Oral cavity morphology among children at risk of sleep disordered breathing

PURPOSE

The aim of this study was to evaluate oral cavity morphology in children at risk of sleep disordered breathing (SDB).

METHODS

The study included children 3-17 years of age. The risk of SDB was evaluated using the paediatric sleep questionnaire (PSQ); afterwards, children at risk of SDB were enrolled in the study group. A control group was randomly established from patients with negative PSQ results. The oral cavity morphology evaluation included assessment of the oropharynx using Mallampati classification (MC), palatine tonsil size using the Pirquet scale, occlusion and the presence of a high-arched palate and lingual frenulum.

RESULTS

A total of 131 children were evaluated, 65 in the study and 66 in the control group. The mean ages were 9.5 ± 3.0 and 9.4 ± 3.1 years, respectively. The presence of higher scores on the MC, higher scores in the Pirquet scale, a crossbite, a high-arched palate and a short frenulum were significantly more frequent in the study group than the control group.

CONCLUSION

The evaluation of oral morphology is an important part of paediatric examination. Enlarged palatine tonsils; higher scores on the MC; and the presence of a crossbite, short lingual frenulum and high-arched palate may suggest abnormal breathing during sleep in children.

Physical rehabilitation and risk of atherosclerosis after successful kidney transplantation

Regular physical activity is usually associated with significant health benefits, but therapeutic exercise is seldom routine in renal transplant recipients. We report a randomized clinical trial of exercise training after renal transplantation. Sixty-nine patients were randomly recruited on the first or second day after kidney transplantation into two groups: exercise intervention (PT) and standard care (CT) as controls. The exercise training program consisted of tailored exercises to be performed under a physiotherapist's supervision for 15 to 30 minutes every second hospital day. At that time, biochemical markers of graft function were assessed including specific tests for atherosclerosis. Repeated measures analysis of variance was performed to determine differences between the two groups. We found an inverse correlation between total homocysteine as well as interleukin-18 (IL:18) levels and muscle strength of the upper limbs (r = -.78, P < .0001). There was a positive correlation between muscle strength and improved graft function in the PT group versus CT groups (r = .05; P < .05). Hyperhomocysteinemia and high IL-18 expression in renal allograft recipients may be independent markers of early atherosclerosis development.