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Objectives: Sleep disorders in patients on hemodialysis are frequent, but few studies correlate these disorders with autonomic dysfunction in these patients. This study aimed to verify whether clinical and laboratory variables and heart rate variability are associated with worse sleep quality verified by the Pittsburg subjective scale in patients on hemodialysis., Material and Methods: A cross-sectional study was performed on forty-eight patients. Epidemiological, clinical, and laboratory data were collected. After were performed by recording the heart rate variability and applied Pittsburg questionnaires, Beck anxiety index (BAI), and Beck depression index (BDI). The global PSQI score >5 indicates that a person is a poor sleeper, the patients were divided according to the scores in the Pittsburg questionnaire into good and poor sleepers and the differences between all variables were analyzed., Results: Forty-eight patients were evaluated and the prevalence of 68.7% (n=33) of poor sleep quality was verified. From the depression and anxiety questionnaires, it was found that only 18.7% (n=9) had criteria for depression. In the analysis of the sympathetic dysfunction parameters, it was found that in the group with good sleep quality in the frequency domain (HFm 2 ) and the LFnu in the group with worse sleep quality. There was a positive correlation between sleep quality scores the anxiety and depression scores. It is also verified that the variables LFnu had a positive correlation with higher scores of quality of sleep and HFnu had a negative correlation with the highest scores of quality of sleep., Conclusion: In patients undergoing hemodialysis, the poorest quality of sleep is correlated with worse cardiac autonomic modulation as well as higher scores on the depression and anxiety scales.

The occlusal matrix technique appears as an alternative to the conventional restorative technique. The aim of this study is to present treatment options for the decayed occlusal surface of posterior teeth by means of an occlusal matrix made with different materials, for an accurate reproduction of the tooth surface. This paper presents five clinical cases using five different materials, such as Bite-Perf, flowable composite, self-curing acrylic resin, silicone and thermoforming foil. Before light-curing, the last layer of composite resin, the matrix, is repositioned and firmly pressed so the replication of the original occlusal anatomy can be achieved. When using an occlusal matrix, minimal or no finishing and polishing procedures are needed and the offered aesthetics are clearly an advantage. Moreover, this technique makes up for the additional chairside work time. The occlusal matrix technique is demonstrated to be effective for direct composite resin restorations in posterior teeth, allowing a reliable and predictable reproduction of the occlusal anatomy and clinical adjustment. For this purpose, a clear material is preferable since it allows light transmission., (© 2021. The Author(s), under exclusive licence to the British Dental Association.)

Aim: To describe the magnetic resonance imaging (MRI) findings of the cervical spine of patients with mucopolysaccharidosis type VI (MPS VI) and correlate them with clinical manifestations., Materials and Methods: This is a cross-sectional study involving 12 patients with MPS VI. A limited neurological examination was undertaken in each patient including Tinel's test, assessment of muscle tone, and the evaluation of deep tendon reflexes. Additionally, each patient underwent cervical spine MRI to evaluate platybasia, odontoid dysplasia, periodontoid soft-tissue thickening, spinal canal stenosis, myelopathy, basilar invagination, platyspondyly, and reduction of nasopharyngeal airway., Results: Nine patients were male (75%). The average age was 12.5 (±3.5 years). Tinel's test was negative in all patients. No muscle tone abnormalities were observed. Approximately 48% of the tested reflexes were considered abnormal, 10 of which (8.3%) were pathological occurring in five different patients (41.6%). At MRI, all patients showed periodontoid soft-tissue thickening and cervical spinal stenosis; six showed spinal cord compression and two showed myelopathy. Odontoid hypoplasia and basilar invagination were observed in nine patients. All patients with cervical stenosis on MRI had abnormal reflexes; however, only two of the six patients with evidence of cord compression on MRI had abnormal reflexes on clinical examination., Conclusions: The present study of 12 patients with MPS VI demonstrated that a normal neurological examination cannot confidently exclude potential cord compression in patients with this condition. MRI may aid in the timely identification of cervical spine abnormalities, and potentially play a role in lessening morbidity and mortality in patients with MPS., (Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Previously, we have shown that electroacupuncture (EA) in rats decreased eosinophil infiltration into the pulmonary tissue (PT) and in the bronchoalveolar lavage (BAL) in an experimental model of asthma. Th2 cytokines, leukotriene B4 (LTB4) and nitric oxide (NO) are involved in the asthma inflammatory process. The aim of this study was to verify the effects of EA on these asthma mediators. Male Wistar rats were divided into control (C), immobilized (I), sham acupuncture (SA), and acupuncture (A) groups. All rats were sensitized, and EA treatment using clinical acupuncture points was started 24h after antigen priming. EA was done every other day for 2weeks. Subsequently, animals were challenged by inhalation and sacrificed 24h later. At this time, the BAL and lungs were collected and used to analyze cytokine production, LTB4 and NO. The EA increased IL-1 and IFN-gamma and decreased IL-4, IL-10, NO and LTB4 in the BAL and PT compared to the C and SA groups. The presence of eosinophils in the BAL negatively correlated with IL-1 and IFN-gamma production and positively correlated with IL-4 and IL-10 production. Our results show that the beneficial anti-inflammatory action of EA on asthma is related to the balance of the Thl/Th2 response and the reduction of LTB4 and NO. These results suggest that EA therapy could be an important complementary treatment for asthma., (Copyright 2010. Published by Elsevier Ltd.)

Introduction: Asthma is a worldwide disabling chronic inflammatory airway disease characterized by an intense eosinophilic inflammatory infiltrate on bronchial mucous membranes. Among the complementary therapeutic approaches to asthma, acupuncture has been widely used., Objective: Here we used a rat pulmonary hypersensitivity experimental model that mimics human asthma in order to address whether electroacupuncture (EA) treatment could reduce the inflammatory process., Materials and Methods: Experimental animals were divided in four groups: control (C), immobilized (I), sham-acupuncture (SA), and acupuncture (A). All rats were sensitized with heat-solidified hen egg white implant. Using clinical acupuncture points, EA treatment began 2 days after antigen priming and was repeated on alternate days for 2 weeks. Subsequently, animals were challenged by inhalation with aggregated ovalbumin and sacrificed 24 hours later when blood samples, bronchoalveolar lavage (BAL), and lungs were collected., Results: Histopathologic analyses showed that peribronchial and perivascular inflammatory cell infiltrates were significantly lower in group A compared to groups SA and I (shown to be similar to group C). Furthermore, BAL total cell count and percentage of polymorphonuclears (as well as the differential counts of neutrophils and eosinophils) were significantly reduced in group A compared to group I. Corsticosterone plasma levels were similar in all groups., Conclusions: Taken together these results show that EA efficiently diminishes the bronchial immune-mediated inflammation induced in rats and that this effect is dependent on the choice of specific acupoints.