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Introduction: Cerebral palsy (CP) is the term used to describe individuals with a movement disorder resulting from non-progressive disturbance to the developing brain1. The diagnosis of CP is based on the presence of a motor deficit, and they manifest with reduced motor capacity. The most widely utilized classification system for the severity of motor limitations is the gross motor function classification system (GMFCS)2. Material and Methods: We tried to describe the white matter injury on Magnetic Resonance Imaging (MRI) in children with cerebral palsy irrespective of clinical subtype. We also studied if there was association between white matter injury on MRI in children with cerebral palsy and motor outcomes-gross motor function classification system Expanded and Revised(GMFCS E &R). It was an observational, Cross sectional Descriptive study with analytical wing aged between 6 months to 12 years of age carried out for 8 months. Children diagnosed to have cerebral palsy on history and clinical examination were enrolled in the study. Results: A total of 50 children diagnosed with cerebral palsy were enrolled in our study. Majority of the study sample were <5years old (29) and males (31). We found that symmetrical involvement, severe white matter loss in the hemisphere and callosal thinning were the strongest predictors of poor gross motor function. Bilateral, extensive WM (white matter) loss was more likely to result in quadriplegia, whereas volume loss in the posterior-mid WM more frequently resulted in diplegia. Asymmetrical involvement was associated with less extensive hemispheric involvement than symmetrical WMI (White matter injury). Cysts, deep grey abnormality, and Wallerian change in the PLIC (Posterior limb of Internal Capsule) and cerebral peduncles were all more commonly seen in association with unilateral and asymmetric patterns of WMI. All children with unilateral WMI functioned at GMFCS levels I or II or III whereas bilateral involvement was associated with wheeled mobility (GMFCS levels IV-V). Motor outcomes for children with asymmetrical WMI fell between those with symmetrical and unilateral WMI on MRI. Conclusion: Laterality/symmetry of WMI along with extent and location of WM loss can predict gross motor function in Cerebral palsy. [ABSTRACT FROM AUTHOR]

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related to problems with eating, such as drooling in individuals with cerebral palsy; (2) Methods: Nineteen patients between the ages of 1 and 14 were examined prior to the physiotherapy intervention. This intervention lasted three months and consisted of: relaxing muscles via the strain-counterstrain technique, functional exercises based on the NeuroDevelopmental Treatment-Bobath method, and functional exercises for eating; (3) Results: the tone of rectus capitis posterior minor muscle on the left side (p = 0.027) and temporalis muscle on the right side (p = 0.048) before the therapy, and scalene muscle on the right side after the therapy (p = 0.024) were correlated with drooling behavior and were considered statistically significant. Gross motor function was not considered statistically significant with the occurrence of drooling behavior (p ≤ 0.05). Following the therapeutic intervention, the frequency of drooling during feeding decreased from 63.16% to 38.89% of the total sample of examined patients; (4) Conclusions: The tightness of the muscles in the head area can cause drooling during feeding. [ABSTRACT FROM AUTHOR]

Abstract Background The rate of chronic drooling in children older than 4 years is 0.5%, but it rises to 60% in those with neurological disorders. Physical and psychosocial consequences lead to a reduction in the quality of Life (QoL) of affected patients; however, the problem remains under-recognized and under-treated. We conducted an Italian consensus through a modified Delphi survey to discuss the current treatment paradigm of drooling in pediatric patients with neurological disorders. Methods After reviewing the literature, a board of 10 experts defined some statements to be administered to a multidisciplinary panel through an online encrypted platform. The answers to the questions were based on a 1–5 Likert scale (1 = strongly disagree; 5 = strongly agree). The scores were grouped into 1–2 (disagreement) and 4–5 (agreement), while 3 was discarded. The consensus was reached when the sum of the disagreement or agreement was ≥75%. Results Fifteen statements covered three main topics, namely clinical manifestations and QoL, quantification of drooling, and treatment strategies. All statements reached consensus (≥75% agreement). The 55 Italian experts agreed that drooling should be assessed in all children with complex needs, having a major impact on the QoL. Attention should be paid to investigating posterior hypersalivation, which is often neglected but may lead to important clinical consequences. Given that the severity of drooling fluctuates over time, its management should be guided by the patients’ current needs. Furthermore, the relative lack of validated and universal scales for drooling quantification limits the evaluation of the response to treatment. Finally, the shared therapeutic paradigm is progressive, with conservative treatments preceding the pharmacological ones and reserving surgery only for selected cases. Conclusion This study demonstrates the pivotal importance of a multidisciplinary approach to the management of drooling. National experts agree that progressive treatment can reduce the incidence of complications, improve the QoL of patients and caregivers, and save healthcare resources. Finally, this study highlights how the therapeutic strategy should be reconsidered over time according to the available drugs on the market, the progression of symptoms, and the patients’ needs.

Objective. To analyse the clinical efficacy of acupuncture and routine treatment in improving dystonia in children with cerebral palsy. Method. The randomized controlled trials published from the establishment of the databases to August 2022 on acupuncture in the treatment of dystonia in children with cerebral palsy were collected and comprehensively searched in China national knowledge infrastructure (CNKI), weipu (VIP), Wanfang, SinoMed, PubMed, Excerpta medica database (EMBASE), and Cochrane Library. The literature was selected according to the established standards, the quality of the included studies was evaluated, the heterogeneity of the included studies was evaluated with the I2 test, and the appropriate model was selected for analysis. Sensitivity analysis was used to evaluate the reliability of the results, and a funnel plot was used to evaluate the publication bias. Results. Fifteen studies were included in the meta-analysis. The control group was treated with routine treatment and acupuncture combined with routine treatment. The outcome index showed that the effect in the treatment group was better: Modified Ashworth Scale score: −0.52, 95% confidence interval (CI) (−0.62 to −0.41), p < 0.01. The treatment group showed reduced muscle tension to a greater extent (integral eletromyographic (iEMG) score: standard mean square deviation = −2.97, 95% CI (−4.87 to −1.06), p < 0.01). The effective rate in the control group was 74.2% and that in the treatment group was 91.5%, odds ratio = 3.70, 95% CI (2.02–6.78), p < 0.01. The funnel plot showed publication bias. Conclusion. Acupuncture combined with routine training could improve muscle tension abnormalities and improve the efficiency of clinical treatment. [ABSTRACT FROM AUTHOR]

Relationship dysfunction—marked by frequent conflicts—is one of the hallmark features of borderline personality disorder (BPD). However, the BPD couple as a dyad and partner-related features have rarely been taken into account. The aim of the present study was to investigate hormonal, personality, and relationship relevant factors, such as relationship satisfaction, attachment, and trauma in both partners within a dyad where one partner is diagnosed with BPD. The total sample consisted of 26 heterosexual couples. All studies were conducted at 2 p.m. Primary outcomes: Neo-Five-Factor-Inventory, Childhood Trauma Questionnaire, Experiences in Close Relationships Scale. Secondary outcomes: Problem List, Partnership Questionnaire, Questionnaire for Assessing Dyadic Coping. Upon questionnaire completion, one saliva sample was taken via passive drool to assess baseline cortisol and testosterone levels. Results showed that females with BPD have higher scores on childhood maltreatment, dysfunctional attachment styles, and neuroticism than mentally healthy females. Furthermore, they have more relationship-related problems and are less satisfied in their romantic relationship. Male partners of women with BPD showed lower testosterone levels, higher levels of childhood maltreatment, dysfunctional attachment styles, neuroticism, and openness compared with the healthy control partners. Furthermore, childhood trauma, neuroticism as well as dysfunctional attachment styles displayed a significant positive correlation with relationship-related problems. Traumatic childhood experiences, insecure attachment styles as well as neurotic personality characteristics contribute to increased relationship disruptions in couples. Relevant hormonal and psychosocial parameters in BPD partners should be taken into account when treating females with BPD. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the validity and reliability of the Turkish version of the Sialorrhea Clinical Scale for Parkinson's disease (SCS-PD) for use in clinical settings. Methods: The original English version of SCS-PD has been adapted to Turkish (SCS-TR) in accordance with international guidelines. Fortyone patients with Parkinson's Disease (PD) and 31 healthy people were included in our study. SCS-TR, Movement Disorders Society United Parkinson's Disease Rating Scale (MDS-UPDRS) Part II (functional subscale 2.2 Saliva and drooling), Drooling Frequency and Severity Scale (DFSS) and The Non-Motor Symptoms Questionnaire (NMSQ) (1st question evaluating saliva) were applied to both groups. The adapted scale was re-tested in PD patients 2 weeks later. Results: A statistically significant relationship was determined between the SCS-TR scale score and all similar scale scores (NMSQ, MDS-UPDRS, DFSS) (p<0.001). The correlation between SCS-TR and similar scales scores was high, linear and positive (84.8% for MDS-UPDRS, 72.3% for DFSS and 70.1% for NMSQ). The Cronbach's alpha coefficient for the evaluation of the reliability of the sialorrhea clinical scale questionnaire was found to be 0.881 which indicates a very good internal consistency. Spearman's correlation test evaluating the relationship between the scores of the preliminary test and re-test of SCS-TR showed a high level, linear and positive relationship. Conclusion: SCS-TR is consistent with the original version of SCS-PD. As its validity and reliability in Turkey have been shown by our study, it can be used for the evaluation of sialorrhea in Turkish PD patients. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Individuals with cerebral palsy may be at risk of obesity, but outcomes and risk factors are understudied. The study objectives are to evaluate the frequency of body mass index (BMI) weight categories of individuals with cerebral palsy and the odds of cardiometabolic-specific diseases and medications. We hypothesize subjects with cerebral palsy and an increased body mass index will have higher odds of cardiometabolic specific diseases and medications. Methods: This is a retrospective observational cohort study utilizing TriNetX, an electronic health record database, in subjects with cerebral palsy aged 2-18 years with an available body mass index. The study population was divided into 4 body mass index percentile categories, underweight (<5th body mass index percentile), healthy weight (≥5th to <85th percentile), overweight (≥85th to <95th percentile), and obese (≥95th percentile), and the odds of the following variables were evaluated: diagnostic codes and medication codes. We computed the odds ratio to test for associations between the body mass index categories and the variables of interest. Results: A total of 5993 subjects were included: underweight (251, 4.2%), healthy weight (2390, 39.9%), overweight (943, 15.7%), and obese (2409, 40.2%). Obese subjects had a higher odds of asthma, diabetes mellitus, hypertension, and sleep apnea when compared to the health weight group. Conclusions: This study found patients with cerebral palsy classified as obese had higher odds of cardiometabolic comorbidity and medication codes that influence weight. Body mass index measurements are limited in this population but may be used cautiously to evaluate the body type of children with cerebral palsy and monitor cardiometabolic-associated comorbidity occurrence. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to provide an overview of the available literature that includes both objective assessments (namely hypersalivation and hyposalivation) and the subjective experience (namely xerostomia and drooling) of salivary problems in patients with Parkinson's disease. Background: In patients with Parkinson's disease, there may be complaints of salivary problems such as xerostomia or drooling. This can have consequences for their oral health and quality of life. To date, systematic reviews have focused on drooling only. Materials and methods: A literature search in 4 databases was performed up to 12 February 2021. Two researchers independently assessed studies for eligibility. Results: In total, 63 studies were included. The prevalence of self‐reported xerostomia ranged from 49% to 77%, and that of self‐reported drooling ranged from 5% to 80%. Ten articles reported a significantly lower mean salivary flow in patients with Parkinson's disease than in controls. None of the articles with both a control group and a patient group reported a significantly higher salivary flow in patients with Parkinson's disease. When questioned about subjective salivary problems, a significantly higher prevalence of both xerostomia (7 studies) and drooling (14 studies) was found in patients with Parkinson's disease than in controls. Patients with Parkinson's disease have a lower salivary flow rate and higher prevalence of both xerostomia and drooling than controls. Conclusion: The complexity of salivary problems present in patients with Parkinson's disease necessitates a multidisciplinary approach in order to avoid mutually counteracting treatments from different healthcare professionals. [ABSTRACT FROM AUTHOR]

Dairy cattle are highly susceptible to heat stress. Heat stress causes a decline in milk yield, reduced dry matter intake, reduced fertility rates, and alteration of physiological traits (e.g., respiration rate, rectal temperature, heart rates, pulse rates, panting score, sweating rates, and drooling score) and other biomarkers (oxidative heat stress biomarkers and stress response genes). Considering the significant effect of global warming on dairy cattle farming, coupled with the aim to reduce income losses of dairy cattle farmers and improve production under hot environment, there is a need to develop heat tolerant dairy cattle that can grow, reproduce and produce milk reasonably under the changing global climate and increasing temperature. The identification of heat tolerant dairy cattle is an alternative strategy for breeding thermotolerant dairy cattle for changing climatic conditions. This review synthesizes information pertaining to quantitative genetic models that have been applied to estimate genetic parameters for heat tolerance and relationship between measures of heat tolerance and production and reproductive performance traits in dairy cattle. Moreover, the review identified the genes that have been shown to influence heat tolerance in dairy cattle and evaluated the possibility of using them in genomic selection programmes. Combining genomics information with environmental, physiological, and production parameters information is a crucial strategy to understand the mechanisms of heat tolerance while breeding heat tolerant dairy cattle adapted to future climatic conditions. Thus, selection for thermotolerant dairy cattle is feasible. [ABSTRACT FROM AUTHOR]

Drooling is a common symptom of Parkinson's Disease (PD) experienced in up to 70% of people with PD (PwP). Drooling can be a major problem in PwP leading to adverse physical and psychosocial issues. Current medical treatments decrease the production of saliva, whereas the problem is due to decreased swallowing frequency, not over production of saliva. Such treatments are problematic as saliva is essential for good oral health. Therefore, non-invasive treatments options such as behavioural cueing methods are recommended. A wrist-worn device delivering haptic cueing has been demonstrated to be an effective treatment method to increase swallowing frequency and a socially acceptable solution for PwP. However, the device had limited functionality and was tested on a small sample size over a short period of usage. Further work is required to understand the real-world behaviours and usage of the intervention to understand the longer-term effects with a larger sample size. This research will deploy CueBand, a discrete and comfortable wrist-worn device designed to work with a smartphone application to support the real-world evaluation of haptic cueing for the management of drooling. We will recruit 3,000 PwP to wear the device day and night for the intervention period to gain a greater understanding of the effectiveness and acceptability of the technology within real-world use. Additionally, 300 PwP who self-identity as having an issue with drooling will be recruited into an intervention study to evaluate the effectiveness of the wrist-worn CueBand to deliver haptic cueing (3-weeks) compared with smartphone cueing methods (3-weeks). PwP will use our smartphone application to self-assess their drooling frequency, severity, and duration using visual analogue scales and through the completion of daily diaries. Semi-structured interviews to gain feedback about utility of CueBand will be conducted following participants completion of the intervention. [ABSTRACT FROM AUTHOR]

Hip displacement is the second most common musculoskeletal deformity in children with cerebral palsy. Hip surveillance programs have been implemented in many countries to detect hip displacement early when it is usually asymptomatic. The aim of hip surveillance is to monitor hip development to offer management options to slow or reverse hip displacement, and to provide the best opportunity for good hip health at skeletal maturity. The long-term goal is to avoid the sequelae of late hip dislocation which may include pain, fixed deformity, loss of function and impaired quality of life. The focus of this review is on areas of disagreement, areas where evidence is lacking, ethical dilemmas and areas for future research. There is already broad agreement on how to conduct hip surveillance, using a combination of standardised physical examination measures and radiographic examination of the hips. The frequency is dictated by the risk of hip displacement according to the child's ambulatory status. Management of both early and late hip displacement is more controversial and the evidence base in key areas is relatively weak. In this review, we summarise the recent literature on hip surveillance and highlight the management dilemmas and controversies. Better understanding of the causes of hip displacement may lead to interventions which target the pathophysiology of hip displacement and the pathological anatomy of the hip in children with cerebral palsy. We have identified the need for more effective and integrated management from early childhood to skeletal maturity. Areas for future research are highlighted and a range of ethical and management dilemmas are discussed. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate our institutions airway management and complications after submandibular duct relocation (SMDR). We analysed a historic cohort of children and adolescents who were examined at the Multidisciplinary Saliva Control Centre between March 2005 and April 2016. Ninety-six patients underwent SMDR for excessive drooling. We studied details of the surgical procedure, postoperative swelling and other complications. Ninety-six patients, 62 males and 34 females, were treated consecutively by SMDR. Mean age at time of surgery was 14 years and 11 months. The ASA physical status was 2 in most patients. The majority of children were diagnosed with cerebral palsy (67.7%). Postoperative swelling of the floor of the mouth or tongue was reported in 31 patients (32.3%). The swelling was mild and transient in 22 patients (22.9%) but profound swelling was seen in nine patients (9.4%). In 4.2% of the patients the airway was compromised. In general, SMDR is a well-tolerated procedure, but we should be aware of swelling of the tongue and floor of the mouth. This may lead to a prolonged period of endotracheal intubation or a need for reintubation which can be challenging. After extensive intra-oral surgery such as SMDR we strongly recommend a extended perioperative intubation and extubation after the airway is checked and secure. [ABSTRACT FROM AUTHOR]

Objective: Botulinum toxin A is known to be effective and safe in managing sialorrhea in pediatric patients; however, there is no consensus on a protocol for optimal injection sites and appropriate dosing for injection. Methods: This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. PubMed, EMBASE, and other databases were queried to identify articles that evaluated botulinum toxin type A for the treatment of sialorrhea in the pediatric population. A total of 405 studies were identified. After applying inclusion and exclusion criteria, 31 articles were included for review. Results: A total of 14 studies evaluated 2-gland injections, and 17 studies evaluated 4-gland injections. Of the 31 studies included, one study assessed incobotulinumtoxinA (Xeomin®) the remaining all used onabotulinumtoxinA (Botox®). For 2-gland injection studies, a combined total of 899 participants were reviewed, where 602 participants received 50 units into their submandibular glands, while 262 participants received 30 to 50 units. Among 4-gland injection studies, there was a combined total of 388 participants, with the most prevalent dosage utilized being 60 to 100 units in 230 participants, followed by 100 units total in 77 participants. The most common adverse event was dysphagia which resolved in nearly all cases. Three studies aimed to examine 2-gland versus 4-gland injections, with 2 of the studies concluding 4-gland injection was superior. Conclusions: The strength of evidence suggests that the dosing of 50 units total of onabotulinumtoxinA to the submandibular glands is safe and effective in the pediatric population. For 4-gland injections, bilateral submandibular and parotid gland injections of 60 to 100 units total is the safe and effective dosage. There is no substantial evidence comparing 4-gland injections to 2-gland injections, but research thus far suggests 4-gland injections to be superior. Future study is needed to evaluate incobotulinumtoxinA and abobotulinumtoxinA dosages in the pediatric population. [ABSTRACT FROM AUTHOR]

A major concern in many electrical drives is the reliability of sensors and actuators. In the paper, the usage of the Drools expert system (ES) for Fault detection and isolation (FDI) of the additive actuator and sensor DC Motor faults using the Structured residuals design technique (SRDT) is presented. The SRDT is used to obtain essential knowledge about the system. Afterward, an expert system that can isolate faults based on the developed structure matrix and generated residuals is designed. Accordingly, following the structure matrix each residual becomes able to answer to a desired subset of faults and stands insensitive to the others. The proposed method is successfully applied in an analyzed laboratory system and can be used for online FDI. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of calcium glycerophosphate (CaGP), with or without fluoride (F), on dual-species biofilms of Streptococcus mutans and Candida albicans. The biofilms were treated three times with 0.125, 0.25, and 0.5% CaGP solutions, with or without 500 ppm F (NaF). Additionally, 500 and 1100 ppm F-solutions and artificial saliva served as controls. After the final treatment, the microbial viability and biofilm structure, metabolic activity, total biomass production, and the composition of the extracellular matrix composition were analyzed. Regardless of the presence of F, 0.25 and 0.5% CaGP promoted a higher biomass production and metabolic activity increase than the controls (p < 0.05). F-free CaGP solutions reduced bacterial cell population significantly more than the 500 ppm F group or the negative control (p < 0.05). All the groups reduced the proteins, and 0.5% CaGP combined with F led to the highest reduction in the carbohydrate and nucleic acids content of the extracellular matrix (p < 0.05). It can be concluded that CaGP alone affected the number of bacterial cells and, when combined with F, reduced its production of biomass, metabolic activity, and the expression of the extracellular matrix components. [ABSTRACT FROM AUTHOR]

Objective. This study is aimed at translating and cross-culturally adapting the Drooling Infants and Preschoolers Scale (DRIPS) into Korean cultural context and examine the content validity and reliability of the Korean version, which is referred as K-DRIPS. Methods. An iterative forward-backward translation sequence of the DRIPS was performed by 20 Korean health professional experts (i.e., occupational therapists (OTs) and professors) with more than 10 years of experience. The study subjects were 77 children with cerebral palsy (CP) exhibiting drooling symptoms aged 2-7 years. They were recruited from two children's rehabilitation hospitals in Korea and completed the K-DRIPS. The content validity and internal consistency of the K-DRIPS items were examined. Results. An assessment with 20 K-DRIPS items was adequately and cross-culturally adapted into Korea. All the items exhibited good content validity (content validity ratio range 4.00-4.95) and good internal consistency (Cronbach's α = 0.98). Conclusion. The study findings indicated that the K-DRIPS was successfully adapted to the Korean cultural context and demonstrated good psychometric properties. This instrument could be used for drooling assessment tool in Korean children with disabilities. [ABSTRACT FROM AUTHOR]

Rationale: Clozapine has proven to be superior to other antipsychotic drugs in the treatment of schizophrenia but is under-prescribed due to its potentially severe side effects. Clozapine-induced sialorrhea (CIS) is a frequent and extremely uncomfortable side effect, which remains understudied. Objectives: To examine the prevalence of diurnal and nocturnal CIS in a sample of patients treated with clozapine, and to evaluate its impact on quality of life. Methods: We conducted a cross-sectional, observational study of 130 patients with schizophrenia spectrum disorders treated with clozapine. The prevalence of CIS was evaluated via specific sialorrhea scales. None of the patients included in the study was receiving a specific treatment for hypersalivation during the study period. Possible associations between sialorrhea and clinical and quality of life variables were analyzed. Results: Of 130 subjects, 120 (92.3%) suffered from CIS. Eighty-one (62.31%) suffered from diurnal CIS, 115 (88.56%) from nocturnal CIS, and 85 (65.38%) suffered from both. Significant positive associations between quality of life and diurnal CIS (B = 0.417; p = 2.1e − 6, R2 = 0.156) and nocturnal CIS (B = 0.411; p = 7.7e − 6, R2 = 0.139) were detected. Thirty per cent of the subjects reported a moderate to severe negative impact of sialorrhea on their quality of life. Conclusions: The present study suggests that CIS is highly prevalent in patients with schizophrenia and has an important impact on quality of life in one-third of our sample. Therefore, the inclusion of a systematic evaluation and treatment of CIS in standard clinical practice is highly recommended. Trial registration: Clinical Trials (https://clinicaltrials.gov) under reference NCT04197037. [ABSTRACT FROM AUTHOR]

Objective: To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. Methods: Cross-sectional study of a consecutive series of children, followed in a referral multi centric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. Results: The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. Conclusions: Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population. [ABSTRACT FROM AUTHOR]

Background: Ultrasonography is considered as the primary imaging technique used for identification, diagnosis, treatment, and follow-up of lesions affecting the major salivary gland. Both grey scale and color Doppler ultrasound maneuvers are frequently used for assessment of various salivary gland infirmities. As well, it is used for classification of the major salivary gland pathologies. This study aimed to assess the validity of ultrasound in the diagnosis and prediction of the parotid and submandibular gland lesions. Patients and Methods: Sixty-nine cases with salivary gland masses were investigated via using grey scale, color Doppler and spectral Doppler. Grey scale was used for the morphological features of each tumor; color Doppler for the blood vessel distribution and frequency; and spectral Doppler for determination of the peak systolic velocity, resistive index and pulsatility index. Postoperative through histopathological examination was carried out for all cases after excision of mass. Results: According to the histopathological examination, 28 of 69 (40.6%) lesions were identified as benign, 13 of 69 (18.8%) as malignant, and 28 of 69 (40.6%) as inflammatory. Color Doppler revealed that malignant lesions had significantly higher grade of vascularity and a mixed "scattered" pattern of distribution. Using spectral Doppler, malignant masses had significantly higher Doppler ultrasound wave forms. Grey scale sonar showed that the rate of illdefined borders, heterogeneous structure, and irregular shape was significantly higher in Malignant than benign tumors. Conclusions: Adding Doppler ultrasound (color and pulse wave) may grant better diagnosis for malignant salivary gland tumors. [ABSTRACT FROM AUTHOR]

Introduction: Oral squamous cell carcinoma (OSCC) accounts for 95% among all head and neck cancers. Literature reveals saliva as a predictive, diagnostic and prognostic tool in carcinoma, inflammatory and genetic disorders. Expression of salivary interleukin-6 (IL‑6) has been reported in patients with OSCC and in oral potentially malignant disorders (OPMDs). This study aims at the following objectives: • To evaluate the changes in the salivary levels of IL‑6 in healthy individuals and those with chronic periodontitis (CP), OPMD and OSCC. • To compare the estimated levels of salivary IL-6 individually in healthy individuals and those with CP, OPMD and OSCC. • To assess the estimated levels of salivary IL‑6 individually within histopathologically differentiated OSCC. • To analyse salivary IL-6 as a reliable biomarker in the diagnosis of OSCC. Materials and Methods: Totally, 60 patients were divided into four groups consisting of 15 patients in each group. Salivary samples were collected by simple drooling method. The concentration of IL-6 is to be determined by using Quantitative sandwich ELISA technique. All analyses were carried out using Statistical Package for Social Sciences (SPSS). Results: The concentration values of IL-6 were found to be more in OSCC group in comparison with the other three groups and the concentration values of OPMD were found to be more than in the CP and control group and was statistically significant. Discussion: We attempted a study to evaluate the salivary IL-6 in patients with OSCC, OPMDs and CP in comparison with the healthy controls. We achieved a pragmatic result showed that salivary IL-6 can be a reliable biomarker in the detection of OSCC. Saliva, due its wide array of functional characteristics, is an upcoming diagnostic fluid in the field of medicine and salivary IL-6 can be one such biomarker in the diagnosis of OSCC. [ABSTRACT FROM AUTHOR]

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Background. Organophosphates are chemicals that lead to the accumulation of acetylcholine, causing muscarinic symptoms such as salivation and nicotinic manifestations like muscle weakness and hypertension and rarely leading to basal ganglia impairment, manifesting as extrapyramidal symptoms. Literature reported that the use of amantadine, an amine that has both antiviral and dopaminergic activities, improves extrapyramidal manifestations. Most of the studies exploring the effect of amantadine were conducted on adults and there are extremely limited data in regards to this topic in Saudi Arabia. Thus, the purpose of this case study is to report the outcome of treating a child who developed extrapyramidal symptoms due to organophosphates poisoning with amantadine. Case Description. A 6-year-old boy was found by his family drowsy and drooling with an insecticide bottle beside him. He was brought to the ER and arrested on arrival, and he was eventually revived after 5 minutes of CPR. Then, he developed features of extrapyramidal involvement such as delirium, hyperactivity, akathisia, aphonia, and tremors. He was started on oral amantadine 50 mg once daily and then increased to twice daily for two weeks while admitted. During admission, his symptoms were assessed daily, and an improvement was noticed by his family and the medical team. Upon discharge, he was able to form sentences; tremors were almost resolved; and there was no rigidity or agitation. He was followed up postdischarge and showed significant improvement. He continued amantadine for almost 3 months until the full resolution of his symptoms. Discussion and Conclusion. This case illustrates the promising benefits of using amantadine in treating extrapyramidal manifestations following organophosphate ingestion. [ABSTRACT FROM AUTHOR]

Background Excessive saliva can be one of the most frustrating symptoms of ALS, the most common of the motor neurone diseases (MND) [[1]], because it can generate a lot of discomfort and moreover can lead to social withdrawal and isolation. A well-designed study of botulinum toxin B compared to placebo injected into the parotid and submandibular glands of 20 participants showed that botulinum toxin B may produce participant-reported improvement in sialorrhea, but the confidence interval (CI) was also consistent with no effect. Is there a treatment effective and safe for sialorrhea in people with amyotrophic lateral sclerosis (ALS)?. [Extracted from the article]

Sialorrhea or excessive drooling is an important problem known as saliva spillage from the mouth. Drooling may accompany many diseases, especially chronic neurological diseases and other chronic diseases. A 57-year-old female patient presented with a complaint of drooling that started after concurrent chemotherapy and radiotherapy due to small-cell lung cancer. The patient's complaints were significantly reduced with an ultrasound-guided botulinum toxin injection into the salivary glands. [ABSTRACT FROM AUTHOR]

Drooling is a common and troublesome symptom in Parkinson's disease (PD), but the underlying pathophysiological mechanisms remain unclear. Studies in recent years have suggested each part of the striatum has different functions. Here, we investigated the association between drooling and dopaminergic dysfunction in each part of the striatum among patients with de novo PD. We retrospectively reviewed consecutive enrolled patients who had been diagnosed with de novo PD. Drooling was assessed using the Non-Motor Symptoms Questionnaire item 1. Uptake of 123I-ioflupane in each part of the striatum bilaterally on single positron emission computed tomography was quantitatively evaluated in PD patients with or without drooling. We enrolled 44 PD patients, comprising 12 with drooling and 32 without drooling. Significantly lower uptake of 123I-ioflupane was identified among patients with drooling compared to patients without drooling in the right anterior putamen (median 0.49 vs 0.74, p = 0.004) and right posterior putamen (median 0.23 vs 0.41, p = 0.02). These findings suggest that in PD patients, drooling is associated with dopaminergic dysfunction in the right putamen.

Introduction- Cerebral palsy (CP) is a group of permanent disorders of movement and posture, causing limitation in an activity that is attributed to non-progressive disturbances in the developing fetal or infant brain. Poor nutritional status is common in this group, and children across all severities of gross motor functional impairment are at risk. Methodology -A total of 80 cases were included in the study, chosen as per inclusion criteria guided by --The Definition and classification of cerebral palsy, April 2006 International consensus. Thorough clinical history regarding presenting complaints, birth history encompassing antenatal, intra-natal and postnatal history, detail developmental history of all 4 domains, nutritional history was noted. After obtaining informed consent, clinical examination, particularly central nervous system examination and anthropometric measurements were done. Anthropometric parameters were plotted against age and gender specific WHO growth charts & interpreted. CBC, iron and ferritin values were compared with age reference standards and categorized as anemic & non anaemic. Results- 75% of the study subjects were <5 years of age. Majority of cerebral palsy children had growth flattering: more than half 53(53.8%) subjects had underweight, 30 (37.6%) were stunted & 6 (7.5%) were over-weighed. 28 (35%) were anemic out of which 46% were diagnosed with iron deficiency anemia. Overall iron & ferritin deficiency was noted in 13 (16.3%) subject of them. Conclusions- In this study, children with cerebral palsy have impaired anthropometric parameters with considerate percentage of anaemia. Early identification and treatment of these patients is very crucial for their optimal growth and development. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 1% of all live births. Intrauterine infection such as CMV infection is a risk factor for developing cerebral palsy. This study aims to investigate the association between congenital CMV infection and the development of cerebral palsy. A systematic literature search was conducted in PubMed, Web of Science and Ovid SP to identify relevant studies. The quality of studies was assessed using the Newcastle–Ottawa Scale. The random‐effect model was used to calculate the pooled prevalence. The generic inverse variance method was used for statistical analysis. A total of 12 studies were included in this systematic review and meta‐analysis. The overall pooled prevalence of cerebral palsy among patients diagnosed with congenital CMV infection was 26% (95% confidence interval (CI), 13–40%). The overall pooled prevalence of congenital CMV infection among patients with cerebral palsy was 10.9% (95% CI, 5–16%). Congenital CMV infection was significantly associated with the development of cerebral palsy in children. Routine follow‐ups should be offered to screen for cerebral palsy. [ABSTRACT FROM AUTHOR]

Reinstein et al ([17]) demonstrated that the dose of clozapine administered could be lowered by 25% by using quetiapine, which has less anticholinergic effects, as a clozapine sparing agent and substituting 2 mg of quetiapine for every 1 mg of clozapine. M. was a 14-year-old adolescent girl brought by her mother to an emergency department for worsening self-injurious behavior by scratching and suicidal ideation in the context of recurrent hospitalizations for similar symptoms. Although M. did not report constipation on admission, upon specific review of systems, M. reported that she had no bowel movements for 3 days after two doses of clozapine. Perhaps the most obvious strategy in preventing CIC would be to obtain a thorough medical history, focusing on risk factors for constipation and pre-existing conditions, such as irritable bowel syndrome, and provide psychoeducation to patients about symptoms and consequences of CIC before beginning clozapine treatment. [Extracted from the article]

Background. Cerebral palsy (CP) is a common cause of physical impairment in children. Brain magnetic resonance imaging (MRI) can define different neuropathological patterns of brain injury in CP. There are limited data available on MRI findings of children with CP in Africa. Objective. To describe the clinical characteristics, risk factors and MRI findings of children with CP attending a developmental clinic at a tertiary hospital in South Africa; and to assess possible associations between the clinical characteristics and pathogenic neuro-imaging patterns. Methods. This was a retrospective cross-sectional study. The cohort of 112 children was identified from the clinic's REDcap database. Clinical information was obtained from existing medical records of the patients. Findings from brain MRI reports were classified according to the MRI classification system (MRICS) for CP. The MRI reports were rated independently by two study investigators. A descriptive analysis was conducted. Results. A total of 112 patient files and MRI brain reports were reviewed. Spastic CP was the most common type of CP (n=75%). The most common perinatal risk factors included prematurity (31%) and low birthweight (28%). Nineteen (17%) children acquired CP after the neonatal period. CP sub-type showed a significant association with functional motor impairment classified as per the gross motor function classification system (GMFCS), p<0.001. Predominant grey matter injury (PGMI) was the most common pathogenic MRI pattern identified (30%). The radiological findings (per MRICS) had a significant association with both the CP sub-type (p<0.005) and functional impairment according to the GMFCS (p<0.001). Conclusion. Standardised classification of neuro-imaging findings can assist in defining the pathogenesis and clinical manifestations of CP. [ABSTRACT FROM AUTHOR]

Coenurus cerebralis is the larval stage of Taenia multiceps which involves particularly the central nervous system of humans and ungulates. A six-month-old Charollais lamb was presented with cortical blindness, dullness, convulsion, head deviation, reluctancy to move, drooling of saliva and ataxia. Haematological findings revealed an inflammatory process. CSF analysis showed leukocytosis associated with increased total protein. By CT imaging, nine cysts were detected in the cerebrum and one in the cerebellum. Hounsfield units were below 10 in all these regions. CT images perfectly revealed multiple Coenurus cysts in various parts of the brain, which was confirmed by necropsy. At necropsy, cysts of variable size were noted at different anatomical sites of the brain. In the cerebrum, atrophy, liquefactive necrosis and mild demyelination were presenty adjacent to the cystic structures. Perivascular and perineuronal oedema, neuronal degeneration, hyperaemia and thrombosis were also seen in the cerebrum. The meninges revealed oedema, thrombosis, and mononuclear meningitis. Based on authors' knowledge, this is the first study in Iran on Coenurus cysts in a lamb brain utilising CT scan. [ABSTRACT FROM AUTHOR]

In recent years, scientific researchers have increasingly become interested in noninvasive sampling methods for therapeutic drug monitoring and disease diagnosis. As a result, dried saliva spot (DSS), which is a sampling technique for collecting dried saliva samples, has been widely used as an alternative matrix to serum for the detection of target molecules. Coupling the DSS method with a highly sensitive detection instrument improves the efficiency of the preparation and analysis of biological samples. Furthermore, dried blood spots, dried plasma spots, and dried matrix spots, which are similar to those of the DSS method, are discussed. Compared with alternative biological fluids used in dried spot methods, including serum, tears, urine, and plasma, saliva has the advantage of convenience in terms of sample collection from children or persons with disabilities. This review aims to provide integral strategies and guidelines for dried spot methods to analyze biological samples by illustrating several dried spot methods. Herein, we summarize recent advancements in DSS methods from June 2014 to March 2021 and discuss the advantages and disadvantages of the key aspects of this method, including sample preparation and method validation. Finally, we outline the challenges and prospects of such methods in practical applications. Dried blood spot (DBS), dried urine spot (DUS) and dried matrix spot (DMS) have shown to be useful tools to measure analyte in blood, urine and various biological fluids. These methods have same advantages of ease of sample collection, transportation and storage, simplicity of pretreatment and requiring small sample volume. Moreover, a new sampling method, dried saliva spot (DSS), is used as an alternative noninvasive specimen to plasma and urine. And there are some differences between DSS and abovementioned methods, including saliva collection is not restricted anytime and anywhere, low invasiveness compared to other biological samples, readily accepted by children and patients, and reflect the plasma free drug concentration. In addition, all aspects of the DSS, including sample collection, selection of an appropriate filter paper types and filter paper cutting tool, sample preparation, advantages and challenges, will be extensively discussed. [Display omitted] • Use of dried saliva spots (DSS) in drug monitoring and disease diagnosis is reviewed. • Advantages and limitations of the development of the DSS methods are discussed. • Different matrices used in the dried spot method were compared with those of DSS. • Feasibility and prospects of DSS in clinical diagnosis are outlined. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Abscess of the tongue is a very rare disease that potentially compromises the airway. Acute tongue abscess symptoms include swelling or a lump in the deep tissues of the tongue, throbbing local pain, a discomfort that radiates to the ears, fever, difficulty swallowing, deliberate fixation of the tongue due to pain, and eventually, difficulties breathing. Case: This is a 50-year-old male patient who presented with a complaint of severe tongue pain and swelling of three days duration. Associated with this, he had pain while swallowing, difficulty opening his mouth, shortness of breath, and drooling saliva. Likewise, he had a high-grade fever and a global type of headache. On physical examination, there was significant tongue swelling on the left anterolateral area, fluctuant on palpation, and had erythematous border. After informed consent was taken the patient was transferred to the operation room with the diagnosis of tongue abscess. Subsequently, incision and drainage were done under general anesthesia, and about 30mL of thick pus was drained. The pocket was washed with normal saline and 2% hydrogen peroxide. The patient was transferred to the surgical ward with stable vital signs and had been on antibiotics. He was discharged after two days of hospital stay. Conclusion: Abscesses in the tongue are quite uncommon due to its rich vascular supply, lymphatic drainage, and saliva's immunologic advantage. Thorough diagnosis and successful treatment of tongue abscess prevent potential airway compromise. Antibiotic treatment should cover gram-positive and gram-negative anaerobes. [ABSTRACT FROM AUTHOR]

One of the most debilitating symptoms of advanced Parkinson's disease is drooling. Currently, the main treatment that is offered for drooling is botulinum toxin injections to the saliva glands which have a number of side effects and do not treat the causes of drooling, such as impaired swallowing and lip closure. This study explored the effect of an alternative therapy approach for drooling that aimed at improving the swallow, expiratory muscle strength training (EMST). Sixteen participants received EMST over a 6- to 8-week period. Measurements were taken pre- and post-training for drooling (Sialorrhea Clinical Scale for Parkinson's Disease; SCS-PD), swallowing, lip strength and peak cough flow. Measures of drooling, swallowing and peak cough flow were stable over pre-training assessments and improved following training (p < 0.01). The most conservative estimate of the within-group change for SCS-PD was - 2.50 (95% confidence interval -  3.22 to -  1.22). No adverse effects were reported and participants gave high satisfaction ratings for the training. A programme of EMST offers promise as a therapy to reduce drooling for people with Parkinson's disease. Adequately powered randomised controlled trials of EMST are now needed. [ABSTRACT FROM AUTHOR]

Background: Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food and environmental adjustments. The aim of this systematic review was to evaluate the effectiveness of FuCT in improving chewing function and the severity of tongue thrust and drooling in children with cerebral palsy as compared with standard treatment. Methods: We conducted a systematic review of randomized controlled trials. The search was performed between October 2021 and January 2022 using the following databases: PubMed, Scopus, Web of Science, and CINAHL. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The initial search yielded 56 articles. After reading the studies in full, 3 articles were chosen based on the inclusion criteria. Included participants were people with PCI; the studies reported a sample size ranging from 40–80 individuals, one study was on a pediatric population, while the others on adults. The selected studies were then evaluated using Jadad and PEDro scales. Conclusion: Our study confirmed the value of FuCT in improving chewing function and the severity of tongue thrust and drooling. Our results may be useful in optimizing appropriate therapeutic management. [ABSTRACT FROM AUTHOR]

Oral health is a window to a patient's general well-being. Balance in oral microbiome functions is crucial for health maintenance. A state of oral dysbiosis may lead to a variety of local and systemic pathological conditions. The presence of dental plaque is related to the majority of oral infections. Proper oral hygiene is crucial and the most economic practice contributing to oral health prophylaxis. Aside from prophylactic treatments provided by dental practitioners, mouth rinses, containing antimicrobial agents, are one of the possible tools used for oral care. Our study was to determine whether available mouth rinses and selected products dedicated for professional use are efficient to eradicate biofilm formed by reference and clinical strains of Streptococcus mutans, Streptococcus sanguinis, Streptococcus oralis, Streptococcus mitis, Staphylococcus aureus, Enterococcus faecalis, Lactobacillus rhamnosus and Candida albicans on the surface of hydroxyapatite – major mineral component of a tooth. Therefore, such antimicrobials as chlorhexidine, cetylpyridine chloride, polyhexanide, silver nanoparticles, sulphonated phenolics, and natural antiplaque essential oils and coconut oil were analyzed. Applied experimental settings in in vitro models were designed to reflect accurately the recommended use of the tested substances, therefore four types of eradication procedure were conducted. Sialorrhea simulation was also performed to evaluate antibiofilm potential of diluted mouth rinses. Biofilm was investigated with quantitative method where absorbance values were measured. Statistical differences were assessed using the Kruskal–Wallis test with a post-hoc Dunnett's analysis. Results have shown that biofilms displayed a diversified sensitivity to the tested antimicrobials. The highest antibiofilm activity was detected for cetylpyridine chloride while the lowest for chlorhexidine. However the differences in E. faecalis biofilm reduction observed after the use of these two compounds were not statistically significant (p > 0.05), whereas all observed differences in S. aureus survival after exposure to the examined antimicrobial agents were statistically significant (p < 0.5). The PHMB, both in standard and in sialorrhea simulated conditions had the highest potential against streptococci. The coconut oil reduced C. albicans fungus biofilm by 65.48% but low eradication level was observed in case of bacterial biofilms. The dehydrating mechanism of action of sulfonated phenolics turned out to be ineffective against streptococcal biofilm which in turn was effectively eradicated by silver nanoparticles. The implementation of Antibiofilm Dressing's Activity Measurement method allowed to observe strain-related differences in terms of antimicrobial sensitivity. The obtained results may be introduced in everyday out-patient dental plaque prophylaxis as well as clinical environment. [ABSTRACT FROM AUTHOR]

Background: There is a dearth of studies on non motor symptoms of Wilson's disease (WD) which is primarily because of the non availability of a suitable scale. Objective: To assess the suitability of the Parkinson's Disease non motor symptoms questionnaire (PD NMS Quest) in the assessment of non motor symptoms of WD patients. Methods: In this case control study, patients of WD above ≥12 years of age diagnosed by Leipzig's criteria and age and gender matched control subjects were recruited. Critically ill patients, patients with severe hepatic impairment, or with pure hepatic WD were excluded. PD NMS Quest was applied and relevant statistical analyses were performed. Results: A total of 18 cases and 25 controls were studied. Patients had a mean age of 22.6 years and a median disease duration of 8 years. WD patients had higher frequencies of all NMS than controls. Drooling (P = 0.0037), dysphagia or choking (P = 0.0088), nocturia (P = 0.0471), anxiety/fear (P = 0.0337), feeling sad or blue (P = 0.0020) and falling (P = 0.0197) were significantly higher in WD patients than controls. Conclusions: Although many NMS of WD patients are picked up effectively with PD NMS Quest, some of them need detail assessment including cognitive, behavioral, and psychiatric symptoms, drooling and dysphagia, sleep as well as autonomic disturbances. Questions pertaining to sexual activity may be omitted from the questionnaire. [ABSTRACT FROM AUTHOR]

Background Antipsychotic choice for the acute phase of a first episode of psychosis (FEP) is of the utmost importance since it may influence long-term outcome. However, head-to-head comparisons between second-generation antipsychotics remain scarce. The aim of this study was to compare the effectiveness in the short term of aripiprazole and risperidone after FEP outbreak. Methods From February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode drug-naïve patients were randomly assigned to aripiprazole (n = 136) or risperidone (n = 130) and followed-up for 12 weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. Results The overall dropout rate at 12 weeks was small (6.39%). Effectiveness measures were similar between treatment arms as treatment discontinuation rates (χ 2 = 0,409; P  = .522), and mean time to all-cause discontinuation (log rank χ 2 = −1.009; P  = .316) showed no statistically significant differences. Despite no statistically significant differences between groups regarding clinical efficacy, aripiprazole required higher chlorpromazine equivalent dosage (χ 2 = 2.160; P  = .032) and extended mean time (W = 8183.5; P  = .008) to reach clinical response. Sex-related adverse events and rigidity were more frequent in the risperidone group, whereas sialorrhea was on the aripiprazole group. Conclusions No differences regarding effectiveness were found between aripiprazole and risperidone for the short-phase treatment of FEP. Despite the importance of efficacy during this phase, differences in side effect profiles and patient's preferences are essential factors that may lead clinical decisions for these patients. Clinicaltrials.gov NCT02532491. Effectiveness of Second-Generation Antipsychotics in First Episode Psychosis Patients: 1-year Follow-up (PAFIP3_1Y). [ABSTRACT FROM AUTHOR]

Cestrum axillare poisoning causes significant economic losses in farms of ruminant production due to a fatal acute hepatic disease. The consumption of C. axillare occurs on farms or pastures with a scarcity of feed or with dry forage. Epidemiological, clinical, and pathological data of poisoning outbreaks by C. axillare from 1953 to 2021 in grazing ruminants in southeastern Brazil are reported. A total of 68 bovines, two buffaloes, and two goats exhibited clinical signs and resulted in death due to C. axillare consumption, with 79% of the cases occurring during the dry period. Clinical signs were apathy, anorexia, ruminal arrest, arched back, and constipation with hard stools, sometimes with blood or mucus. Cases with neurological signs due to hepatic encephalopathy showed excitement, aggressiveness, drooling, staggering, and muscle tremors. The pathological findings included hepatocellular necrosis in the liver and microcavitations in the brain's white matter (status spongiosus). The hepatotoxins, carboxyparquin and parquin, were detected in C. axillare leaf samples collected from paddocks grazed by cattle in three southeastern Brazilian municipalities where outbreaks of C. axillare poisoning occurred. This is the first report of parquin and carboxyparquin in C. axillare. [Display omitted] • Cestrum axillare is a cause of centrilobular hepatocellular necrosis in ruminants. • This is the first report of the hepatotoxins, carboxyparquin and parquin, in Cestrum axillare. • Spontaneous poisoning occurred in cattle, buffalo and goats, mainly in the Southeast region of Brazil. • 79% of the poisoning outbreaks occurred during the dry season, during which C. axillare supports green leaves. • To prevent severe losses, it is essential to plan for supplemental herd nutrition in ruminants during the dry season. [ABSTRACT FROM AUTHOR]

Background: The prevalence and associated factors of dysphagia in Parkinson's disease (PD) are different in studies conducted in different countries. The purpose of our systematic review and meta-analysis was to evaluate the prevalence of dysphagia in PD and to clarify its associated factors. Methods: Two researchers systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, SinoMed and VIP databases and manually searched references in the retrieved articles to identify potential research subjects. The last search was conducted on June 28, 2022. Finally, a total of 58 studies including 60 observations with 20,530 PD patients were included in our meta-analysis. Results: The meta-analysis estimated that the pooled prevalence rate of dysphagia in PD was 36.9% (95% CI: 30.7--43.6%) and instrumental examination showed a higher prevalence (57.3%, 95% CI: 44.3--69.1%). Oceania showed the highest prevalence of dysphagia in PD (56.3%) compared to Africa (39.5%), Asia (38.6%), Europe (36.1%) and America (28.9%). Dysphagia in PD was associated with older age, lower body mass index, longer disease duration, higher Hoehn and Yahr stage and levodopa equivalent daily dose, PIGD subtype, severe motor symptoms, drooling and higher levels of depression, and lower quality of life. Conclusions: In conclusion, our meta-analysis showed that dysphagia occurs in more than one-third of PD patients and was associated with several demographic characteristics and PD-related characteristics, motor symptoms, non-motor symptoms, as well as decreased quality of life. It deserves early screening, diagnosis, and treatment in clinical practice to prevent serious complications from dysphagia. [ABSTRACT FROM AUTHOR]

Background: Cervical dystonia (CD) is characterized by involuntary contractions of the cervical muscles. Data on long-term effectiveness of deep brain stimulation (DBS) are rare. The aim of this study was to evaluate the longitudinal ten years treatment efficacy of DBS in the globus pallidus internus (GPI). Methods: A retrospective single-center data analysis was performed on patients with idiopathic CD, who were treated with GPI DBS for at least 10 years. TWSTR severity score and individual sub-items were compared between pre and post DBS surgery (n = 15) over time. Results: There was a significant and persistent positive effect regarding the severity of TWSTRS between the conditions immediately before and 1, 5, and 10 years after establishment of GPI DBS (mean difference: 6.6–7 ± 1.6). Patients with increasing CD complexity showed a poorer response to established treatment forms, such as injection of botulinum toxin and were thus DBS candidates. Especially a predominant torticollis was significantly improved by DBS. Conclusion: GPI DBS is an effective procedure especially in severely affected patients with a positive 10-year outcome. It should be considered in more complex CD-forms or predominant torticollis. [ABSTRACT FROM AUTHOR]

The cytosolic concentration of free calcium ions ( [ Ca 2 + ] ) is an important intracellular messenger in most cell types, and the spatial distribution of [ Ca 2 + ] is often critical. In a salivary gland acinar cell, a polarised epithelial cell, whose principal function is to transport water and thus secrete saliva, [ Ca 2 + ] controls the secretion of primary saliva, but increases in [ Ca 2 + ] are localised to the apical regions of the cell. Hence, any quantitative explanation of how [ Ca 2 + ] controls saliva secretion must take into careful account the spatial distribution of the various Ca 2 + sources, Ca 2 + sinks, and Ca 2 + -sensitive ion channels. Based on optical slices, we have previously constructed anatomically accurate three-dimensional models of seven salivary gland acinar cells, and thus shown that a model in which Ca 2 + responses are confined to the apical regions of the cell is sufficient to provide a quantitative and predictive explanation of primary saliva secretion. However, reconstruction of such anatomically accurate cells is extremely time consuming and inefficient. Here, we present an alternative, mostly automated method of constructing three-dimensional cells that are approximately anatomically accurate and show that the new construction preserves the quantitative accuracy of the model. [ABSTRACT FROM AUTHOR]

The review is an introduction to medical, non-cosmetic treatments with botulinum neurotoxin (BoNT) in the orofacial region. It focuses on the current most common, best-documented and safest indications of interest for dentists in terms of dystonia and sialorrhea. These conditions are recommended to start with and suitable to gain better skill and experience with BoNT. The introduction also stresses the importance of correct diagnostics based on interdisciplinary cooperation, precise targeting of the injections, measurements of treatment effect, and control of the oral health with regard to side effects. [ABSTRACT FROM AUTHOR]

Background: There is no oncologic basis for the extirpation of the submandibular gland (SMG) in early oral squamous cell carcinomas (OSCC) unless the SMG is truly infiltrated by the tumor. The study aimed at assessing the true involvement of SMG in OSCC and to determine whether the gland extirpation in all cases is justified. Methods: This study prospectively evaluated the pathological involvement of SMG by OSCC in 281 patients, who were diagnosed with OSCC and underwent wide local excision of the primary tumor with simultaneous neck dissection. Results: Among 281 patients, 29 (10%) cases underwent bilateral neck dissection. A total of 310 SMG were evaluated. Involvement of SMG was seen in 5 (1.6%) cases. SMG metastases from Level Ib were seen in 3 (0.9%) of cases, whereas 0.6% showed direct SMG infiltration from the primary tumor. The advanced floor of mouth and lower alveolus cases had a higher tendency to infiltrate SMG. In none of the cases, bilateral or contralateral SMG was involved. Conclusion: The findings of this study show that the extirpation of SMG in all cases is truly irrational. Preserving the SMG is justified in early OSCC with no nodal metastasis. However, SMG preservation is case dependent and is an individual preference. Further studies are required to assess the locoregional control rate and salivary flow rate in postradiotherapy cases where SMG is preserved. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Shanghai Physical Education Institute / Shanghai Tiyu Xueyuan Xuebao is the property of Shanghai Physical Education Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)