Crianças respiradoras bucais apresentam padrão cefalométrico semelhante àquele observado em pacientes adultos com síndrome da apnéia obstrutiva do sono

OBJECTIVE: To determine whether mouth breathing children present the same cephalometric patterns as patients with obstructive sleep apnea syndrome (OSAS). METHOD: Cephalometric variables were traced and measured on vertical lateral cephalometric radiographs. The cephalometric measurements of 52 mouth and 90 nose breathing children were compared with apneic patients. The children had not undergone adenoidectomy or tonsillectomy and had not had or were not receiving orthodontic or orthopedic treatment. RESULTS: Mouth breathing children showed same cephalometric pattern observed in patients with OSAS: a tendency to have a retruded mandible (p=0.05), along with greater inclination of the mandibular and occlusal planes (p<0.01) and a tendency to have greater inclination of the upper incisors (p=0.08). The nasopharyngeal and posterior airway spaces were greatly reduced in mouth breathing children, as observed in patients with apnea (p<0.01). CONCLUSION: Mouth breathing children present abnormal cephalometric parameters and their craniofacial morphology resembles that of patients with OSAS.OBJETIVO: Determinar se crianças respiradoras bucais apresentam o mesmo padrão cefalométrico que os pacientes que tem síndrome da apnéia obstrutiva do sono (SAOS). MÉTODO: Foram traçadas radiografias laterais verticais da cabeça para a mensuração das variáveis cefalométricas. As medidas cefalométricas de 52 crianças respiradoras bucais e de 90 crianças respiradoras nasais foram comparadas à de pacientes com apnéia. Foram excluídas as crianças que haviam sido submetidas à cirurgia de remoção de amídalas ou adenóides, ou que haviam recebido tratamento ortodôntico prévio ou em andamento. RESULTADOS: As crianças respiradoras bucais apresentaram o mesmo padrão cefalométrico observado em pacientes com SAOS: tendência a ter retrusão de mandíbula (p=0,05), assim como uma maior inclinação dos planos mandibular e oclusal (p<0,01) e tendência a ter maior inclinação dos incisivos superiores (p=0,08). O espaço da nasofaringe e o espaço aéreo posterior se apresentaram muito diminuídos nas crianças respiradoras bucais, como é observado em pacientes com SAOS (p<0,01). CONCLUSÃO: Crianças respiradoras bucais apresentam padrão cefalométrico alterado e sua morfologia craniofacial é semelhante àquela observada em pacientes com SAOS.Federal University of São Paulo Hospital São Paulo Department of NeurologyUNIFESP, Hospital São Paulo Department of NeurologySciEL

Clinical co-morbidities in obstructive sleep apnea syndrome treated with mandibular repositioning appliance

Introduction: Intraoral mandibular repositioner appliances (IOMRAs) are designed to enlarge pharyngeal airway space advancing the mandible and increasing genioglossus tone during sleep. Obstructive sleep apnea syndrome (OSAS) treatment with IOMRAs is beneficial, but there is a lack of studies in the literature defining the target population more inclined to respond to this treatment.Methods: We contacted by telephone 188 previously treated patients with IOMRA, detecting 20 not improved patients (Study Group). Twenty improved patients of the remaining 168 were randomly paired according to gender, age, apnea, and hypopnea index as Control Group. Both groups answered questionnaires for diagnosis of sleep disorders, depression, anxiety, and the Epworth sleepiness scale. We did a descriptive and inferential statistical analysis. the inferential analysis was divided into two steps: univariate analysis using Fischer exact test and a multiple inferential analysis using a stepwise regression model.Results: Although the final model included only insomnia, we concluded that the presence of gastric, neurological and rheumatic diseases also tended to be associated with the self-perception of non-improvement. the association between the accumulation of gastric, neurological, and rheumatic diseases and insomnia and improvement demonstrated that an increase in one of these diseases correspond to a two-fold increase in the chance of non-improvement.Conclusions: Insomnia was the most important factor compromising the, success of OSAS treatment with IOMRAs, and the isolated presence of gastric, neurological and rheumatic diseases, but especially their combination, reduces the perception rate of welt-succeeded treatment with IOMRAs. (c) 2005 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Dept Med, BR-04039002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, BR-04039002 São Paulo, BrazilWeb of Scienc

Prevalência de distúrbios do sono em crianças de um hospital público em São Paulo

OBJECTIVE: To investigate the prevalence of sleep disorders in a sample of children from a public hospital in the city of São Paulo, Brazil. METHOD: 330 children, who came to the clinical laboratory, were consecutively investigated for sleep disorders, using the sleep disturbance scale for children. Gender, age, and social/economical classification were considered. RESULTS: Sleep disordered breathing (SDB) showed higher prevalence in our sample (55%) than in data found in the literature. Prevalence of sleep hyperhydrosis (SHY) was 27% considering the whole sample. Boys and children in age range 7.1 to 11 years old showed higher prevalence for SDB as well as children belonging to lower social/economic classifications who were also more prevalent for disorders in the transition of sleep-wakefulness. CONCLUSION: Sleep disorders were highly prevailing in our study, mostly SDB and SHY which were exceedingly more prevalent in boys in relation to international literature.OBJETIVO: Investigar a prevalência de distúrbios do sono numa amostra de crianças de um hospital público da cidade de São Paulo, Brasil. MÉTODO: 330 crianças que compareceram ao laboratório clínico foram consecutivamente investigadas para a presença de distúrbios do sono, usando-se a Escala de Distúrbios do Sono para crianças. Foram consideradas variáveis como sexo, idade e classificação sócio econômica. RESULTADOS: Os distúrbios respiratórios do sono (DRS) mostraram alta prevalência (55%) em nossa amostra em relação aos dados encontrados na literatura. A prevalência de hiper hidrose do sono (HHS) foi de 27%. Meninos e crianças da faixa etária compreendida entre 7,1 e 11 anos apresentaram prevalências mais altas para distúrbios respiratórios do sono assim como crianças pertencentes às classificações sócio econômicas mais baixas, que também foram mais prevalentes para desordens da transição sono-vigília. CONCLUSÃO: Os distúrbios do sono foram altamente presentes em nosso estudo, principalmente DRS e HHS, que foram mais prevalentes nos meninos, comparados com a literatura internacional.Federal University of São Paulo Children's Hospital Candido FontouraUNIFESP, Children's Hospital Candido FontouraSciEL

A apneia obstrutiva do sono impede a esperada diferença de crescimento cranofacial de meninos e meninas

OBJECTIVES: It was to compare cephalometric measures of mouth-breather boys and girls and with the cephalometric pattern observed in obstructive sleep apnea syndrome (OSAS) patients. METHODS: Craniofacial measurements of lateral cephalometric radiographs obtained from 144 children aged 7-14 years were compared between boys and girls, and both were compared to cephalometric pattern of OSAS patients. RESULTS: Mouth-breather boys and girls had no gender differences regarding to craniofacial morphology while nose-breather boys and girls showed those expected differences. Nose-breather boys presented a more retruded mandible and proinclined upper incisor when compared to nose-breather girls, but mouth-breather boys and girls had no differences. The measure NS.GoGn was the only variable with an interaction with gender and breathing. CONCLUSIONS: There were no cephalometric difference in mouth breather-boys and girls related to normal growth, suggesting that oral breathing make the same craniofacial morphology and both have craniofacial morphology close to that of OSAS patients.OBJETIVOS: Foi comparar medidas cefalométricas entre meninos e meninas respiradores bucais com o padrão cefalométrico de pacientes com síndrome da apneia obstrutiva do sono (SAOS). MÉTODOS: Medidas craniofaciais de radiografias cefalométricas laterais de 144 crianças com idade entre 7 e 14 anos foram comparadas entre meninos e meninas, e estas comparadas com o padrão cefalométrico de pacientes com SAOS. RESULTADOS: Meninos e meninas respiradores bucais não apresentaram diferenças em relação à morfologia craniofacial, enquanto meninos e meninas respiradores nasais mostraram as diferenças fisiologicamente esperadas. Meninos respiradores nasais apresentaram mandíbula mais retraída e incisivos superiores inclinados para frente quando comparados com meninas respiradoras nasais, mas os respiradores bucais não apresentaram diferenças. A medida NS.GoGn foi a única variável com interação entre gênero e tipo de respiração. CONCLUSÕES: Não houve diferença cefalométrica entre os respiradores bucais em relação ao crescimento craniofacial, sugerindo que a respiração bucal determina a mesma morfologia, e ambos os gêneros têm morfologia craniofacial semelhante àquela dos pacientes com SAOS.Universidade Federal de Sào Paulo São Paulo Hospital Department of NeurologySciEL

Yield and nutrition of greenhouse-grown strawberries (Fragaria × ananassa (Duchesne ex Weston) Duchesne ex Rozier. cv. Camarosa) as affected by potassium fertilization

In strawberry, potassium fertilization has been little studied, which difficult management strategies for an increasing yield and understanding the use of this nutrient in strawberry crop. The aim of this study was to evaluate the influence of sources and rates of potassium (K) fertilizers on yield, K level and agronomic traits of strawberry cv. Camarosa fruit, carried out under greenhouse conditions. A randomized in a completely block design with four replicates in a factorial arranged 6x3 (six rates of potassium x three sources of potassium fertilizers), was performed. Fertilizers sources used were as follows: potassium sulphate, potassium nitrate and potassium chloride in 0, 60, 120, 180, 240 and 300 kg ha-1 K2O doses. An increasing potassium rates have allowed a higher potassium content in leaves and fruits. A higher potassium content in leaves was obtained by KNO3 (11.70 g kg-1). Yield, fruit number per plant and potassium extraction per plant, increased linearly with the evaluated doses and fruit average weight at a dose of 183 kg ha-1. There was no significant difference among potassium content in leaves. Strawberry production is maximized through potassium fertilization, independent of the source origin.En fresa, se ha estudiado poco la fertilización potásica, lo que complica las estrategias de manejo para aumentar la productividad, y para la comprensión de la utilización de este nutriente en el cultivo de la fresa. El objetivo de este estudio fue evaluar la influencia de las fuentes y dosis de fertilizantes de potasio (K) en el rendimiento, la concentración de K, y las características agronómicas de la fruta de fresa cv. Camarosa, cultivada en condiciones de invernadero. El diseño experimental fue completamente al azar, con cuatro repeticiones, en un 6x3 factorial (seis tasas de K x tres fuentes de fertilizantes potásicos). Las fuentes utilizadas fueron sulfato de potasio, nitrato de potasio y cloruro de potasio aplicado en las siguientes tasas: 0, 60, 120, 180, 240 y 300 kg ha-1 de K2O. Las tasas crecientes de potasio permitieron un mayor contenido de potasio en hojas y frutos. El contenido de potasio más alto a nivel foliar más alto fue obtenido a través de KNO3 (11,70 g kg-1). El rendimiento, número de frutos por planta y la extracción de potasio por planta, aumentó linealmente con las dosis evaluadas y el peso medio del fruto a una dosis de 183 kg. ha-1. No hubo diferencia significativa entre las fuentes de potasio para el contenido foliar de potasio. La producción de fresa se maximiza mediante la fertilización potásica, independientemente del origen de la fuente

Influence of silicon on production and fruit quality of strawberry

In Brazil, the culture of strawberries is an important activity for small and medium farmers. Among the important factors for culture is fertilization, which can interfere in production and fruit quality. Silicon (Si) is one of the little studied in fertilization, which demonstrated some beneficial to several different cultures. The objective of this study was to evaluate the influence of Si on production and concentration of anthocyanin and titratable acid in the fruit and reading SPAD (chlorophyll) in the leaves of the strawberry. The experiment was conducted in a greenhouse using pots containing 14.5 kg of limed soil, fertilized and three plants (cultivar Milsei Tudla) were transplanted to pots. Treatments consisted of application of Si at 0, 12.5, 25, 50 and 100 mg kg-1 rates, via soil or foliar. During this experiment the reading of SPAD (chlorophyll) and the end of the experiment, the shoots was collected, dried, weighed, ground and analyzed by content and accumulation Si. The fruits were weighed and analyzed the concentration of anthocyanin, titratable acidity and Si concentration. The fertilization with Si, via soil or foliar applied, contributed to the increase in fruit production, especially with the application via soil. Applying foliar or soil promoted an increase in the values of titratable acidity and anthocyanins. Rates of Si via soil or foliar applied influenced the reading SPAD (chlorophyll), in the leaves. The Si independent of the form of application promoted improvements in strawberry crop