Differences between the activity of the masticatory muscles of adults with cerebral palsy and healthy individuals while at rest and in function.

OBJECTIVE: The aim of the present study was to compare the electromyographic activity of masticatory muscles of adult patients with different degrees of oral motor impairment (cerebral palsy) with the electromyographic activity of healthy individuals in a control group. Electromyographic activity was compared when the masticatory muscles were at rest and in motion. DESIGN: Thirty adult patients with cerebral palsy and 30 subjects without neuromotor disorders were enrolled in the present study. Oral motor function impairment was classified for each subject according to the Orofacial Motor Function Assessment Scale. Surface electromyography was bilaterally recorded in the masseter and anterior temporalis muscles at rest, during maximal voluntary clench and mouth opening. Comparisons between the groups were statistically assessed using Mann-Whitney test. RESULTS: At rest and mouth opening, electromyographic values were higher among patients with cerebral palsy than control group. During maximal voluntary clench, the opposite occurred. The degree of oral motor impairment affected mouth opening. CONCLUSION: There are significant differences in masticatory muscle activity between adult patients with CP and healthy individuals, and the degree of oral motor impairment is important. SIGNIFICANCE: To improve the masticatory function of these patients, muscle therapy should approach rest, mouth opening and clenching differently.

Hypertonic saline solutions do not influence the solubility of sputum from secretor and non-secretor cystic fibrosis patients.

INTRODUCTION: Functional alterations of the cystic fibrosis transmembrane conductance regulator gene (CFTR) increase the viscoelasticity of pulmonary secretions of cystic fibrosis (CF) patients and require the use of therapeutic aerosols. The biochemical properties of exocrine secretions are influenced by the expression of the FUT2 gene which determine the secretor and non-secretor phenotypes of the ABH glycoconjugates. The aim of this study was to determine the influence of secretor and non-secretor phenotypes by means of photoacoustic analysis, both the typical interaction time (t(0)) and the solubilization interval (Δt) of the sputum of secretor and non-secretor CF patients nebulized by hypertonic saline solutions at different concentrations. MATERIAL AND METHODS: Sputum samples were obtained by spontaneous expectoration from 6 secretor and 4 non-secretor patients with CF. Each sample was nebulized with 3%, 6%, and 7% hypertonic saline solutions in a photoacoustic cell. The values of t(0) and Δt were determined using the Origin 7.5(®) computer program (Microcal Software Inc.). The t-test was employed using the GraphPad Instat 3.0(®) computer program to calculate the mean and standard deviation for each parameter. RESULTS: For all hypertonic saline solutions tested, the mean values of t(0) and Δt do not show statistically significant differences between secretor and non-secretor patients. CONCLUSIONS: The secretor and non-secretor phenotypes do not influence the in vitro solubilization of the sputum nebulized by hypertonic saline solutions at different concentrations when analysed by photoacoustic technique.

Systematic assessment of the impact of oral appliance therapy on the temporomandibular joint during treatment of obstructive sleep apnea: long-term evaluation.

OBJECTIVE: The aim of the present study was to evaluate the symptoms of temporomandibular dysfunction (TMD) in patients with obstructive sleep apnea treated with long-term use of an oral appliance (OA) using a questionnaire based on the Helkimo Anamnestic Dysfunction Index. A further aim of the study was to evaluate the presence of daytime sleepiness using the Epworth Sleep Scale (ESS) and otologic symptoms. MATERIALS AND METHODS: Polysomnograms of 34 patients were performed at baseline and after 6 months of OA use. As follow-up, the patients were contacted by telephone interview to answer the same questionnaires after 36.0 +/- 17.0 months. RESULTS AND DISCUSSION: The intensity of TMD symptoms decreased significantly throughout treatment (p < 0.01). ESS values improved from 12.2 +/- 5.0 to 6.9 +/- 2.6 (p < or = 0.05). Tinnitus was present in nine patients at baseline and decreased in intensity in seven patients by the final assessment while remaining at the same level in two patients. CONCLUSIONS: We conclude that long-term usage of an OA does not cause impairment to the temporomandibular joint. The Helkimo and otologic indexes are simple and useful in long-term patient follow-up. There was a long-term improvement in the ESS values over the years analyzed. A follow-up program could increase compliance by motivating patients to use the device regularly.