Altered Sensation Research Articles

Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour.

Sensory alterations and oral manifestations are prevalent among head and neck cancer (HNC) patients. While taste and smell alterations have been thoroughly investigated, studies on their oral somatosensory perception remain limited. Building upon our previous publication that primarily focused on objective somatosensory measurements, the present work examined self-reported sensory perception, including somatosensation and oral symptoms, in HNC patients and evaluated their link with eating behaviour. A cross-sectional study was conducted using self-reported questionnaires on sensory perception, oral symptoms, sensory-related food preference, and eating behaviour among HNC patients (n = 30). Hierarchical clustering analysis was performed to categorise patients based on their sensory perception. Correlations between oral symptoms score, sensory perception, sensory-related food preference, and eating behaviour were explored. Two distinct sensory profiles of patients were identified: no alteration (n = 14) and alteration (n = 16) group. The alteration group showed decreased preference towards several sensory modalities, especially the somatosensory. Concerning eating behaviour, more patients in the alteration group agreed to negatively connotated statements (e.g. having food aversion and eating smaller portions), demonstrating greater eating difficulties. In addition, several oral symptoms related to salivary dysfunction were reported. These oral symptoms were correlated with sensory perception, sensory-related food preference, and eating behaviour. This study presented evidence demonstrating that sensory alterations in HNC patients are not limited to taste and smell but cover somatosensory perception and are linked to various aspects of eating. Moreover, patients reported experiencing several oral symptoms. Those with sensory alterations and oral symptoms experienced more eating difficulties.

Functional Outcome of Single-Bundle Arthroscopic Anterior Cruciate Ligament Reconstruction using Peroneus Longus Graft and Hamstring Graft: An Open-Label, Randomized, Comparative Study.

Background This study investigates the functional outcomes of single-bundle arthroscopic anterior cruciate ligament (ACL) reconstruction, comparing the use of two distinct graft sources: peroneus longus (PL) graft and hamstring graft. The choice of graft material in ACL reconstruction is crucial for optimal postoperative results, and this study aims to contribute valuable insights into the comparative efficacy of these two graft types. Method This open-label randomized comparative study involved a carefully selected cohort of patients undergoing single-bundle arthroscopic ACL reconstruction. Participants were randomly assigned to either the PLgraft group or the hamstring graft group. Surgical procedures were conducted using standardized techniques, and postoperative rehabilitation protocols were closely monitored. Functional outcomes, including range of motion, stability, and patient-reported measures, were assessed at predefined intervals to ensure comprehensive data collection. Results The study underscores significant demographic and clinical factors in ACL reconstruction outcomes. Participants were predominantly aged 17-30 years (58.33%) with a mean age of 29.27 years and exhibited a male predominance (80.56%). Common complaints included knee pain and instability, primarily due to falls from bikes (55.56%) or sports-related trauma (44.44%). Notably, PL grafts demonstrated advantages over hamstring grafts, with longer mean length (10.11 mm vs. 8.77 mm, p=0.0001) and shorter operation times. Visual analog scale (VAS), International Knee Documentation Committee(IKDC), and Tegner Lysholm scores show no significant differences between grafts over the period of time. There is no notable foot eversion weakness or significant donor site morbidity after the PL graft harvest.Hamstring graft cases exhibit a higher incidence of altered sensation and muscle atrophy, suggesting the potential benefits of PL grafts for improved surgical outcomes. Conclusions Graft comparisonsfavored PL grafts due to longer length, and functional outcome assessments between the two graft types. However, foot and anklestrength assessments revealed fluctuations in strength recovery with PL grafts, highlighting the need for tailored rehabilitation. Thigh circumference variations suggested potentialmuscle atrophy in the hamstring graft group, along with reported paresthesia in theipsilateral proximal leg. In conclusion, PL grafts offer potential advantages for ACL surgery, but ongoing monitoring and specialized rehabilitation are crucial.

Application of Rebuke Techniques and Spiritual Remembrance Therapy for Hallucination Patients in the Purbaratu Community Health Center,Tasikmalaya City

Hallucinations are one of the symptoms of mental disorders in individuals characterized by sensory alterations of perception , perceiving false sensations in the form of sounds, visions, tastings, touching or discolorations that actually feel a stimulus that no client who experiences hallucinations can lose control of himself so as to harm himself, others and the environment. How to control hallucinations, one of which is to rebuke hallucinations by rejecting the hallucinations that appear can control hallucinations. Zikir is defined as all kinds of forms of remembering Allah, mentioning the name of Allah, either by reading tahlil, prayer beads, tahmid, taqdis, takbir, tasmiyah, hasbalah, asmaul husna, or reading prayers that are mat'sur from the Prophet Muhammad SAW. knowing the description of the application of rebuking techniques and zikir spiritual therapy, knowing the ability to control hallucinations after rebuking techniques and zikir spiritual therapy are carried out. The design in this study is qualitative with a case study approach to explore problems in hallucinatory patients using rebuking techniques and spiritual therapy. Data collection with assessment and instruments of signs and symptoms as well as instruments of the ability to control hallucinations. The results of the second study of patients after the act of rebuking and spiritual therapy suggested a decrease in the signs and symptoms of hallucinations as well as the ability to control the patient's hallucinations. In patient 1 there was a decrease in signs and symptoms by 7 signs and symptoms, in patient 2 as many as 4 signs and symptoms. The conclusion after the implementation of the technique of rebuking and spiritual therapy of thought the researcher was able to describe the application, signs and symptoms, the ability to constrict hallucinations. Suggestions for other studies to study in more depth and in conducting research can use a longer time so that the data obtained are more accurate and more convincing that the application of rebuking and spiritual therapy can be useful when hallucinations appear.

A Narrative Review of Aconite Poisoning and Management.

Aconite poisoning refers to toxicity resulting from plants belonging to the Aconitum genus, which comprises over 350 different species of perennial flowering plants that grow in temperate mountainous areas of the northern hemisphere (North America, Europe, Asia). These plants contain a group of toxins known as aconite alkaloids, which encompass numerous closely related toxic compounds. Conventional teaching from toxicology textbooks has broadly classified these alkaloids based on their mechanism of action, often simplifying them as substances that prevent sodium channel inactivation. However, this is an oversimplified and sometimes inaccurate description, as some aconite alkaloids can act as sodium channel blockers. Aconite alkaloids have a long history of use as poisonous substances and have been historically employed for hunting, assassinations, traditional medicine, and self-inflicted harm. Toxicity can occur due to the consumption of traditional medicines derived from aconitum plants or the ingestion of aconite plants and their derivatives. The clinical manifestations of aconite poisoning may encompass gastrointestinal symptoms, sensory alterations, seizures, and life-threatening dysrhythmias that may not respond to standard treatments. Treatment is primarily supportive however evaluation and management of these patients should be personalized and carried out in collaboration with a toxicologist.

Essential Oils from the Perspective of Dentistry

Introduction: With a significant increase in interest in recent years regarding essential oils, the purpose of this work was to identify how Dentistry has researched and utilized these substances through an integrative review of articles available in indexed databases. The bibliographic survey was conducted in November and December 2022, through electronic research, consulting the Pubmed and LILACS databases. The descriptors and boolean operators used were: "volatile oils" OR "essential oils" AND "dentistry". The material published between 2018 and 2022 indexed in the mentioned databases and with a free version was included. Studies that did not address the proposed study theme were excluded. Material and Method: Out of 104 scientific articles found, 29 studies were reviewed and analyzed. Result and Discussion: A variety of plant derivatives have been studied for their inhibitory effect on C. albicans biofilms and for cytotoxicity, several are considered promising for the development of future research and bioproducts applicable to human health. Clinical studies indicated that the EOs from Pelargonium graveolens and Zataria multiflora are potentially effective in treating oral candidiasis, and the most promising EOs were obtained from Allium tubeorosum, Cinnamomum cassia, Cinnamomum zeylanicum, and Coriandrum sativum L. Further non-clinical and clinical studies with these EOs are necessary to determine their potential use and safety for the treatment of oral candidiasis. Listerine mouthwash was often compared with other chemical agents, mainly chlorhexidine, which in terms of plaque control is considered the gold standard in efficacy and substantivity. However, the use of chlorhexidine has disadvantages like altered taste sensations, teeth discoloration. With all this, the World Health Organization (WHO) recommended that researchers analyze the use of natural products, such as extracts of herbs and plants, to combat these negative effects. In another randomized study, they concluded that the mouthwash containing aqueous extracts of essential oils was as effective antibacterial agents as chlorhexidine mouthwashes, corroborating with other descriptive and experimental studies. Conclusion: The articles demonstrated extensive study regarding essential oils in Dentistry, presenting various applications that are still being explored: they have potential in the development of preventive or therapeutic agents for various oral diseases, use in dental materials, and popular applications. There is still a need for more clinical trials to establish safety and efficacy in oral health due to the wide variety of existing essential oils.

Auditory P50 Sensory Gating Alterations in Major Depressive Disorder and their Relationship to Clinical Symptoms

Cognitive deficits in depression are pervasive and include impairments in attention and higher-order functions but the degree to which low-level sensory processes are affected is unclear. The present work examined event-related potential (P50 and N100) features of auditory sensory gating (i.e., the ability to inhibit P50/N100 responses to redundant stimuli) and their relationship to depressive symptoms, including ruminations and dysfunctional attitudes. In 18 patients with major depressive disorder (MDD) and 18 healthy volunteers, auditory sensory gating was measured using a paired-stimulus paradigm yielding ratio (rP50, rN100) and difference (dP50, dN100) gating indices, which reflected amplitude reductions from first (S1) to second (S2) stimulus. Patients with MDD exhibited diminished rP50 and dP50 gating scores and delayed S1-N100 latencies compared to healthy volunteers. These measures were positively associated with ruminative thoughts, negative attitudes and degree of depression. Study findings implicate aberrant sensory processing in depressed patients that is related to severity of maladaptive thinking.

Impacts of COVID-19 on Food Choices and Eating Behavior among New Zealand University Students.

Extensive research suggests that COVID-19 infection can lead to persistent changes in taste and smell perception. These sensory changes have the potential to exert lasting impacts on dietary choices, nutrition, and body weight. This study aims to explore COVID-related shifts in dietary intake among New Zealand university students. We conducted a survey involving 340 university students who had experienced COVID-19 infection between 2022 and 2023. Participants reported any changes in eating behavior since before the pandemic and were asked to complete a 24-h food record. Participants' total daily energy intake, macronutrient intake, and composition were then compared with data collected from a similar cohort before the COVID-19 pandemic, spanning from 2017 to 2019. Dietary outcomes were compared using MANCOVA while controlling for individual age, gender, ethnicity, and BMI. Approximately 25% of participants reported experiencing sensory alterations with COVID-19, with those participants more likely to report changes in their experience of sweet tastes but not salty or fatty foods. Analyses of the pre- and post-COVID cohorts revealed that participants in the post-COVID group exhibited significantly higher consumption of protein and sodium. Understanding the long-term impact of COVID-19 infection may offer crucial insights into the role of chemosensory perception in dietary behavior.

Serotonin receptor 2B induces visceral hyperalgesia in rat model and patients with diarrhea-predominant irritable bowel syndrome

BACKGROUND Serotonin receptor 2B (5-HT2B receptor) plays a critical role in many chronic pain conditions. The possible involvement of the 5-HT2B receptor in the altered gut sensation of irritable bowel syndrome with diarrhea (IBS-D) was investigated in the present study. AIM To investigate the possible involvement of 5-HT2B receptor in the altered gut sensation in rat model and patients with IBS-D. METHODS Rectosigmoid biopsies were collected from 18 patients with IBS-D and 10 patients with irritable bowel syndrome with constipation who fulfilled the Rome IV criteria and 15 healthy controls. The expression level of the 5-HT2B receptor in colon tissue was measured using an enzyme-linked immunosorbent assay and correlated with abdominal pain scores. The IBS-D rat model was induced by intracolonic instillation of acetic acid and wrap restraint. Alterations in visceral sensitivity and 5-HT2B receptor and transient receptor potential vanilloid type 1 (TRPV1) expression were examined following 5-HT2B receptor antagonist administration. Changes in visceral sensitivity after administration of the TRPV1 antagonist were recorded. RESULTS Here, we observed greater expression of the 5-HT2B receptor in the colonic mucosa of patients with IBS-D than in that of controls, which was correlated with abdominal pain scores. Intracolonic instillation of acetic acid and wrap restraint induced obvious chronic visceral hypersensitivity and increased fecal weight and fecal water content. Exogenous 5-HT2B receptor agonist administration increased visceral hypersensitivity, which was alleviated by successive administration of a TRPV1 antagonist. IBS-D rats receiving the 5-HT2B receptor antagonist exhibited inhibited visceral hyperalgesia. Moreover, the percentage of 5-HT2B receptor-immunoreactive (IR) cells surrounded by TRPV1-positive cells (5-HT2B receptor I+) and total 5-HT2B receptor IR cells (5-HT2B receptor IT) in IBS-D rats was significantly reduced by the administration of a 5-HT2B receptor antagonist. CONCLUSION Our finding that increased expression of the 5-HT2B receptor contributes to visceral hyperalgesia by inducing TRPV1 expression in IBS-D patients provides important insights into the potential mechanisms underlying IBS-D-associated visceral hyperalgesia.

COMPARISON OF ROPIVACAINE ALONE VS ROPIVACAINE WITH METHYLPREDNISOLONE INJECTION AS A TREATMENT OF TRIGGER POINTS FOR MYOFASCIAL PAIN: A SUPERIORITY RANDOMIZED CLINICAL TRIAL

Soft tissue rheumatism, known as myofascial pain syndrome (MPS), is typified by taut bands, transferred pain that is distinct, sensory alterations that occur, and a local twitch response. It is also connected with trigger points in one or more muscles. The purpose of the research is to evaluate the effects of injections of Ropivacaine alone vs. Ropivacaine with methylprednisolone in decreasing pain in people in our community who have myofascial pain caused by trigger points. The design of this study was a randomized controlled trial. This study was carried out from July 2022 to August 2023. The research comprised 50 individuals (27 females and 23 males) diagnosed with MPS who came to our clinic. Using online randomization software, the patients were randomly divided into two groups. Group B got a mixture of 0.25% Ropivacaine & 10mg methylprednisolone in 3ml normal saline at each trigger point, whereas Group A received 3ml of 0.25% Ropivacaine. Dry needling of trigger sites was done in both groups. Patients were assessed at two, four, and eight weeks of intervention. The patients' pre-treatment assessment measures showed no statistically significant differences. After 4 and 8 weeks of assessment, Group B NRS pain and BDI scores showed statistically significant improvements compared to pre-treatment results (p<0.05). NRS and BDI scores were reduced in group A compared to their pretreatment values, but that was not clinically significant. Results of our study showed that there was a statistically significant difference between both groups in terms of pain, stress, and anxiety after the intervention. Ropivacaine with methylprednisolone gave better results than Ropivacaine alone in reducing pain and anxiety among the study population.

Assessment of the Anterior Loop and Pattern of Entry of Mental Nerve Into the Mental Foramen: A Radiographic Study of Panoramic Images.

The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction. In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve. The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test. The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible.

Individuals who have been infected with SARS‐CoV‐2 remain with lowered taste and smell sensory‐processing sensitivity: A case study

AbstractThis research aimed to investigate the occurrence and prevalence of possible changes in the sensory perception of individuals who presented total or partial loss of smell or taste when infected by SARS‐CoV‐2, comparing the results with those of individuals who were not diagnosed with the disease and did not show typical symptoms of the infection. One hundred volunteers were recruited, of whom 50 were from the group of people who had COVID‐19 and had signs of smell or taste dysfunction (COVID group), and 50 were from the group of people who did not have the disease and did not show symptoms of the disease (Control group). Gustatory tests were performed to evaluate four primary tastes: sweet, salty, sour, and bitter, and olfactory tests were performed to assess odors: coffee, pineapple, lime, and cinnamon. To determine the detection and recognition thresholds, three‐alternative forced‐choice sessions of tastes and odors were carried out, and intensity scales were used to verify the sensory perception of the participants. Significant differences were confirmed between the groups (Control and COVID) for the detection and recognition thresholds for all tastes and odors. Sour taste was significantly affected in terms of detection and recognition, suggesting that COVID group shows lower sensitivity concerning this taste. Pineapple odor was the most difficult of being recognized by COVID group. The intensity attributed to the stimuli by the COVID group were lower than those of the Control group and differed statistically at the highest concentrations. Data show that individuals in COVID group remained with gustatory and olfactory alterations in sensitivity, detection, and recognition capacity.Practical ApplicationsThis research demonstrated the prevalence of symptoms of sensory‐processing disorders related to gustatory and/or olfactory functions in individuals who tested positive for COVID‐19, even after been cured of the infection. They had sensory alterations in terms of detection and recognition capacity, as well as sensitivity. In practice, several factors associated with quality of life are impaired due to sensory‐processing disorders, such as food, personal hygiene, safety, and physical or mental illnesses, which lead to a necessity of monitor these individuals as these factors are related to public health.

Nociceptive Flexion Reflex Threshold is No Suitable Marker for Diagnosing Opioid-Induced Hyperalgesia.

Opioid induced hyperalgesia (OIH) describes a state of altered pain sensation due to opioid exposure. It often occurs among persons with opioid use disorder receiving substitution therapy. The purpose of this study was to find out, whether OIH diagnosis could be facilitated by an objective pain indicating marker: the Nociceptive Flexion Reflex (NFR). Forty persons with opioid use disorder, 20 of them maintained on methadone and 20 treated with buprenorphine, as well as a control group of 20 opioid-free subjects, were examined. It was aimed to find out whether and in which way these opioid agonists alter reflex threshold (NFR-T). A cold-pressor test was performed to investigate the prevalence of OIH. Furthermore, electrical stimulation and electromyography analyzation were used for NFR-T measurement. Subjective pain ratings were evaluated with a numeric rating scale. Significantly increased sensitivity to cold pressor pain was found in both maintenance groups when compared to their opioid-free counterparts (p < 0.001). Neither methadone nor buprenorphine showed any effect on NFR-T. This might be explained by the reflex approaching at the wrong location in the central nervous system. Consequently, NFR-T is not a suitable marker for diagnosing OIH. Although methadone and buprenorphine have been proven to cause OIH, no effect on NFR-T was observed. A statistically significant effect could have been observed with a larger number of participants. Further research, with special focus on patients' adjuvant medication, should be conducted in the future, to facilitate diagnosis of OIH and provide appropriate pain management for maintenance patients.

The Pathophysiology of Scoliosis Across the Spectrum of Human Physiological Systems

Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine. It can lead to various health issues, affecting mobility, respiratory function, and overall quality of life. There are several types of scoliosis, including idiopathic, congenital, neuromuscular, degenerative, and functional. The severity of scoliosis is measured by the degree of spinal curvature, typically expressed in degrees through a system known as the Cobb angle. Early detection and intervention are fundamental in managing scoliosis, as more severe forms may necessitate bracing or surgical intervention. Healthcare professionals must understand the different types of scoliosis and their unique characteristics to tailor appropriate treatment plans.Scoliosis can significantly impact various physiological systems, including the circulatory, digestive, endocrine, integumentary, lymphatic, muscular, nervous, and respiratory systems. In the circulatory system, scoliosis can cause hemodynamic changes, impaired venous return, cardiac strain, and pulmonary complications. In the digestive system, scoliosis can lead to gastric displacement, impaired intra-abdominal pressure, gastroesophageal reflux, and nutritional implications. The endocrine system can be affected by scoliosis, leading to neuroendocrine dysregulation, growth hormone abnormalities, cortisol dysregulation, and impact on thyroid function. Scoliosis can also affect the integumentary system, leading to pressure ulcers, altered skin sensation, and hygiene challenges. In the lymphatic system, scoliosis can cause lymphatic obstruction, impaired immune response, altered inflammatory responses, fibrosis, and secondary lymphedema. Scoliosis can affect the muscular system, leading to muscle imbalance, myofascial pain, respiratory muscle weakness, and mobility issues. The nervous system can also be impacted by scoliosis, leading to neural compression, central nervous system impact, neurological dysfunction, and coordination challenges. In the respiratory system, scoliosis can cause thoracic deformities, reduced lung compliance, ventilation-perfusion mismatch, respiratory muscle weakness, increased work of breathing (WOB), and an increased risk of respiratory infections.Recognizing and addressing the interplay between scoliosis and these physiological systems is integral for healthcare professionals to provide comprehensive care to individuals with scoliosis.Current research on scoliosis has made progress in diagnostic tools and techniques, including the use of imaging methods like MRI and X-ray, wearable sensors, and 3D reconstruction techniques for better evaluation of spinal motion and function, along with treatment strategies like Schroth exercises and braces, and management measures for respiratory and circulatory problems. However, there are limitations to current studies, such as the heterogeneity of scoliosis, compartmentalized approaches, limited longitudinal studies, reliance on retrospective data, and the need for standardized measures and diagnostic criteria. Future research prospects include advancements in genetic research, biomechanics, artificial intelligence and machine learning, longitudinal studies, non-invasive treatments, and multidisciplinary collaborations among researchers, clinicians, and technologists.

(224) The Use of an Acellular Dermal Matrix for Peyronie’s Plaque Excision and Grafting

Abstract Introduction The optimal surgical approach for severe Peyronie’s disease (PD) and the ideal grafting material are debatable. Acellular dermal matrices (ADM), among other graft materials that have been reported in the literature, are ideal candidates for graft choice due to the ability to retain structural integrity during the healing process and low immunoreactivity levels. Their use remains novel and only a few small studies have described outcomes of ADM grafting for PD. Objective The current study reports on the largest cohort of patients in the literature undergoing PEG with ADM (FlexHD Pliable). Methods After IRB approval, we reviewed the medical records of all patients undergoing PEG with Flex HD Pliable at our institution between the period of 2014 to 2023. A total of 52 patients with PD underwent PEG with FlexHD Pliable graft, with or without simultaneous inflatable penile prosthesis (IPP) insertion. Preoperative urological assessment of plaque was undertaken using penile color duplex ultrasound (PNUS) and degree of angulation and calcifications were recorded. All patients underwent surgery by a single surgeon. Results Patient’s age was 59.1+/-8.4 (43 to 81) years old. Dorsal curvature was recorded in 46.2% of patients, 23% had lateral, 13.5% had ventral and 17.3 % of patients had a combined curvature. Average penile curvature was 61+/-16 degrees (range 30-90 degrees). Hourglass deformity was recorded in 29.4% of cases; plaque calcification was confirmed on PNUS. The mean time between onset of curvature and surgical treatment was 25±37.9 months (range: 1-204 months). 19.2% patients failed intralesional treatment with Xiaflex prior to surgery and 4% had prior surgical treatment. In 75% of cases, simultaneous IPP placement was performed and in 25% of cases we performed PEG with FlexHD Pliable grafting only. Mean operative time for PEG was 114±22 minutes and simultaneous IPP placement prolonged the average operative time to 147±38 minutes. The average defect size was 21±8.3 cm2 (range: 4-48 cm2). A complete curvature correction was achieved in 90.4% and 9.6% had an average residual curvature of 11.25 °±4.8° (range: 5 ° -15 °). Eight patients (15.4%) reported postsurgical complications. Among them, two patients (3.8%) with altered penile sensation. One patient reported absence of sensation at the tip in the right mid glans; a decreased sensation at the ventral part of the penile shaft was recorded in the second case. There was one case of reactive hydrocele following IPP placement (2%) and five patients (9.6%) developed hematomas: 2 subcapsular graft hematomas required needle aspiration under PNUS guidance, a left spermatic cord hematoma and two penile hematomas that resolved spontaneously. Recurrent curvature onset was recorded in 4 patients (7.7%), but only 2 (3.8%) required re-operation. None of the patients suffered from infection-related complications. Conclusions Our results demonstrate the largest experience with ADM grafting for PD in the literature. PEG with FlexHD Pliable is a safe alternative to other commercially available grafting materials with a low complication rate. In the absence of a gold standard treatment for PD grafting materials, FlexHD Pliable is a practical and valuable option for this surgery. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Irrimax.

Chemotherapy-related trigeminal and glossopharyngeal nerves neurotoxicity: a cohort study

The association between orofacial neurotoxicity and chemotherapy treatment is still unclear. In this context, the purpose of this study is to relate the orofacial alterations that manifest during antineoplastic pharmacological treatment, highlighting the drugs commonly related to orofacial neuropathy and the adequate instrument to verify the alterations at clinical levels. This prospective cohort study, addressed patients who would start therapy with taxanes, platinum, or related therapy. The collection of signs and symptoms was divided into 3 different times (baseline, second or third cycle of antineoplastic chemotherapy treatment, and sixth cycle). A total of 40 patients were submitted to the application of the Short McGill pain questionnaire and Neutoxicity Induced by Antineoplastics questionnaire (QNIA). To verify sensory alterations in the face, a clinical evaluation was performed with the help of Semmes-Weinstein monofilaments. Taxanes show greater orofacial neurotoxic potential, being associated with sensory alterations assessed by monofilaments (P = .003) and the presence of orofacial pain analyzed by the Short McGill pain questionnaire (P = .001). These medications related to neuropathy in the orofacial region measured through the QNIA, demonstrating a predominantly acute nature (P < .001). It is suggested that chemotherapy may induce neurotoxicity in the orofacial region.

Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems.

Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history. In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms. As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences. We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.

Time–frequency analysis of gustatory event related potentials (gERP) in taste disorders

In taste disorders, the key to a correct diagnosis and an adequate treatment is an objective assessment. Compared to psychophysical tests, EEG-derived gustatory event-related potentials (gERP) could be used as a less biased measure. However, the responses identified using conventional time-domain averaging show a low signal-to-noise ratio. This study included 44 patients with dysgeusia and 59 healthy participants, who underwent a comprehensive clinical examination of gustatory function. gERPs were recorded in response to stimulation with two concentrations of salty solutions, which were applied with a high precision gustometer. Group differences were examined using gERP analyzed in the canonical time domain and with Time–Frequency Analyses (TFA). Dysgeusic patients showed significantly lower scores for gustatory chemical and electrical stimuli. gERPs failed to show significant differences in amplitudes or latencies between groups. However, TFA showed that gustatory activations were characterized by a stronger power in controls than in patients in the low frequencies (0.1–4 Hz), and a higher desynchronization in the alpha-band (8–12 Hz). Hence, gERPs reflect the altered taste sensation in patients with dysgeusia. TFA appears to enhance the signal-to-noise ratio commonly present when using conventional time-domain averaging, and might be of assistance for the diagnosis of dysgeusia.

Neural oscillations underlying the neural gating of respiratory sensations in generalized anxiety disorder

Individuals with generalized anxiety disorder (GAD) have been shown to have altered neural gating of respiratory sensations (NGRS) using respiratory-related evoked potentials (RREP); however, corresponding neural oscillatory activities remain unexplored. The present study aimed to investigate altered NGRS in individuals with GAD using both time and time-frequency analysis. Nineteen individuals with GAD and 28 healthy controls were recruited. Paired inspiratory occlusions were delivered to elicit cortical neural activations measured from electroencephalography. The GAD group showed smaller N1 amplitudes to the first stimulus (S1), lower evoked gamma and larger evoked beta oscillations compared to controls. Both groups showed larger N1, P3, beta power and theta power in response to S1 compared to S2, suggesting a neural gating phenomenon. These findings suggest that N1, gamma and beta frequency oscillations may be indicators for altered respiratory sensation in GAD populations and that the N1, P3, beta and theta oscillations can reflect the neural gating of respiratory sensations.

Obesity Is Associated with Altered Rectal Sensitivity in Chronic Constipation.

Defecation dysfunction may contribute to chronic constipation (CC), but the impact of obesity on anorectal physiology in CC remains unclear. We aimed to evaluate the relationship between obesity and anorectal function on physiologic testing in patients presenting with CC. This was a retrospective cohort study of consecutive adults who underwent high resolution anorectal manometry (HRAM) at a tertiary center for CC. Patient demographics, clinical history, surgical/obstetric history, medications, and HRAM results were reviewed. Patients were classified into obese (BMI > 30kg/m2) vs non-obese (BMI < 30kg/m2) groups at the time of HRAM. Fisher-exact/student t-test for univariate analyses and general linear regression for multivariable analysis were performed. 383 adults (mean 50.3years; 85.8% female) with CC were included. On HRAM, patients with obesity had lower anal sphincter resting tone (37.3 vs 48.5mmHg, p = 0.005) and maximum squeeze pressure (104.8mmHg vs 120.0mmHg, p = 0.043). No significant differences in dyssynergia (61% vs 53%, p = 0.294) and failed balloon expulsion (18% vs 25%, p = 0.381) were found between obese and non-obese groups. On balloon distention testing, the maximum tolerated (163.5 vs 147.6mL, p = 0.042) and urge sensation (113.9 vs 103.7mL, p = 0.048) volumes were significantly increased among patients with obesity. After adjusting for potential confounders, obesity remained independently associated with increased maximum tolerated volume (β-coefficient 13.7, p = 0.049). Obesity was independently associated with altered rectal sensitivity among patients with CC. Altered rectal sensation may play an important role in CC among patients with obesity. Anorectal physiology testing should be considered to understand the pathophysiology and guide management.

Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up.

Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique. A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well. Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations. In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.