moreover, sleep bruxism was more prevalent among children whose mothers had a higher level of schooling and those with higher degrees of stress.

  18. Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol

    PubMed Central

    2014-01-01

    Background Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition. The two clinical manifestations of the condition (sleep and awake bruxism) are thought to have unrelated aetiologies but are palliated using similar techniques. The lack of a definitive treatment has prompted renewed interest in biofeedback, a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs. This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism; to assess the efficacy and acceptability of biofeedback therapy in management of awake bruxism and, separately, sleep bruxism in adults; and to compare findings between the two variants. Methods A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults. We will search electronic databases and the grey literature using a predefined search strategy to identify randomised and non-randomised studies, technical reports and patents. Searches will not be restricted by language or date and will be expanded through contact with authors and experts, and by following up reference lists and citations. Two authors, working independently, will conduct screening of search results, study selection, data extraction and quality assessment and a third will resolve any disagreements. The primary outcomes of acceptability and effectiveness will be assessed using only randomised studies, segregated by bruxism subtype. A meta-analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met, otherwise the data will be summarized in narrative form. Data from non-randomised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues. PROSPERO registration number: CRD42013006880

  19. Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol.

    PubMed

    Ilovar, Sasa; Zolger, Danaja; Castrillon, Eduardo; Car, Josip; Huckvale, Kit

    2014-05-02

    Bruxism is a disorder of jaw-muscle activity characterised by repetitive clenching or grinding of the teeth which results in discomfort and damage to dentition. The two clinical manifestations of the condition (sleep and awake bruxism) are thought to have unrelated aetiologies but are palliated using similar techniques. The lack of a definitive treatment has prompted renewed interest in biofeedback, a behaviour change method that uses electronic detection to provide a stimulus whenever bruxism occurs. This systematic review aims to provide a comprehensive overview of the state of research into biofeedback for bruxism; to assess the efficacy and acceptability of biofeedback therapy in management of awake bruxism and, separately, sleep bruxism in adults; and to compare findings between the two variants. A systematic review of published literature examining biofeedback as an intervention directed at controlling primary bruxism in adults. We will search electronic databases and the grey literature using a predefined search strategy to identify randomised and non-randomised studies, technical reports and patents. Searches will not be restricted by language or date and will be expanded through contact with authors and experts, and by following up reference lists and citations. Two authors, working independently, will conduct screening of search results, study selection, data extraction and quality assessment and a third will resolve any disagreements. The primary outcomes of acceptability and effectiveness will be assessed using only randomised studies, segregated by bruxism subtype. A meta-analysis of these data will be conducted only if pre-defined conditions for quality and heterogeneity are met, otherwise the data will be summarized in narrative form. Data from non-randomised studies will be used to augment a narrative synthesis of the state of technical developments and any safety-related issues. PROSPERO registration number: CRD42013006880. Biofeedback is not new

  20. Are mental health problems and depression associated with bruxism in children?

    PubMed

    Renner, Andréa Coimbra; da Silva, Antônio Augusto Moura; Rodriguez, Juliana Dalla Martha; Simões, Vanda Maria Ferreira; Barbieri, Marco Antonio; Bettiol, Heloísa; Thomaz, Erika Bárbara Abreu Fonseca; Saraiva, Maria da Conceição

    2012-06-01

    Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression. Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirão Preto - RP (São Paulo), a more developed city, and the other from 805 children in São Luís - SL (Maranhão). Current bruxism - evaluated by means of a questionnaire applied to the parents/persons responsible for the children - was defined when the habit of tooth clenching during daytime and/or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Children's Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention/hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI). There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was

  1. A systematic review of etiological and risk factors associated with bruxism.

    PubMed

    Feu, Daniela; Catharino, Fernanda; Quintão, Catia Cardoso Abdo; Almeida, Marco Antonio de Oliveira

    2013-06-01

    The aim of the present work was to systematically review the literature and identify all peer-reviewed papers dealing with etiological and risk factors associated with bruxism. Data extraction was carried out according to the standard Cochrane systematic review methodology. The following databases were searched for randomized clinical trials (RCT), controlled clinical trials (CCT) or cohort studies: Cochrane Library, Medline, and Embase from 1980 to 2011. Unpublished literature was searched electronically using ClinicalTrials.gov. The primary outcome was bruxism etiology. Studies should have a standardized method to assess bruxism. Screening of eligible studies, assessment of the methodological quality and data extraction were conducted independently and in duplicate. Two reviewers inspected the references using the same search strategy and then applied the same inclusion criteria to the selected studies. They used criteria for methodological quality that was previously described in the Cochrane Handbook. Among the 1247 related articles that were critically assessed, one randomized clinical trial, one controlled clinical trial and seven longitudinal studies were included in the critical appraisal. Of these studies, five were selected, but reported different outcomes. There is convincing evidence that (sleep-related) bruxism can be induced by esophageal acidification and also that it has an important relationship with smoking in a dose-dependent manner. Disturbances in the central dopaminergic system are also implicated in the etiology of bruxism.

  2. Elements of implant-supported rehabilitation planning in patients with bruxism.

    PubMed

    Sarmento, Hugo Ramalho; Dantas, Raquel Venâncio Fernandes; Pereira-Cenci, Tatiana; Faot, Fernanda

    2012-11-01

    The rehabilitation of partial or completely edentulous patients with implant-supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to revise the literature and identify risk factors in implant-supported rehabilitation planning in subjects with bruxism. Available literature was searched through Medline, with no time limit, including only studies in English. Topics discussed were etiology of bruxism and its implications on dental implants, biomechanical considerations regarding the overload on dental implants, and methods to prevent the occurrence of overloads in implant-supported prostheses. The rehabilitation of bruxers using implant-supported prostheses, using implants with adequate length and diameter, as well as proper positioning seems to be a reliable treatment, with reduced risks of failure. Bruxism control through the use of a nightguard by rigid occlusal stabilization appliance relieved in the region of implants is highly indicated. Although it is clear that implant-supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

  3. Are there associations between sleep bruxism, chronic stress, and sleep quality?

    PubMed

    Ohlmann, Brigitte; Bömicke, Wolfgang; Habibi, Yasamin; Rammelsberg, Peter; Schmitter, Marc

    2018-07-01

    The purpose of this study was to identify associations between definite sleep bruxism, as defined by the American academy of sleep medicine, and chronic stress and sleep quality. Sleep bruxism was determined by use of questionnaires, assessment of clinical symptoms, and recording of electromyographic and electrocardiographic data (recorded by the Bruxoff ® device). The study included 67 participants. Of these, 38 were identified as bruxers and 29 as non-bruxers. The 38 bruxers were further classified as 17 moderate and 21 intense bruxers. Self-reported stress and self-reported sleep quality were determined by use of the validated questionnaires "Trier Inventory for the Assessment of Chronic Stress" (TICS) and the "Pittsburgh Sleep Quality Index" (PSQI). No statistically significant association was found between sleep bruxism and self-reported stress or sleep quality. However, a significant association between specific items of chronic stress and poor sleep quality was identified. The results of this study indicate an association between subjective sleep quality and subjective chronic stress, irrespective of the presence or absence of sleep bruxism. Chronic stress and sleep quality do not seem to be associated with sleep bruxism. (clinical trial no. NCT03039985). Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Direct restorative treatment of dental erosion caused by gastroesophageal reflux disease associated with bruxism: a case report.

    PubMed

    Vidal, Cristina de Mattos Pimenta; Catelan, Anderson; Briso, André Luiz Fraga; dos Santos, Paulo Henrique

    2011-09-01

    Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach acids are chronically regurgitated into the esophagus and oral cavity. Continual exposure of the teeth to these acids can cause severe tooth wear. Dentists are often the first healthcare professionals to diagnose dental erosion in patients with GERD. This article presents a case report of a 27-year-old male smoker with tooth wear and dentin sensitivity caused by GERD associated with bruxism. After diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow-up with counseling on dietary and smoking habits, as well as management of the gastric disorders with medication. GERD management and the dental treatment performed for the eroded dentition are described, including diagnosis, treatment planning, and restorative therapy.

  5. Effect of in vitro chewing and bruxism events on remineralization, at the resin-dentin interface.

    PubMed

    Toledano, Manuel; Cabello, Inmaculada; Aguilera, Fátima S; Osorio, Estrella; Osorio, Raquel

    2015-01-02

    The purpose of this study was to evaluate if different in vitro functional and parafunctional habits promote mineralization at the resin-dentin interface after bonding with three different adhesive approaches. Dentin surfaces were subjected to distinct treatments: demineralization by (1) 37% phosphoric acid (PA) followed by application of an etch-and-rinse dentin adhesive, Single Bond (SB) (PA+SB); (2) 0.5 M ethylenediaminetetraacetic acid (EDTA) followed by SB (EDTA+SB); (3) application of a self-etch dentin adhesive, Clearfil SE Bond (SEB). Different loading waveforms were applied: No cycling (I), cycled in sine (II) or square (III) waves, sustained loading hold for 24 h (IV) or sustained loading hold for 72 h (V). Remineralization at the bonded interfaces was assessed by AFM imaging/nano-indentation, Raman spectroscopy and Masson's trichrome staining. In general, in vitro chewing and parafunctional habits, promoted an increase of nano-mechanical properties at the resin-dentin interface. Raman spectroscopy through cluster analysis demonstrated an augmentation of the mineral-matrix ratio in loaded specimens. Trichrome staining reflected a narrow demineralized dentin matrix after loading in all groups except in PA+SB and EDTA+SB samples after sustained loading hold for 72 h, which exhibited a strong degree of mineralization. In vitro mechanical loading, produced during chewing and bruxism (square or hold 24 and 72 h waveforms), induced remineralization at the resin-dentin bonded interface. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Severe group A streptococcal infections in a paediatric intensive care unit.

    PubMed

    Lithgow, Anna; Duke, Trevor; Steer, Andrew; Smeesters, Pierre Robert

    2014-09-01

    To describe the clinical presentation, management and outcomes for children with invasive group A streptococcal (GAS) infection in a paediatric intensive care unit (PICU). We reviewed the clinical and laboratory records of patients admitted to a PICU in Melbourne with invasive GAS infection from April 2010 to April 2013. Outcomes recorded included survival, organ failure, need for extracorporeal support, renal replacement therapy and prolonged neuromuscular weakness. Twelve cases of invasive GAS infection were identified. The most common clinical presentations were pneumonia (n=5), bacteraemia with no septic focus (n=4) and septic arthritis (n=3). Necrotising fasciitis occurred in one patient and another patient presented with ischaemic lower limbs requiring amputation. Of the eight isolates with available emm typing results, the most common emm type was emm1 (n=4) followed by emm4, 12 and 22. Nine patients had multi-organ failure. Ten patients required mechanical ventilation for a median duration of 8 days. Nine patients required inotropic and/or vasopressor support and four patients extracorporeal membrane oxygenation support. Eleven patients survived. A prolonged period of neuromuscular weakness following the initial severe illness was common (n=5), but most children returned to normal or near normal neurological function. Invasive GAS disease in children may cause severe multi-organ failure with resultant prolonged intensive care stay and significant morbidity. However, a high rate of survival and return to normal functioning may be achieved with multi-system intensive care support and multi-disciplinary rehabilitation. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  7. A Randomized Clinical Trial of an Integrative Group Therapy for Children With Severe Mood Dysregulation.

    PubMed

    Waxmonsky, James G; Waschbusch, Daniel A; Belin, Peter; Li, Tan; Babocsai, Lysett; Humphery, Hugh; Pariseau, Meaghan E; Babinski, Dara E; Hoffman, Martin T; Haak, Jenifer L; Mazzant, Jessica R; Fabiano, Gregory A; Pettit, Jeremy W; Fallahazad, Negar; Pelham, William E

    2016-03-01

    Nonepisodic irritability is a common and impairing problem, leading to the development of the diagnoses severe mood dysregulation (SMD) and disruptive mood dysregulation disorder (DMDD). No psychosocial therapies have been formally evaluated for either, with medication being the most common treatment. This study examined the feasibility and efficacy of a joint parent-child intervention for SMD. A total of 68 participants aged 7 to 12 years with attention-deficit/hyperactivity disorder (ADHD) and SMD were randomly assigned to the 11-week therapy or community-based psychosocial treatment. All participants were first stabilized on psychostimulant medication by study physicians. Of the participants, 56 still manifested impairing SMD symptoms and entered the therapy phase. Masked evaluators assessed participants at baseline, midpoint, and endpoint, with therapy participants reassessed 6 weeks later. All but 2 therapy participants attended the majority of sessions (n = 29), with families reporting high levels of satisfaction. The primary outcome of change in mood symptoms using the Mood Severity Index (MSI) did not reach significance except in the subset attending the majority of sessions (effect size = 0.53). Therapy was associated with significantly greater improvement in parent-rated irritability (effect size = 0.63). Treatment effects for irritability but not MSI diminished after therapy stopped. Little impact on ADHD symptoms was seen. Results may not be generalizable to youth with SMD and comorbidities different from those seen in this sample of children with ADHD, and are limited by the lack of a gold standard for measuring change in SMD symptoms. While failing to significantly improve mood symptoms versus community treatment, the integrative therapy was found to be a feasible and efficacious treatment for irritability in participants with SMD and ADHD. Group-Based Behavioral Therapy Combined With Stimulant Medication for Treating Children With Attention Deficit

  8. Sound scattering by several zooplankton groups. I. Experimental determination of dominant scattering mechanisms.

    PubMed

    Stanton, T K; Chu, D; Wiebe, P H; Martin, L V; Eastwood, R L

    1998-01-01

    The acoustic scattering properties of live individual zooplankton from several gross anatomical groups have been investigated. The groups involve (1) euphausiids (Meganyctiphanes norvegica) whose bodies behave acoustically as a fluid material, (2) gastropods (Limacina retroversa) whose bodies include a hard elastic shell, and (3) siphonophores (Agalma okeni or elegans and Nanomia cara) whose bodies contain a gas inclusion (pneumatophore). The animals were collected from ocean waters off New England (Slope Water, Georges Bank, and the Gulf of Maine). The scattering properties were measured over parts or all of the frequency range 50 kHz to 1 MHz in a laboratory-style pulse-echo setup in a large tank at sea using live fresh specimens. Individual echoes as well as averages and ping-to-ping fluctuations of repeated echoes were studied. The material type of each group is shown to strongly affect both the overall echo level and pattern of the target strength versus frequency plots. In this first article of a two-part series, the dominant scattering mechanisms of the three animal types are determined principally by examining the structure of both the frequency spectra of individual broadband echoes and the compressed pulse (time series) output. Other information is also used involving the effect on overall levels due to (1) animal orientation and (2) tissue in animals having a gas inclusion (siphonophores). The results of this first paper show that (1) the euphausiids behave as weakly scattering fluid bodies and there are major contributions from at least two parts of the body to the echo (the number of contributions depends upon angle of orientation and shape), (2) the gastropods produce echoes from the front interface and possibly from a slow-traveling circumferential (Lamb) wave, and (3) the gas inclusion of the siphonophore dominates the echoes, but the tissue plays a role in the scattering and is especially important when analyzing echoes from individual animals on a

  9. Gastrointestinal symptomatology as a predictor of severe outcomes of invasive group A streptococcal infections.

    PubMed

    Khateeb, O M; Osborne, D; Mulla, Z D

    2010-04-01

    Invasive group A streptococcal (GAS) disease is a condition of clinical and public health significance. We conducted epidemiological analyses to determine if the presence of gastrointestinal (GI) complaints (diarrhea and/or vomiting) early in the course of invasive GAS disease is associated with either of two severe outcomes: GAS necrotizing fasciitis, or hospital mortality. Subjects were hospitalized for invasive GAS disease throughout the state of Florida, USA, during a 4-year period. Multiple imputation using the Markov chain Monte Carlo method was used to replace missing values with plausible values. Excluding cases with missing data resulted in a sample size of 138 invasive GAS patients (the complete subject analysis) while the imputed datasets contained 257 records. GI symptomatology within 48 h of hospital admission was not associated with hospital mortality in either the complete subject analysis [adjusted odds ratio (aOR) 0.86, 95% confidence interval (CI) 0.31-2.39] or in the imputed datasets. GI symptoms were significantly associated with GAS necrotizing fasciitis in the complete subject analysis (aOR 4.64, 95% CI 1.18-18.23) and in the imputed datasets but only in patients aged <55 years. The common cause of GI symptoms and necrotizing fasciitis may be streptococcal exotoxins. Clinicians who are treating young individuals presumed to be in the early stages of invasive GAS disease should take note of GI symptoms and remain vigilant for the development of a GAS necrotizing soft-tissue infection.

  10. Management of Contacts of Patients With Severe Invasive Group A Streptococcal Infection.

    PubMed

    de Almeida Torres, Rosângela Stadnick Lauth; dos Santos, Talita Zajac; Torres, Robson Antônio de Almeida; Petrini, Lygia Maria Coimbra de Manuel; Burger, Marion; Steer, Andrew C; Smeesters, Pierre R

    2016-03-01

    Conflicting recommendations regarding antibiotic prophylaxis for contacts of patients with invasive group A streptococcal (GAS) infection exist. Close contacts of patients with such severe and rapidly progressive disease often strongly appeal to the treating clinicians for antimicrobial treatment to prevent additional cases. We aimed to use an approach based on pharyngeal culture testing of contacts and targeted antibiotic prophylaxis. A large throat swab survey including 105 contacts was undertaken after a fulminant and fatal case of GAS necrotizing fasciitis. GAS strains were characterized by emm typing and antimicrobial susceptibility to 7 antibiotics. The presence of 30 virulence determinants was determined by polymerase chain reaction and sequencing. The GAS isolate recovered from the index patient was an M1T1 GAS clone susceptible to all antimicrobial agents tested. The same clone was present in the throat of 36% of close contacts who had exposure to the index patient (family households and classroom contacts) for >24 hours/week, whereas the strain was present in only 2% of the other contacts. Although the study does not allow firm conclusions to be drawn as to whether antibiotic prophylaxis is effective, we describe a practical approach, including an educational campaign and targeted antibiotic treatment to close contacts who have been exposed to an index patient for > 24 hours/week before the initial disease onset. © The Author 2014. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Self-reported bruxism and temporomandibular disorders: findings from two specialised centres.

    PubMed

    Manfredini, D; Winocur, E; Guarda-Nardini, L; Lobbezoo, F

    2012-05-01

    The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. Significant differences were shown between the two clinic samples as for the frequency of TMD diagnoses (chi-square, P<0·001) and the prevalence of at least one positive response to bruxism items (chi-square, P<0·001). The more widespread use of TMJ imaging techniques in one clinic sample led to a higher prevalence of multiple diagnoses, and the higher prevalence of self-reported bruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders. © 2012 Blackwell Publishing Ltd.

  12. Psychosocial Aspects of Bruxism: The Most Paramount Factor Influencing Teeth Grinding

    PubMed Central

    Wieckiewicz, Mieszko; Paradowska-Stolarz, Anna; Wieckiewicz, Wlodzimierz

    2014-01-01

    In clinical practice, patients suffering from an occlusal parafunctional activity have increased. It can be observed that a negative influence of environment aggravates patient's health. The aim of this paper is to present the impact of environment and development of human civilization on the prevalence of bruxism and the correlation between them. The authors grasp the most relevant aspects of psychological and anthropological factors changing over time as well as their interactions and describe a relationship between chronic stress and bruxism. Current literature shows how contemporary lifestyle, working environment, diet, and habits influence the patient's psychoemotional situation and the way these factors affect the occluso-muscle condition. PMID:25101282

  13. The Impact of Group-as-a-Whole Work on Anxiety and Depression in a Severely Mentally Ill Population

    ERIC Educational Resources Information Center

    Semmelhack, Diana J.; Hazell, Clive; Hoffman, William

    2008-01-01

    This study explored the impact of a group-as-a-whole processing group on 11 severely mentally ill adult clients residing in a long term care facility over 30 weeks. Participants were evaluated for the effect of the group on anxiety and depression, using the Beck Depression Index (BDI-II) and the Beck Anxiety Index (BAI). This longitudinal study…

  14. Sleep Bruxism-Tooth Grinding Prevalence, Characteristics and Familial Aggregation: A Large Cross-Sectional Survey and Polysomnographic Validation

    PubMed Central

    Khoury, Samar; Carra, Maria Clotilde; Huynh, Nelly; Montplaisir, Jacques; Lavigne, Gilles J.

    2016-01-01

    Study Objectives: Sleep bruxism (SB) is characterized by tooth grinding and jaw clenching during sleep. Familial factors may contribute to the occurrence of SB. This study aims are: (1) revisit the prevalence and characteristics of SB in a large cross-sectional survey and assess familial aggregation of SB, (2) assess comorbidity such as insomnia and pain, (3) compare survey data in a subset of subjects diagnosed using polysomnography research criteria. Methods: A sample of 6,357 individuals from the general population in Quebec, Canada, undertook an online survey to assess the prevalence of SB, comorbidities, and familial aggregation. Data on familial aggregation were compared to 111 SB subjects diagnosed using polysomnography. Results: Regularly occurring SB was reported by 8.6% of the general population, decreases with age, without any gender difference. SB awareness is concomitant with complaints of difficulties maintaining sleep in 47.6% of the cases. A third of SB positive probands reported pain. A 2.5 risk ratio of having a first-degree family member with SB was found in SB positive probands. The risk of reporting SB in first-degree family ranges from 1.4 to 2.9 with increasing severity of reported SB. Polysomnographic data shows that 37% of SB subjects had at least one first-degree relative with reported SB with a relative risk ratio of 4.625. Conclusions: Our results support the heritability of SB-tooth grinding and that sleep quality and pain are concomitant in a significant number of SB subjects. Citation: Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ. Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation. SLEEP 2016;39(11):2049–2056. PMID:27568807

  15. Autonomic nervous activities associated with bruxism events during sleep.

    PubMed

    Nukazawa, Shinichi; Yoshimi, Hidehiro; Sato, Sadao

    2018-03-01

    To confirm the relationship between sleep bruxism (SB) and autonomic nervous (AN) activities to elucidate SB physiology. Subjects included 11 healthy males (mean age, 24.7 ± 2.3 years). These data were recorded in the sleep laboratory using a system composed of a two-axis accelerometer, an infrared camera, electroencephalography, electromyography, and electrocardiography. Time lapse analysis confirmed correlations between AN activity and SB events during sleep in subjects. Relationships between SB strength and length and AN activity were evaluated. Sympathetic nerve (SN) and parasympathetic nerve (PSN) activities occurred significantly in 93.3% of cases (p < 0.01), with similar predictable patterns during SB. Furthermore, SB length and SN activity in seven of the subjects (four subjects, p < 0.05; three subjects p < 0.01), and PSN and SB muscle activities (% maximum voluntary contraction) in five subjects (four subjects, p < 0.05; one subject, p < 0.01) were significantly correlated. The authors believe that SB is closely related to SN as well as PSN activities and may control the AN system.

  16. Failure of tooth eruption in two patients with cerebral palsy and bruxism-a 10-year follow-up: a case report.

    PubMed

    Staufer, Kirsten; Hamadeh, Sinan; Gesch, Dietmar

    2009-01-01

    The aim of this paper was to analyze delayed tooth eruption in two children with cerebral palsy who had severe bruxism and to determine whether treatment could influence tooth eruption and alignment. Extraction of primary teeth was carried out and orthodontic treatment was considered due to severe tooth wear of primary teeth, lack of space, and development of a class III malocclusion. Analysis was based on clinical examination, photographs, radiographs, and dental casts. In both patients, early mixed dentition was delayed for more than 5 years. Calcification and root development of posterior permanent teeth corresponded with the chronological age. Root resorption of the severely abraded primary teeth and eruption of their successors were delayed or failed. Eruption of permanent teeth occurred slowly after primary teeth were extracted. Orthodontic treatment succeeded in one patient, achieving a normal overjet in combination with a successful orofacial therapy. The disturbed exfoliation of abraded primary teeth and failure of tooth eruption of the posterior teeth could be linked to the systemic pathology and to bruxism. At age 20, eruption of the canines and premolars remained questionable.

  17. Exploration of experiences in therapeutic groups for patients with severe mental illness: development of the Ferrara group experiences scale (FE- GES).

    PubMed

    Caruso, Rosangela; Grassi, Luigi; Biancosino, Bruno; Marmai, Luciana; Bonatti, Luciano; Moscara, Maria; Rigatelli, Marco; Carr, Catherine; Priebe, Stefan

    2013-10-01

    Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context. An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension. The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency. The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.

  18. Functional analysis and treatment of the diurnal bruxism of a 16-year-old girl with autism.

    PubMed

    Armstrong, Amy; Knapp, Vicki Madaus; McAdam, David B

    2014-01-01

    Bruxism is defined as the clenching and grinding of teeth. This study used a functional analysis to examine whether the bruxism of a 16-year-old girl with autism was maintained by automatic reinforcement or social consequences. A subsequent component analysis of the intervention package described by Barnoy, Najdowski, Tarbox, Wilke, and Nollet (2009) showed that a vocal reprimand (e.g., "stop grinding") effectively reduced the participant's bruxism. Results were maintained across time, and effects extended to novel staff members. © Society for the Experimental Analysis of Behavior.

  19. Uncovering Dimensions of Culture in Underperforming Group Homes for People with Severe Intellectual Disability

    ERIC Educational Resources Information Center

    Bigby, Christine; Knox, Marie; Beadle-Brown, Julie; Clement, Tim; Mansell, Jim

    2012-01-01

    Culture recurs as an important but under-investigated variable associated with resident outcomes in supported accommodation for people with intellectual disability. This study aimed to conceptualize the potential dimensions of culture in all group homes and describe the culture in underperforming group homes. A secondary analysis, using an…

  20. Is the grading system of the severity of the OSAHS used presently rational or not?: from the view of incidence of hypertension in different severity groups.

    PubMed

    Li, Jinrang; Chen, Xi; Sun, Jianjun

    2014-09-01

    The grading system of the severity of obstructive sleep apnea hypopnea syndrome (OSAHS) used presently showed that the severe OSAHS had an extensive range of apnea hypopnea index (AHI) (≥ 30, even over 100). So this grading system is not rational. From Jan 1999 to June 2011, there were 2,618 patients complaining of snoring took the polysomnography. The patients were divided into 11 groups according to their AHI. Frequencies of OSAHS with hypertension in each group were tested using crosstabs. The incidence of hypertension was increased as the increasing of AHI. Crosstab analysis showed that there were four cutoff points of AHI (5, 30, 50, 100). There was a significant difference in the incidence of hypertension between the groups of AHI more than the cutoff point and AHI less than the cutoff point. So from the view of hypertension in each group, we recommend that the AHI <5 should be considered as normal or simple snorer, AHI = 5-30 as mild degree of OSAHS, AHI = 30-50 as moderate degree of OSAHS, AHI = 50-100 as severe degree of OSAHS, and AHI ≥ 100 as profound degree of OSAHS.

  1. A Validity Study of the Working Group's Autobiographical Memory Test for Individuals with Moderate to Severe Intellectual Disability

    ERIC Educational Resources Information Center

    Pyo, Geunyeong; Ala, Tom; Kyrouac, Gregory A.; Verhulst, Steven J.

    2011-01-01

    The purpose of the present study was to investigate the validity of the Working Group's Autobiographical Memory Test as a dementia screening tool for individuals with moderate to severe intellectual disabilities (ID). Twenty-one participants with Dementia of Alzheimer's Type (DAT) and moderate to severe ID and 42 controls with similar levels of ID…

  2. Treatment of Bruxism in Individuals with Developmental Disabilities: A Systematic Review

    ERIC Educational Resources Information Center

    Lang, Russell; White, Pamela J.; Machalicek, Wendy; Rispoli, Mandy; Kang, Soyeon; Aquilar, Jeannie; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Didden, Robert

    2009-01-01

    We reviewed studies involving the treatment of bruxism (i.e., teeth clenching or teeth grinding) in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 11 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures…

  3. Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study

    PubMed Central

    Kataoka, Kota; Ekuni, Daisuke; Mizutani, Shinsuke; Tomofuji, Takaaki; Azuma, Tetsuji; Yamane, Mayu; Kawabata, Yuya; Iwasaki, Yoshiaki; Morita, Manabu

    2015-01-01

    Objectives Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students. Methods Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire. Results The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22–3.93) and underweight (BMI <18.5 kg/m2) (OR 1.89; 95% CI, 1.31–2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males. Conclusions Awareness of clenching and underweight were related to malocclusion (crowding) in university male students. PMID:25865057

  4. [Bruxism--a function of the masticatory organ to cope with stress].

    PubMed

    Slavicek, Rudolf; Sato, Sadao

    2004-12-01

    Bruxism is generally defined as a parafunctional clenching and grinding action between the upper and lower teeth. During this activity, extremely strong forces can be applied for time periods exceeding those of functional mastication. These biomechanical loads create many dental problems, such as abfractions, hypersensitivity, periodontal distraction, and temporo-mandibular dysfunction. Researchers studying Bruxism have long discussed psychic stress and emotional tension. It has also been indicated that an aggressive biting is associated with a significant attenuation of the stress-induced increase of nor-adrenalin turnover in the brain, of the striatal DOPAC contents and with the prevention of stomach ulcer formation in experimental animals. The concept of stress management based on the psychological background of Bruxism and the benefits attributable to masticatory muscle activity in attenuating stress-related symptoms such as stomach ulcer. The clenching and bruxing function of the masticatory organ is an emergency exit during periods of psychic overloading. Therefore, occlusion of the masticatory organ contributes significantly to an individual's ability to manage stress. Bruxism in proper dentition can be recognized as a valid system prophylaxis for all stress related diseases.

  5. Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study.

    PubMed

    Kataoka, Kota; Ekuni, Daisuke; Mizutani, Shinsuke; Tomofuji, Takaaki; Azuma, Tetsuji; Yamane, Mayu; Kawabata, Yuya; Iwasaki, Yoshiaki; Morita, Manabu

    2015-01-01

    Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students. Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire. The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22-3.93) and underweight (BMI <18.5 kg/m(2)) (OR 1.89; 95% CI, 1.31-2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males. Awareness of clenching and underweight were related to malocclusion (crowding) in university male students.

  6. Severe congenital neutropenia, a genetically heterogeneous disease group with an increased risk of AML/MDS

    PubMed Central

    Vandenberghe, Peter; Beel, Karolien

    2011-01-01

    Over the past decade, enormous progress has been made in the understanding of severe congenital neutropenia (SCN), by identification of several causal gene mutations: in ELANE, GFI1, HAX1, WAS and G3PC3. SCN is a preleukemic condition, independent of the genetic subtype. Acquired CSF3R mutations are specific for SCN and are strongly associated with malignant progression. In this review, we describe the known genetic subtypes of SCN, their molecular basis and clinical presentation and summarize the available evidence on CSF3R mutations and monosomy 7 in malignant conversion. PMID:22053285

  7. Mandibular movement during sleep bruxism associated with current tooth attrition.

    PubMed

    Okura, Kazuo; Shigemoto, Shuji; Suzuki, Yoshitaka; Noguchi, Naoto; Omoto, Katsuhiro; Abe, Susumu; Matsuka, Yoshizo

    2017-01-01

    Observation of attrition patterns suggests that mandibular movement in sleep bruxism (SB) may be associated with current tooth attrition. The aim of this study was to confirm this phenomenon by investigating mandibular movement and masseter muscle activity. The subject was a healthy 21-year-old Japanese male. We recorded biological signals including mandibular movement and masseter electromyograms (EMGs) with a polysomnograph. Based on the EMG using Okura's criteria, SB events were classified into clenching, grinding and mixed types according to mandibular movement criteria. The close-open mandibular movement cycles (CO-cycles) during grinding and mixed type events were selected based on mandibular movement trajectories. Fifty-eight CO-cycles were selected in seven grinding and three mixed types. We found that SB mandibular movements associated with current tooth attrition. Excessive lateral movements (ELM) beyond the canine edge-to-edge position were observed in the closing (10.3%) and opening (13.8%) phases of the CO-cycle. Total masseter muscle activity was significantly higher during voluntary grinding (VGR) than during CO-cycle including ELM (working side: P=0.036, balancing side: P=0.025). However, in the middle and late parts of the opening phase, working side masseter muscle activity was significantly higher during CO-cycle including ELM than during VGR (P=0.012). In the early part of the closing phase, balancing side masseter muscle activity was significantly higher during CO-cycle including ELM than during VGR (P=0.017). These findings suggest that excessive forceful grinding during ongoing SB events may have caused canine attrition in this patient. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  8. A Novel Group Therapy for Children with ADHD and Severe Mood Dysregulation

    ERIC Educational Resources Information Center

    Waxmonsky, James G.; Wymbs, Fran A.; Pariseau, Meaghan E.; Belin, Peter J.; Waschbusch, Daniel A.; Babocsai, Lysett; Fabiano, Gregory A.; Akinnusi, Opeolowa O.; Haak, Jenifer L.; Pelham, William E.

    2013-01-01

    Objective: No psychosocial treatments have been developed for children with ADHD and severe mood dysregulation (SMD) despite the significant prevalence and morbidity of this combination. Therefore, the authors developed a novel treatment program for children with ADHD and SMD. Method: The novel therapy program integrates components of…

  9. Interactive risk analysis on crash injury severity at a mountainous freeway with tunnel groups in China.

    PubMed

    Huang, Helai; Peng, Yunying; Wang, Jie; Luo, Qizhang; Li, Xiang

    2018-02-01

    Traffic safety of freeways has attracted major concerns, especially for a mountainous freeway affected by adverse terrain conditions, constrained roadway geometry and complicated driving environments. On the basis of a comprehensive dataset collected from a mountainous freeway with a length of 61km but gathering 12 tunnels, this study seeks to examining the interactive effect of mountainous freeway alignment, driving behaviors, vehicle characteristics and environmental factors on crash severity. A classification and regression tree (CART) model is employed as it can deal with high-order interactions between explanatory variables. Results show that the driving behavior is the most important determinant for injury severity of mountainous freeway crashes, followed by the crash time, grade, curve radius and vehicle type. These variables, interacted with the factors of season and crash location, may largely account for the likelihood of high risk events which may result in severe crashes. Events associated with a notably higher probability of severe crashes include coach drivers involved in improper lane changing and other improper actions, drivers involved in speeding during afternoon or evening, drivers involved in speeding along large curve and straight segment during morning, noon or night, and drivers involved in fatigue while passing along the downgrade. Safety interventions to prevent severe crashes at the mountainous freeway include hierarchical supervision in terms of hazardous driving events, enhanced enforcement for speeding and fatigue driving, deployment of advanced driving assistance systems for fatigue driving warning, and cumulative driving time monitoring for long-distance-travel freight vehicles. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients.

    PubMed

    Paesani, D A; Lobbezoo, F; Gelos, C; Guarda-Nardini, L; Ahlberg, J; Manfredini, D

    2013-11-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-nine patients with TMD underwent an assessment including a questionnaire investigating five bruxism-related items (i.e. sleep grinding, sleep grinding referral by bed partner, sleep clenching, awake clenching, awake grinding) and an interview (i.e. oral history taking with specific focus on bruxism habits) plus a clinical examination to evaluate bruxism signs and symptoms. The correlation between findings of the questionnaire, viz., patients' report, and findings of the interview/oral history taking plus clinical examination, viz., clinicians' diagnosis, was assessed by means of φ coefficient. The highest correlations were achieved for the sleep grinding referral item (φ = 0·932) and for the awake clenching item (φ = 0·811), whilst lower correlation values were found for the other items (φ values ranging from 0·363 to 0·641). The percentage of disagreement between the two diagnostic approaches ranged between 1·8% and 18·2%. Within the limits of the present investigation, it can be suggested that a strong positive correlation between a self-reported and a clinically based approach to bruxism diagnosis can be achieved as for awake clenching, whilst lower levels of correlation were detected for sleep-time activities. © 2013 John Wiley & Sons Ltd.

  11. Association of infantile bruxism and the terminal relationships of the primary second molars.

    PubMed

    Junqueira, Tatiana Helena; Nahás-Scocate, Ana Carla Raphaelli; Valle-Corotti, Karyna Martins do; Conti, Ana Claudia de Castro Ferreira; Trevisan, Shirley

    2013-01-01

    The aim of this study was to analyze the association between infantile bruxism and the terminal relationships of the primary second molars. A total of 937 pre-school children (both genders), aged from 2 to 6 years, from municipal schools in São Paulo were evaluated. In this study, a questionnaire considering the bruxism habit and the presence of headaches and/or restless sleep was answered by the parents/guardians. A clinical exam of occlusion in the anteroposterior direction (vertical plane - VP, mesial step - MS and distal step - DS) was performed by the examiners in the school environment. Student's t test, Fisher's test and a logistic regression test were applied for the statistical analysis at a significance level of 5%. The prevalence of the bruxism habit was 29.3% among the total sample. Because there was no significant difference between the sides evaluated, the left side was taken as the standard. Among those children with bruxism, 25.7% presented a mesial step terminal relationship at the primary second molars, 29.1% had DS, and 30.2% had VP. Regarding the association of the parafunctional habit with the type of terminal relationship, no significant results were found. Children who slept restlessly or suffered from headaches were verified to show a higher chance of expressing the habit (OR = 2.4 and 1.6, respectively). The prevalence of bruxism in the studied sample was 29.3%, and its association with the primary second molars' terminal relationship was not statistically significant.

  12. Several nomenclatural clarifications on genus-group names in the Aphididae (Hemiptera Sternorrhyncha)

    USDA-ARS?s Scientific Manuscript database

    The aphidologists attending the Eighth International Symposium on Aphids, held in Fremantle (Western Australia, 2005), charged us with the preparation of a Part of the List of Available Names in Zoology devoted to the aphid genus-group names. Our work was greatly facilitated by reference to the list...

  13. Bill Gates' Great-Great-Granddaughter's Honeymoon: An Astronomy Activity for Several Different Age Groups

    ERIC Educational Resources Information Center

    Fraknoi, Andrew

    2009-01-01

    When students finish a unit or course on the planets these days, they are often overwhelmed with facts, comparisons, and images. A good culminating activity, to help them organize their thinking (and review), is to have them divide into small groups (travel agencies) and come up with their top ten solar system "tourist sights" for future space…

  14. Treatment of severe psoriasis in children: recommendations of an Italian expert group.

    PubMed

    Fortina, Anna Belloni; Bardazzi, Federico; Berti, Samantha; Carnevale, Claudia; Di Lernia, Vito; El Hachem, Maya; Neri, Iria; Gelmetti, Carlo Mario; Lora, Viviana; Mazzatenta, Carlo; Milioto, Mirella; Moretta, Gaia; Patrizi, Annalisa; Peris, Ketty; Villani, Alberto

    2017-10-01

    This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up

  15. Sleep bruxism and related risk factors in adults: A systematic literature review.

    PubMed

    Castroflorio, Tommaso; Bargellini, Andrea; Rossini, Gabriele; Cugliari, Giovanni; Deregibus, Andrea

    2017-11-01

    The aim of this article was to systematically review the literature to assess the relationship between risk factors and sleep bruxism (SB) in adults (age ≥18 years). A systematic search of the following databases was carried out: PubMed, Embase, Scopus, Cochrane Oral Health Group's Trial Register and Cochrane Register of Controlled Trials, Web of Science, LILACs and SciELO. Nine out of the 4583 initially identified articles were selected. This review was conducted according to the guidelines from the Cochrane Handbook for Systematic Reviews of Interventions, with reporting in agreement to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Among the nine analyzed articles, associations between SB and gastro-esophageal reflux disease (GERD) (OR=6.6, CI=1.4-30.9) was found in one randomized clinical trial (RCT). Four cross-sectional studies suggested history of SB during childhood (OR=8.1 CI=5.4-12-2), age (OR=3.1, CI=2.3-4.1) and chronic migraine (OR=3.8, C.I=1.8-7.8) as determinant factors for the development of SB. In one case-control study, patients with genetic polymorphisms were more likely to present SB (OR=4.3, CI=1.6-11.3). Smoking (OR=2.8, CI=2.2-3.5) and alcohol intake (OR=1.9, CI=1.2-2.8) showed moderate association in two case-control studies. History of SB during childhood, gastro-esophageal reflux disease and genetic polymorphisms seem to be important risk factors associated to SB in adults. Dry mouth on awakening seems to be a protective factor. Association does not infer with causality. Even if the evidence emerged from the considered studies was clinically relevant, further studies are requested to better understand the biological mechanisms behind the described associations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Comparison of clinical marking and ultrasound-guided injection of Botulinum type A toxin into the masseter muscles for treating bruxism and its cosmetic effects.

    PubMed

    Quezada-Gaon, Natacha; Wortsman, Ximena; Peñaloza, Osvaldo; Carrasco, Juan Eduardo

    2016-09-01

    Botulinum toxin type A has been used for treating the hypertrophy of the masseter muscles and its cosmetic effects. Ultrasound is increasingly used in dermatology, along with the guidance of mini-invasive procedures. To evaluate the role of ultrasound for guiding the application of Botulinum A toxin in patients with cosmetic alterations due to bruxism, correlate the clinical landmarks with the ultrasound findings, and study the effect on the symptoms, cosmetics, and quality of life. Twenty individuals with bruxism and cosmetic alterations underwent an ultrasound-guided injection of Botulinum toxin type A in each masseter muscle. Clinical and ultrasound marking of the procedure was compared. Clinical and sonographic evaluation was performed at the time of injection and 3 months later. Ten normal individuals underwent ultrasound of the masseter muscles as a control group. Up to 65% of individuals showed anatomical variants of the salivary glands. The method for clinically marking the skin showed a frequently erroneous location of the anterior point (up to 40% of cases) that was proven by ultrasound to be out of the muscle. In 20% of cases, ultrasound showed that the needle should be longer to enter the muscle. After injection, most of the patients demonstrated a decrease of the symptoms and cosmetic and quality of life improvements. Ultrasound can be a potent tool for guiding the injection of Botulinum toxin into the masseter muscles. It may contribute to a more personalized procedure, better cosmetic results, and help to avoid potential complications. © 2016 Wiley Periodicals, Inc.

  17. Validity of the Addiction Severity Index (adapted version) in a Costa Rican population group.

    PubMed

    Sandí Esquivel, L E; Avila Corrales, K

    1990-01-01

    Until recently, no adapted and validated instrument was available for assessing the alcohol and drug problems of individuals in Costa Rica. This article reports the results of a study performed by Costa Rica's Institute on Alcoholism and Drug Dependence in order to test an adapted version of one such instrument, the Addiction Severity Index (ASI), in a Costa Rican setting. The instrument was used to interview 100 male subjects 18 to 64 years old (51 with diagnosed alcohol or drug problems and 49 controls). In general, the subjects with previously diagnosed alcohol or drug problems were assigned substantially higher scores. More specifically, statistical analysis indicated highly significant correlations (p less than 0.001) between the type of subject (test subject or control) and the likelihood that noteworthy problems would be found in the areas of alcohol use, family/social relations, work/finances, and psychological status. Overall, the study demonstrated that the instrument was capable of distinguishing between the affected and unaffected populations, and also of gauging the severity of the problems involved and the patients' treatment needs.

  18. Various fates of neuronal progenitor cells observed on several different chemical functional groups

    NASA Astrophysics Data System (ADS)

    Liu, Xi; Wang, Ying; He, Jin; Wang, Xiu-Mei; Cui, Fu-Zhai; Xu, Quan-Yuan

    2011-12-01

    Neuronal progenitor cells cultured on gold-coated glass surfaces modified by different chemical functional groups, including hydroxyl (-OH), carboxyl (-COOH), amino (-NH2), bromo (-Br), mercapto (-SH), - Phenyl and methyl (-CH3), were studied here to investigate the influence of surface chemistry on the cells' adhesion, morphology, proliferation and functional gene expression. Focal adhesion staining indicated in the initial culture stage cells exhibited morphological changes in response to different chemical functional groups. Cells cultured on -NH2 grafted surface displayed focal adhesion plaque and flattened morphology and had the largest contact area. However, their counter parts on -CH3 grafted surface displayed no focal adhesion and rounded morphology and had the smallest contact area. After 6 days culture, the proliferation trend was as follows: -NH2 > -SH> -COOH> - Phenyl > - Br > -OH> -CH3. To determine the neural functional properties of the cells affected by surface chemistry, the expression of glutamate decarboxylase (GAD67), nerve growth factor (NGF) and brainderived neurotrophic factor (BDNF) were characterized. An increase of GAD67 expression was observed on -NH2, -COOH and -SH grafted surfaces, while no increase in NGF and BDNF expression was observed on any chemical surfaces. These results highlight the importance of surface chemistry in the fate determination of neuronal progenitor cells, and suggest that surface chemistry must be considered in the design of biomaterials for neural tissue engineering.

  19. Trans activation of plasmid-borne promoters by adenovirus and several herpes group viruses.

    PubMed Central

    Everett, R D; Dunlop, M

    1984-01-01

    This paper describes experiments to test the ability of a number of viruses of the Herpes group, and also Adenovirus-2 and SV40, to activate transcription from the Herpes simplex virus-1 glycoprotein D and the rabbit beta-globin promoters. Plasmids containing these genes were transfected into HeLa cells which were then infected with various viruses. Transcriptional activation in trans of the plasmid-borne promoters was monitored by quantitative S1 nuclease analysis of total cytoplasmic RNA isolated after infection. The results showed that Herpes simplex viruses 1 and 2, Pseudorabies virus, Variella Zoster virus, Human Cytomegalovirus, Equine herpes virus-1 and Adenovirus-2 activate transcription from both promoters tested. In contrast, SV40 did not activate transcription in trans in this assay. The possible mechanisms of this activation are discussed. Images PMID:6089105

  20. Increasing self-esteem: efficacy of a group intervention for individuals with severe mental disorders.

    PubMed

    Borras, L; Boucherie, M; Mohr, S; Lecomte, T; Perroud, N; Huguelet, Ph

    2009-06-01

    Individuals with psychosis are known to have a lower self-esteem compared to the general population, in part because of social stigma, paternalistic care, long periods of institutionalization and negative family interactions. This study aimed at assessing the efficacy of a self-esteem enhancement program for individuals with severe mental illness and at analyzing the results in their European context. A randomized cross-over study including 54 outpatients with a diagnosis of schizophrenia from Geneva, Switzerland, was conducted. Twenty-four were recruited from an outpatient facility receiving traditional psychiatric care whereas 30 came from an outpatient facility with case-management care. Psychosocial, diagnostic and symptom measures were taken for all the subjects before treatment, after treatment, and at 3-months' follow-up. Results indicated significant positive self-esteem module effects on self-esteem, self-assertion, active coping strategies and symptom for the participants receiving case-management care. Results were not significant for those receiving traditional care. However, 71% of all participants expressed satisfaction with the module. Individuals with schizophrenia appear to be benefit from the effects of the self-esteem module, particularly when they are involved in a rehabilitation program and followed by a case manager who liaises with the other partners of the multidisciplinary team. This encourages reconsidering the interventions' format and setting in order to ensure lasting effects on the environment and in turn on coping, self-esteem and overall empowerment.

  1. Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group.

    PubMed

    Clemmer, T P; Fisher, C J; Bone, R C; Slotman, G J; Metz, C A; Thomas, F O

    1992-10-01

    To evaluate the consequences of clinical hypothermia associated with sepsis syndrome and septic shock. Analysis of data from a multi-institutional, randomized, placebo-controlled, prospective study with predetermined end-point analysis of development of shock, recovery from shock, hospital length of stay, and death. Multi-institutional medical and surgical ICUs. Patients meeting predetermined criteria for severe sepsis syndrome. Appropriate sepsis and shock care with 50% of patients receiving methylprednisolone and 50% receiving placebo. The occurrence rate of hypothermia (< 35.5 degrees C) is 9% in this population. When compared with febrile patients, hypothermic patients had a higher frequency of central nervous system dysfunction (88% vs. 60%), increased serum bilirubin concentration (35% vs. 15%), prolonged prothrombin times (50% vs. 23%), shock (94% vs. 61%), failure to recover from shock (66% vs. 26%), and death (62% vs. 26%). The hypothermic patients were also more likely to be classified as having a rapidly or ultimately fatal disease upon study admission. This prospective study confirms that hypothermia associated with sepsis syndrome has a significant relationship to outcome manifest by increased frequency of shock and death from shock. This finding is in sharp contrast to the protective effects of induced hypothermia in septic animals and perhaps man.

  2. Loss of Polycomb Group Protein Pcgf1 Severely Compromises Proper Differentiation of Embryonic Stem Cells

    PubMed Central

    Yan, Yun; Zhao, Wukui; Huang, Yikai; Tong, Huan; Xia, Yin; Jiang, Qing; Qin, Jinzhong

    2017-01-01

    The Polycomb repressive complex 1 (PRC1) is essential for fate decisions of embryonic stem (ES) cells. Emerging evidence suggests that six major variants of PRC1 complex, defined by the mutually exclusive presence of Pcgf subunit, regulate distinct biological processes, yet very little is known about the mechanism by which each version of PRC1 instructs and maintains cell fate. Here, we disrupted the Pcgf1, also known as Nspc1 and one of six Pcgf paralogs, in mouse ES cells by the CRISPR/Cas9 technology. We showed that although these mutant cells were viable and retained normal self-renewal, they displayed severe defects in differentiation in vitro. To gain a better understanding of the role of Pcgf1 in transcriptional control of differentiation, we analysed mRNA profiles from Pcgf1 deficient cells using RNA-seq. Interestingly, we found that Pcgf1 positively regulated expression of essential transcription factors involved in ectoderm and mesoderm differentiation, revealing an unexpected function of Pcgf1 in gene activation during ES cell lineage specification. Chromatin immunoprecipitation experiments demonstrated that Pcgf1 deletion caused a decrease in Ring1B and its associated H2AK119ub1 mark binding to target genes. Altogether, our results suggested an unexpected function of Pcgf1 in gene activation during ES cell maintenance. PMID:28393894

  3. [Severe late-onset group B streptococcal infection. A case report].

    PubMed

    Haase, Roland; Nagel, Frank; Hirsch, Wolfgang; Sitka, Uwe

    2003-01-01

    Group B Streptococcus (GBS) is a well-known cause of neonatal pneumonia, sepsis and meningitis. Peripartal antibiotic prophylaxis for early-onset GBS infection is in routine use since the beginning of the last decade, but strategies for effective prevention of late-onset GBS infections are still lacking. Few hours after discharge from a non-local maternity ward a 3-week-old boy was admitted to our hospital because of GBS meningitis with necrotizing encephalomalacia. Maternal mastitis, not a disease of the baby, had led to the first admission. Case history and negative maternal swabs and cultures for GBS led to the hypothesis of nosocomial infection. Screening and risk based peripartal antibiotic prophylaxis, better monitoring and improved therapeutic modalities have reduced the incidence and mortality of early-onset GBS infections, but peripartal prophylaxis failed to influence late-onset GBS infections. Up to 40 % of infants with late-onset meningitis develop neurological sequelae. Maternal vaccination with multivalent conjugate vaccines against GBS is a new strategy which may lead to passive protection of the infant. Further studies to examine the efficacy of vaccines are in progress.

  4. Association of temporomandibular disorder pain with awake and sleep bruxism in adults.

    PubMed

    Sierwald, Ira; John, Mike T; Schierz, Oliver; Hirsch, Christian; Sagheri, Darius; Jost-Brinkmann, Paul-Georg; Reissmann, Daniel R

    2015-07-01

    Parafunctional habits such as clenching or grinding (bruxism) during daytime and at night are considered to have a great impact on the etiopathogenesis of temporomandibular disorders (TMD). However, the size of the effect and how daytime activities interact with nocturnal activities is not yet clear. The aim of this study was to assess the association of TMD pain with both awake and sleep bruxism in adults. In this case-control study, data of a consecutive sample of 733 TMD patients (cases; mean age ± SD: 41.4 ± 16.3 years; 82% women) with at least one pain-related TMD diagnosis according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD) and of a community-based probability sample of 890 subjects (controls; mean age ± SD: 40.4 ± 11.8 years; 57% female) without TMD were evaluated. Clenching or grinding while awake and/or asleep was assessed with self-reports. Association of TMD pain with awake and sleep bruxism was analyzed using multiple logistic regression analyses and controlled for potential confounders. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated. While 11.2% of the controls reported clenching or grinding while awake, this proportion was significantly higher in TMD patients (33.9%; p < 0.001). Nocturnal clenching or grinding was reported by 23.5% of the controls and 49.4% of the TMD patients (p < 0.001). Risk for TMD pain did not differ substantially for the separate reports of awake (OR 1.7; CI 1.0-2.7) or sleep bruxism (OR 1.8; CI 1.4-2.4). However, risk for TMD pain substantially increased in cases of simultaneous presence of awake and sleep bruxism (OR 7.7; CI 5.4-11.1). When occurring separately, awake and sleep bruxism are significant risk factors for TMD pain. In case of simultaneous presence, the risk for TMD pain is even higher.

  5. Antimicrobial Susceptibility Survey of Streptococcus pyogenes Isolated in Japan from Patients with Severe Invasive Group A Streptococcal Infections

    PubMed Central

    Ikebe, Tadayoshi; Hirasawa, Kyoko; Suzuki, Rieko; Isobe, Junko; Tanaka, Daisuke; Katsukawa, Chihiro; Kawahara, Ryuji; Tomita, Masaaki; Ogata, Kikuyo; Endoh, Miyoko; Okuno, Rumi; Watanabe, Haruo

    2005-01-01

    We assessed antimicrobial susceptibility against 211 Streptococcus pyogenes strains isolated from patients with severe invasive group A streptococcal infections. Overall, 3.8, 1.4, 1.4, and 0.5% of the isolates were resistant to erythromycin, clindamycin, telithromycin, and ciprofloxacin, respectively, and 10.4% had intermediate resistance to ciprofloxacin. All isolates were susceptible to ampicillin and cefotaxime. PMID:15673769

  6. A Validity Study of the Working Group's Orientation Test for Individuals with Moderate to Severe Intellectual Disability

    ERIC Educational Resources Information Center

    Pyo, G.; Curtis, K.; Curtis, R.; Markwell, S.

    2009-01-01

    Background: Decline in orientation skill has been reported as an early indicator of Dementia of Alzheimer's Type (DAT). Orientation subtest of the Working Group's Test Battery was examined whether this test is useful to identify DAT patients among adults with moderate to severe ID. Methods: Sixteen DAT patients and 35 non-demented normal controls…

  7. The Effect of ABO Blood Groups, Hemoglobinopathy, and Heme Oxygenase-1 Polymorphisms on Malaria Susceptibility and Severity.

    PubMed

    Kuesap, Jiraporn; Na-Bangchang, Kesara

    2018-04-01

    Malaria is one of the most important public health problems in tropical areas on the globe. Several factors are associated with susceptibility to malaria and disease severity, including innate immunity such as blood group, hemoglobinopathy, and heme oxygenase-1 (HO-1) polymorphisms. This study was carried out to investigate association among ABO blood group, thalassemia types and HO-1 polymorphisms in malaria. The malarial blood samples were collected from patients along the Thai-Myanmar border. Determination of ABO blood group, thalassemia variants, and HO-1 polymorphisms were performed using agglutination test, low pressure liquid chromatography and polymerase chain reaction, respectively. Plasmodium vivax was the major infected malaria species in the study samples. Distribution of ABO blood type in the malaria-infected samples was similar to that in healthy subjects, of which blood type O being most prevalent. Association between blood group A and decreased risk of severe malaria was significant. Six thalassemia types (30%) were detected, i.e. , hemoglobin E (HbE), β-thalassemia, α-thalassemia 1, α-thalassemia 2, HbE with α-thalassemia 2, and β-thalassemia with α-thalassemia 2. Malaria infected samples without thalassemia showed significantly higher risk to severe malaria. The prevalence of HO-1 polymorphisms, S/S, S/L and L/L were 25, 62, and 13%, respectively. Further study with larger sample size is required to confirm the impact of these 3 host genetic factors in malaria patients.

  8. Diabetes Prevalence Among Racial-Ethnic Minority Group Members With Severe Mental Illness Taking Antipsychotics: Double Jeopardy?

    PubMed

    Mangurian, Christina; Keenan, Walker; Newcomer, John W; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean

    2017-08-01

    This study assessed differences in diabetes prevalence based on race-ethnicity among people with severe mental illnesses. This retrospective cohort study examined diabetes prevalence in 2009 among California Medicaid enrollees with severe mental illness who were screened for diabetes (N=19,364). Poisson regression assessed differences in diabetes prevalence by race-ethnicity. The sample was standardized to the U.S. The overall prevalence of diabetes was 32.0%. The adjusted prevalence for all minority groups with severe mental illness, except for Asians, was significantly higher than for whites (1.21-1.28 adjusted prevalence ratios). With inverse probability weighting to reduce selection bias captured by measured factors, estimated prevalence of diabetes among screened participants was 27.3%. The prevalence of diabetes in minority groups with severe mental illness was significantly higher than among whites with severe mental illness. Mental health administrators should implement universal diabetes screening with specific outreach efforts targeting minority populations with severe mental illness.

  9. Cyclic Alternating Pattern Associated with Catathrenia and Bruxism in a 10-Year-Old Patient

    PubMed Central

    Villafuerte-Trisolini, Brian; Adrianzén-Álvarez, Fiorella; Duque, Kevin R.; Palacios-García, Jimmy; Vizcarra-Escobar, Darwin

    2017-01-01

    Cyclic alternating pattern (CAP) is widely recognized as an expression of sleep instability in electroencephalogram activity during non-rapid eye movement sleep. We report a case with sequences of CAP followed by bruxism and catathrenia in a 10-y-old male patient with a diagnosis of attention deficit hyperactivity disorder in treatment with methylphenidate. We found CAP in 83.1% of all episodes of catathrenia, and the CAP rate was 12.8%. We propose to consider catathrenia as one of the sleep disorders that may be accompanied by CAP. Citation: Villafuerte-Trisolini B, Adrianzén-Álvarez F, Duque KR, Palacios-García J, Vizcarra-Escobar D. Cyclic alternating pattern associated with catathrenia and bruxism in a 10-year-old patient. J Clin Sleep Med. 2017;13(3):511–512. PMID:28095970

  10. Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families.

    PubMed

    de Alencar, Nashalie Andrade; Leão, Cecília Sued; Leão, Anna Thereza Thomé; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

    This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. Healthy children aged 3-7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p<0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism.

  11. Diagnostic accuracy of sleep bruxism scoring in absence of audio-video recording: a pilot study.

    PubMed

    Carra, Maria Clotilde; Huynh, Nelly; Lavigne, Gilles J

    2015-03-01

    Based on the most recent polysomnographic (PSG) research diagnostic criteria, sleep bruxism is diagnosed when >2 rhythmic masticatory muscle activity (RMMA)/h of sleep are scored on the masseter and/or temporalis muscles. These criteria have not yet been validated for portable PSG systems. This pilot study aimed to assess the diagnostic accuracy of scoring sleep bruxism in absence of audio-video recordings. Ten subjects (mean age 24.7 ± 2.2) with a clinical diagnosis of sleep bruxism spent one night in the sleep laboratory. PSG were performed with a portable system (type 2) while audio-video was recorded. Sleep studies were scored by the same examiner three times: (1) without, (2) with, and (3) without audio-video in order to test the intra-scoring and intra-examiner reliability for RMMA scoring. The RMMA event-by-event concordance rate between scoring without audio-video and with audio-video was 68.3 %. Overall, the RMMA index was overestimated by 23.8 % without audio-video. However, the intra-class correlation coefficient (ICC) between scorings with and without audio-video was good (ICC = 0.91; p < 0.001); the intra-examiner reliability was high (ICC = 0.97; p < 0.001). The clinical diagnosis of sleep bruxism was confirmed in 8/10 subjects based on scoring without audio-video and in 6/10 subjects with audio-video. Although the absence of audio-video recording, the diagnostic accuracy of assessing RMMA with portable PSG systems appeared to remain good, supporting their use for both research and clinical purposes. However, the risk of moderate overestimation in absence of audio-video must be taken into account.

  12. 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.

  13. Efficacy of Desvenlafaxine Compared With Placebo in Major Depressive Disorder Patients by Age Group and Severity of Depression at Baseline.

    PubMed

    Mosca, Daniel; Zhang, Min; Prieto, Rita; Boucher, Matthieu

    2017-04-01

    This post hoc meta-analysis evaluated the efficacy and safety of desvenlafaxine 50 and 100 mg versus placebo across age groups and severity of depression at baseline in patients with major depressive disorder. Data from placebo and desvenlafaxine 50-mg and 100-mg dose arms were pooled from 9 short-term, placebo-controlled, major depressive disorder studies (N = 4279). Effects of age (18-40 years, >40 to <55 years, 55-<65 years, and ≥65 years) and baseline depression severity (mild, 17-item Hamilton Rating Scale for Depression total score [HAM-D17] ≤18; moderate, HAM-D17 >18 to <25; severe, HAM-D17 ≥25) on desvenlafaxine efficacy were assessed using analysis of covariance for continuous end points and logistic regression for categorical end points. Desvenlafaxine-treated (50 or 100 mg/d) patients had significantly (P < 0.05, 2-sided) greater improvement in most measures of depression and function compared with placebo for patients 18 to 40 years, older than 40 to younger than 55 years, and 55 to younger than 65 years, with no significant evidence of an effect of age. Desvenlafaxine significantly improved most measures of depression and function in moderately and severely depressed patients. There was a significant baseline severity by treatment interaction for HAM-D17 total score only (P = 0.027), with a larger treatment effect for the severely depressed group. Desvenlafaxine significantly improved depressive symptoms in patients younger than 65 years and in patients with moderate or severe baseline depression. Sample sizes were not adequate to assess desvenlafaxine efficacy in patients 65 years or older or with mild baseline depression.

  14. The study of grinding patterns and factors influencing the grinding areas during sleep bruxism.

    PubMed

    Tao, Jianxiang; Liu, Weicai; Wu, Junhua; Zhang, Xuying; Zhang, Yongting

    2015-10-01

    The purpose of this study is to investigate the grinding patterns and discuss the factors influencing the position relationship between intercuspal position (ICP) and grinding area during sleep bruxism. Lateral condylar inclination, inclination of lateral incisal path and freedom in long centric of thirty subjects were measured. The grinding patterns during sleep bruxism were recorded with a bruxism recording device, BruxChecker. The position relationship between ICP and the grinding area was examined. Spearman's rank correlation coefficient was used for correlation analysis between grinding area and free factors (grinding patterns, freedom in long centric and discrepancy between lateral condylar inclination and inclination of lateral incisal path). All 12 subjects with 0mm-freedom in long centric exhibited that ICP of both sides located within the grinding areas. 4 subjects showed that ICP of both sides located outside the grinding areas. There is a significant correlation between 0mm-freedom in long centric and ICP within the grinding areas (p <0.01). Freedom in long centric has a significant effect on position relationship between intercuspal position and the grinding area. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Occlusal splint versus modified nociceptive trigeminal inhibition splint in bruxism therapy: a randomized, controlled trial using surface electromyography.

    PubMed

    Dalewski, B; Chruściel-Nogalska, M; Frączak, B

    2015-12-01

    An occlusal splint and a modified nociceptive trigeminal inhibition splint (AMPS, anterior deprogrammer, Kois deprogrammer, Lucia jig, etc.) are commonly and quite frequently used in the treatment of masticatory muscle disorders, although their sustainable and long-lasting effect on these muscles' function is still not very well known. Results of scant surface electromyography studies in patients with temporomandibular disorders have been contradictory. The aim of this study was to evaluate both devices in bruxism therapy; EMG activity levels during postural activity and maximum voluntary contraction of the superficial temporal and masseter muscles were compared before and after 30 days of treatment. Surface electromyography of the examined muscles was performed in two groups of bruxers (15 patients each). Patients in the first group used occlusal splints, while those in the second used modified nociceptive trigeminal inhibition splints. The trial was randomized, controlled and semi-blind. Neither device affected the asymmetry index or postural activity/maximum voluntary contraction ratio after 1 month of treatment. Neither the occlusal nor the nociceptive trigeminal inhibition splint showed any significant influence on the examined muscles. Different scientific methods should be considered in clinical applications that require either direct influence on the muscles' bioelectrical activity or a quantitative measurement of the treatment quality. © 2015 Australian Dental Association.

  16. Serum levels of copeptin, C-reactive protein and cortisol in different severity groups of sickle cell anaemia.

    PubMed

    Akinlade, K S; Atere, A D; Rahamon, S K; Olaniyi, J A

    2013-12-20

    It is well known that individuals with SCA undergo constant physiological stress even, in steady state. However, there is little information on the relationship between the severity of sickle cell anaemia (SCA) and serum levels of biomarkers of stress. This study therefore determined the serum levels of copeptin, cortisol and CRP in adults with SCA in different severity groups. Sixty adults with sickle cell anaemia in steady state (27.1±6.3 years) and in vaso-occlusive crisis (24.9±4.9 years) were recruited into this cross-sectional study. Degree of severity (mild, moderate or severe) was determined using a scoring system incorporating annual number of blood transfusions, crisis and presence of anaemia, vaso-occlusive pain and organ complications. Standard methods were used for the determination of packed cell volume (PCV), total white blood cell count (WBC), blood pressure measurements and anthropometric indices. Serum levels of copeptin, cortisol and CRP were determined using ELISA with the ratios calculated accordingly. Data obtained were statistically analyzed using the Student's t-test, Mann Whitney U and Chi-square test as appropriate. P<0.05 was considered significant. The mean systolic blood pressure (SBP) and copeptin level were significantly higher in subjects with moderate SCA compared with those with mild SCA. Similarly SBP, pulse, WBC, copeptin and cortisol were significantly higher while body weight was significantly lower in subjects with severe SCA compared with subjects with mild SCA. However, WBC and cortisol-to-copeptin ratio were significantly higher in subjects with severe SCA compared with subjects with moderate SCA. There was progressive rise in serum levels of CRP from mild SCA through severe SCA but the differences were not statistically significant. Also, proportions of subjects with elevated SBP and WBC were higher than the proportion of subjects with lower SBP and WBC in the severe SCA group. Serum levels of cortisol, copeptin, and

  17. Clonal Clusters and Virulence Factors of Group C and G Streptococcus Causing Severe Infections, Manitoba, Canada, 2012-2014.

    PubMed

    Lother, Sylvain A; Demczuk, Walter; Martin, Irene; Mulvey, Michael; Dufault, Brenden; Lagacé-Wiens, Philippe; Keynan, Yoav

    2017-07-01

    The incidence of group C and G Streptococcus (GCGS) bacteremia, which is associated with severe disease and death, is increasing. We characterized clinical features, outcomes, and genetic determinants of GCGS bacteremia for 89 patients in Winnipeg, Manitoba, Canada, who had GCGS bacteremia during 2012-2014. Of the 89 patients, 51% had bacteremia from skin and soft tissue, 70% had severe disease features, and 20% died. Whole-genome sequencing analysis was performed on isolates derived from 89 blood samples and 33 respiratory sample controls: 5 closely related genetic lineages were identified as being more likely to cause invasive disease than non-clade isolates (83% vs. 57%, p = 0.002). Virulence factors cbp, fbp, speG, sicG, gfbA, and bca clustered clonally into these clades. A clonal distribution of virulence factors may account for severe and fatal cases of bacteremia caused by invasive GCGS.

  18. Hypoxia and inflammation indicate significant differences in the severity of obstructive sleep apnea within similar apnea-hypopnea index groups.

    PubMed

    Yilmaz Avci, Aynur; Avci, Suat; Lakadamyali, Huseyin; Can, Ufuk

    2017-09-01

    We determined whether hypoxia parameters are associated with C-reactive protein (CRP), mean platelet volume (MPV), white matter hyperintensity (WMH), and the severity of obstructive sleep apnea (OSA), and also evaluated whether hypoxia parameters, CRP, MPV, and WMH differ in patients with similar apnea-hypopnea index (AHI) scores. A total of 297 patients, who were evaluated using polysomnography, were assessed retrospectively. The measured hypoxia parameters included total sleep time with oxygen saturation <90% (ST 90 ), percentage of cumulative time with oxygen saturation <90% (CT 90 ), and lowest oxygen saturation (min SaO 2 ). The patients were divided into subgroups according to their CT 90 values, and patients with different AHI severities were divided into subgroups according to their ST 90 and min SaO 2 levels. Hypoxia parameters are associated with CRP, MPV, WMH, and the severity of OSA (P < 0.05). The hypoxia parameters differed in all subgroup analyses of similar AHI groups (P < 0.001), and CRP differed only in severe OSA (P < 0.008, P < 0.001). In subgroup analyses of similar AHI groups, MPV and WMH were not significantly different (P > 0.05). Above the hypoxia threshold (CT 90  ≥ 10%) of CRP, MPV increased significantly and the presence of WMH increased twofold. These data suggest that increased hypoxia severity may mediate increased inflammation and activation of platelets and contribute to the pathogenesis of WMH in patients with OSA. In addition, patients with severe OSA may show significant variability in inflammation and vascular risk. Further prospective data are needed.

  19. 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

  20. Sleep bruxism in individuals with and without attrition-type tooth wear: An exploratory matched case-control electromyographic study.

    PubMed

    Jonsgar, Christine; Hordvik, Paul-Arne; Berge, Morten E; Johansson, Ann-Katrin; Svensson, Peter; Johansson, Anders

    2015-12-01

    To examine if there is a difference in possible sleep bruxism activity (SB) in subjects with or without attrition-type tooth wear. Sixteen individuals with pronounced attritional-type tooth wear were compared with sex and aged matched controls without tooth wear by means of measurement of electromyographic (EMG) activity during a minimum of four consecutive nights of sleep. Mean age and range for the study- and control- group was 23.7 years (range 19.9-28.5) and 23.6 years (range 20.3-27.9), respectively. There were 11 females and five males in each of the two groups. The attrition group presented incisal/occlusal attrition wear into dentin and matching wear facets between opposing anterior teeth. The controls had negligible signs of incisal/occlusal wear and a minimal number of matching wear facets. The prevalence of both self-reported and partner-reported SB was significantly more common in the attrition group compared to the controls (P=0.04 and P=0.007, respectively). Self-reported morning facial pain was similarly more common in the attrition group (P=0.014). Maximum opening capacity, number of muscles painful to palpation, salivary flow rate and buffering capacity were not significantly different between the groups. Interestingly, none of the measures of jaw muscle EMG activity during sleep, as recorded by the portable EMG equipment, differed significantly between the attrition group and the matched controls (P>0.05). The results from this exploratory study suggest that there is no difference in EMG activity between subjects with and without attrition-type tooth wear. Further research is needed in order to substantiate these preliminary findings. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. "Healthcare seems to vary a lot": A focus group study among parents of children with severe allergy.

    PubMed

    Lagercrantz, Birgitta; Persson, Åsa; Kull, Inger

    2017-09-01

    Living with an allergic disease has consequences for both affected children and their families. The aim of this qualitative study was to gain deeper knowledge of what life is like for families of children with severe allergic disease, in order to improve care and thereby reduce the consequences of living with a chronic disease. Four focus group interviews were performed with Swedish parents of children, aged 6-11 and 12-16 years, with severe allergic disease (from one or more allergic conditions, such as food allergy/eczema/hay fever/asthma). The participants were attending a family support weekend. Interviews were analyzed with a qualitative method. Based on parental experiences, the following themes were presented in the analysis: limitations, control, injustices, and fear and anxiety. It was evident that the families lived isolated lives and experienced different kinds of limitations. Parents felt a need to have control of their child's everyday life and described a feeling of constantly being on guard. They also suggested that understanding of the child's allergies was lacking in preschool/school and that healthcare did not provide adequate support. They felt that the same care should be offered to children and families, no matter where they lived. Based on parental experiences, having a child with severe allergic disease implies a need to constantly be on guard. In order to improve the care of children with severe allergy and their families, a more person- and family-centered approach is needed.

  2. Factors influencing service utilization and mood symptom severity in children with mood disorders: effects of multifamily psychoeducation groups (MFPGs).

    PubMed

    Mendenhall, Amy N; Fristad, Mary A; Early, Theresa J

    2009-06-01

    This study investigated the impact of psychoeducation on service utilization and mood symptom severity in children with mood disorders. Parents' knowledge of mood disorders, beliefs about treatment, and perceptions of children's need for treatment were hypothesized to mediate the relationship between psychoeducation and service utilization and between psychoeducation and mood symptom severity. Linear mixed effects modeling and joint significance test for mediation were used in secondary data analyses of the multifamily psychoeducation group (MFPG) study, a randomized controlled trial of 165 children ages 8 to 12 years with mood disorders. A majority of those sampled were male (73%) and White, non-Hispanic (90%), and the median range of family income was $40,000-$59,000. Participation in MFPG significantly improved quality of services utilized, mediated by parents' beliefs about treatment. Participation in MFPG also significantly improved severity of child's mood symptoms, mediated by quality of services utilized. MFPG appears to be a psychoeducational intervention that helps parents to become better consumers of the mental health system who access higher quality services. Children's symptom severity decreases as a result. Copyright 2009 APA

  3. Narrative Enhancement and Cognitive Therapy: A New Group-Based Treatment for Internalized Stigma among Persons with Severe Mental Illness

    PubMed Central

    Yanos, Philip T.; Roe, David; Lysaker, Paul H.

    2011-01-01

    Internalized stigma has been suggested to play a major role in negative changes in identity in severe mental illness. Evidence suggests that roughly one-third of people with severe mental illness show elevated internalized stigma and that it is linked to compromised outcomes in both subjective and objective aspects of recovery. Despite substantial evidence for the impact of internalized stigma, few efforts have been made to develop professionally-led treatment to address this issue. In this article, we discuss our development of a new, group-based approach to the treatment of internalized stigma which we have termed “narrative enhancement and cognitive therapy” (NECT). We describe the treatment approach and offer an illustration of it by way of a case vignette. PMID:21985260

  4. The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness.

    PubMed

    Grocke, Denise; Bloch, Sidney; Castle, David

    2009-01-01

    A 10-week group music therapy project was designed to determine whether music therapy influenced quality of life and social anxiety for people with a severe and enduring mental illness living in the community. Ten one-hour weekly sessions including song singing, song writing and improvisation, culminated in each group recording original song/s in a professional studio. The principal outcome measure was the WHOQOLBREF Quality of Life (QoL) Scale; other instruments used were the Social Interaction Anxiety Scale (SIAS) and the Brief Symptom Inventory (BSI). Qualitative data were gathered through focus group interviews and an analysis of lyric themes. Statistically significant improvement was found on five items of the QoL Scale. There were no changes on the BSI indicating that QoL improvement was not mediated by symptomatic change. Themes from the focus groups were: music therapy gave joy and pleasure, working as a team was beneficial, participants were pleasantly surprised at their creativity, and they took pride in their song. An analysis of song lyrics resulted in 6 themes: a concern for the world, peace and the environment; living with mental illness is difficult; coping with mental illness requires strength; religion and spirituality are sources of support; living in the present is healing; and working as a team is enjoyable.

  5. A pre-operative group rehabilitation programme provided limited benefit for people with severe hip and knee osteoarthritis.

    PubMed

    Wallis, Jason A; Webster, Kate E; Levinger, Pazit; Fong, Cynthia; Taylor, Nicholas F

    2014-01-01

    To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis. Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol). Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes. A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.

  6. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial.

    PubMed

    Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Ryding, Elsa-Lena; Saisto, Terhi

    2015-01-01

    Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.

  7. Clinical Decision Support Model to Predict Occlusal Force in Bruxism Patients.

    PubMed

    Thanathornwong, Bhornsawan; Suebnukarn, Siriwan

    2017-10-01

    The aim of this study was to develop a decision support model for the prediction of occlusal force from the size and color of articulating paper markings in bruxism patients. We used the information from the datasets of 30 bruxism patients in which digital measurements of the size and color of articulating paper markings (12-µm Hanel; Coltene/Whaledent GmbH, Langenau, Germany) on canine protected hard stabilization splints were measured in pixels (P) and in red (R), green (G), and blue (B) values using Adobe Photoshop software (Adobe Systems, San Jose, CA, USA). The occlusal force (F) was measured using T-Scan III (Tekscan Inc., South Boston, MA, USA). The multiple regression equation was applied to predict F from the P and RGB. Model evaluation was performed using the datasets from 10 new patients. The patient's occlusal force measured by T-Scan III was used as a 'gold standard' to compare with the occlusal force predicted by the multiple regression model. The results demonstrate that the correlation between the occlusal force and the pixels and RGB of the articulating paper markings was positive (F = 1.62×P + 0.07×R -0.08×G + 0.08×B + 4.74; R 2 = 0.34). There was a high degree of agreement between the occlusal force of the patient measured using T-Scan III and the occlusal force predicted by the model (kappa value = 0.82). The results obtained demonstrate that the multiple regression model can predict the occlusal force using the digital values for the size and color of the articulating paper markings in bruxism patients.

  8. Clinical Decision Support Model to Predict Occlusal Force in Bruxism Patients

    PubMed Central

    Thanathornwong, Bhornsawan

    2017-01-01

    Objectives The aim of this study was to develop a decision support model for the prediction of occlusal force from the size and color of articulating paper markings in bruxism patients. Methods We used the information from the datasets of 30 bruxism patients in which digital measurements of the size and color of articulating paper markings (12-µm Hanel; Coltene/Whaledent GmbH, Langenau, Germany) on canine protected hard stabilization splints were measured in pixels (P) and in red (R), green (G), and blue (B) values using Adobe Photoshop software (Adobe Systems, San Jose, CA, USA). The occlusal force (F) was measured using T-Scan III (Tekscan Inc., South Boston, MA, USA). The multiple regression equation was applied to predict F from the P and RGB. Model evaluation was performed using the datasets from 10 new patients. The patient's occlusal force measured by T-Scan III was used as a ‘gold standard’ to compare with the occlusal force predicted by the multiple regression model. Results The results demonstrate that the correlation between the occlusal force and the pixels and RGB of the articulating paper markings was positive (F = 1.62×P + 0.07×R –0.08×G + 0.08×B + 4.74; R2 = 0.34). There was a high degree of agreement between the occlusal force of the patient measured using T-Scan III and the occlusal force predicted by the model (kappa value = 0.82). Conclusions The results obtained demonstrate that the multiple regression model can predict the occlusal force using the digital values for the size and color of the articulating paper markings in bruxism patients. PMID:29181234

  9. Ixekizumab for Treating Moderate-to-Severe Plaque Psoriasis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    PubMed

    Ramaekers, Bram L T; Wolff, Robert F; Pouwels, Xavier; Oosterhoff, Marije; Van Giessen, Anoukh; Worthy, Gill; Noake, Caro; Armstrong, Nigel; Kleijnen, Jos; Joore, Manuela A

    2018-02-26

    The National Institute for Health and Care Excellence invited Eli Lilly and Company Ltd, the company manufacturing ixekizumab (tradename Taltz ® ), to submit evidence for the clinical and cost effectiveness of ixekizumab. Ixekizumab was compared with tumour necrosis factor-α inhibitors (etanercept, infliximab, adalimumab), ustekinumab, secukinumab, best supportive care and, if non-biological treatment or phototherapy is suitable, also compared with systemic non-biological therapies and phototherapy with ultraviolet B radiation for adults with moderate-to-severe plaque psoriasis. Kleijnen Systematic Reviews Ltd, in collaboration with Maastricht University Medical Center, was commissioned as the independent Evidence Review Group. This article presents a summary of the company submission, the Evidence Review Group report and the development of the National Institute for Health and Care Excellence guidance for the use of this drug in England and Wales by the Appraisal Committee. The Evidence Review Group produced a critical review of the clinical and cost effectiveness of ixekizumab based on the company submission. The company submission presented three randomised controlled trials identified in a systematic review. All randomised controlled trials were phase III, multicentre placebo-controlled trials including 3866 participants with moderate-to-severe psoriasis. Two trials also included an active comparator (etanercept). All randomised controlled trials showed statistically significant increases in two primary outcomes, static Physician Global Assessment (0,1) and improvement of 75% from baseline in the Psoriasis Area and Severity Index. Ixekizumab was generally well tolerated in the randomised controlled trials, with similar discontinuation rates because of adverse events as placebo or etanercept. The most frequent adverse events of special interest were infections and injection-site reactions. The company submission also included a network meta-analysis of

  10. Time-linked concurrence of sleep bruxism, periodic limb movements, and EEG arousals in sleep bruxers and healthy controls.

    PubMed

    van der Zaag, Jacques; Naeije, Machiel; Wicks, Darrel J; Hamburger, Hans L; Lobbezoo, Frank

    2014-01-01

    Sleep bruxism (SB) and periodic limb movements during sleep (PLMS) may have a common underlying neurophysiologic mechanism, especially in relation to the occurrence of sleep-related electroencephalographic (EEG) arousals. To test this hypothesis, three research questions were assessed. First, it was assessed whether PLMS events occur more frequently in SB patients than in individuals without SB. Second, the question was put forward whether the combined presence of SB and PLMS events is more common than that of isolated SB or PLMS events in a group of SB patients. Third, as to further unravel the possible role of EEG arousals in the underlying neurophysiologic mechanism of SB and PLMS, it was assessed in a group of SB patients whether combined SB/PLMS events with associated EEG arousals are more common than those without associated EEG arousals. Positive answers to these questions could suggest a common neurophysiological basis for both movement disorders. Seventeen SB patients and 11 healthy controls were polysomnographically studied. SB, PLMS, and EEG arousals were scored. An association was noted when the occurrence was within a 3-s association zone. The PLMS index was higher in SB patients than in healthy controls (P < 0.001). Within the group of SB patients, the combined SB/PLMS index was higher than the isolated SB index (P < 0.001) and the isolated PLMS index (P = 0.018). Similarly, the combined SB/PLMS index with EEG arousal was higher than the combined SB/PLMS index without EEG arousal in SB patients (P < 0.001). The results of this study indicate that SB, PLMS, and EEG arousals commonly concur during sleep in a time-linked manner. SB and PLMS probably have a common underlying neurophysiological mechanism.

  11. Pediatric outcomes data collection instrument scores in ambulatory children with cerebral palsy: an analysis by age groups and severity level.

    PubMed

    Barnes, Douglas; Linton, Judith L; Sullivan, Elroy; Bagley, Anita; Oeffinger, Donna; Abel, Mark; Damiano, Diane; Gorton, George; Nicholson, Diane; Romness, Mark; Rogers, Sarah; Tylkowski, Chester

    2008-01-01

    The Pediatric Outcomes Data Collection Instrument (PODCI) was developed in 1994 as a patient-based tool for use across a broad age range and wide array of musculoskeletal disorders, including children with cerebral palsy (CP). The purpose of this study was to establish means and SDs of the Parent PODCI measures by age groups and Gross Motor Function Classification System (GMFCS) levels for ambulatory children with CP. This instrument was one of several studied in a prospective, multicenter project of ambulatory patients with CP between the aged 4 and 18 years and GMFCS levels I through III. Participants included 338 boys and 221 girls at a mean age of 11.1 years, with 370 diplegic, 162 hemiplegic, and 27 quadriplegic. Both baseline and follow-up data sets of the completed Parent PODCI responses were statistically analyzed. Age was identified as a significant predictor of the PODCI measures of Upper Extremity Function, Transfers and Basic Mobility, Global Function, and Happiness With Physical Condition. Gross Motor Function Classification System levels was a significant predictor of Transfers and Basic Mobility, Sports and Physical Function, and Global Function. Pattern of involvement, sex, and prior orthopaedic surgery were not statistically significant predictors for any of the Parent PODCI measures. Mean and SD scores were calculated for age groups stratified by GMFCS levels. Analysis of the follow-up data set validated the findings derived from the baseline data. Linear regression equations were derived, with age as a continuous variable and GMFCS levels as a categorical variable, to be used for Parent PODCI predicted scores. The results of this study provide clinicians and researchers with a set of Parent PODCI values for comparison to age- and severity-matched populations of ambulatory patients with CP.

  12. Factitious buccal lesion secondary to bruxism in a child with cerebral palsy

    PubMed Central

    Harris, D

    2006-01-01

    Children with cerebral palsy are at greater risk of a whole range of oral conditions than their peers. These include bruxism (tooth grinding), oral skill dysfunction, gross malocclusion due to effects of the abnormal orofacial muscle tone on tooth eruption, drooling of saliva, and poor oral hygiene.1 A challenging case of a painful buccal lesion in a 2 year old girl with cerebral palsy (CP) that did not respond to antifungal, antiviral or antibiotic treatment is presented as a factitious lesion. The recognition and significance of self‐injurious behaviour and factitious lesions in children are discussed. PMID:16373789

  13. Factitious buccal lesion secondary to bruxism in a child with cerebral palsy.

    PubMed

    Harris, D

    2006-01-01

    Children with cerebral palsy are at greater risk of a whole range of oral conditions than their peers. These include bruxism (tooth grinding), oral skill dysfunction, gross malocclusion due to effects of the abnormal orofacial muscle tone on tooth eruption, drooling of saliva, and poor oral hygiene. A challenging case of a painful buccal lesion in a 2 year old girl with cerebral palsy (CP) that did not respond to antifungal, antiviral or antibiotic treatment is presented as a factitious lesion. The recognition and significance of self-injurious behaviour and factitious lesions in children are discussed.

  14. Cyclic Alternating Pattern Associated with Catathrenia and Bruxism in a 10-Year-Old Patient.

    PubMed

    Villafuerte-Trisolini, Brian; Adrianzén-Álvarez, Fiorella; Duque, Kevin R; Palacios-García, Jimmy; Vizcarra-Escobar, Darwin

    2017-03-15

    Cyclic alternating pattern (CAP) is widely recognized as an expression of sleep instability in electroencephalogram activity during non-rapid eye movement sleep. We report a case with sequences of CAP followed by bruxism and catathrenia in a 10-y-old male patient with a diagnosis of attention deficit hyperactivity disorder in treatment with methylphenidate. We found CAP in 83.1% of all episodes of catathrenia, and the CAP rate was 12.8%. We propose to consider catathrenia as one of the sleep disorders that may be accompanied by CAP. © 2017 American Academy of Sleep Medicine

  15. Haematopoietic SCT in severe autoimmune diseases: updated guidelines of the European Group for Blood and Marrow Transplantation

    PubMed Central

    Snowden, J A; Saccardi, R; Allez, M; Ardizzone, S; Arnold, R; Cervera, R; Denton, C; Hawkey, C; Labopin, M; Mancardi, G; Martin, R; Moore, J J; Passweg, J; Peters, C; Rabusin, M; Rovira, M; van Laar, J M; Farge, D

    2012-01-01

    In 1997, the first consensus guidelines for haematopoietic SCT (HSCT) in autoimmune diseases (ADs) were published, while an international coordinated clinical programme was launched. These guidelines provided broad principles for the field over the following decade and were accompanied by comprehensive data collection in the European Group for Blood and Marrow Transplantation (EBMT) AD Registry. Subsequently, retrospective analyses and prospective phase I/II studies generated evidence to support the feasibility, safety and efficacy of HSCT in several types of severe, treatment-resistant ADs, which became the basis for larger-scale phase II and III studies. In parallel, there has also been an era of immense progress in biological therapy in ADs. The aim of this document is to provide revised and updated guidelines for both the current application and future development of HSCT in ADs in relation to the benefits, risks and health economic considerations of other modern treatments. Patient safety considerations are central to guidance on patient selection and HSCT procedural aspects within appropriately experienced and Joint Accreditation Committee of International Society for Cellular Therapy and EBMT accredited centres. A need for prospective interventional and non-interventional studies, where feasible, along with systematic data reporting, in accordance with EBMT policies and procedures, is emphasized. PMID:22002489

  16. An autonomous, automated and mobile device to concurrently assess several cognitive functions in group-living non-human primates.

    PubMed

    Fizet, Jonas; Rimele, Adam; Pebayle, Thierry; Cassel, Jean-Christophe; Kelche, Christian; Meunier, Hélène

    2017-11-01

    Research methods in cognitive neuroscience using non-human primates have undergone notable changes over the last decades. Recently, several research groups have described freely accessible devices equipped with a touchscreen interface. Two characteristics of such systems are of particular interest: some apparatuses include automated identification of subjects, while others are mobile. Here, we designed, tested and validated an experimental system that, for the first time, combine automatization and mobility. Moreover, our system allows autonomous learning and testing of cognitive performance in group-living subjects, including follow-up assessments. The mobile apparatus is designed to be available 24h a day, 7days a week, in a typical confined primate breeding and housing facility. Here we present as proof of concept, the results of two pilot studies. We report that rhesus macaques (Macaca mulatta) learned the tasks rapidly and achieved high-level of stable performance. Approaches of this kind should be developed for future pharmacological and biomedical studies in non-human primates. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Baricitinib for Previously Treated Moderate or Severe Rheumatoid Arthritis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    PubMed

    Ren, Shijie; Bermejo, Iñigo; Simpson, Emma; Wong, Ruth; Scott, David L; Young, Adam; Stevenson, Matt

    2018-03-03

    As part of its single technology appraisal process, the National Institute for Health and Care Excellence invited the manufacturer (Eli Lilly) of baricitinib (BARI; Olumiant ® ; a Janus kinase inhibitor that is taken orally) to submit evidence of its clinical and cost effectiveness for the treatment of moderate to severe rheumatoid arthritis (RA) after the failure of disease-modifying antirheumatic drugs (DMARDs). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a detailed review of the evidence for the clinical and cost effectiveness of the technology, based on the company's submission (CS) to NICE. The clinical-effectiveness evidence in the CS for BARI was based predominantly on three randomised controlled trials comparing the efficacy of BARI against adalimumab or placebo, as well as one long-term extension study. The clinical-effectiveness review identified no head-to-head evidence on the efficacy of BARI against all the comparators within the scope. Therefore, the company performed network meta-analyses (NMAs) in two different populations: one in patients who had experienced an inadequate response to conventional DMARDs (cDMARD-IR), and the other in patients who had experienced an inadequate response to tumour necrosis factor inhibitors (TNFi-IR). The company's NMAs concluded BARI had comparable efficacy as the majority of its comparators in both populations. The company submitted a de novo discrete event simulation model that analysed the incremental cost-effectiveness of BARI versus its comparators for the treatment of RA from the perspective of the National Health Service (NHS) in four different populations: (1) cDMARD-IR patients with moderate RA, defined as a 28-Joint Disease Activity Score (DAS28) > 3.2 and no more than 5.1; (2) cDMARD-IR patients with severe RA (defined as a DAS28 > 5.1); (3) TNFi-IR patients

  18. Mepolizumab for Treating Severe Eosinophilic Asthma: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    PubMed

    Bermejo, Iñigo; Stevenson, Matt; Cooper, Katy; Harnan, Sue; Hamilton, Jean; Clowes, Mark; Carroll, Christopher; Harrison, Tim; Saha, Shironjit

    2018-02-01

    As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the company (GlaxoSmithKline) that manufactures mepolizumab (Nucala ® ) to submit evidence on the clinical and cost effectiveness of mepolizumab for the treatment of severe eosinophilic asthma. The School of Health and Related Research Technology Appraisal Group (ScHARR-TAG) at the University of Sheffield was commissioned to act as the independent evidence review group (ERG). The ERG produced a review of the evidence for the clinical and cost effectiveness of mepolizumab as add-on to standard of care (SoC) compared with SoC and omalizumab, based upon the company's submission to NICE. The clinical-effectiveness evidence in the company's submission was based predominantly on three randomised controlled trials (DREAM, MENSA and SIRIUS) comparing add-on mepolizumab with placebo plus SoC. The relevant population was defined in terms of degree of asthma severity (four or more exacerbations in the previous year and/or dependency on maintenance oral corticosteroids [mOCS]) and degree of eosinophilia (a blood eosinophil count of ≥ 300 cells/µl in the previous year) based on post hoc subgroup analyses of the pivotal trials. Other subpopulations were considered throughout the appraisal, defined by different eosinophil measurements, number of exacerbations and dependency (or lack thereof) on mOCS. Statistically significant reductions in clinically significant exacerbations were observed in patients receiving mepolizumab compared with SoC meta-analysed across MENSA and DREAM in the modified intention-to-treat (ITT) population (rate ratio [RR] 0.51; 95% confidence interval [CI] 0.42-0.62) as well as in the relevant population (RR 0.47; 95% CI 0.36-0.62). In terms of quality of life, differences on the St. George's Respiratory Questionnaire in MENSA for add-on subcutaneous mepolizumab 100 mg vs. placebo were 7 and 7.5 units in the modified ITT and

  19. CMV Infection in Pediatric Severe Ulcerative Colitis - A Multicenter Study from the Pediatric IBD Porto Group of ESPGHAN.

    PubMed

    Cohen, Shlomi; Martinez-Vinson, Christine; Aloi, Marina; Turner, Dan; Assa, Amit; de Ridder, Lissy; Wolters, Victorien M; de Meij, Tim; Alvisi, Patrizia; Bronsky, Jiri; Kopylov, Uri

    2017-07-31

    Data on the clinical course and outcomes of pediatric patients with cytomegalovirus (CMV) infection complicating acute severe ulcerative colitis (ASC) are very limited. The aim of our study was to compare outcomes of children with ASC who were CMV-positive or CMV-negative. This was a multicenter retrospective case-controlled study, from centers affiliated with the Pediatric IBD Porto Group of ESPGHAN. We included CMV -positive children hospitalized for ASC and compared their colectomy rate during hospitalization and up to 1 year thereafter, matched with CMV-negative controls. A total of 56 children were included; 15 CMV-positive and 41 CMV-negative. More CMV-positive patients were resistant to intravenous corticosteroids as compare to CMV negative (93% and 56% respectively, p=0.009). Fourteen of the CMV-positive children (93%) were treated with ganciclovir (5/14 (36%) with 5mg/kg and 9/14 (64%) with 10mg/kg). During hospitalization, 3 (20%) CMV-positive and 3 (7.8%) CMV-negative patients required colectomy (p=0.17). By 12 months, 5 (33%) and 5 (13%) CMV-positive and negative patients required colectomy, respectively (p=0.049); the significance was not retained on multivariate analysis. A higher prevalence of CMV-positivity was found in pediatric UC patients who required colectomy within 12 months of hospitalization for ASC. Further studies are needed to clarify the impact of CMV infection on the outcome of acute severe colitis in pediatric patients.

  20. Influence of SNPs in Genes that Modulate Lung Disease Severity in a Group of Mexican Patients with Cystic Fibrosis.

    PubMed

    Yokoyama, Emiy; Chávez-Saldaña, Margarita; Orozco, Lorena; Cuevas, Francisco; Lezana, José Luis; Vigueras-Villaseñor, Rosa María; Rojas-Castañeda, Julio Cesar; Landero, Daniel Adrian

    2018-04-24

    The variation in cystic fibrosis (CF) lung disease not always is explained by the CFTR genotype, so it has become apparent that modifier genes must play a considerable role in the phenotypic heterogeneity of CF, so we investigated the association of allelic variants in modifier genes that modulate the severity of lung function in a group of Mexican patients diagnosed with CF. We included 140 CF patients classified according to lung phenotype and analyzed 17 single nucleotide polymorphisms (SNPs) by TaqMan ® allelic discrimination. We demonstrated that patients with GG or GC genotype of the allelic variant rs11003125 (MBL2-550) of the MBL2 gene exhibit most of the lung manifestations at an earlier age; and the rs1042713 allelic variant of ADRB2 gene, showed statistical difference only with the age of first spirometry. When we used the dominant model, the MBL2 allele rs11003125 (MBL2-550; p = 0.022, Odds Ratio (OR) 2.87, 95% CI 1.14-7.27) was significantly associated with CF patients as risk factor, and the ADRB2 allele rs1042713 (p.Arg16Gly; p = 0.005, Odds Ratio (OR) 0.37, 95% CI 0.19-0.75) was significantly associated with CF patients as protect factor. Our findings suggest that the MBL2 and ADRB2 genes exerts an important genetic influence on the lung disease in our patients. Taking into account our results, we insist on not leaving aside this type of studies, since having techniques such as GWAS or WES will be able to advance in achieving a better quality of life for CF patients with severe lung disease. Copyright © 2018 IMSS. Published by Elsevier Inc. All rights reserved.

  1. Clinical correlates and outcomes in a group of Puerto Ricans with systemic lupus erythematosus hospitalized due to severe infections

    PubMed Central

    Jordán-González, Patricia; Shum, Lee Ming; González-Sepúlveda, Lorena

    2018-01-01

    Objective: Infections are a major cause of morbidity and mortality in systemic lupus erythematosus. Clinical outcomes of systemic lupus erythematosus patients hospitalized due to infections vary among different ethnic populations. Thus, we determined the outcomes and associated factors in a group of Hispanics from Puerto Rico with systemic lupus erythematosus admitted due to severe infections. Methods: Records of systemic lupus erythematosus patients admitted to the Adult University Hospital, San Juan, Puerto Rico, from January 2006 to December 2014 were examined. Demographic parameters, lupus manifestations, comorbidities, pharmacologic treatments, inpatient complications, length of stay, readmissions, and mortality were determined. Patients with and without infections were compared using bivariate and multivariate analyses. Results: A total of 204 admissions corresponding to 129 systemic lupus erythematosus patients were studied. The mean (standard deviation) age was 34.7 (11.6) years; 90% were women. The main causes for admission were lupus flare (45.1%), infection (44.0%), and initial presentation of systemic lupus erythematosus (6.4%). The most common infections were complicated urinary tract infections (47.0%) and soft tissue infections (42.0%). In the multivariate analysis, patients admitted with infections were more likely to have diabetes mellitus (odds ratio: 4.20, 95% confidence interval: 1.23–14.41), exposure to aspirin prior to hospitalization (odds ratio: 4.04, 95% confidence interval: 1.03–15.80), and higher mortality (odds ratio: 6.00, 95% confidence interval: 1.01–35.68) than those without infection. Conclusion: In this population of systemic lupus erythematosus patients, 44% of hospitalizations were due to severe infections. Patients with infections were more likely to have diabetes mellitus and higher mortality. Preventive and control measures of infection could be crucial to improve survival in these patients.

  2. Clinical correlates and outcomes in a group of Puerto Ricans with systemic lupus erythematosus hospitalized due to severe infections.

    PubMed

    Jordán-González, Patricia; Shum, Lee Ming; González-Sepúlveda, Lorena; Vilá, Luis M

    2018-01-01

    Infections are a major cause of morbidity and mortality in systemic lupus erythematosus. Clinical outcomes of systemic lupus erythematosus patients hospitalized due to infections vary among different ethnic populations. Thus, we determined the outcomes and associated factors in a group of Hispanics from Puerto Rico with systemic lupus erythematosus admitted due to severe infections. Records of systemic lupus erythematosus patients admitted to the Adult University Hospital, San Juan, Puerto Rico, from January 2006 to December 2014 were examined. Demographic parameters, lupus manifestations, comorbidities, pharmacologic treatments, inpatient complications, length of stay, readmissions, and mortality were determined. Patients with and without infections were compared using bivariate and multivariate analyses. A total of 204 admissions corresponding to 129 systemic lupus erythematosus patients were studied. The mean (standard deviation) age was 34.7 (11.6) years; 90% were women. The main causes for admission were lupus flare (45.1%), infection (44.0%), and initial presentation of systemic lupus erythematosus (6.4%). The most common infections were complicated urinary tract infections (47.0%) and soft tissue infections (42.0%). In the multivariate analysis, patients admitted with infections were more likely to have diabetes mellitus (odds ratio: 4.20, 95% confidence interval: 1.23-14.41), exposure to aspirin prior to hospitalization (odds ratio: 4.04, 95% confidence interval: 1.03-15.80), and higher mortality (odds ratio: 6.00, 95% confidence interval: 1.01-35.68) than those without infection. In this population of systemic lupus erythematosus patients, 44% of hospitalizations were due to severe infections. Patients with infections were more likely to have diabetes mellitus and higher mortality. Preventive and control measures of infection could be crucial to improve survival in these patients.

  3. Prevalence, severity and risk factors of asthma, rhinitis and eczema in a large group of Chinese schoolchildren.

    PubMed

    Song, Ning; Shamssain, Mohammed; Mohammed, Shamssain; Zhang, Jin; Wu, Jianling; Fu, Chunling; Hao, Shuting; Guan, Jitao; Yan, Xixin

    2014-04-01

    There is a lack of information on the prevalence, severity and risk factors of asthma, rhinitis and eczema in Chinese children. To establish baseline data for a major longitudinal study of factors affecting asthma, rhinitis and eczema in a large group of children from the industrialized city of Shijiazhuang, China. We used the International Study of Asthma and Allergies in Childhood questionnaire and studied 10 338 children, ages 6-18, from Shijiazhuang. The prevalence of childhood asthma, rhinitis and eczema is 1.2%, 13.5% and 11.8%, respectively. Boys had higher prevalence of these conditions than girls and younger children had higher prevalence of asthma and eczema but lower prevalence of rhinitis than older children. Breastfed children had lower prevalence of asthma and rhinitis, but not eczema, than non-breastfed children. Overweight children had higher prevalence of asthma and rhinitis than those who were not overweight. Children exposed to paternal smoking had higher prevalence of rhinitis and eczema than those not exposed; children exposed to pets had higher prevalence of asthma and rhinitis than those not exposed. The prevalence of asthma in this study group is low, but the prevalence of rhinitis is high, and could be considered a major public health problem. The prevalence of asthma, rhinitis and eczema is generally higher in boys and younger children generally have higher prevalence of asthma and eczema but lower prevalence of rhinitis. Exposure to pets is a risk factor for rhinitis, being overweight is a risk factor for asthma and rhinitis, and exposure to parental smoking is a risk factor for asthma, rhinitis and eczema in these children.

  4. Influence of experimental esophageal acidification on sleep bruxism: a randomized trial.

    PubMed

    Ohmure, H; Oikawa, K; Kanematsu, K; Saito, Y; Yamamoto, T; Nagahama, H; Tsubouchi, H; Miyawaki, S

    2011-05-01

    The aim of this cross-over, randomized, single-blinded trial was to examine whether intra-esophageal acidification induces sleep bruxism (SB). Polysomnography with electromyogram (EMG) of masseter muscle, audio-video recording, and esophageal pH monitoring were performed in a sleep laboratory. Twelve healthy adult males without SB participated. Intra-esophageal infusions of 5-mL acidic solution (0.1 N HCl) or saline were administered. The frequencies of EMG bursts, rhythmic masticatory muscle activity (RMMA) episodes, grinding noise, and the RMMA/microarousal ratio were significantly higher in the 20-minute period after acidic infusion than after saline infusion. RMMA episodes including SB were induced by esophageal acidification. This trial is registered with the UMIN Clinical Trials Registry, UMIN000002923. ASDA, American Sleep Disorders Association; EMG, electromyogram; GER, gastroesophageal reflux; LES, lower esophageal sphincter; NREM, non-rapid eye movement; REM, rapid eye movement; RMMA, rhythmic masticatory muscle activity; SB, sleep bruxism; SD, standard deviation; UES, upper esophageal sphincter.

  5. Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow up.

    PubMed

    Giannasi, Lilian Chrystiane; Santos, Israel Reis; Alfaya, Thays Almeida; Bussadori, Sandra Kalil; Franco de Oliveira, Luis Vicente

    2013-10-01

    The aim of the present study was to evaluate the effect of the use of an occlusal splint in children with bruxism in a pilot study with a short-term follow up. Seventeen children were recruited, only nine of whom formed the sample following the application of the inclusion criteria: presence of sleep bruxism for at least six months (based on parents' reports); presence of at least the first permanent molars; and no previous history of treatment involving an occlusal splint. The sample was submitted to a clinical exam. Other sleep problems were screened with the use of a sleep questionnaire filled out by parents before and after 90 days of occlusal splint usage. The children received a flat acrylic resin splint with full coverage of the occlusal surfaces to be worn in the maxilla. In children with erupting teeth, a space was created in the splint to allow normal eruption. After the 90-day period, the absence of sleep bruxism and sleep movements was noted in most of children. Moreover, snoring was reduced in nearly 50%, which raises a new issue to be investigated with regard to the pathophysiology of sleep bruxism. The use of an occlusal splint was effective in reducing the symptoms of sleep bruxism and other sleep problems. Further investigations should be carried out on the relationship between snoring and sleep bruxism in children. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Classification and reporting of severity experienced by animals used in scientific procedures: FELASA/ECLAM/ESLAV Working Group report

    PubMed Central

    Smith, David; Anderson, David; Degryse, Anne-Dominique; Bol, Carla; Criado, Ana; Ferrara, Alessia; Gyertyan, Istvan; Orellana, Jose M; Ostergaard, Grete; Varga, Orsolya; Voipio, Hanna-Marja

    2018-01-01

    Directive 2010/63/EU introduced requirements for the classification of the severity of procedures to be applied during the project authorisation process to use animals in scientific procedures and also to report actual severity experienced by each animal used in such procedures. These requirements offer opportunities during the design, conduct and reporting of procedures to consider the adverse effects of procedures and how these can be reduced to minimize the welfare consequences for the animals. Better recording and reporting of adverse effects should also help in highlighting priorities for refinement of future similar procedures and benchmarking good practice. Reporting of actual severity should help inform the public of the relative severity of different areas of scientific research and, over time, may show trends regarding refinement. Consistency of assignment of severity categories across Member States is a key requirement, particularly if re-use is considered, or the safeguard clause is to be invoked. The examples of severity classification given in Annex VIII are limited in number, and have little descriptive power to aid assignment. Additionally, the examples given often relate to the procedure and do not attempt to assess the outcome, such as adverse effects that may occur. The aim of this report is to deliver guidance on the assignment of severity, both prospectively and at the end of a procedure. A number of animal models, in current use, have been used to illustrate the severity assessment process from inception of the project, through monitoring during the course of the procedure to the final assessment of actual severity at the end of the procedure (Appendix 1). PMID:29359995

  7. Classification and reporting of severity experienced by animals used in scientific procedures: FELASA/ECLAM/ESLAV Working Group report.

    PubMed

    Smith, David; Anderson, David; Degryse, Anne-Dominique; Bol, Carla; Criado, Ana; Ferrara, Alessia; Franco, Nuno Henrique; Gyertyan, Istvan; Orellana, Jose M; Ostergaard, Grete; Varga, Orsolya; Voipio, Hanna-Marja

    2018-02-01

    Directive 2010/63/EU introduced requirements for the classification of the severity of procedures to be applied during the project authorisation process to use animals in scientific procedures and also to report actual severity experienced by each animal used in such procedures. These requirements offer opportunities during the design, conduct and reporting of procedures to consider the adverse effects of procedures and how these can be reduced to minimize the welfare consequences for the animals. Better recording and reporting of adverse effects should also help in highlighting priorities for refinement of future similar procedures and benchmarking good practice. Reporting of actual severity should help inform the public of the relative severity of different areas of scientific research and, over time, may show trends regarding refinement. Consistency of assignment of severity categories across Member States is a key requirement, particularly if re-use is considered, or the safeguard clause is to be invoked. The examples of severity classification given in Annex VIII are limited in number, and have little descriptive power to aid assignment. Additionally, the examples given often relate to the procedure and do not attempt to assess the outcome, such as adverse effects that may occur. The aim of this report is to deliver guidance on the assignment of severity, both prospectively and at the end of a procedure. A number of animal models, in current use, have been used to illustrate the severity assessment process from inception of the project, through monitoring during the course of the procedure to the final assessment of actual severity at the end of the procedure (Appendix 1).

  8. Reliability of a portable device for the detection of sleep bruxism.

    PubMed

    Deregibus, Andrea; Castroflorio, Tommaso; Bargellini, Andrea; Debernardi, Cesare

    2014-11-01

    The aim of the study was to assess the repeatability in detecting sleep bruxism (SB) episodes by combined surface electromyography and heart rate (HR) signals recorded by a compact portable device (Bruxoff®). SB episodes are preceded by a sudden HR change. Thus, HR detection increases the precision of automatic detection of SB. Ten healthy subjects (five women and five men; 30.2 ± 11.02 years) were selected for the study. Rhythmic masseter muscle activities, constituting the basic pattern of SB, were detected during three nights of recording during three different weeks with the Bruxoff device. The two-way ANOVA was not significant for SB episodes per night, SB episodes per hour, and heart frequency: no significant differences were observed during the three different nights of recording for each of the abovementioned variables (P > 0.05). The intraclass correlation coefficient showed a good reproducibility for SB episodes per night (69 %), SB per hour (74 %), and heart frequency (82 %). A poor reproducibility was revealed for the number of masseter contractions (53 %). The Pearson analysis showed the absence of a significant correlation between the number of masseter contractions per night and the number of SB episodes per night (r = -0.02, P = 0.91). The Bruxoff device showed a good reproducibility of measurements of sleep bruxism episodes over time. These findings are important in the light of the need for simple and reliable portable devices for the diagnosis of SB both in the clinical and research settings.

  9. Bruxism and Dental Implants: A Meta-Analysis.

    PubMed

    Chrcanovic, Bruno Ramos; Albrektsson, Tomas; Wennerberg, Ann

    2015-10-01

    To test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss after the insertion of dental implants in bruxers compared with the insertion in non-bruxers against the alternative hypothesis of a difference. An electronic search was undertaken in June 2014. Eligibility criteria included clinical studies, either randomized or not. Ten publications were included with a total of 760 implants inserted in bruxers (49 failures; 6.45%) and 2989 in non-bruxers (109 failures; 3.65%). Due to lack of information, meta-analyses for the outcomes "postoperative infection" and "marginal bone loss" were not possible. A risk ratio of 2.93 was found (95% confidence interval, 1.48-5.81; P = 0.002). These results cannot suggest that the insertion of dental implants in bruxers affects the implant failure rates due to a limited number of published studies, all characterized by a low level of specificity, and most of them deal with a limited number of cases without a control group. Therefore, the real effect of bruxing habits on the osseointegration and survival of endosteal dental implants is still not well established.

  10. Factors Influencing Service Utilization and Mood Symptom Severity in Children with Mood Disorders: Effects of Multifamily Psychoeducation Groups (MFPGs)

    ERIC Educational Resources Information Center

    Mendenhall, Amy N.; Fristad, Mary A.; Early, Theresa J.

    2009-01-01

    This study investigated the impact of psychoeducation on service utilization and mood symptom severity in children with mood disorders. Parents' knowledge of mood disorders, beliefs about treatment, and perceptions of children's need for treatment were hypothesized to mediate the relationship between psychoeducation and service utilization and…

  11. A relationship between bruxism and orofacial-dystonia? A trigeminal electrophysiological approach in a case report of pineal cavernoma.

    PubMed

    Frisardi, Gianni; Iani, Cesare; Sau, Gianfranco; Frisardi, Flavio; Leornadis, Carlo; Lumbau, Aurea; Enrico, Paolo; Sirca, Donatella; Staderini, Enrico Maria; Chessa, Giacomo

    2013-10-28

    In some clinical cases, bruxism may be correlated to central nervous system hyperexcitability, suggesting that bruxism may represent a subclinical form of dystonia. To examine this hypothesis, we performed an electrophysiological evaluation of the excitability of the trigeminal nervous system in a patient affected by pineal cavernoma with pain symptoms in the orofacial region and pronounced bruxism. Electrophysiological studies included bilateral electrical transcranial stimulation of the trigeminal roots, analysis of the jaw jerk reflex, recovery cycle of masseter inhibitory reflex, and a magnetic resonance imaging study of the brain. The neuromuscular responses of the left- and right-side bilateral trigeminal motor potentials showed a high degree of symmetry in latency (1.92 ms and 1.96 ms, respectively) and amplitude (11 mV and 11.4 mV, respectively), whereas the jaw jerk reflex amplitude of the right and left masseters was 5.1 mV and 8.9 mV, respectively. The test stimulus for the recovery cycle of masseter inhibitory reflex evoked both silent periods at an interstimulus interval of 150 ms. The duration of the second silent period evoked by the test stimulus was 61 ms and 54 ms on the right and left masseters, respectively, which was greater than that evoked by the conditioning stimulus (39 ms and 35 ms, respectively). We found evidence of activation and peripheral sensitization of the nociceptive fibers, the primary and secondary nociceptive neurons in the central nervous system, and the endogenous pain control systems (including both the inhibitory and facilitatory processes), in the tested subject. These data suggest that bruxism and central orofacial pain can coexist, but are two independent symptoms, which may explain why numerous experimental and clinical studies fail to reach unequivocal conclusions.

  12. A relationship between bruxism and orofacial-dystonia? A trigeminal electrophysiological approach in a case report of pineal cavernoma

    PubMed Central

    2013-01-01

    Background In some clinical cases, bruxism may be correlated to central nervous system hyperexcitability, suggesting that bruxism may represent a subclinical form of dystonia. To examine this hypothesis, we performed an electrophysiological evaluation of the excitability of the trigeminal nervous system in a patient affected by pineal cavernoma with pain symptoms in the orofacial region and pronounced bruxism. Methods Electrophysiological studies included bilateral electrical transcranial stimulation of the trigeminal roots, analysis of the jaw jerk reflex, recovery cycle of masseter inhibitory reflex, and a magnetic resonance imaging study of the brain. Results The neuromuscular responses of the left- and right-side bilateral trigeminal motor potentials showed a high degree of symmetry in latency (1.92 ms and 1.96 ms, respectively) and amplitude (11 mV and 11.4 mV, respectively), whereas the jaw jerk reflex amplitude of the right and left masseters was 5.1 mV and 8.9 mV, respectively. The test stimulus for the recovery cycle of masseter inhibitory reflex evoked both silent periods at an interstimulus interval of 150 ms. The duration of the second silent period evoked by the test stimulus was 61 ms and 54 ms on the right and left masseters, respectively, which was greater than that evoked by the conditioning stimulus (39 ms and 35 ms, respectively). Conclusions We found evidence of activation and peripheral sensitization of the nociceptive fibers, the primary and secondary nociceptive neurons in the central nervous system, and the endogenous pain control systems (including both the inhibitory and facilitatory processes), in the tested subject. These data suggest that bruxism and central orofacial pain can coexist, but are two independent symptoms, which may explain why numerous experimental and clinical studies fail to reach unequivocal conclusions. PMID:24165294

  13. Development of a group therapy to enhance treatment motivation and decision making in severely obese patients with a comorbid mental disorder.

    PubMed

    Wild, Beate; Herzog, Wolfgang; Wesche, Daniela; Niehoff, Dorothea; Müller, Beat; Hain, Bernhard

    2011-05-01

    The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery. Descriptive data of the first two intervention groups are provided. The treatment program and topics of the group sessions are explained. Time series analysis methods are used to investigate the development of a single patient during the intervention program. Initially, 16 patients joined the group program; ten of these attended the group therapy to completion. The remaining ten patients showed clinically relevant reduction in depression levels and improvement in mental quality of life. Results of the single-case time series analysis indicate that the temporal relationship between eating behavior and depression changed during treatment. The group program, as outlined, could be a useful intervention for severely obese patients with comorbid depression, anxiety, or eating disorder. A gap in the health care system is thus bridged by this short intervention that can encourage further treatment decisions such as bariatric surgery.

  14. Friendship quality and sociometric status: between-group differences and links to loneliness in severely abused and nonabused children.

    PubMed

    Howe, T R; Parke, R D

    2001-05-01

    There were two main aims: first, to illuminate the difference between abused children's general popularity with classmates and success in close friendships; second, to examine the specific interactional qualities of abused children's friendships and their links to loneliness. Thirty-five severely abused children and 43 matched, nonabused children were compared on peer-rated sociometric status, self-reported loneliness, and observed and self-reported friendship quality. Abused children were not rated significantly lower sociometrically, nor did they differ significantly from control children on several measures of friendship quality, such as resolving conflicts and helping each other. However, abused children were observed to be more negative and less proactive in their interactions. They also reported their friendships as being more conflictual, and as higher on betrayal and lower on caring. Only observational friendship variables predicted loneliness. The results challenge the assumption that abused children's peer relationships are uniformly more maladaptive than nonabused children's, and point to the possible benefits of structured interventions for "normalizing" their friendship interactions. The pattern of difficulties exhibited by abused children (e.g., conflict) provides foci for more specific interventions. Multi-method assessments are necessary and the multi-dimensional nature of children's social adjustment is important to understand.

  15. [Nutritional value of daily diets prepared in several regions of the country. Part V. Value of group b vitamins].

    PubMed

    Nadolna, I; Wiśniewska, W; Kunachowicz, H

    1991-01-01

    Studies of the content of group B vitamins: thiamin, riboflavin, niacin and vitamin b6 in daily diets of manual and mental workers with medium income were carried on. The diets were prepared for five regions of the country (Warszawa, Lublin, Olsztyn, Poznań, Wrocław) under laboratory conditions. These diets contained respectively: thiamin 1.17 and 1.11 mg, riboflavin 1.48 and 1.55 mg; niacin 11.3 and 10.2 mg and vitamin B6 1.50 and 1.21 mg per day. According to the studies the realization of daily requirements by these diets for thiamin were met 82 and 98%, for niacin 62 and 65%, and for vitamin B6 79 and 64%. The comparison of the presently studied diets with the ones from 1973, 1980 and 1981 showed that the content of niacin and vitamin B6 intakes systematically decrease. There were no considerable differences in the contents of group B vitamins between diets prepared in all five regions of Poland.

  16. Protein energy malnutrition in severe alcoholic hepatitis: diagnosis and response to treatment. The VA Cooperative Study Group #275.

    PubMed

    Mendenhall, C L; Moritz, T E; Roselle, G A; Morgan, T R; Nemchausky, B A; Tamburro, C H; Schiff, E R; McClain, C J; Marsano, L S; Allen, J I

    1995-01-01

    Active nutrition therapy and the anabolic steroid oxandrolone (OX), in selected patients with severe alcoholic hepatitis, significantly improved liver status and survival. We report here on the changes in their nutritional parameters. Protein energy malnutrition (PEM) was evaluated and expressed as percent of low normal in 271 patients initially, at 1 month and at 3 months. Active therapy consisted of OX plus a high caloric food supplement vs a matching placebo and a low calorie supplement. PEM was present in every patient; mean PEM score 60% of low normal. Most of the parameters improved significantly from baseline on standard care; the largest improvement seen in visceral proteins, the smallest in fat stores (skinfold thickness). Total PEM score significantly correlated with 6 month mortality (p = .0012). Using logistic regression analysis, creatinine height index, hand grip strength and total peripheral blood lymphocytes were the best risk factors for survival. When CD lymphocyte subsets replaced total lymphocyte counts in the equation, CD8 levels became a significant risk factor (p = .004). Active treatment produced significant risk factor (p = .004). Active treatment produced significant improvements in those parameters related to total body and muscle mass (ie, mid arm muscle area, p = .02; creatinine height index, p = .03; percent ideal body weight, p = .04). Deterioration in nutritional parameters is a significant risk factor for survival in severe patients with alcoholic hepatitis. This deterioration is reversible with standard hospital care. Active therapy further improves creatinine height index, mid arm muscle area and total lymphocyte counts. Hence, these later parameters appear to be the best indicators for follow-up assessments.

  17. Human lung surfactant protein A exists in several different oligomeric states: oligomer size distribution varies between patient groups.

    PubMed Central

    Hickling, T. P.; Malhotra, R.; Sim, R. B.

    1998-01-01

    BACKGROUND: Lung surfactant protein A (SP-A) is a complex molecule composed of up to 18 polypeptide chains. In vivo, SP-A probably binds to a wide range of inhaled materials via the interaction of surface carbohydrates with the lectin domains of SP-A and mediates their interaction with cells as part of a natural defense system. Multiplicity of lectin domains gives high-affinity binding to carbohydrate-bearing surfaces. MATERIALS AND METHODS: Gel filtration analyses were performed on bronchoalveolar lavage (BAL) fluid samples from three patient groups: pulmonary alveolar proteinosis (n = 12), birch pollen allergy (n = 11), and healthy volunteers (n = 4). Sucrose density gradient centrifugation was employed to determine molecular weights of SP-A oligomers. SP-A was solubilized from the lipid phase to compare oligomeric state with that of water soluble SP-A. RESULTS: SP-A exists as fully assembled complexes with 18 polypeptide chains, but it is also consistently found in smaller oligomeric forms. This is true for both the water- and lipid-soluble fractions of SP-A. CONCLUSION: The three patient groups analyzed show a shift towards lower oligomeric forms of SP-A in the following sequence: healthy-pulmonary alveolar proteinosis-pollen allergy. Depolymerization would be expected to lead to loss of binding affinity for carbohydrate-rich surfaces, with loss or alteration of biological function. While there are many complex factors involved in the establishment of an allergy, it is possible that reduced participation of SP-A in clearing a potential allergen from the lungs could be an early step in the chain of events. Images Fig. 4 FIG. 6 Fig. 7 Fig. 8 PMID:9606179

  18. Trends in age and red blood cell donation habits among several racial/ethnic minority groups in the United States.

    PubMed

    Yazer, Mark H; Vassallo, Ralph; Delaney, Meghan; Germain, Marc; Karafin, Matthew S; Sayers, Merlyn; van de Watering, Leo; Shaz, Beth H

    2017-07-01

    To meet the needs of a diverse patient population, an adequate supply of red blood cells (RBCs) from ethnic/racial minority donors is essential. We previously described the 10-year changes in minority blood donation in the United States. This study describes donation patterns by donor status, age, and race/ethnicity. Data on the age and the number of unique black/African American, Hispanic/Latino, Asian, and white RBC donors were obtained from eight US blood collectors for 2006, 2009, 2012, and 2015. Donors self-identified their race/ethnicity. First-time (FT) and repeat (R) donors were analyzed separately. Overall, for both FT and R donor groups, whites constituted the majority of unique donors (FT 66.7% and R 82.7%) and also donated the greatest proportion of RBC units (FT 66.6% and R 83.8%). Donors less than 20 years old comprised the greatest proportion of FT donors for all racial/ethnic groups (39.2%) and had the highest mean number of RBC donations per donor (1.12) among FT donors. Conversely, R donors less than 20 years old had some of the lowest mean number of RBC donations per donor (1.55) among R donors, whereas R donors at least 60 years old had the highest mean (1.88). Year by year, the percentage of FT donors who were less than 20 years old increased for all race/ethnicities. For R donors, whites were more frequently older, while Hispanics/Latinos and Asians were younger. Greater efforts to convert FT donors less than 20 years into R donors should be undertaken to ensure the continued diversity of the blood supply. © 2017 AABB.

  19. Avoiding Severe Toxicity From Combined BRAF Inhibitor and Radiation Treatment: Consensus Guidelines from the Eastern Cooperative Oncology Group (ECOG)

    PubMed Central

    Anker, Christopher J.; Grossmann, Kenneth F.; Atkins, Michael B.; Suneja, Gita; Tarhini, Ahmad A.; Kirkwood, John M.

    2016-01-01

    BRAF kinase gene V600 point mutations drive approximately 40% to 50% of all melanomas, and BRAF inhibitors (BRAFi) have been found to significantly improve survival outcomes. Although radiation therapy (RT) provides effective symptom palliation, there is a lack of toxicity and efficacy data when RT is combined with BRAFi, including vemurafenib and dabrafenib. This literature review provides a detailed analysis of potential increased dermatologic, pulmonary, neurologic, hepatic, esophageal, and bowel toxicity from the combination of BRAFi and RT for melanoma patients described in 27 publications. Despite 7 publications noting potential intracranial neurotoxicity, the rates of radionecrosis and hemorrhage from whole brain RT (WBRT), stereotactic radiosurgery (SRS), or both do not appear increased with concurrent or sequential administration of BRAFis. Almost all grade 3 dermatitis reactions occurred when RT and BRAFi were administered concurrently. Painful, disfiguring nondermatitis cutaneous reactions have been described from concurrent or sequential RT and BRAFi administration, which improved with topical steroids and time. Visceral toxicity has been reported with RT and BRAFi, with deaths possibly related to bowel perforation and liver hemorrhage. Increased severity of radiation pneumonitis with BRAFi is rare, but more concerning was a potentially related fatal pulmonary hemorrhage. Conversely, encouraging reports have described patients with leptomeningeal spread and unresectable lymphadenopathy rendered disease free from combined RT and BRAFi. Based on our review, the authors recommend holding BRAFi and/or MEK inhibitors ≥3 days before and after fractionated RT and ≥1 day before and after SRS. No fatal reactions have been described with a dose <4 Gy per fraction, and time off systemic treatment should be minimized. Future prospective data will serve to refine these recommendations. PMID:27131079

  20. Avoiding Severe Toxicity From Combined BRAF Inhibitor and Radiation Treatment: Consensus Guidelines from the Eastern Cooperative Oncology Group (ECOG)

    SciTech Connect

    Anker, Christopher J., E-mail: chris.anker@UVMHealth.org; Grossmann, Kenneth F.; Atkins, Michael B.

    2016-06-01

    BRAF kinase gene V600 point mutations drive approximately 40% to 50% of all melanomas, and BRAF inhibitors (BRAFi) have been found to significantly improve survival outcomes. Although radiation therapy (RT) provides effective symptom palliation, there is a lack of toxicity and efficacy data when RT is combined with BRAFi, including vemurafenib and dabrafenib. This literature review provides a detailed analysis of potential increased dermatologic, pulmonary, neurologic, hepatic, esophageal, and bowel toxicity from the combination of BRAFi and RT for melanoma patients described in 27 publications. Despite 7 publications noting potential intracranial neurotoxicity, the rates of radionecrosis and hemorrhage from wholemore » brain RT (WBRT), stereotactic radiosurgery (SRS), or both do not appear increased with concurrent or sequential administration of BRAFis. Almost all grade 3 dermatitis reactions occurred when RT and BRAFi were administered concurrently. Painful, disfiguring nondermatitis cutaneous reactions have been described from concurrent or sequential RT and BRAFi administration, which improved with topical steroids and time. Visceral toxicity has been reported with RT and BRAFi, with deaths possibly related to bowel perforation and liver hemorrhage. Increased severity of radiation pneumonitis with BRAFi is rare, but more concerning was a potentially related fatal pulmonary hemorrhage. Conversely, encouraging reports have described patients with leptomeningeal spread and unresectable lymphadenopathy rendered disease free from combined RT and BRAFi. Based on our review, the authors recommend holding RT ≥3 days before and after fractionated RT and ≥1 day before and after SRS. No fatal reactions have been described with a dose <4 Gy per fraction, and time off systemic treatment should be minimized. Future prospective data will serve to refine these recommendations.« less

  1. Evaluation of a Proton Pump Inhibitor for Sleep Bruxism: A Randomized Clinical Trial.

    PubMed

    Ohmure, H; Kanematsu-Hashimoto, K; Nagayama, K; Taguchi, H; Ido, A; Tominaga, K; Arakawa, T; Miyawaki, S

    2016-12-01

    Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting of the mandible. Recent advances have clarified the relationship between gastroesophageal reflux and sleep bruxism (SB). However, the influence of pharmacological elimination of gastric acid secretion on SB has not been confirmed. The authors aimed to assess the efficacy of a proton pump inhibitor (PPI) on SB and to examine the gastrointestinal (GI) symptoms and endoscopic findings of the upper GI tract in SB patients. The authors performed a randomized double-blind placebo-controlled crossover study at Kagoshima University Hospital. Twelve patients with polysomnography (PSG)-diagnosed SB underwent an assessment of GI symptoms using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) and esophagogastroduodenoscopy. At baseline (i.e., before interventions), the mean frequencies of electromyography (EMG) bursts and rhythmic masticatory muscle activity (RMMA) episodes were 65.4 ± 49.0 bursts/h and 7.0 ± 4.8 episodes/h, respectively, and at least 1 RMMA episode with grinding noise was confirmed in all participants. The mean FSSG score was 8.4 ± 5.6, and 41.7% of patients were diagnosed with gastroesophageal reflux disease. Mild reflux esophagitis was confirmed in 6 patients. PSG, including EMG of the left masseter muscle and audio-video recording, was performed on days 4 and 5 of administration of 10 mg of the PPI (rabeprazole) or placebo. PPI administration yielded a significant reduction in the frequency of EMG bursts, RMMA episodes, and grinding noise. No significant differences were observed regarding the swallowing events and sleep variables. Since the clinical application of PPI for SB treatment should remain on hold at present, the results of this trial highlight the potential application of pharmacological gastroesophageal reflux disease treatment for SB patients. Larger scale studies are warranted to

  2. An Evaluation Report of Project INTERACT: A Teacher Inservice Training Course on Career Education Using Two-Way TV in Texas to Several Groups Simultaneously.

    ERIC Educational Resources Information Center

    Fruchter, Dorothy A.; Higginson, George M.

    A third party evaluation was conducted of an experiment in service training program (Project Interact) in career education using duplex (two-way) television to reach several groups in different cities simultaneously. Two main aspects of the project were under study: the particular curriculum content on career education and the use of the Texas…

  3. Injury severity analysis of commercially-licensed drivers in single-vehicle crashes: Accounting for unobserved heterogeneity and age group differences.

    PubMed

    Osman, Mohamed; Mishra, Sabyasachee; Paleti, Rajesh

    2018-05-18

    This study analyzes the injury severity of commercially-licensed drivers involved in single-vehicle crashes. Considering the discrete ordinal nature of injury severity data, the ordered response modeling framework was adopted. The moderating effect of driver's age on all other factors was examined by segmenting the parameters by driver's age group. Additional effects of the different drivers' age groups are taken into consideration through interaction terms. Unobserved heterogeneity of the different covariates was investigated using the Mixed Generalized Ordered Response Probit (MGORP) model. The empirical analysis was conducted using four years of the Highway Safety Information System (HSIS) data that included 6247 commercially-licensed drivers involved in single-vehicle crashes in the state of Minnesota. The MGORP model elasticity effects indicate that key factors that increase the likelihood of severe crashes for commercially-licensed drivers across all age groups include: lack of seatbelt usage, collision with a fixed object, speeding, vehicle age of 11 years or more, wind, night time, weekday, and female drivers. Also, the effects of several covariates were found to vary across different age groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

    PubMed Central

    Fassbinder, Eva; Schuetze, Maren; Kranich, Annika; Sipos, Valerija; Hohagen, Fritz; Shaw, Ida; Farrell, Joan; Arntz, Arnoud; Schweiger, Ulrich

    2016-01-01

    Borderline Personality Disorder (BPD) is a severe, challenging to treat mental disorder. Schema therapy (ST) as an individual therapy has been proven to be an effective psychological treatment for BPD. A group format of ST (GST) has been developed and evaluated in a randomized controlled trial in the United States and piloted in The Netherlands. These results suggest that GST speeds up and amplifies treatment effects of ST and might reduce delivery costs. However, feasibility in the German health care system and with BPD patients with high BPD severity and comorbidity, and frequent hospitalization, has not been tested to date. We investigated GST in 10 severely impaired, highly comorbid female patients with BPD, that needed frequent hospital admission. Patients received an outpatient ST-treatment program with weekly group and individual sessions for 1 year. Outcome measures including BPD severity, general psychopathology, psychosocial functioning, quality of life, happiness, schemas, and modes, and days of hospitalization were assessed at the start of treatment and 6, 12, and 36 months later with semi-structured interviews and self-report measures. We observed significant decreases in severity of BPD symptoms, general symptom severity, dysfunctional BPD-specific modes and schemas, and days of hospitalization. Functional modes, quality of live and happiness improved. The results of this feasibility study are promising and encourage further implementation of ST outpatient treatment programs even for patients with severe BPD and high hospitalization risk. However, small sample size and the missing of a control group do not allow the generalizability of these findings. PMID:27933020

  5. High plasma levels of high mobility group box 1 is associated with the risk of sepsis in severe blunt chest trauma patients: a prospective cohort study.

    PubMed

    Wang, Xiao-Wen; Karki, Avash; Zhao, Xing-Ji; Xiang, Xiao-Yong; Lu, Zhi-Qian

    2014-08-02

    High mobility group box 1 (HMGB1) is a late mediator of systemic inflammation. Extracellular HMGB1 play a central pathogenic role in critical illness. The purpose of the study was to investigate the association between plasma HMGB1 concentrations and the risk of poor outcomes in patients with severe blunt chest trauma. The plasma concentrations of HMGB1 in patients with severe blunt chest trauma (AIS ≥ 3) were measured by a quantitative enzyme-linked immunosorbent assay at four time points during seven days after admission, and the dynamic release patterns were monitored. The biomarker levels were compared between patients with sepsis and non-sepsis, and between patients with multiple organ dysfunction syndrome (MODS) and non-MODS. The related factors of prognosis were analyzed by using multivariate logistic regression analysis. The short-form 36 was used to evaluate the quality of life of patients at 12 months after injury. Plasma HMGB1 levels were significantly higher both in sepsis and MODS group on post-trauma day 3, 5, and 7 compared with the non-sepsis and non-MODS groups, respectively. Multivariate analysis showed that HMGB1 levels and ISS were independent risk factors for sepsis and MODS in patients with severe blunt chest trauma. Plasma HMGB1 levels were significantly elevated in patients with severe blunt chest trauma. HMGB1 levels were associated with the risk of poor outcome in patients with severe blunt chest trauma. Daily HMGB1 levels measurements is a potential useful tool in the early identification of post-trauma complications. Further studies are needed to determine whether HMGB1 intervention could prevent the development of sepsis and MODS in patients with severe blunt chest trauma.

  6. Sleep bruxism frequency and platelet serotonin transporter activities in young adult subjects.

    PubMed

    Minakuchi, Hajime; Sogawa, Chiharu; Miki, Haruna; Hara, Emilio S; Maekawa, Kenji; Sogawa, Norio; Kitayama, Shigeo; Matsuka, Yoshizo; Clark, Glenn Thomas; Kuboki, Takuo

    2016-03-01

    To evaluate correlations between serotonin transporter (SERT) uptake ability in human peripheral platelets and sleep bruxism (SB) frequency. Subjects were consecutively recruited from sixth-year students at Okayama University Dental School. Subjects were excluded if they (1) were receiving orthodontic treatment, (2) had a dermatological disease, (3) had taken an antidepressant within 6 months, or (4) had used an oral appliance within 6 months. SB frequency was determined as the summary score of three consecutive night assessments using a self-contained electromyography detector/analyzer in their home. Fasting peripheral venous blood samples were collected in the morning following the final SB assessment. SERT amount and platelet number were quantified via an ELISA assay and flow cytometry, respectively. Functional SERT characterization, 5-hydroxytryptamine (5-HT) uptake, maximum velocity (V max), and an affinity constant (K m ) were assessed with a [(3)H] 5-HT uptake assay. The correlations between these variables and SB level were evaluated. Among 50 eligible subjects (26 males, mean age 25.4 ± 2.41 years), 7 were excluded because of venipuncture failure, smoking, and alcohol intake during the experimental period. A small but significant negative correlation between SB level and [(3)H] 5-HT uptake was observed (Spearman's correlation R (2) = 0.063, p = 0.04). However, there were no significant correlations between SB level and total platelet amount, SERT, V max, and K m values (p = 0.08, 0.12, 0.71, and 0.68, respectively). Platelet serotonin uptake is significantly associated with SB frequency, yet only explains a small amount of SB variability.

  7. Activation properties of trigeminal motoneurons in participants with and without bruxism

    PubMed Central

    D'Amico, Jessica M.; Yavuz, Ş. Utku; Saraçoğlu, Ahmet; Atiş, Elif Sibel; Türker, Kemal S.

    2013-01-01

    In animals, sodium- and calcium-mediated persistent inward currents (PICs), which produce long-lasting periods of depolarization under conditions of low synaptic drive, can be activated in trigeminal motoneurons following the application of the monoamine serotonin. Here we examined if PICs are activated in human trigeminal motoneurons during voluntary contractions and under physiological levels of monoaminergic drive (e.g., serotonin and norepinephrine) using a paired motor unit analysis technique. We also examined if PICs activated during voluntary contractions are larger in participants who demonstrate involuntary chewing during sleep (bruxism), which is accompanied by periods of high monoaminergic drive. In control participants, during a slowly increasing and then decreasing isometric contraction, the firing rate of an earlier-recruited masseter motor unit, which served as a measure of synaptic input to a later-recruited test unit, was consistently lower during derecruitment of the test unit compared with at recruitment (ΔF = 4.6 ± 1.5 imp/s). The ΔF, therefore, is a measure of the reduction in synaptic input needed to counteract the depolarization from the PIC to provide an indirect estimate of PIC amplitude. The range of ΔF values measured in the bruxer participants during similar voluntary contractions was the same as in controls, suggesting that abnormally high levels of monoaminergic drive are not continually present in the absence of involuntary motor activity. We also observed a consistent “onion skin effect” during the moderately sized contractions (<20% of maximal), whereby the firing rate of higher threshold motor units discharged at slower rates (by 4–7 imp/s) compared with motor units with relatively lower thresholds. The presence of lower firing rates in the more fatigue-prone, higher threshold trigeminal motoneurons, in addition to the activation of PICs, likely facilitates the activation of the masseter muscle during motor activities

  8. First study conducted in Northern India that identifies group C rotavirus as the etiological agent of severe diarrhea in children in Delhi.

    PubMed

    Tiku, Vasundhara Razdan; Jiang, Baoming; Kumar, Praveen; Aneja, Satender; Bagga, Arvind; Bhan, Maharaj Kishen; Ray, Pratima

    2017-05-30

    Group C Rotavirus (RVC) is an enteric pathogen responsible for acute gastroenteritis in children and adults globally. At present there are no surveillance studies on group C Rotaviruses in India and therefore their prevalence in India remains unknown. The present study aimed to evaluate group C rotavirus infection among <5 years old children hospitalized with acute gastroenteritis in New Delhi. A total of 350 fecal specimens were collected during September 2013 to November 2014 from <5 years old diarrheal patients admitted at KSCH hospital, Delhi. The samples found negative for group A rotavirus (N = 180) by Enzyme immunoassay were screened for group C rotavirus by RT-PCR with VP6, VP7 and VP4 gene specific primers. The PCR products were further sequenced (VP6, VP7, VP4) and analyzed to ascertain their origin and G and P genotypes. Six out of 180 (group A rotavirus negative) samples were found positive for group C rotavirus by VP6 gene specific RT-PCR, of which 3 were also found positive for VP7 and VP4 genes. Phylogenetic analysis of VP7 and VP4 genes of these showed them to be G4 and P[2] genotypes. Overall, the nucleotide sequence data (VP6, VP7 and VP4) revealed a close relationship with the human group C rotavirus with no evidence of animal ancestry. Interestingly, the nucleotide sequence analysis of various genes also indicated differences in their origin. While the identity matrix of VP4 gene (n = 3) showed high amino acid sequence identity (97.60 to 98.20%) with Korean strain, the VP6 gene (n = 6) showed maximum identity with Nigerian strain (96.40 to 97.60%) and VP7 gene (n = 3) with Bangladeshi and USA strains. This is true for all analyzed samples. Our study demonstrated the group C rotavirus as the cause of severe diarrhea in young children in Delhi and provides insights on the origin of group C rotavirus genes among the local strains indicating their source of transmission. Our study also highlights the need for a simple and reliable

  9. A small group aerobic exercise programme that reduces body weight is feasible in adults with severe chronic schizophrenia: a pilot study.

    PubMed

    Dodd, Karen J; Duffy, Sean; Stewart, Jan A; Impey, Jennifer; Taylor, Nicholas

    2011-01-01

    To evaluate the feasibility and effects of an exercise programme on people with severe, chronic schizophrenia. A single-group, pre-post pilot study incorporating a baseline familiarisation phase was followed by a 24-week, small-group aerobic exercise programme for up to 30-min each session, twice a week and a 30-min weekly walking session. Adherence was assessed by attendance, and by analysing the exercise supervisor's comments in a programme diary and in each participant's exercise logbook. Body weight, cardio-respiratory fitness (VO₂ max), walking endurance (6-min walk test) and psychiatric symptoms (the Positive and Negative Syndrome Scale) were measured at each time point. Eight participants (6 men, 2 women; mean age 45 years, 9 months (SD 10 years, 1 month); mean body mass index 27.0 (SD 4.2)) attended a mean of 73% of the scheduled exercise sessions, and 83% of the walking sessions, with no adverse events and no dropouts. All participants displayed positive and negative behaviours during training sessions. There were significant reductions in weight (2.4%) and body mass index (2.2%), but no changes in other measures. It was feasible and safe to conduct a small-group aerobic exercise programme for adults with severe chronic schizophrenia that reduced body weight.

  10. Evaluation of Cranio-cervical Posture in Children with Bruxism Before and After Bite Plate Therapy: A Pilot Project.

    PubMed

    Bortoletto, Carolina Carvalho; Cordeiro da Silva, Fernanda; Silva, Paula Fernanda da Costa; Leal de Godoy, Camila Haddad; Albertini, Regiane; Motta, Lara J; Mesquita-Ferrari, Raquel Agnelli; Fernandes, Kristianne Porta Santos; Romano, Renata; Bussadori, Sandra Kalil

    2014-07-01

    [Purpose] The aim of the present study was to evaluate the effect of a biteplate on the cranio-cervical posture of children with bruxism. [Subjects and Methods] Twelve male and female children aged six to 10 years with a diagnosis of bruxism participated in this study. The children used a biteplate during sleep for 30 days and were submitted to three postural evaluations: initial, immediately following placement of the biteplate, and at the end of treatment. Posture analysis was performed with the aid of the Alcimagem(®) 2.1 program. Data analysis (IBM SPSS Statistics 2.0) involved descriptive statistics and the Student's t-test. [Results] A statistically significant difference was found between the initial cranio-cervical angle and the angle immediately following placement of the biteplate. However, no statistically significant difference was found between the initial angle and the angle after one month of biteplate usage. [Conclusion] No significant change in the cranio-cervical posture of the children was found one month of biteplate usage. However, a reduction occurred in the cranio-cervical angle when the biteplate was in position.

  11. The use of botulinum toxin in the treatment of the consequences of bruxism on cervical spine musculature.

    PubMed

    Finiels, P J; Batifol, D

    2014-03-01

    Hypertonia and hyperactivity of masticatory muscles are involved in pain and contractions of the cervical spine musculature, but their pathophysiology remains nonetheless unknown and its treatment far to be codified. In this study, 8 patients, showing disabling posterior neck muscle contractures linked with bruxism were prospectively treated and followed for an average 15 months period, after having received Injections of botulinum toxin A essentially in masticatory muscles. Injections were made every 3 months, varying from 10 to 100 U Botox* by muscles, without administrating more than 300 U Botox* in the same patient. The angle of cervical lordosis were calculated on lateral sitting radiographs in neutral position, good results being considered to be achieved in the case of a 2 point diminution of VAS score as well as at least a 5° positive gain in the curve. 7 patients out of 8 showed a real improvement in their symptoms after an average of 3 injections, showing a decrease of 4.5 points on the VAS score and an average increment of 15° in cervical lordosis. Although the follow-up period of patients was relatively short and the sample quite small, the general impression, confirmed by the patients' experience, seems to suggest a potential place for the use of botulinum toxin amongst the array of treatments which can be offered in certain selected cases which associate bruxism and posterior cervical contractions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Diagnosis of sleep bruxism can assist in the detection of cases of verbal school bullying and measure the life satisfaction of adolescents.

    PubMed

    Fulgencio, Livia Bonfim; Corrêa-Faria, Patrícia; Lage, Carolina Freitas; Paiva, Saul Martins; Pordeus, Isabela Almeida; Serra-Negra, Junia Maria

    2017-07-01

    Adolescence is a period with changes and conflicts. The aim of this study was to investigate the association between sleep bruxism, verbal bullying at school, and life satisfaction among Brazilian adolescents. A cross-sectional study of 1344 Brazilian adolescents was performed. Possible sleep bruxism was identified using the consensus criteria based on the reports of parents. The parents and the adolescents answered validated questionnaires. The data were statistically analyzed using the chi-squared test, Mann-Whitney U-test, and Poisson regression with robust variance. A total of 205 adolescents presented possible sleep bruxism (15.3%). This parafunction was more prevalent among adolescents who were victims of verbal bullying at school (PR: 6.31; 95% CI: 4.78-8.32), victim/perpetrators (PR: 5.27; 95% CI: 3.82-7.27), and who belonged to families from a higher socioeconomic status (RP: 1.51; 95% CI: 1.23-1.86). Possible sleep bruxism was also associated with higher scores in the domains of self (PR: 1.04; 95% CI: 1.00-1.08), school (PR: 1.05; 95% CI: 1.02-1.09) and self-efficacy (PR: 1.07; 95% CI: 1.03-1.12), and lower scores in the non-violence domain (PR: 0.96; 95% CI: 0.93-0.99). Possible sleep bruxism can assist in the detection of adolescents involved in school bullying at school in the roles of victim and victim/perpetrator. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    PubMed Central

    Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2016-01-01

    Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Results Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39, 95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Conclusions Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism. Key words:Diagnosis, temporomandibular joint disorders, migraine, tension-type headache, bruxism. PMID:26615507

  14. Detection of Severe Acute Respiratory Syndrome-Like, Middle East Respiratory Syndrome-Like Bat Coronaviruses and Group H Rotavirus in Faeces of Korean Bats.

    PubMed

    Kim, H K; Yoon, S-W; Kim, D-J; Koo, B-S; Noh, J Y; Kim, J H; Choi, Y G; Na, W; Chang, K-T; Song, D; Jeong, D G

    2016-08-01

    Bat species around the world have recently been recognized as major reservoirs of several zoonotic viruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), Nipah virus and Hendra virus. In this study, consensus primer-based reverse transcriptase polymerase chain reactions (RT-PCRs) and high-throughput sequencing were performed to investigate viruses in bat faecal samples collected at 11 natural bat habitat sites from July to December 2015 in Korea. Diverse coronaviruses were first detected in Korean bat faeces, including alphacoronaviruses, SARS-CoV-like and MERS-CoV-like betacoronaviruses. In addition, we identified a novel bat rotavirus belonging to group H rotavirus which has only been described in human and pigs until now. Therefore, our results suggest the need for continuing surveillance and additional virological studies in domestic bat. © 2016 Blackwell Verlag GmbH.

  15. The accuracy of Patient Health Questionnaire-9 in detecting depression and measuring depression severity in high-risk groups in primary care.

    PubMed

    Wittkampf, Karin; van Ravesteijn, Hiske; Baas, Kim; van de Hoogen, Henk; Schene, Aart; Bindels, Patrick; Lucassen, Peter; van de Lisdonk, Eloy; van Weert, Henk

    2009-01-01

    Only half of patients with depressive disorder are diagnosed by their family physicians. Screening in high-risk groups might reduce this hidden morbidity. This study aims to determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) in (a) screening for depressive disorder, (b) diagnosing depressive disorder and (c) measuring the severity of depressive disorder in groups that are at high risk for depressive disorder. We compared the performance of the PHQ-9 as a screening instrument and as a diagnostic instrument to that of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview, which we used as reference standard. Three high-risk groups of patients were selected: (a) frequent attenders, (b) patients with mental health problems and (c) patients with unexplained complaints. Patients completed the PHQ-9. Next, patients who were at risk for depression (based on PHQ scores) and a random sample of 20% of patients who were not at risk were selected for a second PHQ-9 and the reference standard (SCID-I). We assessed the adequacy of the PHQ-9 as a tool for severity measurement by comparing PHQ-9 scores with scores on the 17-item Hamilton Depression Rating Scale (HDRS-17) in patients diagnosed with a depressive disorder. Among 440 patients, both PHQ-9 and SCID-I were analyzed. The test characteristics for screening were sensitivity=0.93 and specificity=0.85; those for diagnosing were sensitivity=0.68 and specificity=0.95. The positive likelihood ratio for diagnosing was 14.2. The HDRS-17 was administered in 49 patients with depressive disorder. The Pearson correlation coefficient of the PHQ-9 to the HDRS-17 was r=.52 (P<.01). The PHQ-9 performs well as a screening instrument, but in diagnosing depressive disorder, a formal diagnostic process following the PHQ-9 remains imperative. The PHQ-9 does not seem adequate for measuring severity.

  16. Medicare program; revisions to FY 2009 Medicare severity-long-term care diagnosis-related group (MS-LTC-DRG) weights. Interim final rule with comment period.

    PubMed

    2009-06-03

    This interim final rule with comment period implements revised Medicare severity long-term care diagnosis-related group (MS-LTC-DRG) relative weights for payment under the long-term care hospital (LTCH) prospective payment system (PPS) for federal fiscal year (FY) 2009. We are revising the MS-LTC-DRG relative weights for FY 2009 due to the misapplication of our established methodology in the calculation of the budget neutrality factor. The revised FY 2009 MS-LTC-DRG relative weights are effective for the remainder of FY 2009 (that is, from June 3, 2009 through September 30, 2009).

  17. Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial.

    PubMed

    Eggen, Marit Horst; Stuge, Britt; Mowinckel, Petter; Jensen, Kjersti Smee; Hagen, Kåre Birger

    2012-06-01

    Many women have low back pain (LBP) or pelvic girdle pain (PGP) during pregnancy, but there is limited evidence of effective primary and secondary preventive strategies. The purpose of this study was to investigate whether a group-based exercise program can reduce the prevalence and severity of LBP and PGP in pregnant women. An observer-blinded randomized controlled trial with equal assignments to a training group and a control group was conducted. The study was conducted in primary care maternity units in 2 suburban municipalities in the southeastern part of Norway. The participants were 257 pregnant women who were healthy and between 18 and 40 years of age before gestation week 20. The training group received supervised exercises in groups once a week, and the control group received standard care. The main outcome measures were self-reported LBP and self-reported PGP. Secondary outcome measures were pain intensity in the morning and evening, disability, and 8-Item Short-Form Health Survey (SF-8) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Follow-up measurements were performed at gestation weeks 24, 28, 32, and 36. Overall, there was no effect of the program on the prevalence of PGP (odds ratio = 1.03, 95% confidence interval [CI] = 0.66 to 1.59) or LBP (odds ratio = 0.77, 95% CI = 0.50 to 1.19). For the secondary outcomes, the estimated mean differences between the groups were -0.4 (95% CI = -0.8 to 0.1) for pain intensity in the morning, -0.4 (95% CI = -1.0 to 0.2) for pain intensity in the evening, -1.0 (95% CI = -2.2 to 0.0) for disability, 1.8 (95% CI = 0.0 to 3.7) for the SF-8 PCS, and -0.6 (95% CI = -2.2 to 1.4) for the SF-8 MCS. Due to low statistical power, the estimates for the primary outcomes are imprecise. Supervised group exercise did not reduce the prevalence of LBP or PGP in pregnancy.

  18. Variation in woody plant mortality and dieback from severe drought among soils, plant groups, and species within a northern Arizona ecotone.

    PubMed

    Koepke, Dan F; Kolb, Thomas E; Adams, Henry D

    2010-08-01

    Vegetation change from drought-induced mortality can alter ecosystem community structure, biodiversity, and services. Although drought-induced mortality of woody plants has increased globally with recent warming, influences of soil type, tree and shrub groups, and species are poorly understood. Following the severe 2002 drought in northern Arizona, we surveyed woody plant mortality and canopy dieback of live trees and shrubs at the forest-woodland ecotone on soils derived from three soil parent materials (cinder, flow basalt, sedimentary) that differed in texture and rockiness. Our first of three major findings was that soil parent material had little effect on mortality of both trees and shrubs, yet canopy dieback of trees was influenced by parent material; dieback was highest on the cinder for pinyon pine (Pinus edulis) and one-seed juniper (Juniperus monosperma). Ponderosa pine (Pinus ponderosa) dieback was not sensitive to parent material. Second, shrubs had similar mortality, but greater canopy dieback, than trees. Third, pinyon and ponderosa pines had greater mortality than juniper, yet juniper had greater dieback, reflecting different hydraulic characteristics among these tree species. Our results show that impacts of severe drought on woody plants differed among tree species and tree and shrub groups, and such impacts were widespread over different soils in the southwestern U.S. Increasing frequency of severe drought with climate warming will likely cause similar mortality to trees and shrubs over major soil types at the forest-woodland ecotone in this region, but due to greater mortality of other tree species, tree cover will shift from a mixture of species to dominance by junipers and shrubs. Surviving junipers and shrubs will also likely have diminished leaf area due to canopy dieback.

  19. Validation of the All Patient Refined Diagnosis Related Group (APR-DRG) Risk of Mortality and Severity of Illness Modifiers as a Measure of Perioperative Risk.

    PubMed

    McCormick, Patrick J; Lin, Hung-Mo; Deiner, Stacie G; Levin, Matthew A

    2018-03-22

    The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients. We analyzed all adult (age over 18 years) inpatient non-cardiac surgery at our institution between December 2005 and July 2013. After exclusions, we split the cohort into training and validation sets. We created prediction models of inpatient mortality using the Charlson Comorbidity Index, ROM only, SOI only, and ROM with SOI. Models were compared by receiver-operator characteristic (ROC) curve, area under the ROC curve (AUC), and Brier score. After exclusions, we analyzed 63,681 patient-visits. Overall in-hospital mortality was 1.3%. The median number of ICD-9-CM diagnosis codes was 6 (Q1-Q3 4-10). The median Charlson Comorbidity Index was 0 (Q1-Q3 0-2). When the model was applied to the validation set, the c-statistic for Charlson was 0.865, c-statistic for ROM was 0.975, and for ROM and SOI combined the c-statistic was 0.977. The scaled Brier score for Charlson was 0.044, Brier for ROM only was 0.230, and Brier for ROM and SOI was 0.257. The APR-DRG ROM or SOI subclasses are better predictors than the Charlson Comorbidity Index of in-hospital mortality among surgical patients.

  20. Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: Proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group.

    PubMed

    Holtfreter, Birte; Albandar, Jasim M; Dietrich, Thomas; Dye, Bruce A; Eaton, Kenneth A; Eke, Paul I; Papapanou, Panos N; Kocher, Thomas

    2015-05-01

    Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are severely hampered and inferences regarding the global variation in prevalence can hardly be drawn. To overcome these limitations, the authors suggest standardized principles for the reporting of the prevalence and severity of periodontal diseases in future epidemiological studies. These principles include the comprehensive reporting of the study design, the recording protocol, and specific subject-related and oral data. Further, a range of periodontal data should be reported in the total population and within specific age groups. Periodontal data include the prevalence and extent of clinical attachment loss (CAL) and probing depth (PD) on site and tooth level according to specific thresholds, mean CAL/PD, the CDC/AAP case definition, and bleeding on probing. Consistent implementation of these standards in future studies will ensure improved reporting quality, permit meaningful comparisons of the prevalence of periodontal diseases across populations, and provide better insights into the determinants of such variation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Severe group A streptococcal infections in Uppsala County, Sweden: clinical and molecular characterization of a case cluster from 2006 to 2007.

    PubMed

    Vikerfors, Anna; Haggar, Axana; Darenberg, Jessica; Low, Aili; Melhus, Asa; Hedlund, Johan; Sylvan, Staffan; Norrby-Teglund, Anna; Eriksson, Britt-Marie

    2009-01-01

    This study describes a recent cluster of 30 patients (median age 52 years) with serious group A streptococcal (GAS) infections in Uppsala County, Sweden, from December 2006 to May 2007. Patients hospitalized with a severe GAS infection, i.e. cases with either invasive GAS (iGAS) disease or patients with a positive non-sterile site culture/rapid antigen test for GAS and clinically considered as having a critical disease, were included in the study. Common clinical presentations were skin and soft tissue infections (53%) and pneumonia (17%). Eight patients (27%) were diagnosed with streptococcal toxic shock syndrome. In 40% of the cases no relevant underlying disease was reported. Among the 16 patients with soft tissue infections, the upper chest, neck or upper arm area was frequently affected and the infection was associated with severe pain. Among the 20 collected isolates, the T1/emm1 type dominated (80%). The majority (86%) of 7 analysed acute sera lacked neutralizing activity against superantigens produced by the patients' own infecting isolate. The study underscores the association between T1/emm1 and outbreaks of serious GAS infections. This highlights the importance of surveillance for prompt identification of more aggressive isolates in the community, thereby increasing awareness among healthcare professionals of these life-threatening infections.

  2. Group-Level Progressive Alterations in Brain Connectivity Patterns Revealed by Diffusion-Tensor Brain Networks across Severity Stages in Alzheimer’s Disease

    PubMed Central

    Rasero, Javier; Alonso-Montes, Carmen; Diez, Ibai; Olabarrieta-Landa, Laiene; Remaki, Lakhdar; Escudero, Iñaki; Mateos, Beatriz; Bonifazi, Paolo; Fernandez, Manuel; Arango-Lasprilla, Juan Carlos; Stramaglia, Sebastiano; Cortes, Jesus M.

    2017-01-01

    Alzheimer’s disease (AD) is a chronically progressive neurodegenerative disease highly correlated to aging. Whether AD originates by targeting a localized brain area and propagates to the rest of the brain across disease-severity progression is a question with an unknown answer. Here, we aim to provide an answer to this question at the group-level by looking at differences in diffusion-tensor brain networks. In particular, making use of data from Alzheimer’s Disease Neuroimaging Initiative (ADNI), four different groups were defined (all of them matched by age, sex and education level): G1 (N1 = 36, healthy control subjects, Control), G2 (N2 = 36, early mild cognitive impairment, EMCI), G3 (N3 = 36, late mild cognitive impairment, LMCI) and G4 (N4 = 36, AD). Diffusion-tensor brain networks were compared across three disease stages: stage I (Control vs. EMCI), stage II (Control vs. LMCI) and stage III (Control vs. AD). The group comparison was performed using the multivariate distance matrix regression analysis, a technique that was born in genomics and was recently proposed to handle brain functional networks, but here applied to diffusion-tensor data. The results were threefold: First, no significant differences were found in stage I. Second, significant differences were found in stage II in the connectivity pattern of a subnetwork strongly associated to memory function (including part of the hippocampus, amygdala, entorhinal cortex, fusiform gyrus, inferior and middle temporal gyrus, parahippocampal gyrus and temporal pole). Third, a widespread disconnection across the entire AD brain was found in stage III, affecting more strongly the same memory subnetwork appearing in stage II, plus the other new subnetworks, including the default mode network, medial visual network, frontoparietal regions and striatum. Our results are consistent with a scenario where progressive alterations of connectivity arise as the disease severity increases and provide the brain areas

  3. Management of Broken Dental Implant Abutment in a Patient with Bruxism: A Rare Case Report and Review of Literature.

    PubMed

    Al-Almaie, Saad

    2017-01-01

    This rare case report describes prosthodontic complications resulting from a dental implant was placed surgically more distally in the area of the missing mandibular first molar with a cantilever effect and a crest width of >12 mm in a 59-year-old patient who had a history of bruxism. Fracture of abutment is a common complication in implant was placed in area with high occlusal forces. Inability to remove the broken abutment may most often end up in discarding the implant. Adding one more dental implant mesially to the previously placed implant, improvisation of technique to remove the broken abutment without sacrificing the osseointegrated dental implant, fabrication with cemented custom-made abutment to replace the broken abutment for the first implant, and the use of the two implants to replace a single molar restoration proved reliable and logical treatment solutions to avoid these prosthodontic complications.

  4. Elevated levels of von Willebrand factor and high mobility group box 1 (HMGB1) are associated with disease severity and clinical outcome of scrub typhus.

    PubMed

    Chen, Hongliu; Ning, Zong; Qiu, Ying; Liao, Yuanli; Chang, Haihua; Ai, Yuanyuan; Wei, Yinghua; Deng, Yiming; Shen, Ying

    2017-08-01

    This study aimed to investigate whether von Willebrand factor (vWF) and high mobility group box 1 (HMGB1) are associated with the severity and clinical outcome of scrub typhus and to seek novel biomarkers for surveillance and prediction of the prognosis of this infection. Serum concentrations of vWF and HMGB1 were measured twice by ELISA for scrub typhus patients (n=103), once prior to doxycycline therapy and then on day 7 of doxycycline therapy; concentrations were measured once for healthy controls (n=32). Among the total 103 patients enrolled, 38 had disease complicated by multiple organ dysfunction syndrome (MODS). Serum concentrations of vWF and HMGB1 were significantly higher in all the patients than in the healthy controls, both prior to doxycycline treatment and on day 7 of doxycycline treatment (p<0.01). Furthermore, serum levels of vWF, HMGB1, and creatinine (SCr) in the patients with MODS increased distinctly, while the platelet (PLT) count diminished markedly compared to the levels in patients without MODS (p<0.01). The concentration of vWF was positively correlated with that of HMGB1 (r=0.764, p<0.001) and SCr (r=0.528, p<0.001), but negatively correlated with the PLT count (r=-0.632, p<0.001). Both HMGB1 and vWF were significantly associated with mortality in scrub typhus (area under the curve (AUC)=0.864, p=0.001, and AUC=0.862, p=0.001, respectively). Elevated levels of vWF and HMGB1 are associated with the severity and clinical outcome of scrub typhus. These represent possible new biomarkers for use in the assessment and prognostic prediction of this infection. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. Long-term follow-up of patients receiving lung-volume-reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group.

    PubMed

    Naunheim, Keith S; Wood, Douglas E; Mohsenifar, Zab; Sternberg, Alice L; Criner, Gerard J; DeCamp, Malcolm M; Deschamps, Claude C; Martinez, Fernando J; Sciurba, Frank C; Tonascia, James; Fishman, Alfred P

    2006-08-01

    The National Emphysema Treatment Trial defined subgroups of patients with severe emphysema in whom lung-volume-reduction surgery (LVRS) improved survival and function at 2 years. Two additional years of follow-up provide valuable information regarding durability. A total of 1218 patients with severe emphysema were randomized to receive LVRS or medical treatment. We present updated analyses (4.3 versus 2.4 years median follow-up), including 40% more patients with functional measures 2 years after randomization. The intention-to-treat analysis of 1218 randomized patients demonstrates an overall survival advantage for LVRS, with a 5-year risk ratio (RR) for death of 0.86 (p = 0.02). Improvement was more likely in the LVRS than in the medical group for maximal exercise through 3 years and for health-related quality of life (St. George's Respiratory Questionnaire [SGRQ]) through 4 years. Updated comparisons of survival and functional improvement were consistent with initial results for four clinical subgroups of non-high-risk patients defined by upper-lobe predominance and exercise capacity. After LVRS, the upper-lobe patients with low exercise capacity demonstrated improved survival (5-year RR, 0.67; p = 0.003), exercise throughout 3 years (p < 0.001), and symptoms (SGRQ) through 5 years (p < 0.001 years 1 to 3, p = 0.01 year 5). Upper-lobe-predominant and high-exercise-capacity LVRS patients obtained no survival advantage but were likely to improve exercise capacity (p < 0.01 years 1 to 3) and SGRQ (p < 0.01 years 1 to 4). Effects of LVRS are durable, and it can be recommended for upper-lobe-predominant emphysema patients with low exercise capacity and should be considered for palliation in patients with upper-lobe emphysema and high exercise capacity.

  6. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    PubMed

    Costa, Yuri-Martins; Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2016-01-01

    The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39, 95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism.

  7. Relationship between Tasks Performed, Personality Traits, and Sleep Bruxism in Brazilian School Children - A Population-Based Cross-Sectional Study

    PubMed Central

    Serra-Negra, Junia Maria; Paiva, Saul Martins; Abreu, Mauro Henrique; Flores-Mendoza, Carmen Elvira; Pordeus, Isabela Almeida

    2013-01-01

    Background Tasks can be instruments of stress and may affect the health of children. Sleep bruxism is a multifactorial sleep-related movement disorder that affects children and adults. The aim of the present study was to analyze the association between children’s tasks, personality traits and sleep bruxism. Methods And Findings A cross-sectional, population-based study of 652 randomly selected Brazilian schoolchildren (52% of whom were female), aged from 7 to 10 years was conducted in the city of Belo Horizonte, Brazil. A questionnaire based on criteria proposed by the American Academy of Sleep Medicine (AASM) was completed by parents. In addition, the Neuroticism and Responsibility sub-scales of the Big Five Questionnaire for Children (BFQ-C) were administered to the children. Psychological tests were administered and evaluated by psychologists. The Social Vulnerability Index from the city council database was used to determine the social classification of the families. Chi-square and Poisson regression statistical tests were used with a 95% confidence interval. The majority of families were classified as having low social vulnerability (61.3%), whereas, 38.7% were classified as having high social vulnerability. Regarding extracurricular activities, the majority of girls performed household work (56.4%) and some artistic activity (51.3%) while sporting activities were most common among boys (61%). The results of the Poisson regression model indicated that sleep bruxism was most prevalent in children who scored highly in the Neuroticism sub-scale, and who frequently performed household tasks. Conclusion Children whose personality domain has a high level of Neuroticism and who perform household chores imposed by the family are more vulnerable to sleep bruxism. PMID:24244614

  8. Outcome of aplastic anaemia in children. A study by the severe aplastic anaemia and paediatric disease working parties of the European group blood and bone marrow transplant.

    PubMed

    Dufour, Carlo; Pillon, Marta; Sociè, Gerard; Rovò, Alicia; Carraro, Elisa; Bacigalupo, Andrea; Oneto, Rosi; Passweg, Jakob; Risitano, Antonio; Tichelli, Andrè; Peffault de Latour, Regis; Schrezenmeier, Hubert; Hocshmann, Britta; Peters, Christina; Kulasekararaj, Austin; Van Biezen, Anja; Samarasinghe, Sujith; Hussein, Ayad Ahmed; Ayas, Mouhab; Aljurf, Mahmoud; Marsh, Judith

    2015-05-01

    This study analysed the outcome of 563 Aplastic Anaemia (AA) children aged 0-12 years reported to the Severe Aplastic Anaemia Working Party database of the European Society for Blood and Marrow Transplantation, according to treatment received. Overall survival (OS) after upfront human leucocyte antigen-matched family donor (MFD) haematopoietic stem cell transplantation (HSCT) or immunosuppressive treatment (IST) was 91% vs. 87% (P 0·18). Event-free survival (EFS) after upfront MFD HSCT or IST was 87% vs. 33% (P 0·001). Ninety-one of 167 patients (55%) failed front-line IST and underwent rescue HSCT. The OS of this rescue group was 83% compared with 91% for upfront MFD HSCT patients and 97% for those who did not fail IST up-front (P 0·017). Rejection was 2% for MFD HSCT and HSCT post-IST failure (P 0·73). Acute graft-versus-host disease (GVHD) grade II-IV was 8% in MFD graft vs. 25% for HSCT post-IST failure (P < 0·0001). Chronic GVHD was 6% in MFD HSCT vs. 20% in HSCT post-IST failure (P < 0·0001). MFD HSCT is an excellent therapy for children with AA. IST has a high failure rate, but remains a reasonable first-line choice if MFD HSCT is not available because high OS enables access to HSCT, which is a very good rescue option. © 2015 John Wiley & Sons Ltd.

  9. Vedolizumab for the Treatment of Adults with Moderate-to-Severe Active Ulcerative Colitis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    PubMed

    Essat, Munira; Tappenden, Paul; Ren, Shijie; Bessey, Alice; Archer, Rachel; Wong, Ruth; Lobo, Alan; Hoque, Sami

    2016-03-01

    As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of vedolizumab (Takeda UK) to submit evidence of the clinical effectiveness and cost effectiveness of vedolizumab for the treatment of patients with moderate-to-severe active ulcerative colitis (UC). The Evidence Review Group (ERG) produced a critical review of the evidence for the clinical effectiveness and cost effectiveness of the technology, based upon the company's submission to NICE. The evidence was derived mainly from GEMINI 1, a Phase 3, multicentre, randomised, double-blinded, placebo-controlled study of the induction and maintenance of clinical response and remission by vedolizumab (MLN0002) in patients with moderate-to-severe active UC with an inadequate response to, loss of response to or intolerance of conventional therapy or anti-tumour necrosis factor (TNF)-α. The clinical evidence showed that vedolizumab performed significantly better than placebo in both the induction and maintenance phases. In the post hoc subgroup analyses in patients with or without prior anti-TNF-α therapy, vedolizumab performed better then placebo (p value not reported). In addition, a greater improvement in health-related quality of life was observed in patients treated with vedolizumab, and the frequency and types of adverse events were similar in the vedolizumab and placebo groups, but the evidence was limited to short-term follow-up. There were a number of limitations and uncertainties in the clinical evidence base, which warrants caution in its interpretation--in particular, the post hoc subgroup analyses and high dropout rates in the maintenance phase of GEMINI 1. The company also presented a network meta-analysis of vedolizumab versus other biologic therapies indicated for moderate-to-severe UC. However, the ERG considered that the results presented may have underestimated the uncertainty in treatment effects, since fixed

  10. Opsonic Antibodies to the Surface M Protein of Group A Streptococci in Pooled Normal Immunoglobulins (IVIG): Potential Impact on the Clinical Efficacy of IVIG Therapy for Severe Invasive Group A Streptococcal Infections

    PubMed Central

    Basma, Hesham; Norrby-Teglund, Anna; McGeer, Allison; Low, Donald E.; El-Ahmedy, Omar; Dale, James B.; Schwartz, Benjamin; Kotb, Malak

    1998-01-01

    The surface M protein of group A streptococci (GAS) is one of the major virulence factors for this pathogen. Antibodies to the M protein can facilitate opsonophagocytosis by phagocytic cells present in human blood. We investigated whether pooled normal immunoglobulin G (IVIG) contains antibodies that can opsonize and enhance the phagocytosis of type M1 strains of GAS and whether the levels of these antibodies vary for different IVIG preparations. We focused on the presence of anti-M1 antibodies because the M1T1 serotype accounts for the majority of recent invasive GAS clinical isolates in our surveillance studies. The level of anti-M1 antibodies in three commercial IVIG preparations was determined by enzyme-linked immunosorbent assay (ELISA), and the opsonic activity of these antibodies was determined by neutrophil-mediated opsonophagocytosis of a representative M1T1 isolate. High levels of opsonic anti-M1 antibodies were found in all IVIG preparations tested, and there was a good correlation between ELISA titers and opsonophagocytic activity. However, there was no significant difference in the levels of opsonic anti-M1 antibodies among the various IVIG preparations or lots tested. Adsorption of IVIG with M1T1 bacteria removed the anti-M1 opsonic activity, while the level of anti-M3 opsonophagocytosis was unchanged. Plasma was obtained from seven patients with streptococcal toxic shock syndrome who received IVIG therapy, and the level of anti-M1 antibodies was assessed before and after IVIG administration. A significant increase in the level of type M1-specific antibodies was found in the plasma of all patients who received IVIG therapy (P < 0.006). The results reveal another potential mechanism by which IVIG can ameliorate severe invasive group A streptococcal infections. PMID:9573118

  11. Child maltreatment as a risk factor for opioid dependence: Comparison of family characteristics and type and severity of child maltreatment with a matched control group.

    PubMed

    Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P; Nelson, Elliot C

    2009-06-01

    To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history. This study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls. Given the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence. The high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child maltreatment history could help inform the development of

  12. Child maltreatment as a risk factor for opioid dependence: comparison of family characteristics and type and severity of child maltreatment with a matched control group

    PubMed Central

    Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P.; Nelson, Elliot C.

    2009-01-01

    Objective To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. Method The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history. Results This study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls. Conclusions Given the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid-dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence. Practice Implications The high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child

  13. Shift within age-groups of mumps incidence, hospitalizations and severe complications in a highly vaccinated population. Spain, 1998-2014.

    PubMed

    López-Perea, Noemí; Masa-Calles, Josefa; Torres de Mier, María de Viarce; Fernández-García, Aurora; Echevarría, Juan E; De Ory, Fernando; Martínez de Aragón, María Victoria

    2017-08-03

    The mumps vaccine (Jeryl-Lynn-strain) was introduced in Spain in 1981, and a vaccination policy which included a second dose was added in 1995. From 1992-1999, a Rubini-strain based vaccine was administered in many regions but later withdrawn due to lack of effectiveness. Despite high levels of vaccination coverage, epidemics have continued to appear. We characterized the three epidemic waves of mumps between 1998 and 2014, identifying major changes in susceptible populations using Poisson regression. For the period 1998-2003 (P1), the most affected group was from 1 to 4years old (y) [Incidence Rate (IR)=71.7 cases/100,000 population]; in the periods 2004-2009 (P2) and 2010-2014 (P3) IR ratio (IRR) increased among 15-24y (P2=1.46; P3=2.68) and 25-34y (P2=2.17; P3=4.05). Hospitalization rate (HR), complication rate (CR) and neurological complication rate (NR) among hospitalized subjects decreased across the epidemics, except for 25-34y which increased: HR ratio (HRR) (P2=2.18; P3=2.16), CRR (P3=2.48), NRR (P3=2.41). In Spain mumps incidence increased, while an overall decrease of hospitalizations and severe complications occurred across the epidemics. Cohorts born during periods of low vaccination coverage and those vaccinated with Rubini-strain were the most affected populations, leading to a shift in mumps cases from children to adolescents and young adults; this also reveals the waning immunity provided by the mumps vaccine. Despite not preventing all mumps cases, the vaccine appears to prevent serious forms of the disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Polyphyly of the traditional family Flabellinidae affects a major group of Nudibranchia: aeolidacean taxonomic reassessment with descriptions of several new families, genera, and species (Mollusca, Gastropoda)

    PubMed Central

    Korshunova, Tatiana; Martynov, Alexander; Bakken, Torkild; Evertsen, Jussi; Fletcher, Karin; Mudianta, I Wayan; Saito, Hiroshi; Lundin, Kennet; Michael Schrödl; Picton, Bernard

    2017-01-01

    Abstract The Flabellinidae, a heterogeneous assembly of supposedly plesiomorphic to very derived sea slug groups, have not yet been addressed by integrative studies. Here novel material of rarely seen Arctic taxa as well as North Atlantic, North and South Pacific, and tropical Indo-West Pacific flabellinid species is investigated morpho-anatomically and with multi-locus markers (partial COI, 16S rDNA, 28S rDNA and H3) which were generated and analysed in a comprehensive aeolid taxon sampling. It was found that the current family Flabellinidae is polyphyletic and its phylogeny and taxonomic patterns cannot be understood without considering members from all the Aeolidacean families and, based on a robust phylogenetic hypothesis, morpho-anatomical evolution of aeolids is more complex than suspected in earlier works and requires reclassification of the taxon. Morphological diversity of Flabellinidae is corroborated by molecular divergence rates and supports establishing three new families (Apataidae fam. n., Flabellinopsidae fam. n., Samlidae fam. n.), 16 new genera, 13 new species, and two new subspecies among the former Flabellinidae. Two families, namely Coryphellidae and Paracoryphellidae, are restored and traditional Flabellinidae is considerably restricted. The distinctness of the recently described family Unidentiidae is confirmed by both morphological and molecular data. Several species complexes among all ex-“Flabellinidae” lineages are recognised using both morphological and molecular data. The present study shows that Facelinidae and Aeolidiidae, together with traditional “Tergipedidae”, deeply divide traditional “Flabellinidae.” Diagnoses for all aeolidacean families are therefore provided and additionally two new non-flabellinid families (Abronicidae fam. n. and Murmaniidae fam. n.) within traditional tergipedids are established to accommodate molecular and morphological disparity. To address relationships and disparity, we propose a new family

  15. Vedolizumab for Treating Moderately to Severely Active Crohn's Disease After Prior Therapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    PubMed

    Rafia, Rachid; Scope, Alison; Harnan, Sue; Stevens, John W; Stevenson, Matt; Lobo, Alan

    2016-12-01

    As part of its single technology appraisal process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of vedolizumab (Takeda UK) to submit evidence of the clinical effectiveness and cost effectiveness of vedolizumab for the treatment of patients with moderate-to-severe, active Crohn's disease. The School of Health and Related Research (ScHARR) at the University of Sheffield was commissioned as the Evidence Review Group (ERG) and produced a critical review of the evidence of the clinical effectiveness and cost effectiveness of the technology, based upon the company's submission to NICE. The GEMINI II and III trials formed the main supporting evidence for the intervention. Both studies were phase III, randomised, double-blind, placebo-controlled, multicentre trials designed to evaluate the efficacy and safety of vedolizumab. They included patients who were naïve to tumour necrosis factor alpha antagonist (anti-TNF-α) therapy and patients who had an inadequate response to, loss of response to or intolerance of immunomodulators or anti-TNF-α agents. GEMINI II was designed to evaluate the efficacy and safety of vedolizumab as an induction treatment (dosing at weeks 0 and 2, with assessment at week 6) and maintenance treatment (during weeks 6-52). In contrast, GEMINI III was designed to evaluate the efficacy and safety of vedolizumab as an induction treatment only, with doses at weeks 0, 2 and 6, and assessment at weeks 6 and 10. In the absence of any direct head-to-head, randomised, controlled trials comparing vedolizumab with other relevant biologic therapies (adalimumab and infliximab) for the treatment of moderate-to-severe Crohn's disease, the company conducted a network meta-analysis, which compared vedolizumab, adalimumab, infliximab and placebo for the outcomes of clinical response, enhanced clinical response, clinical remission and discontinuation due to adverse events. The company model estimated the incremental

  16. [Severe hypercholesterolaemia--when to use the proprotein convertase subtilisin-kexin type 9 protease inhibitors (PCSK9 inhibitors)? Polish Society of Cardiology experts' group statement].

    PubMed

    Cybulska, Barbara; Gaciong, Zbigniew; Hoffman, Piotr; Jankowski, Piotr; Kłosiewicz-Latoszek, Longina; Kaźmierczak, Jarosław; Mitręga, Katarzyna; Opolski, Grzegorz; Pająk, Andrzej; Ponikowski, Piotr; Rynkiewicz, Andrzej; Stępińska, Janina; Średniawa, Beata; Kalarus, Zbigniew

    2016-01-01

    The severe hypercholesterolaemia can be recognised when low density lipoprotein cholesterol (LDL-C) serum levels are equal to or above 5 mmol/L (≥ 190 mg/dL). The prevalence of LDL-C ≥ 5 mmol/L is 3.8% in Polish population aged 18-79 years. Among these adults there are patients with familial hypercholesterolaemia (FH). According to meta-analysis of 6 Polish population surveys prevalence of heterozygous FH (HeFH) diagnosed using Dutch Lipid Clinic criteria is 0.4% (95% Cl 0.28-0.53%) in men and women aged 20-74 years, i.e. one in every 250 people. As HeFH is a wellknown cause of premature coronary heart disease the rigorous treatment targets for LDL-C have been established in clinical guidelines. Their achievements, even with a high dose of high efficacy statin therapy is difficult or even impossible. New strong hypolipidaemic drugs i.e. PCSK9 inhibitors have been initiated against this chalange. Both drugs, evolocumab and alirocumab, have been extensively studied in numerous phase 2 and phase 3 trials. Fewer studies with bococizumab are available until now. The PCSK9 inhibitors, as monotherapy as well in combination with statins were associated with mean LDL-C reduction about 60%. It means that the majority of patients (70-90%) with severe hypercholesterolaemia (including HeFH), treated with statins, after addition of PCSK9 inhibitors were able to achieve an LDL-C < 2.5 mmol/L (< 100 mg/dL) or < 1.8 mmol/L (< 70 mg/dL) level. Another group of patients who may benefit from PCSK9 inhibitors include those who need lipid lowering therapy, but who are statin intolerant, especially because of statin-associated muscle symptoms (SAMS). In our statement we have accepted the diagnosis of SAMS proposed recently by European Atherosclerosis Society. Today the longest clinical trial with evolocumab (11 months) was the open OSLER study, and with alirocumab ODYSSEY LONG TERM (78 weeks). In the first one the reduction of cardiovascular events by 53% (95% Cl 22-72%) was observed

  17. Proactive Groups.

    ERIC Educational Resources Information Center

    Galassi, John P., Ed.

    Several authors describe group counseling programs provided by a university counseling center to meet student needs for developing interpersonal communication skills and self-assertion behavior. In response to these needs, the counseling center provided personal growth groups, a proactive black group, a women's group, a marriage growth group, and…

  18. Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

    PubMed

    Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Saisto, Terhi

    2015-05-01

    Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well-being and costs of group psychoeducation and conventional care for fear of childbirth. Randomized controlled trial. A total of 371 nulliparous women scoring over the 95th centile in the Wijma Delivery Expectancy Questionnaire (W-DEQ) during the first trimester. Finland, data from obstetrical patient records and questionnaires. Randomization to group psychoeducation with relaxation (six sessions during pregnancy, one after childbirth, n = 131), or surveillance and referral on demand (n = 240). All costs in maternity care during pregnancy, delivery and postnatally according to Diagnoses Related Groups. Life satisfaction and general well-being 3 months after childbirth (by a Satisfaction with Life Scale and Well-being Visual Analogue Scale). The groups did not differ in total direct costs (€3786/woman in psychoeducative group and €3830/woman in control group), nor in life satisfaction or general well-being. Although only 76 (30%) of the women assigned to the surveillance were referred to special maternity care and 36 (15%) attended advanced prenatal classes, costs in the psychoeducation group did not exceed the costs of the controls, mostly because of the greater number of uncomplicated vaginal deliveries (63% vs. 47%, p = 0.005). Through an association with safer childbirth and equal well-being after delivery, psychoeducative group treatment for nulliparous women with fear of childbirth can be a recommended choice for the same overall costs as conventional treatment. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Clinical Predictors of Severe Cetuximab-Induced Rash: Observations from 933 Patients Enrolled in North Central Cancer Treatment Group Study N0147

    PubMed Central

    Jatoi, Aminah; Green, Erin M.; Rowland, Jr., Kendrith M.; Sargent, Daniel J.; Alberts, Steven R.

    2009-01-01

    Objective Epidermal growth factor receptor inhibitors can result in a severe rash in 5–10% of patients and can detract from quality of life. The objective of this study was to identify clinical predictors of severe rash in the hope of utilizing such factors in the design of future rash palliative and prevention trials. Methods 933 cetuximab-treated patients enrolled on N0147, an adjuvant chemotherapy trial for colon cancer, were evaluated for clinical risk factors of severe rash. Results Within this cohort, 50 patients (5%) developed a severe rash (grade 3). More men compared to women developed such a rash: 34 (7%) versus 16 (3%) (multivariate odds ratio = 2.12; 95% confidence interval: 1.14–3.88; p = 0.017). A greater number of younger patients (<70 years of age) also developed a rash: 48 (6%) versus 2 (1%) (multivariate odds ratio = 0.21; 95% confidence interval: 0.05–0.88; p = 0.032). Race and performance score were not predictive. Conclusion Men and younger patients are at greater risk for a severe cetuximab-induced rash although overall the risk is low. These observations are particularly important in designing future rash prevention and palliation trials. PMID:19622902

  20. The Relationship of Severe Early Childhood Caries and Body Mass Index in a Group of 3- to 6-year-old Children in Shiraz.

    PubMed

    Edalat, A; Abbaszadeh, M; Eesvandi, M; Heidari, A

    2014-06-01

    Early childhood caries can cause pain, discomfort and also inability to have a healthy nutrition .Malnutrition can be characterized when there is a weight, height, and body mass index (BMI) deficiency. The aim of this study was to evaluate the relationship between the severe early childhood caries (based on the dmft index) and BMI in pre-school children in Shiraz. A descriptive analytical cross-sectional study was enrolled on 202 healthy preschool children with the age range of 3-6 years recruited from the kindergartens of different socio- economical parts of Shiraz, Iran. The Anthropometric measurements, weight and height were evaluated. The Z-scores were calculated employing WHO Anthro software (www.who.int/childgrowth/software/en/ index.html) to elucidate the subject's status on the age- and sex-specific growth chart. Every Child who has received two Z-scores under the normal value (< -2) was considered as abnormal. The relationship between dmft index and BMI was then investigated. The mean of dmft was 4.13. From children with severe early childhood caries, 12.5%were under weight, 5% had height deficiency and 19.5% had BMI deficiency, however, there was no significant relationship between increasing dmft and the height, weight and BMI deficiency. There was not a linear correlation between severe early childhood caries and BMI, height, and weight deficiency. An incidence of 55% was yielded for severe early childhood caries which was an additional finding of this study.

  1. Calcipotriol Plus Betamethasone Dipropionate Aerosol Foam in Patients with Moderate-to-Severe Psoriasis: Sub-Group Analysis of the PSO-ABLE Study.

    PubMed

    Paul, Carle; Leonardi, Craig; Menter, Alan; Reich, Kristian; Gold, Linda Stein; Warren, Richard B; Møller, Anders; Lebwohl, Mark

    2017-06-01

    Fixed-combination calcipotriol 50 μg/g plus betamethasone 0.5 mg/g (Cal/BD) aerosol foam is a new topical treatment for psoriasis. Although moderate-to-severe psoriasis is typically treated with systemic/biologic therapies, a topical treatment that is efficacious in these patients may be a significant cost-saving alternative to systemic therapy. The objective of this study was to assess the response to Cal/BD foam and gel in patients with moderate-to-severe psoriasis enrolled in the phase III, 12-week PSO-ABLE study. Patients eligible for this analysis had moderate-to-severe psoriasis, defined by the 'Rule of Tens': body surface area ≥10% or Psoriasis Area and Severity Index (PASI) [excluding head; modified PASI (mPASI)] >10 or Dermatology Life-Quality Index >10. Endpoints included: proportion of patients achieving mPASI75 or mPASI90; change in body surface area; proportion of patients clear/almost clear with a ≥2 grade improvement (i.e., treatment success); change in Dermatology Life-Quality Index. Seventy-seven Cal/BD foam patients and 82 gel patients had moderate-to-severe psoriasis. A greater proportion achieved mPASI75 and mPASI90 with Cal/BD foam than gel at weeks 4, 8, and 12 (57.1 vs. 35.4%; p = 0.006 and 15.6 vs. 12.2% at week 12, respectively); overall reduction in mPASI from baseline to week 12 was 64% with the foam vs. 51% with the gel. Overall reduction in body surface area at week 12 was 50% with the foam and 39% with the gel. Treatment success rates were higher with the Cal/BD foam than the gel at weeks 1, 2, 4, 8 (p = 0.0089), and 12, and a greater proportion of foam patients achieved a Dermatology Life-Quality Index score of 0/1 at weeks 4 (p = 0.004), 8, and 12 (p = 0.001). Cal/BD foam can be considered as a treatment option in some patients with moderate-to-severe psoriasis who are potential candidates for systemic therapy. CLINICALTRIALS. NCT02132936.

  2. A Preliminary Study of the Validity of Memory Tests Recommended by the Working Group for Individuals with Moderate to Severe Intellectual Disability

    ERIC Educational Resources Information Center

    Pyo, G.; Kripakaran, K.; Curtis, K.; Curtis, R.; Markwell, S.

    2007-01-01

    Background: Normal aging and Dementia of Alzheimer's Type (DAT) among higher functioning individuals with intellectual disability (ID) have been relatively well studied using a variety of cognitive tests. However, cognitive studies for lower functioning individuals with ID are scarce in the literature. The Working Group recommended the Test…

  3. 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

  4. Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group.

    PubMed

    Foocharoen, Chingching; Tyndall, Alan; Hachulla, Eric; Rosato, Edoardo; Allanore, Yannick; Farge-Bancel, Dominique; Caramaschi, Paola; Airó, Paolo; Nikolaevna, Starovojtova M; Pereira da Silva, José António; Stamenkovic, Bojana; Riemekasten, Gabriela; Rednic, Simona; Sibilia, Jean; Wiland, Piotr; Tarner, Ingo; Smith, Vanessa; Onken, Anna T; Abdel Atty Mohamed, Walid Ahmed; Distler, Oliver; Morović-Vergles, Jadranka; Himsel, Andrea; de la Peña Lefebvre, Paloma Garcia; Hügle, Thomas; Walker, Ulrich A

    2012-02-20

    Erectile dysfunction (ED) is common in men with systemic sclerosis (SSc) but the demographics, risk factors and treatment coverage for ED are not well known. This study was carried out prospectively in the multinational EULAR Scleroderma Trial and Research database by amending the electronic data-entry system with the International Index of Erectile Function-5 and items related to ED risk factors and treatment. Centres participating in this EULAR Scleroderma Trial and Research substudy were asked to recruit patients consecutively. Of the 130 men studied, only 23 (17.7%) had a normal International Index of Erectile Function-5 score. Thirty-eight per cent of all participants had severe ED (International Index of Erectile Function-5 score ≤ 7). Men with ED were significantly older than subjects without ED (54.8 years vs. 43.3 years, P < 0.001) and more frequently had simultaneous non-SSc-related risk factors such as alcohol consumption. In 82% of SSc patients, the onset of ED was after the manifestation of the first non-Raynaud's symptom (median delay 4.1 years). ED was associated with severe cutaneous, muscular or renal involvement of SSc, elevated pulmonary pressures and restrictive lung disease. ED was treated in only 27.8% of men. The most common treatment was sildenafil, whose efficacy is not established in ED of SSc patients. Severe ED is a common and early problem in men with SSc. Physicians should address modifiable risk factors actively. More research into the pathophysiology, longitudinal development, treatment and psychosocial impact of ED is needed.

  5. A Polymorphism in the Retinol Binding Protein 4 Gene is Not Associated with Gestational Diabetes Mellitus in Several Different Ethnic Groups

    PubMed Central

    Urschitz, Johann; Sultan, Omar; Ward, Kenneth

    2011-01-01

    Objective Various Asian and Pacifific Islander groups have higher prevalence rates of type 2 diabetes and gestational diabetes. This increased incidence is likely to include genetic factors. Single nucleotide polymorphisms in the retinol binding protein 4 gene have been linked to the occurrence of type 2 diabetes. Hypothesizing a link between retinol binding protein 4 and gestational diabetes, we performed a candidate gene study to look for an association between an important retinol binding protein gene polymorphism (rs3758539) and gestational diabetes. Study Design Blood was collected from Caucasian, Asian, and Pacific Islander women diagnosed with gestational diabetes and from ethnically matched non-diabetic controls. DNA was extracted and real time PCR technology (TaqMan, Applied Biosystems) used to screen for the rs3758539 single nucleotide polymorphism located 5′ of exon 1 of the retinol binding protein 4 gene. Results Genotype and allele frequencies in the controls and gestational diabetes cases were tested using chi-square contingency tests. Genotype frequencies were in Hardy-Weinberg equilibrium. There was no association between the rs3758539 retinol binding protein 4 single nucleotide polymorphism and gestational diabetes in the Caucasian, Filipino, or Pacific Islander groups. Conclusion Interestingly, the rs3758539 retinol binding protein 4 single nucleotide polymorphism was not found to be associated with gestational diabetes. The absence of association suggests that gestational and type 2 diabetes may have more divergent molecular pathophysiology than previously suspected. PMID:21886308

  6. Phasic jaw motor episodes in healthy subjects with or without clinical signs and symptoms of sleep bruxism: a pilot study.

    PubMed

    Yoshizawa, Shuichiro; Suganuma, Takeshi; Takaba, Masayuki; Ono, Yasuhiro; Sakai, Takuro; Yoshizawa, Ayako; Kawana, Fusae; Kato, Takafumi; Baba, Kazuyoshi

    2014-03-01

    To investigate the association between each clinical diagnosis criterion for sleep bruxism (SB) and the frequency of jaw motor events during sleep. Video-polysomnography was performed on 17 healthy adult subjects (mean age, 26.7 ± 2.8 years), with at least one of the following clinical signs and symptoms of SB: (1) a report of frequent tooth grinding, (2) tooth attrition with dentine exposure through at least three occlusal surfaces, (3) morning masticatory muscle symptoms, and (4) masseter muscle hypertrophy. Episodes of rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored visually. These variables were compared with regards to the presence or absence of each clinical sign and symptom. In 17 subjects, 4.0 ± 2.5/h (0.1-10.2) RMMA and 1.0 ± 0.8/h (0-2.4) isolated tonic episodes were observed (total episodes: 5.0 ± 2.4/h (1.2-11.6)). Subjects with self-reported grinding sounds (n=7) exhibited significantly higher numbers of RMMA episodes (5.7 ± 2.3/h) than those without (n=10; 2.8 ± 1.8/h) (p=0.011). Similarly, subjects with tooth attrition (n=6) showed significantly higher number of RMMA episodes (5.6 ± 3.1/h) than those without (n=11; 3.2 ± 1.6/h) (p=0.049). The occurrence of RMMA did not differ between the presence and absence of morning masticatory muscle symptoms or muscle hypertrophy. Clinical signs and symptoms frequently used for diagnosing SB can represent different clinical and physiological aspects of jaw motor activity during sleep.

  7. [Pandemic influenza A in the ICU: experience in Spain and Latin America. GETGAG/SEMICYUC/(Spanish Working Group on Severe Pandemic Influenza A/SEMICYUC)].

    PubMed

    Rodríguez, A; Socías, L; Guerrero, J E; Figueira, J C; González, N; Maraví-Poma, E; Lorente, L; Martín, M; Albaya-Moreno, A; Algora-Weber, A; Vallés, J; León-Gil, C; Lisboa, T; Balasini, C; Villabón, M; Pérez-Padilla, R; Barahona, D; Rello, J

    2010-03-01

    Pandemic Influenza A (H1N1)v infection is the first pandemic in which intensive care units (ICU) play a fundamental role. It has spread very rapidly since the first cases were diagnosed in Mexico with the subsequent spread of the virus throughout the Southern Cone and Europe during the summer season. This study has aimed to compare the clinical presentation and outcome among the critical patients admitted to the ICU until July 31, 2009 in Spain with some series from Latin America. Six series of critically ill patients admitted to the ICU were considered. Clinical characteristics, complications and outcome were compared between series. Young patients (35-45 years) with viral pneumonia as a predominant ICU admission cause with severe respiratory failure and a high need of mechanical ventilation (60-100%) were affected. Obesity, pregnancy and chronic lung disease were risk factors associated with a worse outcome, however there was a high number of patients without comorbidities (40-50%). Mortality rate was between 25-50% and higher in the Latin America series, demonstrating the specific potential pathogenesis of the new virus. The use of antiviral treatment was delayed (between 3 and 6 days) and not generalized, with greater delay in Latin America in regards to Spain. These data suggest that a more aggressive treatment strategy, with earlier and easier access to the antiviral treatment might reduce the number of ICU admissions and mortality. Copyright 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  8. Validation of a multi-residue method for the determination of several antibiotic groups in honey by LC-MS/MS.

    PubMed

    Bohm, Detlef A; Stachel, Carolin S; Gowik, Petra

    2012-07-01

    The presented multi-method was developed for the confirmation of 37 antibiotic substances from the six antibiotic groups: macrolides, lincosamides, quinolones, tetracyclines, pleuromutilines and diamino-pyrimidine derivatives. All substances were analysed simultaneously in a single analytical run with the same procedure, including an extraction with buffer, a clean-up by solid-phase extraction, and the measurement by liquid chromatography tandem mass spectrometry in ESI+ mode. The method was validated on the basis of an in-house validation concept with factorial design by combination of seven factors to check the robustness in a concentration range of 5-50 μg kg(-1). The honeys used were of different types with regard to colour and origin. The values calculated for the validation parameters-decision limit CCα (range, 7.5-12.9 μg kg(-1)), detection capability CCβ (range, 9.4-19.9 μg kg(-1)), within-laboratory reproducibility RSD(wR) (<20% except for tulathromycin with 23.5% and tylvalosin with 21.4 %), repeatability RSD(r) (<20% except for tylvalosin with 21.1%), and recovery (range, 92-106%)-were acceptable and in agreement with the criteria of Commission Decision 2002/657/EC. The validation results showed that the method was applicable for the residue analysis of antibiotics in honey to substances with and without recommended concentrations, although some changes had been tested during validation to determine the robustness of the method.

  9. Matched sibling versus matched unrelated allogeneic hematopoietic stem cell transplantation in children with severe acquired aplastic anemia: experience of the polish pediatric group for hematopoietic stem cell transplantation.

    PubMed

    Szpecht, Dawid; Gorczyńska, Ewa; Kałwak, Krzysztof; Owoc-Lempach, Joanna; Choma, Marta; Styczyński, Jan; Goździk, Jolanta; Dłużniewska, Agnieszka; Wysocki, Mariusz; Kowalczyk, Jerzy R; Chybicka, Alicja; Pieczonka, Anna; Wachowiak, Jacek

    2012-06-01

    In the study, 48 children with severe acquired aplastic anemia (SAA) transplanted from matched sibling donor (MSD) between 1991 and 2009, and 38 children with SAA transplanted from matched unrelated donor (MUD) between 2000 and 2009 were evaluated. Engraftment was achieved in 45 (93.75 %) patients after MSD-hematopoietic stem cell transplantation (HSCT) and in 33 (86.8 %) after MUD-HSCT. Transplant-related mortality rate after MSD-HSCT was 8 %, while 37 % after MUD-HSCT. After MSD-HSCT 44 (91.7 %) patients are alive for 1-216 months (median: 85 months), while after MUD-HSCT 24 (63.2 %) patients for 1-84 months (median: 16 months). The 5-year probability of event-free survival after MSD-HSCT and MUD-HSCT was 87 and 53 %, respectively, while 5 years of overall survival was 91 and 64 %, respectively. It was concluded that MSD-HSCT as the first line treatment for children with SAA is a safe therapeutic approach with a low rate of treatment failures and excellent outcome. Results of MUD-HSCT in pediatric patients with SAA who failed to respond to immunosuppressive therapy are still inferior than those of MSD-HSCT. Treatment failures of MUD-HSCT are mainly related to infectious complications and graft failure. It seems, however, that HLA-matching of unrelated donors at allelic level along with early MUD-HSCT after FCA (FLUDA, low-dose cyclophosphamide, and anti-thymocyte globulin) conditioning, perhaps using lower Thymoglobulin dose could enable further improvement of long-term results in children with SAA who lack MSD.

  10. A community study of sleep bruxism in Hong Kong children: association with comorbid sleep disorders and neurobehavioral consequences.

    PubMed

    Lam, M H B; Zhang, Jihui; Li, A M; Wing, Y K

    2011-08-01

    The prevalence of childhood sleep bruxism (SB) varied from 5% to 46% among various studies. In addition to local facial and dental adverse consequences, accumulating evidence suggests that childhood SB could be associated with comorbid sleep and systemic neurobehavioral disturbances. This study attempted to investigate the prevalence and clinical correlates of SB in a large community sample. This study was part of an ongoing epidemiologic study about sleep problems among Hong Kong Chinese children. A total of 9172 questionnaires were distributed to children of grades 1-6 from 13 randomly selected primary schools. Parents of the children were asked to complete and return the Hong Kong children sleep questionnaire, which aimed to explore the sleep problems and patterns of their children. Six thousand three hundred and eighty-nine questionnaires with valid answers to SB were received and the response rate was 69.7%. The mean age of the recruited children was 9.2±1.8years (50.6%, boys). The prevalence of SB with teeth grinding frequency more than thrice weekly over the past year was 5.9%. SB was more prevalent among boys with decreasing prevalence across age. SB was associated with chronic medical diseases, sleep-related breathing problem, upper respiratory infection, and other parasomnia features, especially sleep talking (OR (95%CI)=4.07 (2.33-7.11)). Children with SB were more likely noticed by their parents to be hyperactive (OR (95%CI)=1.61 (1.25-2.07)) and bad-tempered (OR (95%CI)=1.69 (1.35-2.12)) and had deterioration in their academic performance (OR (95%CI)=1.22(1.03-1.43)). Almost 6% of Hong Kong primary schoolchildren suffered from frequent SB. The condition was most prevalent among young boys. SB was found to be associated with a variety of medical conditions, neuropsychiatric sequelae, and comorbid sleep conditions, especially sleep talking and sleep related breathing problems. Further prospective studies will need to clarify the longitudinal course of

  11. Could transient hypoxia be associated with rhythmic masticatory muscle activity in sleep bruxism in the absence of sleep-disordered breathing? A preliminary report.

    PubMed

    Dumais, I E; Lavigne, G J; Carra, M C; Rompré, P H; Huynh, N T

    2015-11-01

    Sleep bruxism (SB) is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth during sleep. Sleep bruxism activity is characterised by rhythmic masticatory muscle activity (RMMA). Many but not all RMMA episodes are associated with sleep arousal. The aim of this study was to evaluate whether transient oxygen saturation level change can be temporally associated with genesis of RMMA/SB. Sleep laboratory or home recordings data from 22 SB (tooth grinding history in the absence of reported sleep-disordered breathing) and healthy subjects were analysed. A total of 143 RMMA/SB episodes were classified in four categories: (i) no arousal + no body movement; (ii) arousal + no body movement; (iii) no arousal + body movement; (iv) arousal + body movement. Blood oxygen levels (SaO2 ) were assessed from finger oximetry signal at the baseline (before RMMA), and during RMMA. Significant variation in SaO2 over time (P = 0·001) was found after RMMA onset (+7 to +9 s). No difference between categories (P = 0·91) and no interaction between categories and SaO2 variation over time (P = 0·10) were observed. SaO2 of six of 22 subjects (27%) remained equal or slight increase after the RMMA/SB onset (+8 s) compared to baseline; 10 subjects (45%) slightly decreased (drop 0·01-1%) and the remaining (27%) decreased between 1% and 2%. These preliminary findings suggest that a subgroup of SB subjects had (i) a minor transient hypoxia potentially associated with the onset of RMMA episodes, and this (ii) independently of concomitant sleep arousal or body movements. © 2015 John Wiley & Sons Ltd.

  12. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This month's insert, Severe Weather, has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in this poster are hurricanes,…

  13. Severe Weather

    ERIC Educational Resources Information Center

    Forde, Evan B.

    2004-01-01

    Educating the public about safety issues related to severe weather is part of the National Oceanic and Atmospheric Administration's (NOAA) mission. This article deals with a poster entitled, "Severe Weather," that has been created by NOAA to help educate the public about hazardous weather conditions. The four types of severe weather highlighted in…

  14. Exploratory double-blind, parallel-group, placebo-controlled study of edaravone (MCI-186) in amyotrophic lateral sclerosis (Japan ALS severity classification: Grade 3, requiring assistance for eating, excretion or ambulation).

    PubMed

    2017-10-01

    Our objective was to explore the efficacy and safety of edaravone in amyotrophic lateral sclerosis (ALS) patients with a Japan ALS severity classification of Grade 3. In a 24-week, double-blind, randomized study, 25 patients who met all of the following criteria were enrolled: Japan ALS severity classification Grade 3; definite, probable, or probable-laboratory supported ALS (El Escorial/revised Airlie House); forced vital capacity (%FVC) ≥60%; duration of disease ≤3 years at consent; and change in the revised ALS functional rating scale (ALSFRS-R) score of -1 to -4 points during the 12-week pre-observation period. Patients received edaravone (n = 13) or placebo (n = 12) for six cycles. The efficacy outcome was change in the ALSFRS-R score. The least-squares mean change in the ALSFRS-R score ± standard error during the 24-week treatment was -6.52 ± 1.78 in the edaravone group and -6.00 ± 1.83 in the placebo group; the difference of -0.52 ± 2.46 was not statistically significant (p = 0.835). Incidence of adverse events was 92.3% (12/13) in the edaravone group and 100.0% (12/12) in the placebo group. There was no intergroup difference in the changes in the ALSFRS-R score. The incidences of adverse events were similar in the two groups.

  15. Sever's Disease

    MedlinePlus

    ... immobilize the foot so that it can heal. Recovery and Recurrence One of the most important things ... The sooner Sever's disease is addressed, the quicker recovery is. Most kids can return to physical activity ...

  16. Prophylactic tetracycline does not diminish the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash: results from the North Central Cancer Treatment Group (Supplementary N03CB).

    PubMed

    Jatoi, Aminah; Dakhil, Shaker R; Sloan, Jeff A; Kugler, John W; Rowland, Kendrith M; Schaefer, Paul L; Novotny, Paul J; Wender, Donald B; Gross, Howard M; Loprinzi, Charles L

    2011-10-01

    Previous studies suggest tetracycline and other antibiotics lessen the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash. This study sought to confirm such findings. Patients starting an EGFR inhibitor were eligible for this randomized, double-blinded, placebo-controlled study and had to be rash-free. They were then randomly assigned to tetracycline 500 mg orally twice a day for 28 days versus a placebo. Rash development and severity (monthly physician assessment and weekly patient-reported questionnaires), quality of life (SKINDEX-16), and adverse events were monitored during the 4-week intervention and then for an additional 4 weeks. The primary objective was to compare the incidence of grade 2 or worse rash between study arms; 32 patients per group provided a 90% probability of detecting a 40% difference in incidence with a type I error rate of 0.05 (two-sided). Sixty-five patients were enrolled, and groups were balanced on baseline characteristics. During the first 4 weeks, healthcare provider-reported data found that 27 tetracycline-treated patients (82%) and 24 placebo-exposed patients (75%) developed a rash. This rash was a grade 2+ in 17 (52%) and 14 (44%), respectively (p = 0.62). Comparable grade 2+ rash rates were observed during weeks 5 through 8 as well as with patient-reported rash data throughout the study period. Quality of life was comparable across study arms, and tetracycline was well tolerated. Although previous studies suggest otherwise, this randomized, double-blinded, placebo-controlled study did not find that tetracycline lessened rash incidence or severity in patients who were taking EGFR inhibitors.

  17. Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial.

    PubMed

    Chupp, Geoffrey L; Bradford, Eric S; Albers, Frank C; Bratton, Daniel J; Wang-Jairaj, Jie; Nelsen, Linda M; Trevor, Jennifer L; Magnan, Antoine; Ten Brinke, Anneke

    2017-05-01

    Mepolizumab, an anti-interleukin-5 monoclonal antibody approved as add-on therapy to standard of care for patients with severe eosinophilic asthma, has been shown in previous studies to reduce exacerbations and dependency on oral corticosteroids compared with placebo. We aimed to further assess mepolizumab in patients with severe eosinophilic asthma by examining its effect on health-related quality of life (HRQOL). We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial (MUSCA) in 146 hospitals or research centres in 19 countries worldwide. Eligible participants were patients aged 12 years or older with severe eosinophilic asthma and a history of at least two exacerbations requiring treatment in the previous 12 months before screening despite regular use of high-dose inhaled corticosteroids plus other controller medicines. Exclusion criteria included current smokers or former smokers with a history of at least ten pack-years. We randomly assigned participants (1:1) by country to receive a subcutaneous injection of either mepolizumab 100 mg or placebo, plus standard of care, every 4 weeks for 24 weeks (the final dose was given at week 20). We did the randomisation using an interactive voice response system and a centralised, computer-generated, permuted-block design of block size six. The two treatments were identical in appearance and administered in a masked manner; patients, investigators, other site staff and the entire study team including those assessing outcomes data were also masked to group assignment. The primary endpoint was the mean change from baseline in the St George's Respiratory Questionnaire (SGRQ) total score at week 24 in the modified intention-to-treat (modified ITT) population (analysed according to their randomly assigned treatment). Safety was assessed in all patients who received at least one dose of trial medication (analysed according to the actual treatment received). This trial is registered

  18. Radiotherapy Does Not Influence the Severe Pulmonary Toxicity Observed With the Administration of Gemcitabine and Bleomycin in Patients With Advanced-Stage Hodgkin's Lymphoma Treated With the BAGCOPP Regimen: A Report by the German Hodgkin's Lymphoma Study Group

    SciTech Connect

    Macann, Andrew; Bredenfeld, Henning; Mueller, Rolf-Peter

    2008-01-01

    Purpose: To evaluate the effect of radiotherapy on the severe pulmonary toxicity observed in the pilot study of BAGCOPP (bleomycin, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone, and gemcitabine) for advanced-stage Hodgkin's lymphoma. Methods and Materials: Patients with Stage III or IV Hodgkin's lymphoma or Stage IIB with risk factors participated in this single-arm, multicenter pilot study. Results: Twenty-seven patients were enrolled on the study before its premature closure as a result of the development of serious pulmonary toxicity in 8 patients. The pulmonary toxicity occurred either during or immediately after the BAGCOPP chemotherapy course. Pulmonary toxicity contributed to one early fatalitymore » but resolved in the other 7 patients after cessation of gemcitabine and bleomycin, allowing continuation of therapy. Fifteen patients received consolidative radiotherapy, including 4 who previously had pulmonary toxicity. There were no reported cases of radiation pneumonitis and no exacerbation of pulmonary symptoms in the 4 patients who had had previous pulmonary toxicity. Conclusions: The severe pulmonary toxicity observed in this study has been attributed to an interaction between gemcitabine and bleomycin. Gemcitabine (when administered without bleomycin) remains of interest in Hodgkin's lymphoma and is being incorporated into a new German Hodgkin's Lymphoma Study Group protocol that also includes consolidative radiotherapy. This study supports the concept of the integration of radiotherapy in gemcitabine-containing regimens in Hodgkin's lymphoma if there is an interval of at least 4 weeks between the two modalities and with a schedule whereby radiotherapy follows the chemotherapy.« less

  19. Sub-group Analyses from a Trial of a Fixed Combination of Clindamycin Phosphate 1.2% and Benzoyl Peroxide 3.75% Gel for the Treatment of Moderate-to-severe Acne Vulgaris

    PubMed Central

    Korotzer, Andrew

    2015-01-01

    Background: Acne vulgaris is commonplace and can be difficult to manage. Providing an effective and well-tolerated treatment may lead to improved adherence, increased patient satisfaction, and improved clinical outcomes. Methods: A review of efficacy, safety, and cutaneous tolerability of clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel in 498 patients with moderate-to-severe acne vulgaris enrolled in a multicenter Phase III study randomized to receive active or vehicle once daily for 12 weeks, including the most recent post-hoc analyses. Results: Significantly superior reductions in lesion counts were observed with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel from Week 4, with median percent reductions in inflammatory and noninflammatory lesions from baseline of 68.4 and 57.9 percent, respectively (bothp<0.001 versus vehicle). More than half (55.1%) of the severe acne vulgaris patients treated with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel achieved ≥2-grade improvement from baseline in their Evaluator’s Global Severity Score, and almost a third of the adolescent acne vulgaris patients (32.4%) achieved at least a marked improvement in their acne vulgaris as early as Week 2. In adult female acne overall treatments success was achieved in 52.7 percent of patients treated with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel. Overall, and in the specific subpopulations, clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel was well-tolerated with a similar adverse event profile to vehicle. Limitations: Post-hoc analyses from a single clinical trial with demographic imbalances that could potentially confound the results. Conclusion: Clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel appears to be effective in treating acne across various clinically relevant sub-groups. PMID:26705445

  20. Veterinary practice and occupational health. An epidemiological study of several professional groups of Dutch veterinarians. I. General physical examination and prevalence of allergy, lung function disorders, and bronchial hyperreactivity.

    PubMed

    Elbers, A R; Blaauw, P J; de Vries, M; van Gulick, P J; Smithuis, O L; Gerrits, R P; Tielen, M J

    1996-12-01

    The prevalence of allergy, lung function disorders, and bronchial hyperreactivity was studied in 102 Dutch veterinarians, subdivided into five professional groups (predominantly working with either swine, cattle, poultry, companion animals, or as a non-practitioner). The mean age of the participants was 43 years; 6 participants were females. Twenty-two per cent of the participants were overweight, and relatively more non-practitioners than practitioners were overweight. Approximately 23% of the vets reported complaints of prolonged fatigue. The data suggest a relationship between complaints of prolonged fatigue and a more than average number of daily working hours. Only a small proportion of vets were sensitized against several allergens. There were no significant differences in prevalence of distinct lung function disorders or bronchial hyperreactivity between professional groups. It is hypothesized that the respiratory complaints (chronic coughing, chronic phlegm production, stuffed nose, sneezing) reported by the vets predominantly working in swine and/or poultry practice could be caused by irritation and/or inflammation of the first part of the trachea-bronchial tree that has no measurable and permanent consequences for changes in lung function or increased bronchial hyperreactivity. The results of a skin test against allergens and determination of allergen-specific IgE in blood indicated that the respiratory complaints were probably not related to allergy against the panel of allergens tested.

  1. Long-term variability of sleep bruxism and psychological stress in patients with jaw-muscle pain: Report of two longitudinal clinical cases.

    PubMed

    Muzalev, K; Visscher, C M; Koutris, M; Lobbezoo, F

    2018-02-01

    Sleep bruxism (SB) and psychological stress are commonly considered as contributing factors in the aetiology of temporomandibular disorder (TMD) pain. However, the lack of longitudinal studies and fluctuating nature of SB, psychological stress and TMD pain have led to contradictory results regarding the association between the possible aetiological factors and TMD pain. In the present study we investigated the contribution of SB and psychological stress to TMD pain in a longitudinal study of 2 clinical TMD pain cases during a 6-week study protocol. Two female volunteers with clinically diagnosed myalgia based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) participated in the study. Questionnaires were used to record jaw-muscle pain and psychological stress experience, and an ambulatory polysomnography technique was used to record SB intensity. Visual analysis of the data revealed that the intensity of TMD pain was not hardwired, neither with psychological stress experience nor with increased SB activity. Within the limitations of single-patient clinical cases design, our study suggested that the presence of TMD pain cannot be explained by a simple linear model which takes psychological stress or SB into account. It also seems that psychological stress was a more important predictor factor for TMD pain than SB. © 2017 John Wiley & Sons Ltd.

  2. Frequency of awake bruxism behaviours in the natural environment. A 7-day, multiple-point observation of real-time report in healthy young adults.

    PubMed

    Bracci, A; Djukic, G; Favero, L; Salmaso, L; Guarda-Nardini, L; Manfredini, D

    2018-06-01

    The aim of this study was to assess awake bruxism (AB) behaviours in a sample of healthy young adults using a smartphone-based application for a real-time report (ie, ecological momentary assessment [EMA], also called experience sampling method [ESM]). Forty-six dental students used a smartphone application that sent 15 alerts at random intervals during the day for 1 week to collect AB self-reports. They had to answer on time by tapping on the display icon that refers to their current condition of jaw muscles: relaxed; teeth contact; teeth clenching; teeth grinding; jaw clenching without teeth contact (ie, bracing). The average frequency of relaxed jaw muscles, as a percentage of answers over the 7 days, was 71.7%. Teeth contact (14.5%) and jaw clenching (10.0%) were the most frequent AB behaviours. No significant gender differences were detected. Interindividual differences were quite relevant, but the overall frequency was in general only moderately variable from day-to-day. Coefficient of variation (CV) was low for the condition "relaxed jaw muscles" (0.44). At the individual level, teeth contact was the most prevalent behaviour, with a 39.1%-52.2% proportion of subjects reporting it at least once a day. During a 7-day observation period, the frequency of real-time report of AB behaviours in a sample of healthy young adults was 28.3%. The low daily variability in the average frequency value for the relaxed jaw muscles condition suggests that EMA may be a reliable strategy to get deeper into the epidemiology of oral behaviours. This investigation introduced EMA principles to the study of AB and provided data on the frequency of AB behaviours in young adults that could be compared to populations with risk/associated factors and possible clinical consequences. © 2018 John Wiley & Sons Ltd.

  3. Predictors of severe systemic anaphylactic reactions in patients with Hymenoptera venom allergy: importance of baseline serum tryptase-a study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity.

    PubMed

    Ruëff, Franziska; Przybilla, Bernhard; Biló, Maria Beatrice; Müller, Ulrich; Scheipl, Fabian; Aberer, Werner; Birnbaum, Joëlle; Bodzenta-Lukaszyk, Anna; Bonifazi, Floriano; Bucher, Christoph; Campi, Paolo; Darsow, Ulf; Egger, Cornelia; Haeberli, Gabrielle; Hawranek, Thomas; Körner, Michael; Kucharewicz, Iwona; Küchenhoff, Helmut; Lang, Roland; Quercia, Oliviero; Reider, Norbert; Severino, Maurizio; Sticherling, Michael; Sturm, Gunter Johannes; Wüthrich, Brunello

    2009-11-01

    Severe anaphylaxis to honeybee or vespid stings is associated with a variety of risk factors, which are poorly defined. Our aim was to evaluate the association of baseline serum tryptase concentrations and other variables routinely recorded during patient evaluation with the frequency of past severe anaphylaxis after a field sting. In this observational multicenter study, we enrolled 962 patients with established bee or vespid venom allergy who had a systemic reaction after a field sting. Data were collected on tryptase concentration, age, sex, culprit insect, cardiovascular medication, and the number of preceding minor systemic reactions before the index field sting. A severe reaction was defined as anaphylactic shock, loss of consciousness, or cardiopulmonary arrest. The index sting was defined as the hitherto first, most severe systemic field-sting reaction. Relative rates were calculated with generalized additive models. Two hundred six (21.4%) patients had a severe anaphylactic reaction after a field sting. The frequency of this event increased significantly with higher tryptase concentrations (nonlinear association). Other factors significantly associated with severe reactions after a field sting were vespid venom allergy, older age, male sex, angiotensin-converting enzyme inhibitor medication, and 1 or more preceding field stings with a less severe systemic reaction. In patients with honeybee or vespid venom allergy, baseline serum tryptase concentrations are associated with the risk for severe anaphylactic reactions. Preventive measures should include substitution of angiotensin-converting enzyme inhibitors.

  4. Severe cerebral white matter involvement in a case of dentatorubropallidoluysian atrophy studied at autopsy.

    PubMed

    Muñoz, Esteban; Campdelacreu, Jaume; Ferrer, Isidre; Rey, María J; Cardozo, Adriana; Gómez, Beatriz; Tolosa, Eduardo

    2004-06-01

    The pathophysiology of white matter involvement in dentatorubropallidoluysian atrophy (DRPLA) is controversial. Moreover, the clinical repercussions and evolution of these lesions have not been well documented. To describe a case of DRPLA with severe cerebellar white matter involvement. Case report. Patient A 62-year-old woman with DRPLA. When the genetic diagnosis was made, the patient manifested severe ataxia, slight dysarthria, and subcortical cognitive impairment. Cranial magnetic resonance imaging showed atrophy of the cerebellum and brainstem and moderate high-intensity signal alterations in the periventricular cerebral white matter in T2-weighted sequences. In the following 5 years, she developed uncontrolled head movements associated with severe bruxism and tetraparesis, and became deeply demented. New magnetic resonance imaging showed severe diffuse cerebral white matter alterations in T2 sequences with only slight progression of brainstem and cerebellar atrophy. After her death at 67 years of age, the autopsy study showed diffuse myelin pallor, axonal preservation, and reactive astrogliosis in the cerebral white matter, with only mild atherosclerotic changes, and moderate neuronal loss in the cerebellum and brainstem. Leukoencephalopathy could be a prominent finding in some patients with DRPLA, explaining, at least in part, their clinical evolution. In our case, the disproportion between the severity of white matter damage and vascular changes does not support a cardinal role for ischemic mechanisms in leukoencephalopathy.

  5. Gestalt Interactional Groups

    ERIC Educational Resources Information Center

    Harman, Robert L.; Franklin, Richard W.

    1975-01-01

    Gestalt therapy in groups is not limited to individual work in the presence of an audience. Describes several ways to involve gestalt groups interactionally. Interactions described focus on learning by doing and discovering, and are noninterpretive. (Author/EJT)

  6. Allergy in severe asthma.

    PubMed

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  8. Cardiovascular group

    NASA Technical Reports Server (NTRS)

    Blomqvist, Gunnar

    1989-01-01

    As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

  9. Integrated Play Groups

    ERIC Educational Resources Information Center

    Glovak, Sandra

    2007-01-01

    As an occupational therapist running social play groups with sensory integration for children on the autism spectrum, the author frequently doubted the wisdom of combining several children on the spectrum into a group. In fact, as the owner of a clinic she said, "No more!" The groups seemed like a waste of parents' time and money, and she refused…

  10. Treatment of severe tinnitus.

    PubMed

    Laurikainen, E; Johansson, R; Akaan-Penttilä, E; Haapaniemi, J

    2000-01-01

    In 1995-96 we selected a group of 26 patients who were suffering from severe invalidating idiopathic tinnitus (IT) in order to evaluate the efficacy of rehabilitation and some alternative therapies. All patients were assessed thoroughly by means of audiology and radiology regarding any objective cause for the symptom. In order to help patients control their symptom by increasing knowledge and adding supportive elements, they were given basic education (presentations of the anatomy and physiology of the ear and hearing system, psychological and social aspects of IT, guided and non-guided group discussions, relaxation therapy, physiotherapy, music therapy) for 4 months, comprising one 2-h session bi-weekly. This type of group therapy was found to be extremely helpful, although no objective evaluation revealed effects on IT sensation (VAS) or psychometric measures (SLC-90). In a second limb of the study, the same patients attended a 6-day intensive course in a spa. The purpose was to evaluate the possible usefulness of the widely recommended alternative therapies for IT. All patients had an opportunity to sample the treatments. Six months later only a few had tried any of these treatments, but all reported that the lessons were the most helpful in association with supportive group discussions. The results indicated that none of these therapies can be recommended, based on rational medical practise.

  11. The evolution of HIV-1 group M genetic variability in Southern Cameroon is characterized by several emerging recombinant forms of CRF02_AG and viruses with drug resistance mutations.

    PubMed

    Agyingi, Lucy; Mayr, Luzia M; Kinge, Thompson; Orock, George Enow; Ngai, Johnson; Asaah, Bladine; Mpoame, Mbida; Hewlett, Indira; Nyambi, Phillipe

    2014-03-01

    The HIV epidemic in Cameroon is marked by a broad genetic diversity dominated by circulating recombinant forms (CRFs). Studies performed more than a decade ago in urban settings of Southern Cameroon revealed a dominance of the CRF02_AG and clade A variants in >90% of the infected subjects; however, little is known about the evolving viral variants circulating in this region. To document circulating HIV viral diversity, four regions of the viral genome (gag, PR, reverse transcriptase, env) in 116 HIV-1 positive individuals in Limbe, Southern Cameroon, were PCR-amplified. Sequences obtained at the RT and protease regions were analyzed for mutations that conferred drug resistance using the Stanford Drug Resistance Database. The present study reveals a broad genetic diversity characterized by several unique recombinant forms (URF) accounting for 36% of infections, 48.6% of patients infected with CRF02_AG, and the emergence of CRF22_01A1 in 7.2% of patients. Three out of 15 (20%) treated patients and 13 out of 93 (13.9%) drug naïve patients harbor drug resistance mutations to RT inhibitors, while 3.2% of drug naïve patients harbor drug resistance mutations associated with protease inhibitors. The high proportion (13.9%) of drug resistance mutations among the drug naïve patients reveals the ongoing transmission of these viruses in this region of Cameroon and highlights the need for drug resistance testing before starting treatment for patients infected with HIV-1. © 2013 Wiley Periodicals, Inc.

  12. Ferritin levels predict severe dengue.

    PubMed

    Soundravally, R; Agieshkumar, B; Daisy, M; Sherin, J; Cleetus, C C

    2015-02-01

    Currently, no tests are available to monitor and predict severity and outcome of dengue. To find potential markers that predict dengue severity, the present study validated the serum level of three acute-phase proteins α-1 antitrypsin, ceruloplasmin and ferritin in a pool of severe dengue cases compared to non-severe forms and other febrile illness controls. A total of 96 patients were divided into two equal groups with group 'A' comprising dengue-infected cases and group 'B' with other febrile illness cases negative for dengue. Out of 48 dengue-infected cases, 13 had severe dengue and the remaining 35 were classified as non-severe dengue. Immunoassays were performed to evaluate the serum levels of acute-phase proteins both on the day of admission and on the day of defervescence. The efficiency of individual proteins in predicting the disease severity was assessed using receiver operating characteristic curve. The study did not find any significant difference in the levels of α-1 antitrypsin between the clinical groups. A significant increase in the levels of ceruloplasmin around defervescence in severe cases compared to non-severe and other febrile controls was observed and this is the first report describing the potential association of ceruloplasmin and dengue severity. Interestingly, a steady increase in the level of serum ferritin was recorded throughout the course of illness. Among all the three proteins, the elevated ferritin level could predict the disease severity with highest sensitivity and specificity of 76.9 and 83.3 %, respectively, on the day of admission and the same was found to be 90 and 91.6 % around defervescence. On the basis of this diagnostic efficiency, we propose that ferritin may serve as a potential biomarker for an early prediction of disease severity.

  13. Group X

    SciTech Connect

    Fields, Susannah

    2007-08-16

    This project is currently under contract for research through the Department of Homeland Security until 2011. The group I was responsible for studying has to remain confidential so as not to affect the current project. All dates, reference links and authors, and other distinguishing characteristics of the original group have been removed from this report. All references to the name of this group or the individual splinter groups has been changed to 'Group X'. I have been collecting texts from a variety of sources intended for the use of recruiting and radicalizing members for Group X splinter groups for themore » purpose of researching the motivation and intent of leaders of those groups and their influence over the likelihood of group radicalization. This work included visiting many Group X websites to find information on splinter group leaders and finding their statements to new and old members. This proved difficult because the splinter groups of Group X are united in beliefs, but differ in public opinion. They are eager to tear each other down, prove their superiority, and yet remain anonymous. After a few weeks of intense searching, a list of eight recruiting texts and eight radicalizing texts from a variety of Group X leaders were compiled.« less

  14. Group Flow and Group Genius

    ERIC Educational Resources Information Center

    Sawyer, Keith

    2015-01-01

    Keith Sawyer views the spontaneous collaboration of group creativity and improvisation actions as "group flow," which organizations can use to function at optimum levels. Sawyer establishes ideal conditions for group flow: group goals, close listening, complete concentration, being in control, blending egos, equal participation, knowing…

  15. Isopermutation group

    SciTech Connect

    Muktibodh, A. S.

    2015-03-10

    The concept of ‘Isotopy’ as formulated by Ruggero Maria Santilli [1, 2, 3] plays a vital role in the development of Iso mathematics. Santilli defined iso-fields of characteristic zero. In this paper we extend this definition to define Iso-Galois fields [4] which are essentially of non-zero characteristic. Isotopically isomorphic realizations of a group define isopermutation group which gives a clear cut distinction between automorphic groups and isotopic groups.

  16. Hot Groups.

    ERIC Educational Resources Information Center

    Vail, Kathleen

    1996-01-01

    Collaborators sparked by creative ideas and obsessed by a common task may not realize they're part of a "hot group"--a term coined by business professors Harold J. Leavitt and Jean Lipman-Blumen. Spawned by group decision making and employee empowerment, hot groups can flourish in education settings. They're typically small, short lived,…

  17. Galaxy groups

    SciTech Connect

    Brent Tully, R.

    2015-02-01

    Galaxy groups can be characterized by the radius of decoupling from cosmic expansion, the radius of the caustic of second turnaround, and the velocity dispersion of galaxies within this latter radius. These parameters can be a challenge to measure, especially for small groups with few members. In this study, results are gathered pertaining to particularly well-studied groups over four decades in group mass. Scaling relations anticipated from theory are demonstrated and coefficients of the relationships are specified. There is an update of the relationship between light and mass for groups, confirming that groups with mass of a few times 10{supmore » 12}M{sub ⊙} are the most lit up while groups with more and less mass are darker. It is demonstrated that there is an interesting one-to-one correlation between the number of dwarf satellites in a group and the group mass. There is the suggestion that small variations in the slope of the luminosity function in groups are caused by the degree of depletion of intermediate luminosity systems rather than variations in the number per unit mass of dwarfs. Finally, returning to the characteristic radii of groups, the ratio of first to second turnaround depends on the dark matter and dark energy content of the universe and a crude estimate can be made from the current observations of Ω{sub matter}∼0.15 in a flat topology, with a 68% probability of being less than 0.44.« less

  18. GROUP INEQUALITY

    PubMed Central

    Bowles, Samuel; Loury, Glenn C.; Sethi, Rajiv

    2014-01-01

    We explore the combined effect of segregation in social networks, peer effects, and the relative size of a historically disadvantaged group on the incentives to invest in market-rewarded skills and the dynamics of inequality between social groups. We identify conditions under which group inequality will persist in the absence of differences in ability, credit constraints, or labor market discrimination. Under these conditions, group inequality may be amplified even if initial group differences are negligible. Increases in social integration may destabilize an unequal state and make group equality possible, but the distributional and human capital effects of this depend on the demographic composition of the population. When the size of the initially disadvantaged group is sufficiently small, integration can lower the long-run costs of human capital investment in both groups and result in an increase the aggregate skill share. In contrast, when the initially disadvantaged group is large, integration can induce a fall in the aggregate skill share as the costs of human capital investment rise in both groups. We consider applications to concrete cases and policy implications. PMID:25554727

  19. GROUP INEQUALITY.

    PubMed

    Bowles, Samuel; Loury, Glenn C; Sethi, Rajiv

    2014-02-01

    We explore the combined effect of segregation in social networks, peer effects, and the relative size of a historically disadvantaged group on the incentives to invest in market-rewarded skills and the dynamics of inequality between social groups. We identify conditions under which group inequality will persist in the absence of differences in ability, credit constraints, or labor market discrimination. Under these conditions, group inequality may be amplified even if initial group differences are negligible. Increases in social integration may destabilize an unequal state and make group equality possible, but the distributional and human capital effects of this depend on the demographic composition of the population. When the size of the initially disadvantaged group is sufficiently small, integration can lower the long-run costs of human capital investment in both groups and result in an increase the aggregate skill share. In contrast, when the initially disadvantaged group is large, integration can induce a fall in the aggregate skill share as the costs of human capital investment rise in both groups. We consider applications to concrete cases and policy implications.

  20. About the group - ATLAS group

    Science.gov Websites

    ATLAS group Studies of particle collisions at highest energy frontiers Home • About the group About the group Welcom to the home page of the ATLAS group of High-Energy Physics division of the Argonne National Laboratory ATLAS is one of the two general purpose detectors for the Large Hadron

  1. [Severe familial hypercholesterolemia treatment].

    PubMed

    Vrablík, Michal; Freiberger, Tomáš; Bláha, Vladimír; Češka, Richard

    Familial hypercholesterolemia (FH) represents the most frequent of inborn errors of metabolism. It is a group of disorders with a codominant mode of inheritance characterized by marked elevations of LDL-cholesterol as well as atherosclerotic cardiovascular disease risk. Clinical (phenotypic) picture of FH varies widely depending on genotype and concomitant risk factors. Identification of most seriously affected FH individuals is necessary for proper clinical management. The therapeutic approach must be complex and comprehensive. The corner stone of pharmacotherapy is high-intensity statin therapy usually combined with ezetimibe (possibly complemented with bile acid sequestrant). Even this multi-drug combination do not lead majority of patients to their treatment goals. Thus, combinations with other pharmacological (PCSK9 inhibitors, apoB-100 anti-sense therapy, MTP inhibition) and non-pharmacological (LDL-apheresis, liver transplantation) approaches is being used.Key words: ezetimibe - LDL-apheresis - lomitapide - mipomersen - PCSK9 inhibitors - severe familial hypercholesterolemia - statins.

  2. Empirical Bayes Estimation of Proportions in Several Groups.

    DTIC Science & Technology

    1981-01-01

    Street NW Washington, DC 20208 Dr. William Graham Testing Directorate 1 Dr. Lorraine D. Eyde MEPCOM/MEPCT-P Personnel R&D Center Ft. Sheridan, IL...D-53 BONN 1, GERMANY Princeton, NJ 08540 1 Dr. Mark D. Reckase Dr. Gary Marco Educational Psychology Dept. Educational Testing Service University of...GED Testing Service, Suite 20 Columbia, SC 29208 One Dupont Cirle, NW Washington, DC 20036 1 PROF. FUMIKO SAMEJIMA DEPT. OF PSYCHOLOGY UNIVERSITY OF

  3. Multiple Family Group Counseling

    ERIC Educational Resources Information Center

    Sauber, S. Richard

    1971-01-01

    This article describes the innovative, short term approach of multiple family group counseling in which the counseling applies the principles and dynamics found in family and group counseling to the treatment of the student and his family. Several family units met together to discuss the problems that adversely affect the adolescent and result in…

  4. Oral health in a group of patients with Rett syndrome in the regions of Valencia and Murcia (Spain): A case-control study

    PubMed Central

    Fuertes-González, María C.

    2014-01-01

    Objectives: Rett syndrome (RS) is a rare disease with oral manifestations that have not been described in detail or in a standardized manner in the literature. The present study describes the oral health of the population with RS in two Spanish regions, following the protocol of the World Health Organization for conducting common oral health surveys. Study Design: A prospective, observational case-control study was carried out, involving a group of patients with RS (n1=41) and a mean age of 13.37±3.19 years, and an age- and gender-matched control group without RS (n0=82). The data referred to oral health and habits were recorded by means of a questionnaire and oral examination was used to document caries indicators (prevalence of caries, df(t), df(s), DMF(T), DMF(S) and indices referred to dental loss, morbidity, restoration), the Community Periodontal Index (CPI), and the most characteristic oral manifestations. Results: The most frequent oral habit in the patients with RS was diurnal bruxism, followed by stereotyped tongue movements and oral breathing. The caries scores were lower in the RS population than in the control group, but patients with RS showed greater periodontal alterations and a greater prevalence of drooling, dental wear, high-arched palate and anterior open bite. Conclusions: The population with RS exhibits characteristic and early oral habits and alterations, and periodontal problems that are more notorious than caries disease, so that our efforts should focus on the diagnosis and early correction of the parafunctional habits, promoting restorative treatment, and providing instructions on correct oral hygiene. Key words:Rett syndrome, oral habits, bruxism, caries. PMID:25350594

  5. Big Sunspot Group

    NASA Image and Video Library

    2015-08-26

    A large group of sunspots that rotated across the Sun over six days (Aug. 21-26, 2015) started out as a single cluster, but gradually separated into distinct groups. This region produced several M-class (medium-sized) flares. These were the only significant spots on the Sun during this period. The still image shows the separated group as it appeared on Aug. 26., 2015. http://photojournal.jpl.nasa.gov/catalog/PIA19876

  6. Group Theatre.

    ERIC Educational Resources Information Center

    Clark, Brian

    The group interpretation approach to theatre production is defined as a method that will lead to production of plays that will appeal to "all the layers of the conscious and unconscious mind." In practice, it means that the group will develop and use resources of the theatre that orthodox companies too often ignore. The first two chapters of this…

  7. Group Work

    ERIC Educational Resources Information Center

    Wilson, Kristy J.; Brickman, Peggy; Brame, Cynthia J.

    2018-01-01

    Science, technology, engineering, and mathematics faculty are increasingly incorporating both formal and informal group work in their courses. Implementing group work can be improved by an understanding of the extensive body of educational research studies on this topic. This essay describes an online, evidence-based teaching guide published by…

  8. Artemether for severe malaria

    PubMed Central

    Esu, Ekpereonne; Effa, Emmanuel E; Opie, Oko N; Uwaoma, Amirahobu; Meremikwu, Martin M

    2014-01-01

    Background In 2011 the World Health Organization (WHO) recommended parenteral artesunate in preference to quinine as first-line treatment for people with severe malaria. Prior to this recommendation, many countries, particularly in Africa, had begun to use artemether, an alternative artemisinin derivative. This review evaluates intramuscular artemether compared with both quinine and artesunate. Objectives To assess the efficacy and safety of intramuscular artemether versus any other parenteral medication in treating severe malaria in adults and children. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE and LILACS, ISI Web of Science, conference proceedings and reference lists of articles. We also searched the WHO clinical trial registry platform, ClinicalTrials.gov and the metaRegister of Controlled Trials (mRCT) for ongoing trials up to 9 April 2014. Selection criteria Randomized controlled trials (RCTs) comparing intramuscular artemether with intravenous or intramuscular antimalarial for treating severe malaria. Data collection and analysis The primary outcome was all-cause death.Two authors independently assessed trial eligibility, risk of bias and extracted data. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD), and presented both measures with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. Main results We included 18 RCTs, enrolling 2662 adults and children with severe malaria, carried out in Africa (11) and in Asia (7). Artemether versus quinine For children in Africa, there is probably little or no difference in the risk of death between intramuscular artemether and quinine (RR 0.96, 95% CI 0.76 to 1.20; 12 trials, 1447 participants, moderate quality evidence). Coma recovery may be about five hours shorter with

  9. Group Grammar

    ERIC Educational Resources Information Center

    Adams, Karen

    2015-01-01

    In this article Karen Adams demonstrates how to incorporate group grammar techniques into a classroom activity. In the activity, students practice using the target grammar to do something they naturally enjoy: learning about each other.

  10. Group dynamics.

    PubMed

    Scandiffio, A L

    1990-12-01

    Group dynamics play a significant role within any organization, culture, or unit. The important thing to remember with any of these structures is that they are made up of people--people with different ideas, motivations, background, and sometimes different agendas. Most groups, formal or informal, look for a leader in an effort to maintain cohesiveness of the unit. At times, that cultural bond must be developed; once developed, it must be nurtured. There are also times that one of the group no longer finds the culture comfortable and begins to act out behaviorally. It is these times that become trying for the leader as she or he attempts to remain objective when that which was once in the building phase of group cohesiveness starts to fall apart. At all times, the manager must continue to view the employee creating the disturbance as an integral part of the group. It is at this time that it is beneficial to perceive the employee exhibiting problem behaviors as a special employee, as one who needs the benefit of your experience and skills, as one who is still part of the group. It is also during this time that the manager should focus upon her or his own views in the area of power, communication, and the corporate culture of the unit that one has established before attempting to understand another's point of view. Once we understand our own motivation and accept ourselves, it is then that we may move on to offer assistance to another. Once we understand our insecurities recognizing staff dysfunction as a symptom of system dysfunction will not be so threatening to the concept of the manager that we perceive ourselves to be. It takes a secure person to admit that she or he favors staff before deciding to do something to change things. The important thing to know is that it can be done. The favored staff can find a new way of relating to others, the special employee can find new modes of behavior (and even find self-esteem in the process), the group can find new ways

  11. Polyradiculopathy secondary to severe hypertriglyceridemia.

    PubMed

    Nesbitt, Cassie; Wong, Daniel; Batchelor, Peter

    2015-05-08

    A 74-year-old man presented with a subacute severe thoracic polyradiculopathy affecting the T4-T8 dermatomes bilaterally. Extensive investigation demonstrated markedly raised triglyceride levels of 44 mmol/L (<1.7). The patient's unique presentation is discussed alongside a review of triglyceride-induced neurotoxicity and therapeutic management. 2015 BMJ Publishing Group Ltd.

  12. [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].

    PubMed

    Mastro-Martínez, Ignacio; Montes-Arjona, Ana María; Escudero-Lirio, Margarita; Hernández-García, Bárbara; Fernández-Cantalejo Padial, José

    2015-01-01

    Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Group Learning.

    ERIC Educational Resources Information Center

    Black, Susan

    1992-01-01

    Research suggests that cooperative learning works best when students are first taught group-processing skills, such as leadership, decision making, communication, trust building, and conflict management. Inadequate teacher training and boring assignments can torpedo cooperative learning efforts. Administrators should reassure teachers with…

  14. Family Grouping.

    ERIC Educational Resources Information Center

    Young, Vivienne; Reich, Carol

    This report describes an observational study of one family-grouped classroom, a system in which elementary school children remain with the same teacher for two or more years. The class was composed of junior kindergarten, senior kindergarten, and grade 1 pupils. Each child was observed over a period of one year. A detailed observation schedule,…

  15. [Identifying the severe acute pancreatitis].

    PubMed

    Acevedo Tizón, Anais; Targarona Modena, Javier; Málaga Rodríguez, Germán; Barreda Cevasco, Luis

    2011-01-01

    To compare patients with acute necrotizing pancreatitis without any additional complications during their hospital stay (Group A) versus patients with Acute Necrotizing Pancreatitis with additional complications during their hospital stay (Group B). Data obtained from a pre-existing base from hospitalized patients with diagnosis of acute necrotizing pancreatitis in the specialized unit of "Unidad de Pancreatitis Aguda Grave del Hospital Nacional Edgardo Rebagliati Martins" between 2000 and 2010. Data included patients with diagnosis of acute necrotizing pancreatitis, of ages 18 and over. Data from 215 patients with acute necrotizing pancreatitis was included. Patients from Group A represented 32% (68) and from Group B 68% (147). Group A had a average of 39 hospitalized days and Group B had an average of 56 days (p=0.01). From Group A 22% had more than 50% of necrosis while 43% of Group B had this extension of necrosis (p <0.05, OR 3.4, IC (1.12-10)). Of the 14 deaths of the population, all part of Group B, 12 of them had more than 50% of necrosis. Not every patient classified as severe acute pancreatitis, based on the presence of necrosis, behave likewise. It is an extended necrosis, described as more than 50% of pancreatic necrosis, and not the presence itself which will determine additional complications during the course of disease and a greater mortality.

  16. Cantor Groups

    ERIC Educational Resources Information Center

    Mathes, Ben; Dow, Chris; Livshits, Leo

    2011-01-01

    The Cantor subset of the unit interval [0, 1) is "large" in cardinality and also "large" algebraically, that is, the smallest subgroup of [0, 1) generated by the Cantor set (using addition mod 1 as the group operation) is the whole of [0, 1). In this paper, we show how to construct Cantor-like sets which are "large" in cardinality but "small"…

  17. Underrepresented groups

    NASA Technical Reports Server (NTRS)

    Peters, David A.

    1990-01-01

    The problem with the shortage of under represented groups in science and engineering is absolutely crucial, especially considering that U.S. will experience a shortage of 560,000 science and engineering personnel by the year 2010. Most studies by the National Science Foundation also concluded that projected shortages cannot be alleviated without significant increases in the involvement of Blacks, Hispanics, Native Americans, handicapped persons, and women.

  18. Morbidity of severe obesity.

    PubMed

    Kral, J G

    2001-10-01

    Although obesity is an easy diagnosis to make, its etiologies, pathophysiology, and symptomatology are extraordinarily complex. Progress in surgical technique and anesthesiological management has substantially improved the safety of performing operations on the severely obese in the last 20 years. These improvements have occurred more or less empirically, without a full understanding of etiology or pathophysiology, although this has advanced concomitantly with improvements in practice. This review has attempted to provide a framework to facilitate progress in the neglected areas of patient selection and choice of operation, in an effort to improve long-term outcome. Despite the disparate etiologies of obesity and its diverse comorbidities and complications, there are unifying interdependent pathogenetic mechanisms of great relevance to the practice of antiobesity surgery. The rate of eating, whether driven by HPA dysfunction, ambient stress, or related hereditary susceptibility factors including the increased energy demands of an expanded body fat mass, participates in a cycle that results in disordered satiety (see Fig. 3). This leads to substrate overload, causing extensive metabolic abnormalities such as atherogenesis, insulin resistance, thrombogenesis, and carcinogenesis. This interpretation of the pathophysiology of obesity ironically accords with the original meaning of the word obesity: "to overeat." The ultimate solution to the problem of obesity--preventing it--will not be forthcoming until the food industry is forced to lower production and change its marketing strategies, as the liquor and tobacco industries in the United States were compelled to do. This cannot occur until the large and fast-growing populations of industrialized nations become educated in the personal implications of the energy principle. Regardless of whether school curricula are modified to prioritize health education, the larger problems of cultural and economic change remain for

  19. National Melon Research Group

    USDA-ARS?s Scientific Manuscript database

    The National Melon Research Group met with the Cucurbitaceae 2010 conference in Charleston, South Carolina at 7:00 P.M. on November 17. The discussion was focused solely on cucurbit powdery mildew (CPM). Several reported increased problem with CPM or apparent changes in race. Ales Lebeda (Palacký Un...

  20. Analysis of the causes of dental implant fracture: A retrospective clinical study.

    PubMed

    Stoichkov, Biser; Kirov, Dimitar

    2018-01-01

    Fracture of osseointegrated dental implants is the most severe mechanical complication. The aim of the present study was to analyze possible causative factors for implant body fracture. One hundred and one patients with 218 fitted implants and a follow-up period of 3 to 10 years were studied. Factors associated with biomechanical and physiologic overloading such as parafunctional activity (eg, bruxism), occlusion, and cantilevers, and factors related to the planning of the dental prosthesis, available bone volume, implant area, implant diameter, number of implants, and their inclination were tracked. The impact of their effect was analyzed using the Bonferroni-corrected post-hoc Mann-Whitney test for each group. The incidence of dental implant fracture was 2.3% in the investigated cases. Improper treatment planning, bruxism, and time of the complication setting in were the main factors leading to this complication. Typical size effect was established only for available bruxism, occlusal errors, and their activity duration. These complications were observed most often with single crown prostheses, and in combination with parafunctional activities such as bruxism and lack of implant-protected occlusion. Occlusal overload due to bruxism or inappropriate or inadequate occlusion as a single factor or a combination of these factors during the first years after the functional load can cause implant fracture. Fracture of the implant body more frequently occurred with single crowns than with other implant-supported fixed dental prostheses.

  1. Group evaporation

    NASA Technical Reports Server (NTRS)

    Shen, Hayley H.

    1991-01-01

    Liquid fuel combustion process is greatly affected by the rate of droplet evaporation. The heat and mass exchanges between gas and liquid couple the dynamics of both phases in all aspects: mass, momentum, and energy. Correct prediction of the evaporation rate is therefore a key issue in engineering design of liquid combustion devices. Current analytical tools for characterizing the behavior of these devices are based on results from a single isolated droplet. Numerous experimental studies have challenged the applicability of these results in a dense spray. To account for the droplets' interaction in a dense spray, a number of theories have been developed in the past decade. Herein, two tasks are examined. One was to study how to implement the existing theoretical results, and the other was to explore the possibility of experimental verifications. The current theoretical results of group evaporation are given for a monodispersed cluster subject to adiabatic conditions. The time evolution of the fluid mechanic and thermodynamic behavior in this cluster is derived. The results given are not in the form of a subscale model for CFD codes.

  2. Severe Bleeding: First Aid

    MedlinePlus

    ... 12, 2017. Jevon P, et al. Part 5 — First-aid treatment for severe bleeding. Nursing Times. 2008;104:26. Oct. 19, 2017 Original article: http://www.mayoclinic.org/first-aid/first-aid-severe-bleeding/basics/ART-20056661 . Mayo ...

  3. Severe hyperkalaemia: demographics and outcome

    PubMed Central

    Phillips, B.M.; Milner, S.; Zouwail, S.; Roberts, G.; Cowan, M.; Riley, S.G.; Phillips, A.O.

    2014-01-01

    Background Few studies have evaluated the prevalence of severe hyperkalaemia in unselected patient populations. We identified all episodes of severe hyperkalaemia occurring in 1 year, and described patient demographics, clinical response and outcome. We also assessed junior doctor knowledge of its causes and significance. Materials and methods A retrospective interrogation of the database of the regional biochemical laboratory identified all episodes of severe hyperkalaemia (K≥ 6.5 mmol/L) occurring in 2011. The understanding of trainee doctors of the importance, causes and treatment of severe hyperkalaemia was assessed by structured questionnaire. Results Severe hyperkalaemia was recorded in 433 samples (365 patients) giving a prevalence of 0.11%. Thirty-six per cent of episodes occurred in patients under the care of a nephrologist, who were significantly younger than those not under the care of a nephrologist. In the nephrology cohort, 86% occurred in patients with chronic kidney disease (CKD), the majority of which had CKD Stage 5. In the non-nephrology cohort, only 65% occurred in the context of CKD, which was equally distributed between Stages 3 and 5 CKD. In both patient groups, roughly 50% of episodes occurred in association with acute kidney injury (AKI). Acute mortality (death within 48 h of documented severe hyperkalaemia) was higher in the non-nephrology compared with the nephrology cohort. Time to repeat serum potassium was influenced by the clinical setting with shorter time to repeat for acute care compared with ward settings. Assessment of trainee doctor's knowledge suggested significant deficiencies in relation to severe hyperkalaemia. Conclusions The prevalence of severe hyperkalaemia was low and occurred predominantly in the context of CKD and/or AKI. The majority of episodes occurred in patients not under the care of a nephrologist. Variability in time to repeat serum potassium levels suggested deficiencies in care, and assessment of trainee

  4. Severe childhood malnutrition.

    PubMed

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  5. Severe Exoplanetary Storm

    NASA Image and Video Library

    2009-01-28

    These computer-generated images from NASA Spitzer Space Telescope chart the development of severe weather patterns on the highly eccentric exoplanet HD 80606b during the days after its closest approach to its parent star.

  6. Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery.

    PubMed

    Na, Boo Suk; Cho, Jin Whan; Park, Kwan; Kwon, Soonwook; Kim, Ye Sel; Kim, Ji Sun; Youn, Jinyoung

    2018-04-27

    Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD). We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups. The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD. Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD. Copyright © 2018 Korean Neurological Association.

  7. Severe soft tissue infections.

    PubMed

    Napolitano, Lena M

    2009-09-01

    Severe skin and soft tissue infections (SSTIs) frequently require management in the ICU, in part related to associated septic shock or toxic shock syndrome or associated organ failure. Four fundamental management principles are key to a successful outcome in caring for patients who have severe SSTIs, including (1) early diagnosis and differentiation of necrotizing versus nonnecrotizing SSTI, (2) early initiation of appropriate empiric broad-spectrum antimicrobial therapy with consideration of risk factors for specific pathogens and mandatory coverage for methicillin-resistant Staphylococcus aureus (MRSA), (3) source control (ie, early aggressive surgical intervention for drainage of abscesses and debridement of necrotizing soft tissue infections), and (4) pathogen identification and appropriate de-escalation of antimicrobial therapy. MRSA has emerged as the most common identifiable cause of severe SSTIs; therefore, initiation of empiric anti-MRSA antimicrobials is warranted in all cases of severe SSTIs. In addition, appropriate critical care management-including fluid resuscitation, organ support and nutritional support-is a necessary component in treating severe SSTIs.

  8. Facilities removal working group

    SciTech Connect

    NONE

    This working group`s first objective is to identify major economic, technical, and regulatory constraints on operator practices and decisions relevant to offshore facilities removal. Then, the group will try to make recommendations as to regulatory and policy adjustments, additional research, or process improvements and/or technological advances, that may be needed to improve the efficiency and effectiveness of the removal process. The working group will focus primarily on issues dealing with Gulf of Mexico platform abandonments. In order to make the working group sessions as productive as possible, the Facilities Removal Working Group will focus on three topics that address amore » majority of the concerns and/or constraints relevant to facilities removal. The three areas are: (1) Explosive Severing and its Impact on Marine Life, (2) Pile and Conductor Severing, and (3) Deep Water Abandonments This paper will outline the current state of practice in the offshore industry, identifying current regulations and specific issues encountered when addressing each of the three main topics above. The intent of the paper is to highlight potential issues for panel discussion, not to provide a detailed review of all data relevant to the topic. Before each panel discussion, key speakers will review data and information to facilitate development and discussion of the main issues of each topic. Please refer to the attached agenda for the workshop format, key speakers, presentation topics, and panel participants. The goal of the panel discussions is to identify key issues for each of the three topics above. The working group will also make recommendations on how to proceed on these key issues.« less

  9. Severe storms forecast systems

    NASA Technical Reports Server (NTRS)

    Kaplan, M.; Zack, J.

    1980-01-01

    Two research tasks are described: (1) the improvement and enhancement of an existing mesoscale numerical simulation system, and (2) numerical diagnostic studies associated with an individual case of severe storm development (April 10, 1979 in the Red River Valley of Texas and Oklahoma).

  10. Modelling runway incursion severity.

    PubMed

    Wilke, Sabine; Majumdar, Arnab; Ochieng, Washington Y

    2015-06-01

    Analysis of the causes underlying runway incursions is fundamental for the development of effective mitigation measures. However, there are significant weaknesses in the current methods to model these factors. This paper proposes a structured framework for modelling causal factors and their relationship to severity, which includes a description of the airport surface system architecture, establishment of terminological definitions, the determination and collection of appropriate data, the analysis of occurrences for severity and causes, and the execution of a statistical analysis framework. It is implemented in the context of U.S. airports, enabling the identification of a number of priority interventions, including the need for better investigation and causal factor capture, recommendations for airfield design, operating scenarios and technologies, and better training for human operators in the system. The framework is recommended for the analysis of runway incursions to support safety improvements and the methodology is transferable to other areas of aviation safety risk analysis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Group Capability Model

    NASA Technical Reports Server (NTRS)

    Olejarski, Michael; Appleton, Amy; Deltorchio, Stephen

    2009-01-01

    The Group Capability Model (GCM) is a software tool that allows an organization, from first line management to senior executive, to monitor and track the health (capability) of various groups in performing their contractual obligations. GCM calculates a Group Capability Index (GCI) by comparing actual head counts, certifications, and/or skills within a group. The model can also be used to simulate the effects of employee usage, training, and attrition on the GCI. A universal tool and common method was required due to the high risk of losing skills necessary to complete the Space Shuttle Program and meet the needs of the Constellation Program. During this transition from one space vehicle to another, the uncertainty among the critical skilled workforce is high and attrition has the potential to be unmanageable. GCM allows managers to establish requirements for their group in the form of head counts, certification requirements, or skills requirements. GCM then calculates a Group Capability Index (GCI), where a score of 1 indicates that the group is at the appropriate level; anything less than 1 indicates a potential for improvement. This shows the health of a group, both currently and over time. GCM accepts as input head count, certification needs, critical needs, competency needs, and competency critical needs. In addition, team members are categorized by years of experience, percentage of contribution, ex-members and their skills, availability, function, and in-work requirements. Outputs are several reports, including actual vs. required head count, actual vs. required certificates, CGI change over time (by month), and more. The program stores historical data for summary and historical reporting, which is done via an Excel spreadsheet that is color-coded to show health statistics at a glance. GCM has provided the Shuttle Ground Processing team with a quantifiable, repeatable approach to assessing and managing the skills in their organization. They now have a common

  12. [Severe depression : psychoanalysis].

    PubMed

    Bouvet de la Maisonneuve, O

    2009-12-01

    The indication for psychoanalysis in severe depression is not clear. And yet, demands for this type of intervention are increasing, despite the absence of any form of consensus on the subject. Freud considered depression as a failure of analytical efforts and, based on this observation, revised his theory, in particular to include the notions of narcissism and the death drive. Many analysts have been reluctant to follow his teachings on this last point and provide depressed patients with analytical-type therapies aimed at restoring narcissism. Melanie Klein pushed Freud's ideas about depression even further and brought such therapies back to the heart of analytical practice. Jacques Lacan took the debate to another level by proposing an overhaul of the principles on which analysis has been based. Today, while following certain precautionary rules, true psychoanalyses can be proposed to patients with severe depression, whether of the bipolar, recurring or even neurotic type that can reach this level of severity. Copyright 2009 L'Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  13. Historical Group Debriefing Following Combat

    DTIC Science & Technology

    1993-05-01

    participants shortly after its termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which...termination. Debriefing has been recommended by several authors as a stress management technique suitable for groups which have been exposed to traumatic...the event and the participants’ reactions, and (b) application of a "stress management " technique (e.g., working-through negative emotions, psycho

  14. A Phase IIIb, Multicentre, Randomised, Parallel-Group, Placebo-Controlled, Double-Blind Study to Investigate the Efficacy and Safety of OROS Hydromorphone in Subjects with Moderate-to-Severe Chronic Pain Induced by Osteoarthritis of the Hip or the Knee

    PubMed Central

    Vojtaššák, Jozef; Vojtaššák, Jozef; Jacobs, Adam; Rynn, Leonie; Waechter, Sandra; Richarz, Ute

    2011-01-01

    Background. Opioid analgesics are included in treatment guidelines for the symptomatic management of osteoarthritis (OA). Starting with a low dose of opioid and slowly titrating to a higher dose may help avoid intolerable side effects. Methods. Subjects aged ≥40 years, with moderate to severe pain induced by OA of the hip or knee not adequately controlled by previous non-steroidal anti-inflammatory drugs (NSAIDs) or paracetamol treatment, were enrolled. Subjects received OROS hydromorphone 4 mg or placebo once-daily. The dose was titrated every 3-4 days in case of unsatisfactory pain control during the 4-week titration phase. A 12 week maintenance phase followed. The primary efficacy endpoint was the change in “pain on average” measured on the Brief Pain Inventory (BPI) scale from baseline to the end of the maintenance phase. Results. 139 subjects received OROS hydromorphone and 149 subjects received placebo. All efficacy endpoints showed similar improvements from baseline to end of study in the 2 groups. The safety results were consistent with the safety profile of OROS hydromorphone. Conclusion.The study did not meet the primary endpoint; although many subjects' pain was not adequately controlled at inclusion, their pain may have improved with continued paracetamol or NSAID treatment. PMID:22110921

  15. Novel antipsychotics and severe hyperlipidemia.

    PubMed

    Meyer, J M

    2001-08-01

    Newer atypical antipsychotics demonstrate superior effectiveness, with a diminished incidence of extrapyramidal side effects compared with older typical antipsychotics, but they have been associated with the development of obesity and new-onset diabetes. A small number of reports documenting modest hypertriglyceridemia related to newer antipsychotics have implicated fluperlapine, clozapine, and, most recently, olanzapine. This study summarizes the results of 14 cases of severe hypertriglyceridemia (>600 mg/dL) associated with olanzapine and quetiapine therapy occurring among inpatients at Oregon State Hospital, including 7 patients whose serum triglyceride levels exceeded 1,000 mg/ dL. Four of these patients also developed new-onset diabetes. Nine cases occurred during the first 8 months of treatment, with three cases identified within 3 months of commencing olanzapine or quetiapine therapy. Weight gain in olanzapine and quetiapine groups was modest (12.3 lb and 8.5 lb, respectively) and did not correlate with the severity of hypertriglyceridemia. Biochemical causes for severe hypertriglyceridemia associated with novel antipsychotics are unclear, but clinical monitoring of serum lipids must be added to the concerns about the metabolic consequences of therapy with certain newer antipsychotic agents.

  16. My Career: Group Fitness Instructor

    ERIC Educational Resources Information Center

    Green, Kathleen

    2013-01-01

    This article presents an interview with Tammy Kenney, who teaches a yoga-Pilates class in several different gyms. In this interview, Kenney talks about her career as a group fitness instructor and gives her best advice for someone who wants to teach group fitness.

  17. Evaluation of the DSM-5 Severity Indicator for Bulimia Nervosa

    PubMed Central

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having higher levels than moderate and mild groups. Depression differed with the extreme group having higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators. PMID:25744910

  18. Evaluation of the DSM-5 severity indicator for bulimia nervosa.

    PubMed

    Grilo, Carlos M; Ivezaj, Valentina; White, Marney A

    2015-04-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having significantly higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having significantly higher levels than moderate and mild groups. Depression differed with the extreme group having significantly higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Arnold, R. T.; Rust, W. D.

    1984-01-01

    Successful ground truth support of U-2 overflights was been accomplished. Data have been reduced for 4 June 1984 and some of the results have been integrated into some of MSFC's efforts. Staccato lightning (multiply branched, single stroke flash with no continuing current) is prevalent within the rainfree region around the main storm updraft and this is believed to be important, i.e., staccato flashes might be an important indicator of severe storm electrification. Results from data analysis from two stations appear to indicate that charge center heights can be estimated from a combination of intercept data with data from the fixed laboratory at NSSL. An excellent data base has been provided for determining the sight errors and efficiency of NSSL's LLP system. Cloud structures, observable in a low radar reflectivity region and on a scale smaller than is currently resolved by radar, which appear to be related to electrical activity are studied.

  20. LEAD SEVERING CONTRIVANCE

    DOEpatents

    Widmaier, W.

    1958-04-01

    A means for breaking an electrical circuit within an electronic tube during the process of manufacture is described. Frequently such circuits must be employed for gettering or vapor coating purposes, however, since an external pair of corector pins having no use after manufacture, is undesirable, this invention permits the use of existing leads to form a temporary circuit during manufacture, and severing it thereafter. One portion of the temporary circuit, made from a springy material such as tungsten, is spot welded to a fusable member. To cut the circuit an external radiant heat source melts the fusable member, allowing the tensed tungsten spring to contract and break the circuit. This inexpensive arrangement is particularly useful when the tube has a great many external leads crowded into the tube base.

  1. Abandoning wells working group

    SciTech Connect

    NONE

    The primary objective of this working group is to identify major technical, regulatory, and environmental issues that are relevant to the abandonment of offshore wellbores. Once the issues have been identified, the working group also has the objective of making recommendations or providing potential solutions for consideration. Areas for process improvement will be identified and {open_quotes}best practices{close_quotes} will be discussed and compared to {open_quotes}minimum standards.{close_quotes} The working group will primarily focus on wellbore abandonment in the Gulf of Mexico. However, workshop participants are encouraged to discuss international issues which may be relevant to wellbore abandonment practices in the Gulf ofmore » Mexico. The Abandoning Wells Group has identified several major areas for discussion that have concerns related to both operators and service companies performing wellbore abandonments in the Gulf of Mexico. The following broad topics were selected for the agenda: (1) MMS minimum requirements and state regulations. (2) Co-existence of best practices, new technology, and P & A economics. (3) Liability and environmental issues relating to wellbore abandonment.« less

  2. Group Composition, Creative Synergy, and Group Performance.

    ERIC Educational Resources Information Center

    Taggar, Simon

    2001-01-01

    A study of 94 intact autonomous work groups performing multi-part tasks revealed that group creative performance increased exponentially with the number of highly creative group members composing the group. However, this occurred only when Team Creativity-Relevant Processes within the group were relatively high. (Contains references.) (Author/CR)

  3. Severe acute malnutrition.

    PubMed

    Nel, E D

    2016-05-01

    The mortality and morbidity associated with severe acute malnutrition (SAM) remain high. A summary of recent studies that are of interest to clinicians treating children with SAM is provided. Three important themes emerged in 2015: the use of anthropometry in the diagnosis of SAM and its correlation with body composition; the composition of ready-to-use therapeutic feeds (RUTF); and an improved understanding of the pathophysiology of SAM. Standard anthropometry does not accurately predict body composition and mid-upper arm circumference more accurately reflects fat mass in children. As single measure, mid-upper arm circumference identifies those children who are most likely to die from SAM and is not influenced by dehydration. However, a significant proportion of SAM children requiring treatment will not be detected. Present RUTF formulations are deficient in long chain polyunsaturated fatty acids. Current evidence suggests that preformed docosahexaenoic acid should be added and/or the content of linoleic acid reduced in RUTF. In contrast to an animal model, stabile children with SAM have the same cardiac index as children without SAM. The situation in haemodynamically unstable children is unknown, continued conservative use of intravenous fluids seems advisable. A reduction in variability of the faecal DNA virome may account for increased susceptibility to malnutrition in vulnerable children.

  4. Severe storm electricity

    NASA Technical Reports Server (NTRS)

    Rust, W. D.; Macgorman, D. R.; Taylor, W.; Arnold, R. T.

    1984-01-01

    Severe storms and lightning were measured with a NASA U2 and ground based facilities, both fixed base and mobile. Aspects of this program are reported. The following results are presented: (1) ground truth measurements of lightning for comparison with those obtained by the U2. These measurements include flash type identification, electric field changes, optical waveforms, and ground strike location; (2) simultaneous extremely low frequency (ELF) waveforms for cloud to ground (CG) flashes; (3) the CG strike location system (LLP) using a combination of mobile laboratory and television video data are assessed; (4) continued development of analog-to-digital conversion techniques for processing lightning data from the U2, mobile laboratory, and NSSL sensors; (5) completion of an all azimuth TV system for CG ground truth; (6) a preliminary analysis of both IC and CG lightning in a mesocyclone; and (7) the finding of a bimodal peak in altitude lightning activity in some storms in the Great Plains and on the east coast. In the forms on the Great Plains, there was a distinct class of flash what forms the upper mode of the distribution. These flashes are smaller horizontal extent, but occur more frequently than flashes in the lower mode of the distribution.

  5. Urine ethanol concentration and alcohol hangover severity.

    PubMed

    Van de Loo, Aurora; Mackus, Marlou; Korte-Bouws, Gerdien; Brookhuis, Karel; Garssen, Johan; Verster, Joris

    2017-01-01

    The aim of this study was to examine the relationship between urine ethanol concentration and alcohol hangover severity. N = 36 healthy social drinkers participated in a naturalistic study, comprising a hangover day and a control day. N = 18 of them have regular hangovers (the hangover group), while the other N = 18 claim to be hangover immune (hangover-immune group). On each test day at 9.30 am, urine samples were collected. Participants rated their overall hangover severity on a scale from 0 (absent) to 10 (extreme), as well as 18 individual hangover symptoms. Urine ethanol concentration was significantly higher on the hangover day when compared to the control day (p = 0.006). On the hangover day, urine ethanol concentration was significantly lower in the hangover-immune group when compared to the hangover group (p = 0.027). In the hangover-immune group, none of the correlations of urine ethanol concentration with individual hangover symptoms was significant. In contrast, in the hangover group, significant correlations were found with a variety of hangover symptoms, including nausea, concentration problems, sleepiness, weakness, apathy, sweating, stomach pain, thirst, heart racing, anxiety, and sleep problems. Urine ethanol levels are significantly associated with the presence and severity of several hangover symptoms.

  6. Severe limb ischemia syndrome.

    PubMed

    Suchý, T

    1991-01-01

    In the course of the study of the syndrome of severe limb ischemia (SLI) in a representative clinical material of 300 patients and a number of experimental studies, we arrived to the proposal of this optimal methodical procedure for acute vascular closures of traumatic and non-traumatic origin in the limbs: a) In every injury and sudden pain with a change of the function of the limb, it is necessary to think of the SLI syndrome and to search targetedly for it. b) In injuries connected with bleeding our first-rate task is the control of this bleeding. For a temporary arrest of the bleeding it is necessary to prefer more physiological methods sparing collateral circulation to the still most used tourniquet. For this purpose a new device for temporary hemostasis called Hemostop has proved itself, designed by the author and attested both experimentally and clinically, protected as a Czechoslovak patent. From surgical measures have acquitted themselves from this viewpoint the insertion of vascular clamp, ligature of the vessel or its temporary cannulation. c) To set the diagnosis of SLI, it usually suffices a careful anamnesis and clinical examination, advantageous is the investigation by ultrasound. The angiography because of time consumption should be used only in indicated cases. d) The time factor--"race against the time"--has to be always borne on our mind. It is necessary to achieve the recovery of blood circulation in the limb up to 6 or at the latest up to 10 hours from the onset of injury or closure. e) For shortening of the period of tissue hypoxia it is of advantage to use the temporary cannulation of injured vessels. This should be used always, whenever because of any reasons, it is not possible to execute the final reconstructive operation up to 10 hours since the injury, e. g. in polytraumatism, transport difficulties and the like. f) In isolated vascular injuries without bleeding (about 45%) and in all non-traumatic SLI the patients must be efficiently

  7. Early nutritional support in severe traumatic patients.

    PubMed

    Chuntrasakul, C; Siltharm, S; Chinswangwatanakul, V; Pongprasobchai, T; Chockvivatanavanit, S; Bunnak, A

    1996-01-01

    Multiple trauma is associated with altered metabolism, wasting of the lean body mass and compromised wound healing. Nutritional support is one way to improve the condition of these critically ill patients. We performed a prospective randomized study on the effect of early nutritional support in severely injured patients admitted to the Division of Traumatic Surgery, Siriraj Hospital between June 1992 and January 1994. Thirty-eight severe traumatic patients with ISS between 20-40 were randomly divided into control and study group. The 17 patients in the control group were treated in the conventional method with administration of hypo caloric intravenous regimen and supplement with oral diet as soon as the bowel function was returned. The 21 patients of the study group were fed either by enteral or parenteral feeding or both with an appropriate caloric and protein requirement as soon as hemodynamic status was stabilized. We found the study group had a lower mortality rate, a lower complication rate, a shorter period of ICU stay, and an earlier weaning from the ventilator than the control group. The study group also lost less weight than the control group. Nitrogen balance in the study group was significantly lower than the control group.

  8. Group Cohesion in Experiential Growth Groups

    ERIC Educational Resources Information Center

    Steen, Sam; Vasserman-Stokes, Elaina; Vannatta, Rachel

    2014-01-01

    This article explores the effect of web-based journaling on changes in group cohesion within experiential growth groups. Master's students were divided into 2 groups. Both used a web-based platform to journal after each session; however, only 1 of the groups was able to read each other's journals. Quantitative data collected before and…

  9. Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008.

    PubMed

    Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Wilczak, Magdalena; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz

    2012-02-29

    Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes.

  10. Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008

    PubMed Central

    Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz

    2012-01-01

    Introduction Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. Material and methods The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Results Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. Conclusions The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. PMID:22457683

  11. Urine methanol concentration and alcohol hangover severity.

    PubMed

    Mackus, M; Van de Loo, A J A E; Korte-Bouws, G A H; Van Neer, R H P; Wang, X; Nguyen, T T; Brookhuis, K A; Garssen, J; Verster, J C

    2017-03-01

    Congeners are substances, other than ethanol, that are produced during fermentation. Previous research found that the consumption of congener-rich drinks contributes to the severity of alcohol hangover. Methanol is such a congener that has been related to alcohol hangover. Therefore, the aim of this study was to examine the relationship between urine methanol concentration and alcohol hangover severity. N = 36 healthy social drinkers (22 females, 14 males), aged 18-30 years old, participated in a naturalistic study, comprising a hangover day and a control day (no alcohol consumed the previous day). N = 18 of them had regular hangovers (the hangover group), while the other N = 18 claimed to be hangover-immune (hangover-immune group). Overall hangover severity was assessed, and that of 23 individual hangover symptoms. Urine methanol concentrations on the hangover and control days were compared, and correlated to hangover (symptom) severity. Urine methanol concentration was significantly higher on hangover days compared to control days (p = 0.0001). No significant differences in urine methanol concentration were found between the hangover group and hangover-immune group. However, urine methanol concentration did not significantly correlate with overall hangover severity (r = -0.011, p = 0.948), nor with any of the individual hangover symptoms. These findings were observed also when analyzing the data separately for the hangover-immune group. In the hangover group, a significant correlation with urine methanol concentration was found only with vomiting (r = 0.489, p = 0.037). No significant correlation was observed between urine methanol concentration and hangover severity, nor with individual core hangover symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Group Work Publication-1991.

    ERIC Educational Resources Information Center

    Zimpfer, David G.

    1992-01-01

    Lists 21 new publications in group work, of which 9 are reviewed. Those discussed include publications on group counseling and psychotherapy, structured groups, support groups, psychodrama, and social group work. (Author/NB)

  13. Group typicality, group loyalty and cognitive development.

    PubMed

    Patterson, Meagan M

    2014-09-01

    Over the course of childhood, children's thinking about social groups changes in a variety of ways. Developmental Subjective Group Dynamics (DSGD) theory emphasizes children's understanding of the importance of conforming to group norms. Abrams et al.'s study, which uses DSGD theory as a framework, demonstrates the social cognitive skills underlying young elementary school children's thinking about group norms. Future research on children's thinking about groups and group norms should explore additional elements of this topic, including aspects of typicality beyond loyalty. © 2014 The British Psychological Society.

  14. 7 CFR 30.7 - Group.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Group. 30.7 Section 30.7 Agriculture Regulations of... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.7 Group. A group of grades, or a division of a type covering several closely related grades, based on the...

  15. 7 CFR 30.7 - Group.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Group. 30.7 Section 30.7 Agriculture Regulations of... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.7 Group. A group of grades, or a division of a type covering several closely related grades, based on the...

  16. 7 CFR 30.7 - Group.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Group. 30.7 Section 30.7 Agriculture Regulations of... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.7 Group. A group of grades, or a division of a type covering several closely related grades, based on the...

  17. 7 CFR 30.7 - Group.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Group. 30.7 Section 30.7 Agriculture Regulations of... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.7 Group. A group of grades, or a division of a type covering several closely related grades, based on the...

  18. 7 CFR 30.7 - Group.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 30.7 Section 30.7 Agriculture Regulations of... AND STANDARDS Classification of Leaf Tobacco Covering Classes, Types and Groups of Grades § 30.7 Group. A group of grades, or a division of a type covering several closely related grades, based on the...

  19. Dealing with Parasites in Group Projects.

    ERIC Educational Resources Information Center

    Carter, Judy H.

    While it is generally accepted that people working in groups can accomplish more than people working individually, it is equally accepted that parasites will attempt to feed on the other group members. Group work has been called by several names--group learning, cooperative learning, collaborative learning--all of which carry slightly different…

  20. Severe Weather Planning for Schools

    ERIC Educational Resources Information Center

    Watson, Barbara McNaught; Strong, Christopher; Bunting, Bill

    2008-01-01

    Flash floods, severe thunderstorms, and tornadoes occur with rapid onset and often no warning. Decisions must be made quickly and actions taken immediately. This paper provides tips for schools on: (1) Preparing for Severe Weather Emergencies; (2) Activating a Severe Weather Plan; (3) Severe Weather Plan Checklist; and (4) Periodic Drills and…

  1. Group Dynamic Processes in Email Groups

    ERIC Educational Resources Information Center

    Alpay, Esat

    2005-01-01

    Discussion is given on the relevance of group dynamic processes in promoting decision-making in email discussion groups. General theories on social facilitation and social loafing are considered in the context of email groups, as well as the applicability of psychodynamic and interaction-based models. It is argued that such theories may indeed…

  2. Group Cohesiveness in the Industrial Work Group.

    ERIC Educational Resources Information Center

    Seashore, Stanley E.

    Originally published in 1954, this investigation was designed to explore the formation of cohesiveness within work groups in an industrial setting, and the relationship of cohesiveness to productivity and to group members' mental health and adjustment. A company wide questionnaire survey, involving 228 groups totaling 5,871 workers, was made of…

  3. Small Group Learning: Do Group Members' Implicit Theories of Ability Make a Difference?

    ERIC Educational Resources Information Center

    Beckmann, Nadin; Wood, Robert E.; Minbashian, Amirali; Tabernero, Carmen

    2012-01-01

    We examined the impact of members' implicit theories of ability on group learning and the mediating role of several group process variables, such as goal-setting, effort attributions, and efficacy beliefs. Comparisons were between 15 groups with a strong incremental view on ability (high incremental theory groups), and 15 groups with a weak…

  4. Coexisting Problem Behaviour in Severe Dyslexia

    ERIC Educational Resources Information Center

    Dahle, Anne Elisabeth; Knivsberg, Ann-Mari; Andreassen, Anne Brit

    2011-01-01

    A small group of children and young adolescent with dyslexia has severely impaired reading skills despite prolonged special education. These are the students in focus. In dyslexia, problem behaviour, internalised as well as externalised, has previously been reported, so also for the participants with dyslexia in this study. The aim of the present…

  5. Measuring Severity and Change in Anorexia Nervosa.

    ERIC Educational Resources Information Center

    Piazza, Eugene; And Others

    1983-01-01

    Describes the State of Mind (SOM) Questionnaire, which measures severity and change of clinical state in anorexia nervosa. A study of 42 anorexia patients and 4 control groups showed a strong correlation between depression as measured by the Beck Depression Inventory and the Anorexia Scale, which comprise the SOM. (JAC)

  6. Increased Atherosclerosis Correlates with Subjective Tinnitus Severity.

    PubMed

    Yüksel, Fatih; Karataş, Duran; Türkdoğan, Figen Tunalı; Yüksel, Özlem

    2018-03-01

    The aim of the present study was to investigate whether increased intima media thickness was associated with the severity of subjective non-pulsatile tinnitus and hearing loss. Data of the patients who came to Otorhinolaryngology Department of Isparta Government Hospital with subjective non-pulsatile tinnitus complaint, between January 2012 and June 2013, were evaluated retrospectively. A total of 215 patients were included in the present study. Hearing tests, biochemical analysis, tinnitus handicap inventory (THI), visual analogue scale (VAS) and doppler ultrasonography results of the patients were reviewed and recorded. The patients were classified into two groups as those having an increased intima media thickness and those having a normal intima media thickness. The said groups were compared with respect to age, gender, THI, VAS, hearing test findings and lipid values. Moreover, THI and VAS groups were compared with respect to intima-media thickness. In the group having increased intima-media thickness, THI and VAS average, frequency of hypertension, total cholesterol, low density lipoprotein and triglyceride averages and mean frequencies obtained by hearing test were significantly higher. Comparison of THI and VAS groups showed that intima-media thickness was significantly different between those having a mild tinnitus and those having a severe tinnitus. Increased intima-media thickness was associated with the severity of subjective non-pulsatile tinnitus and hearing loss. For this reason, the carotid system should be examined in subjective non-pulsatile tinnitus patients.

  7. Bruxism (Teeth Grinding or Clenching) (For Parents)

    MedlinePlus

    ... cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, dentists may prescribe a special night guard. Molded to a child's teeth, the night guard is similar to the ...

  8. A brief history of human blood groups.

    PubMed

    Farhud, Dariush D; Zarif Yeganeh, Marjan

    2013-01-01

    The evolution of human blood groups, without doubt, has a history as old as man himself. There are at least three hypotheses about the emergence and mutation of human blood groups. Global distribution pattern of blood groups depends on various environmental factors, such as disease, climate, altitude, humidity etc. In this survey, the collection of main blood groups ABO and Rh, along with some minor groups, are presented. Several investigations of blood groups from Iran, particularly a large sampling on 291857 individuals from Iran, including the main blood groups ABO and Rh, as well as minor blood groups such as Duffy, Lutheran, Kell, KP, Kidd, and Xg, have been reviewed.

  9. Equal Severity Curve (ESC) update.

    DOT National Transportation Integrated Search

    2009-07-01

    Caltrans uses the Equal Severity Curve to determine appropriate locations for the placement of guardrail on : embankments. The ESC assists designers in determining the relative severity of encroachments on embankments : versus impacts with roadside b...

  10. Group Time: Building Language at Group Time

    ERIC Educational Resources Information Center

    Church, Ellen Booth

    2004-01-01

    This article features energizing and surprising activities for children at group time. In the drawing activity, children are asked to give instructions on how to draw a picture using vocabulary and descriptive language. In the mailbox activity, children will be surprised to discover that they have mail at group time. Mailboxes can be used for…

  11. Group Work: How to Use Groups Effectively

    ERIC Educational Resources Information Center

    Burke, Alison

    2011-01-01

    Many students cringe and groan when told that they will need to work in a group. However, group work has been found to be good for students and good for teachers. Employers want college graduates to have developed teamwork skills. Additionally, students who participate in collaborative learning get better grades, are more satisfied with their…

  12. Small Group Research

    ERIC Educational Resources Information Center

    McGrath, Joseph E.

    1978-01-01

    Summarizes research on small group processes by giving a comprehensive account of the types of variables primarily studied in the laboratory. These include group structure, group composition, group size, and group relations. Considers effects of power, leadership, conformity to social norms, and role relationships. (Author/AV)

  13. SOFIA Science Working Group

    NASA Technical Reports Server (NTRS)

    Zmuldzinas, J.

    1997-01-01

    The SOFIA Science Working Group was established to help develop the plans and specifications for the next-generation airborne observatory ("SOFIA"), which is now under development. The P.I. has developed several astronomical instruments for the Kuiper Airborne Observatory, NASA's previous airborne astronomy platform (which was decommisioned in 1995 in preparation for SOFIA). SOFIA, which will be a 747 SP aircraft carrying a 2.7 meter diameter telescope, is a joint project sponsored by NASA and DLR (the German space agency), and is now under development by a consortium including Universities Space Research Association (USRA), Raytheon, Sterling Software, and United Airlines. Rather than develop the SOFIA observatory in-house, NASA decided to privatize the project by issuing a Request for Proposals (RFP). The respondents to this RFP were consortia of private organizations which together had the required facilities and expertise to be able to carry out the project; the winner was the group led by USRA. One of the main roles of the SSWG was to help develop the technical specifications for the SOFIA observatory. In particular, the SSWG provided advice to NASA on the specifications that were written into the RFP, particularly those which had an important impact on the scientific productivity of the observatory. These specifications were discussed at the meetings of the SSWG, which were held primarily at NASA/Ames (in California) and at NASA Headquarters (in Washington DC). Apart from these meetings, members of the SSWG were expected to perform more detailed analyses of the impact of certain parameters and specifications on the performance of astronomical instruments. The SSWG ended its activities with the selection of the USRA team in January 1997.

  14. Classification of rollovers according to crash severity.

    PubMed

    Digges, K; Eigen, A

    2006-01-01

    NASS/CDS 1995-2004 was used to classify rollovers according to severity. The rollovers were partitioned into two classes - rollover as the first event and rollover preceded by an impact with a fixed or non-fixed object. The populations of belted and unbelted were examined separately and combined. The average injury rate for the unbelted was five times that for the belted. Approximately 21% of the severe injuries suffered by belted occupants were in crashes with harmful events prior to the rollover that produced severe damage to the vehicle. This group carried a much higher injury risk than the average. A planar damage measure in addition to the rollover measure was required to adequately capture the crash severity of this population. For rollovers as the first event, approximately 1% of the serious injuries to belted occupants occurred during the first quarter-turn. Rollovers that were arrested during the 1 ( st ) quarter-turn carried a higher injury rate than average. The number of quarter-turns were grouped in various ways including the number of times the vehicle roof faces the ground (number of vehicle inversions). The number of vehicle inversions was found to be a statistically significant injury predictor for 78% of the belted and unbelted populations with MAIS 3+F injuries in rollovers. The remaining 22% required crash severity metrics in addition to the number of vehicle inversions.

  15. Classification of Rollovers According to Crash Severity

    PubMed Central

    Digges, K.; Eigen, A.

    2006-01-01

    NASS/CDS 1995–2004 was used to classify rollovers according to severity. The rollovers were partitioned into two classes – rollover as the first event and rollover preceded by an impact with a fixed or non-fixed object. The populations of belted and unbelted were examined separately and combined. The average injury rate for the unbelted was five times that for the belted. Approximately 21% of the severe injuries suffered by belted occupants were in crashes with harmful events prior to the rollover that produced severe damage to the vehicle. This group carried a much higher injury risk than the average. A planar damage measure in addition to the rollover measure was required to adequately capture the crash severity of this population. For rollovers as the first event, approximately 1% of the serious injuries to belted occupants occurred during the first quarter-turn. Rollovers that were arrested during the 1st quarter-turn carried a higher injury rate than average. The number of quarter-turns were grouped in various ways including the number of times the vehicle roof faces the ground (number of vehicle inversions). The number of vehicle inversions was found to be a statistically significant injury predictor for 78% of the belted and unbelted populations with MAIS 3+F injuries in rollovers. The remaining 22% required crash severity metrics in addition to the number of vehicle inversions. PMID:16968634

  16. Management Information Task Group

    DTIC Science & Technology

    2002-12-18

    Defense Business Practice Implementation Board Management Information Task Group Report...Std Z39-18 Defense Business Practice Implementation Board Management Information Task Group... Business Practice Implementation Board Management Information Task Group Report FY02-2 3

  17. Blood Groups in Infection and Host Susceptibility

    PubMed Central

    2015-01-01

    SUMMARY Blood group antigens represent polymorphic traits inherited among individuals and populations. At present, there are 34 recognized human blood groups and hundreds of individual blood group antigens and alleles. Differences in blood group antigen expression can increase or decrease host susceptibility to many infections. Blood groups can play a direct role in infection by serving as receptors and/or coreceptors for microorganisms, parasites, and viruses. In addition, many blood group antigens facilitate intracellular uptake, signal transduction, or adhesion through the organization of membrane microdomains. Several blood groups can modify the innate immune response to infection. Several distinct phenotypes associated with increased host resistance to malaria are overrepresented in populations living in areas where malaria is endemic, as a result of evolutionary pressures. Microorganisms can also stimulate antibodies against blood group antigens, including ABO, T, and Kell. Finally, there is a symbiotic relationship between blood group expression and maturation of the gastrointestinal microbiome. PMID:26085552

  18. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  19. Sofia Science Working Group

    NASA Technical Reports Server (NTRS)

    Zmuidzinas, J.

    1997-01-01

    The purpose of this grant was to enable the Principal Investigator (P.I.) to travel to and participate in the meetings and activities of the NASA SOFIA Science Working Group (SSWG), and to spend time working on some of the associated technical issues relating to the SOFIA (Stratospheric Observatory for Infrared Astronomy) project. The SOFIA Science Working Group was established to help develop the plans and specifications for the next-generation airborne observatory ("SOFIA"), which is now under development. The P.I. was asked to serve on the SSWG due to his experience in airborne astronomy: he has developed several astronomical instruments for the Kuiper Airborne Observatory NASA's previous airborne astronomy platform (which was decommissioned in 1995 in preparation for SOFIA). SOFIA, which will be a 747 SP aircraft carrying a 2.7 meter diameter telescope, is a joint project sponsored by NASA and DLR (the German space agency), and is now under development by a consortium including Universities Space Research Association (USRA), Raytheon, Sterling Software, and United Airlines. Further details on the SOFIA project can be found on the internet at http: //sofia. arc. nasa. gov. Rather than develop the SOFIA observatory in-house, NASA decided to privatize the project by issuing a Request for Proposals (RFP). The respondents to this RFP were consortia of private organizations which together had the required facilities and expertise to be able to carry out the project; the winner was the group led by USRA. One of the main roles of the SSWG was to help develop the technical specifications for the SOFIA observatory. In particular, the SSWG provided advice to NASA on the specifications that were written into the RFP, particularly those which had an important impact on the scientific productivity of the observatory. These specifications were discussed at the meetings of the SSWG, which were held primarily at NASA/Ames (in California) and at NASA Headquarters (in Washington

  20. Severe community-acquired pneumonia. Assessment of severity criteria.

    PubMed

    Ewig, S; Ruiz, M; Mensa, J; Marcos, M A; Martinez, J A; Arancibia, F; Niederman, M S; Torres, A

    1998-10-01

    The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community-acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, multilobar involvement, PaO2/FIO2 < 250] or one of two major criteria [requirement of mechanical ventilation, presence of septic shock]) had a sensitivity of 78%, a specificity of 94%, a positive predictive value of 75%, and a negative predictive value of 95%. The ATS definition of severe pneumonia was highly sensitive but insufficiently specific and had a low positive predictive value. Our suggested modified rule had a more balanced performance and, if validated in an independent population, may represent a more accurate definition of severe CAP.

  1. Upgrade Summer Severe Weather Tool

    NASA Technical Reports Server (NTRS)

    Watson, Leela

    2011-01-01

    The goal of this task was to upgrade to the existing severe weather database by adding observations from the 2010 warm season, update the verification dataset with results from the 2010 warm season, use statistical logistic regression analysis on the database and develop a new forecast tool. The AMU analyzed 7 stability parameters that showed the possibility of providing guidance in forecasting severe weather, calculated verification statistics for the Total Threat Score (TTS), and calculated warm season verification statistics for the 2010 season. The AMU also performed statistical logistic regression analysis on the 22-year severe weather database. The results indicated that the logistic regression equation did not show an increase in skill over the previously developed TTS. The equation showed less accuracy than TTS at predicting severe weather, little ability to distinguish between severe and non-severe weather days, and worse standard categorical accuracy measures and skill scores over TTS.

  2. Current concepts of severe asthma

    PubMed Central

    Raundhal, Mahesh; Oriss, Timothy B.; Ray, Prabir; Wenzel, Sally E.

    2016-01-01

    The term asthma encompasses a disease spectrum with mild to very severe disease phenotypes whose traditional common characteristic is reversible airflow limitation. Unlike milder disease, severe asthma is poorly controlled by the current standard of care. Ongoing studies using advanced molecular and immunological tools along with improved clinical classification show that severe asthma does not identify a specific patient phenotype, but rather includes patients with constant medical needs, whose pathobiologic and clinical characteristics vary widely. Accordingly, in recent clinical trials, therapies guided by specific patient characteristics have had better outcomes than previous therapies directed to any subject with a diagnosis of severe asthma. However, there are still significant gaps in our understanding of the full scope of this disease that hinder the development of effective treatments for all severe asthmatics. In this Review, we discuss our current state of knowledge regarding severe asthma, highlighting different molecular and immunological pathways that can be targeted for future therapeutic development. PMID:27367183

  3. Severity of notified whooping cough.

    PubMed Central

    M