RESUMO
UNLABELLED: In the Netherlands a case control study into cot death was undertaken as part of the European Concerted Action on sudden infant death syndrome. Children between 1 week and 2 years of age who died suddenly and unexpectedly were reported. Non cot death cases were excluded after a consensus by three pathologists. The study comprised 73 cot death cases and two controls per case, matched for date of birth. Compared to national data, the coverage was 91%. We investigated whether in the Netherlands new risk or preventive factors might have emerged. The present report focuses on the relative risks of dummy use, thumb sucking, breast versus bottle feeding, and sleeping with the mouth open. CONCLUSION: Dummy use seems to be an important preventive factor for cot death in the Netherlands, independent of other risk factors such as prone sleeping and bedding. We recommend dummy use at least for bottle-fed infants. We found no indication that dummies influence the frequency or duration of breast feeding but more data are needed. Mouth breathing appears to be associated with an increased risk for cot death, but again further research is needed.
Assuntos
Aleitamento Materno , Sucção de Dedo , Respiração Bucal , Morte Súbita do Lactente/epidemiologia , Alimentação com Mamadeira , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Estudos de Coortes , Intervalos de Confiança , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Manequins , Países Baixos/epidemiologia , Valores de Referência , Fatores de Risco , Morte Súbita do Lactente/prevenção & controleRESUMO
The tongue is as an organ of speech and articulation not as indispensable as the soft palate. The recovery of speech after extirpation of the tongue is usually satisfactory, and the intelligibility of patients with microglossia compares favourably with the speech of an untreated cleft palate patient. Hypernasality and nasal escape of air are typical also for the congenital short palate (in the absence of a cleft); syndromes with a congenital short palate are often misdiagnosed as suprabulbar paralysis. The function and involuntary usage of the tongue e.g. in swallowing, influence the growth and development of the surrounding bony structures and the teeth. A frontal open bite due to the tongue thrust habit is a popular example. A case if made for the notion that the mouth-breathing habit has grave consequences such as nasal obstruction, adenoids and glue ears. Mouth breathing should not be looked upon as a trivial accessory phenomenon, but as a behaviour that needs systematic reeducation treatment. Rehabilitative procedures are pointed out for patients with respiratory problems due to two-sides laryngeal nerve paralysis and patients with swallowing problems after partial extirpation of the base of the tongue.
Assuntos
Transtornos de Deglutição/fisiopatologia , Respiração , Distúrbios da Fala/fisiopatologia , Língua/fisiopatologia , Adulto , Criança , Transtornos de Deglutição/reabilitação , Glossectomia , Humanos , Desenvolvimento Maxilofacial , Respiração Bucal/fisiopatologia , Distúrbios da Fala/reabilitação , Língua/anormalidades , Hábitos Linguais , Prega Vocal/fisiopatologiaAssuntos
Comunicação , Distúrbios da Fala/reabilitação , Humanos , Métodos , Voz Alaríngea/instrumentaçãoRESUMO
The normal course of speech acquisition after laryngectomy is described, with emphasis on the initial stage. Factors that favor or thwart the training process are discussed and particular methods applied when functional or organic impediments deviate or block the development of esophageal speech. A few remarks are added on the rehabilitation after extended forms of surgery and on the use of the artificial larynxes.
