Intraoral Swallow Pressure Profiles-General Features and Aids to Categorization

Purpose: The primary goal of this study was to establish a normative data set representing intraoral time series swallow pressure profiles for healthy adults using a novel wearable intraoral pressure sensing system, OroPress, developed to help with dysphagia (swallow disorder) clinical screening. Methods: Swallow intraoral pressure-time profiles for 35 healthy adults (17 male, 18 female) swallowing water (3 × 5cm3 ; 3 × 10cm3 ) and custard (3 × 5cm3 ) boluses (N = 9 × 35 = 315) were recorded using OroPress. Results: General swallow profile traits are identified to characterise an effective, efficient swallow. A profile-specific swallow envelope function is devised which in combination with profile metrics, provides a simple means of categorizing swallows as effective or impaired. Conclusion: The swallow profile data trace with superimposed and colour coded peaks, envelope function and related swallow metrics provides a simple human readable graphic to aid the real-time instrumented identification of subjects warranting more in-depth clinical assessment. It may also prove useful in the selection of training set profiles for machine learning and other analysis tools which could improve the discriminatory capabilities of intraoral pressure measurement in dysphagia diagnostics.

Effects of newborn intraoral pressure on colostrum intake

ABSTRACT Objective To explore the effects of intraoral pressure on colostrum intake. Methods Healthy women with full-term infants were admitted in the study after birth. Intraoral pressure was detected before and after the mothers’ onset of lactation by a pressure sensor during a breastfeeding session. Colostrum intake was measured by weighting the infant before and after breastfeeding. The onset of lactation was confirmed by the mothers’ perceptions of sudden breast fullness. Results The newborns’ peak sucking pressure was 19.89±7.67kPa before the onset of lactation, dropping to 11.54±4.49kPa after mothers’ onset of lactation (p<0.01). The colostrum intake was 4.02±4.26g before the onset of lactation, and 11.09±9.43g after the onset of lactation. Sucking pressure was correlated with the amount of colostrum intake before and after the onset of lactation after adjusting the confounding factors. Conclusions The newborns’ intraoral pressure at early stage played a predominant role in colostrum intake. It is recommended to initiate breastfeeding immediately after the birth to take advantages of the active and robust sucking response. It is valuable to understand the importance that the sucking pressure plays in the colostrum intake and active immunity achievement during the first several days after birth.

Preliminary Validation of Infant Sucking Measurement System with Healthy Term Infants

Background: Although various methods have been used to objectively evaluate an infant’s sucking behavior during breast- and bottle-feeding, variations in instruments and technologies currently employed make it difficult to compare findings across breast and bottle-feeding conditions. Therefore, we developed a new method, the Infant Sucking Measurement System (ISMS) that provides a consistent assessment of sucking across breast and bottle-feeding. The purpose of this study was to present preliminary findings of the feasibility and validity of the ISMS.Methods: In Phase 1, we examined the ability of the ISMS to differentiate different levels of negative pressure generated by an artificial sucking condition using a breast pump. In Phase 2, we tested the feasibility and validity of the ISMS with data obtained from four mothers and their healthy full-term infants (two bottle-feedings and two breastfeedings). Intraoral pressures were measured using the ISMS along with a video camera simultaneously recording the infant’s cheek movements. Mothers provided feedback for improvement of the ISMS design. Following each observation, the team reviewed the findings and refined the system; refinements were trialed with the next study. To test the validity of the ISMS, a one-minute period with the highest quality ISMS signal was selected from each feeding to examine the synchrony between ISMS intraoral pressure measurements and coded cheek movements.Results: The ISMS differential pressures when low, medium, and high suction pressures were applied by a breast pump were 18.8, 29.6, and 40.3 kPa, respectively. The agreement between direct observation of sucking and ISMS data was high (mean: 90.6%, range: 84.6-100%). With a series of modifications, we found that the ISMS was a feasible method of reliably measuring intraoral pressure during breast-feeding; however, further testing is necessary to optimize methods of securing the catheter to the bottle nipple.Conclusions: Preliminary data support the validity of the ISMS for identifying sucks and quantifying intraoral pressure generated by sucks in both breast and bottle-feeding. Although further modifications are needed to improve the attachment of the device to the bottle nipple, our initial results support further investigation of the ISMS for use in high-risk infants to evaluate sucking behaviors.

IMPORTANCE OF MOTIVATION IN TOLERABILITY OF INCREASED BREATHING RESISTANCE

Cortical mechanisms play an important role in breathing control under increased breathing resistance (resistive loads). Cortical mechanisms determine the level of voluntary motivation, which significantly affects the tolerance of resistive breathing loads. The purpose of the paper is to determine the effect of voluntary motivation on the tolerance of additional breathing resistance. Materials and Methods. The authors formed procedural motivation by means of moral encouragement or financial rewards of the subjects. Simulation of increased breathing resistance was performed using in-creasing values of thresholdless inspiratory aerodynamic loads: 40, 60, 70, and 80 % from the maximum intraoral pressure. Results. The maximum level of tolerance of additional breathing resistance was observed in volunteers with a material and subsidiary procedural motivation of activity. Under respiratory loads, these subjects demonstrated the greatest deviations of the functional state indicators. Undefined motivation based on the mobilization of goal-oriented resources with moral stimulation showed less efficiency. Lack of specially formed procedural motivation led to minimal tolerance of resistive loads. Conclusion. Procedural motivation, aimed at overcoming additional breathing resistance, significantly increases the tolerance of individual protective means of respiratory organs, which maintains health of workers in a polluted technological environment. Keywords: motivation, tolerance, increased breathing resistance. Большую роль в регуляции дыхания при увеличенном сопротивлении дыханию (резистивных нагрузках) играют кортикальные механизмы. Корковые механизмы определяют уровень произвольной мотивации, которая существенно влияет на переносимость резистивных дыхательных нагрузок. Цель исследования – определение влияния произвольной мотивации на переносимость дополнительного респираторного сопротивления. Материалы и методы. Процессуальную мотивацию формировали методом морального или материального поощрения испытуемых. Моделирование увеличенного сопротивления дыханию проводили с помощью предъявления возрастающих значений беспороговых инспираторных аэродинамических нагрузок: 40, 60, 70 и 80 % от максимального внутриротового давления. Результаты. Максимальный уровень переносимости дополнительного респираторного сопротивления наблюдался у добровольцев, у которых была сформирована материально-субсидивная процессуальная мотивация деятельности; у этой категории испытуемых во время действия дыхательных нагрузок отмечались наибольшие отклонения показателей функционального состояния. Произвольная мотивация на основе мобилизации волевых ресурсов при моральном стимулировании характеризовалась меньшей эффективностью, а отсутствие специально сформированной процессуальной мотивации сопровождалось минимальной переносимостью резистивных нагрузок. Выводы. Процессуальная мотивация, сформированная для преодоления дополнительного респираторного сопротивления, существенно повышает переносимость средств индивидуальной защиты органов дыхания, что имеет большое значение для сохранения здоровья работающих в условиях загрязненной производственной среды. Ключевые слова: мотивация, переносимость, увеличенное сопротивление дыханию.

The Discourse on Measuring Frequency of Tongue Strength

Iowa Oral Performance Instrument (IOPI) is an instrument used to measure tongue strength. The standard protocol of operating IOPI is three trials separated by 10-15 seconds of rest. The highest pressure of these three trials is recorded as the tongue strength. The purpose of this study was to investigate the difference of three trials. Forty-one healthy adults were taken as research subjects. Repeated-measurements analysis of covariance (RANCOVAs) was used to analyze the anterior and posterior tongue strength under four conditions: maximum isometric pressure, dry swallowing, 5c.c. and 10c.c. of water swallowing. The results showed that there were no statistically significant differences among three trials of anterior and posterior tongue strength. It is suggested that before measuring the tongue strength, the participants should be provided with the opportunity to practice, and one or two trials in formal measurements can be adopted to reduce their fatigue. Keywords: Intraoral pressure; Swallowing; Dysphagia

Posttraumatic Pneumosialodenitis of the Submandibular Gland

There are multiple etiologies for facial subcutaneous emphysema, including facial trauma, dissection of air along facial planes from a pneumomediastinum, infection, and entry of air through defects in teeth due to decay, trauma, or dental procedure. In addition, air can be forced through lacerations of the oral or pharyngeal mucosa by increased intraoral pressure. An infrequently reported cause of subcutaneous emphysema is autoinsufflation of the parotid duct with extravasation of air into the surrounding tissue. In this report, the authors present a 14-year-old patient treated at the Department of Oral and Maxillofacial Surgery of the Hospital Escuela Universitario due to an increase in size in the buccal region and left masseterine space of 2 months of evolution. Presenting with a sudden evolution, without any possible explanation, which caused displacement of adjacent structures without damage to the bone or surrounding tissues. After a series of echographic and tomographic studies, it showed that inside the submandibular gland there was a hypodense image with gas density (-1100 UH) expanding the gland and its respective excretory duct.

A Feeding Appliance for an Infant with Cleft Palate

Cleft palate and cleft lip are the most common congenital deformities involving the orofacial region. One of the most important problems with this deformation is difficulties with feeding due to lack of sufficient negative intraoral pressure which prevents regurgitation of food into the nasal cavity. Cleft lip and cleft palate can be surgically treated but repair of the palate is usually delayed until 6 months to 2 years of age. Early repair of the palate may have a negative effect on the growth and development of maxilla due to the resulting scar tissue. This article presents the Prosthodontic management of an infant with a cleft palate through fabricating a feeding plate (palatal obturator). Keywords: Cleft palate, Feeding plate, Palatal obturator