Open-mouth Breathing Research Articles

In vitro comparison of unit dose vs infusion pump administration of albuterol via high-flow nasal cannula in toddlers.

Transnasal pulmonary aerosol delivery using high-flow nasal cannula (HFNC) devices has become a popular route of aerosol administration in toddlers. Clinically, albuterol is administered using an infusion pump or unit doses. However, little evidence is available to compare the two administration strategies. A toddler manikin (15 kg) with appropriate anatomic airway was connected with collecting filter to a simulator of distressed breathing. HFNC device with mesh nebulizer placed at the inlet of a humidifier at 37°C, with the gas flow set at 25 and 3.75 L/min. Five milligrams of albuterol was delivered in all experiments. With infusion pump administration, albuterol concentrations of 5 and 1 mg/mL were delivered at 4 and 20 mL/hr for 15 minutes. With unit dose administration, 1 mL (5 mg/mL) and 2 mL (2.5 mg/mL) of albuterol were nebulized. Additional tests with mouth open and nebulizers via mask were using 5 mg/1 mL for mesh nebulizer and 5 mg/3 mL for jet nebulizer (n = 3). The drug was eluted from the filter and assayed with UV spectrophotometry (276 nm). The inhaled dose was higher with unit dose than infusion pump administration with gas flows of 25 L/min (2.66 ± 0.38 vs 1.16 ± 0.28%; P = .004) and 3.75 L/min (10.51 ± 1.29 vs 8.58 ± 0.68%; P = .025). During unit dose administration, compared with closed-mouth breathing, open-mouth breathing generated a higher inhaled dose at 3.75 L/min and lower inhaled dose at 25 L/min. Compared to the nebulizers via mask with both open and closed-mouth breathing, nebulization via HFNC at 3.75 L/min generated greater inhaled dose, while HFNC at 25 L/min generated lower inhaled dose. During transnasal aerosol delivery, the inhaled dose was higher with medication administrated using unit dose than using an infusion pump.

Evaluation of a New Interface Combining High-Flow Nasal Cannula and CPAP

This study assessed the effects of a new interface that combined CPAP 10 cm H2O by using a helmet with high-flow nasal cannula (HFNC) at varying flows in healthy volunteers. Outcome measures included pharyngeal pressures, diaphragm kinetics, breathing frequency, the temperature inside the helmet, and comfort. After baseline assessment during spontaneous breathing, HFNC was applied at flows of 30, 40, and 50 L/min. Successively, the volunteers underwent helmet CPAP at 10 cm H2O and CPAP + HFNC at flows of 30, 40, and 50 L/min. We measured the variations of pharyngeal pressures at end-expiration and end-inspiration, referenced to spontaneous breathing for HFNC and to CPAP for CPAP + HFNC, diaphragm displacement and thickness at end-expiration and thickness at end-inspiration, breathing frequency, the temperature inside the helmet, the occurrence of the fog effect, and comfort. Variations of pharyngeal pressures at end-inspiration changes were small overall and clinically unimportant. With the mouth closed, at increasing HFNC flow, variations of pharyngeal pressures at end-expiration increased during both HFNC (from 2.8 up to 7.7) and, to a lesser extent, CPAP + HFNC (from 2.7 up to 3.8) (P < .001 for all comparisons). These variations were attenuated during open-mouth breathing. HFNC ≥ 40 L/min and CPAP + HFNC ≥ 40 L/min compared with spontaneous breathing and CPAP, respectively, increased diaphragm displacement (P = .001), thickness at end-inspiration and thickness at end-expiration (P < .003 for both). At all flows, breathing frequency was slightly, although significantly, lower with CPAP + HFNC than with HFNC alone (P < .003). The temperature inside the helmet increased slightly and insignificantly at flows of ≤40 L/min with CPAP + HFNC compared with CPAP alone. The fog effect never occurred, whereas comfort was always rated as optimal, without differences between trials. CPAP + HFNC was well tolerated, with no adverse effects. Based on our findings, there was no need to vary the CPAP level when adding HFNC. At least in healthy subjects, CPAP + HFNC at 30 L/min seemed to be the best combination.

Recognizing Poor Sleep Quality Factors During Oral Health Evaluations.

Oral health practitioners routinely perform oral health assessments for the dental patient to determine if oral disease is present. Systemic health is often a contributor to oral health concerns. One area in particular that has a direct effect on oral structures and oral health is poor sleep quality and open mouth breathing. Sleep is a fundamental process of the human body, which regulates core biological functions. Sleep quality reflects a person's ability to fall asleep, stay asleep, and enter into the various rejuvenating sleep cycles for the full duration. A person who does not obtain quality sleep can exhibit a wide range of oral, systemic, and cognitive health problems. Obstructive sleep apnea, which historically has been considered an adult male disease, is being recognized more often in women children. Research suggests various oral malformations found in newborns and young children can manifest as obstructive sleep apnea in adults. Oral health professionals are in a position to recognize the relationship between sleep and health, identify sleep quality concerns in relation to oral health assessments, administer sleep quality assessments, and determine appropriate referrals for further sleep quality evaluation.

Acute Septicemia in a Hermaphrodite Veiled Chameleon (Chamaeleo calyptratus) Infected with Mycobacterium chelonae Chemovar niacinogenes

A 2-yr-old male veiled chameleon (Chamaeleo calyptratus) was presented for open-mouthed breathing, lethargy, and progressive deterioration culminating in euthanasia. Postmortem examination revealed red discoloration of the lungs, liver, and coelomic fat pads and mild fluid accumulation in the coelom. Histopathological evaluation revealed acute septicemia characterized by numerous intravascular acid-fast bacteria and intravascular fibrin thrombi in multiple organs. Bacteriologic culture of the lung yielded heavy growth of Gram-positive, acid-fast pleomorphic bacilli which were identified as Mycobacterium chelonae chemovar niacinogenes with the use of 16s and hsp65 gene sequencing. The gonads were determined to be ovotestes. To the authors' knowledge, this is the first report of acute Mycobacterium chelonae septicemia in a veiled chameleon and also the first report of hermaphroditism in this species.

PEEP Generated by High-Flow Nasal Cannula in a Pediatric Model.

High-flow nasal cannulas (HFNC) have been increasingly used in the pediatric critical care patient population. There are different theories about the mechanism by which HFNC reduces work of breathing, including diminishing upper airway dead space by the washout of carbon dioxide. However, one of the likely primary mechanisms by which HFNC reduces work of breathing is by generating PEEP. There are limited data assessing the PEEP delivered by moderate flows (8-50 L/min) of HFNC, which are used most commonly in pediatric patients. Pediatric upper-airway models were created with 5 different nares produced by a 3-dimensional printer and connected to a lung simulator. Age-specific flows were delivered via the 5 different setups. Pressure throughout the simulated airway was measured at HFNC flows of 6-60 L/min with 25%, 50%, and 75% air leak to simulate open-mouth breathing. PEEPs of 1.2-36 cm H2O were generated with HFNC flows of 6-60 L/min. In general, for each specific cannula, increasing the flow and decreasing the air leak resulted in higher levels of PEEP delivered (P < .001 and > 10% difference). Changes in lung mechanics as generated by the lung simulator to simulate different patient ages resulted in the establishment of different levels of PEEP. HFNCs deliver varying amounts of PEEP at the alveolar level with flows of 6-60 L/min. Increasing flow and decreasing leak resulted in the generation of greater PEEP. PEEP levels differed across cannulas and model weights at the same leak level, likely due to differences in the nasal interface between the HFNC device and the model nares.

Reptarenaviruses in apparently healthy snakes in an Australian zoological collection.

Inclusion body disease (IBD) is a disease of snakes with a global distribution and has recently been shown to be caused by reptarenaviruses. Testing for this group of viruses in asymptomatic snakes allows the association between infection and disease to be further elucidated. A reptarenavirus was detected by RT-PCR in a reticulated python (Malayopython reticulatus) from an Australian zoological collection that was open-mouth breathing and had erythematous oral mucosa. Another 27 pythons, 4 elapids, 2 colubrids and 2 boas from this collection were then screened. From these animals, swabs, whole blood and/or tissue were tested for reptarenaviruses by RT-PCR. Additionally, blood films from 10 snakes were examined by light microscopy for the presence of inclusion bodies. The majority of samples were collected over a 484-day period. A total of 8 animals were RT-PCR-positive (8/36 = 22.2%): 6 were pythons, 1 was a corn snake (Pantherophis guttatus) and 1 was a Madagascar tree boa (Sanzinia madagascariensis). From them, 57 samples were collected, but only one from each animal was RT-PCR-positive (8/57 = 14.0%). From all 36 animals in this study, 8/182 samples were RT-PCR-positive (4.4%). Inclusion bodies were not recognised in any of the blood films. Only the reticulated python showed signs of illness, which improved without any further intervention. All other RT-PCR-positive snakes were apparently healthy throughout the duration of the study. This study showed a weak association between the presence of reptarenaviruses and disease. Testing serially collected swab and whole-blood samples increased the number of animals in which reptarenaviruses were detected.

Oral myiasis: a rare case comprising of more than 100 maggots

Oral myiasis is a rare condition caused due to larvae infestation within the oral cavity. This can be caused by several species of fly larvae and is usually secondary to severe uncontrolled physical or mental illness. Common predisposing factors for oral myiasis are incompetent lips, poor oral hygiene, anterior open bite, mouth breathing, facial trauma and oral carcinoma in a mentally challenged patient. In this case report we describe a case of oral myiasis of the anterior palate in a hemiplegic patient harbouring more than 100 larvae.

A Two-Step Process of Nitrous Oxide before Carbon Dioxide for Humanely Euthanizing Piglets: On-Farm Trials.

Simple SummaryThe current approved method of using carbon dioxide (CO2) to euthanize newborn piglets is raising animal welfare concerns on whether the method is truly humane. A new form of euthanasia that is humane, practical, and socially acceptable is needed. Nitrous oxide (N2O), also known as laughing gas, has been shown to induce narcosis in piglets. We used a novel two-step system of exposing compromised piglets for six minutes to N2O followed by carbon dioxide and compared it to using CO2 alone. After exposure to nitrous oxide, all piglets lost posture, a sign of the onset of loss of consciousness, before being exposed to CO2 when they showed behavioral distress. On-farm use of a two-step method reduced the amount of time the piglets were exposed to CO2 but did not reduce the amount of distressful behaviors. Therefore, the results do not support the hypothesis that using N2O in a two-step system is more humane than CO2 alone.Current methods of euthanizing piglets are raising animal welfare concerns. Our experiment used a novel two-step euthanasia method, using nitrous oxide (N2O) for six minutes and then carbon dioxide (CO2) on compromised 0- to 7-day-old piglets. A commercial euthanasia chamber was modified to deliver two euthanasia treatments: the two-step method using N2O then CO2 (N2O treatment) or only CO2 (CO2 treatment). In Experiment 1, 18 piglets were individually euthanized. In Experiment 2, 18 groups of four to six piglets were euthanized. In the N2O treatment, piglets lost posture, indicating the onset of losing consciousness, before going into CO2 where they showed heavy breathing and open-mouth breathing; whereas piglets in the CO2 treatment did not lose posture until after exhibiting these behaviors (p ≤ 0.004). However, piglets in the N2O treatment took longer to lose posture compared to the CO2 treatment (p < 0.001). Piglets in the N2O treatment displayed more behavioral signs of stress and aversion: squeals/minute (p = 0.004), escape attempts per pig (p = 0.021), and righting responses per pig (p = 0.084) in a group setting. In these regards, it cannot be concluded that euthanizing piglets for 6 min with N2O and then CO2 is more humane than euthanizing with CO2 alone.

Respiratory disease in ball pythons (Python regius) experimentally infected with ball python nidovirus

Circumstantial evidence has linked a new group of nidoviruses with respiratory disease in pythons, lizards, and cattle. We conducted experimental infections in ball pythons (Python regius) to test the hypothesis that ball python nidovirus (BPNV) infection results in respiratory disease. Three ball pythons were inoculated orally and intratracheally with cell culture isolated BPNV and two were sham inoculated. Antemortem choanal, oroesophageal, and cloacal swabs and postmortem tissues of infected snakes were positive for viral RNA, protein, and infectious virus by qRT-PCR, immunohistochemistry, western blot and virus isolation. Clinical signs included oral mucosal reddening, abundant mucus secretions, open-mouthed breathing, and anorexia. Histologic lesions included chronic-active mucinous rhinitis, stomatitis, tracheitis, esophagitis and proliferative interstitial pneumonia. Control snakes remained negative and free of clinical signs throughout the experiment. Our findings establish a causal relationship between nidovirus infection and respiratory disease in ball pythons and shed light on disease progression and transmission.

Effect Of Mixed Experimental Infection With Gallibacterium Anatis And Mycoplasma Gallisepticum on Performance Of Broiler Chickens

Gallibacterium anatis and Mycoplasma gallisepticum are bacterial pathogens affecting the respiratory tract of broiler chickens. Tracking the mixed experimental infection effect with G. anatis and M. gallisepticum in broiler chickens regarding clinical signs, performance, PM and histopathological lesions was the aim of this work. Birds inoculated with G. anatis (G2) or M. gallisepticum (G4) alone showed less severe clinical signs and gross pathological lesions in the respiratory tract. While, co-infection with G. anatis and M. gallisepticum (G3) exaggerated the clinical signs like rales, sneezing, nasal discharge, coughing, lacrimation and open mouth breathing and also gross and microscopical lesions which appeared as severe conjunctivitis with hemorrhagic congestive tracheitis, pneumonia and hyperplasia of the epithelium lining of trachea as compared to other groups which were infected with single pathogen or control negative group (G1). In conclusion, G. anatis produce less severe clinical signs and lesions regarding respiratory system than coinfection with M. gallisepticum which may be a most important factor enhancing the pathogenicity of G. anatis under field conditions.

The effect of age and method of gas delivery on carbon dioxide euthanasia of pigs

AbstractThe objectives of this research were to evaluate the effect of age and delivering method during carbon dioxide (CO2) euthanasia on the welfare of pigs (Sus scrofa). In Experiment 1, pigs aged 1, 2, 3, 4, 5 and 6 weeks (GRAD; n = 5 pigs per age) were placed in a chamber gradually filled with CO2 released at a flow rate of 20% chamber volume per min. In Experiment 2, three week old pigs were placed in a chamber pre-filled with 100% CO2 (PRE; n = 5). In both experiments, plasma cortisol concentrations were measured before and after exposure to CO2. Behaviours indicative of stress and insensibility were recorded continuously during gas exposure; panting, open-mouth breathing, righting response, escape attempts, loss of posture, muscular excitation and respiratory arrest. Cortisol concentrations were elevated in pigs after CO2 euthanasia, regardless of age or gas delivery method. The behavioural response to CO2 was not affected by pig age. Latency to display panting, righting response, escape attempts, loss of posture, muscular excitation and respiratory arrest were shorter for PRE than GRAD pigs, but, duration of escape attempts and the cortisol response to euthanasia were similar between PRE and GRAD pigs. However, pigs placed in a chamber pre-filled with CO2 spent a greater proportion of time prior to loss of posture displaying escape attempts. Regardless of age or induction method, exposure to CO2 causes behavioural changes indicative of stress prior to loss of consciousness, therefore there is a need to continue to evaluate alternative methods of euthanasia.

Oral capnography is more effective than nasal capnography during sedative upper gastrointestinal endoscopy.

The role of capnography in esophagogastroduodenoscopy (EGD) is controversial. Simultaneous supplemental oxygen, position of patient, open mouth breathing pattern, and anatomy of the oral and nasal cavity can influence capnography accuracy. This study first measured capnographic data via the nasal or oral cavity during sedated EGD. Secondly, we investigated the influence of supplementary oxygen through the oral cavity on the capnographic reading. Patients with ASA class I or II status admitted for routine EGD exams were enrolled. End-tidal carbon dioxide measurements were performed simultaneously via nasal catheter and oral catheter with standard oral bite and nasal cannula supplementary oxygen when the patient is awake, during sedation and during sedation with endoscopy. The influence of oral supplementary oxygen, oral capnography were recorded using a mandibular advancement bite block. One hundred and four patients were enrolled. Breathing in the conscious patient is conducted primarily via the nostrils (95%). When sedated with endoscope placement, the percentage of nasal breathing decreased significantly to 47% and oral capnography sufficiently captured data in 100% of patients. Supplementary oral oxygen decreased oral capnographic measurement significantly (38.89 ± 7.148 vs. 30.73 ± 7.84, p < 0.001). However, the measurements using the MA bite block did not differ from oral cavity catheter (28.86 ± 8.51 vs. 30.73 ± 7.839, p = 0.321). The conscious patient breathes mostly nasally while the sedated patient breathes mostly orally during EGD when an oral bite is in place. Capnography measurement via oral cannula increases the measurement accuracy and efficacy. Oral supplementary oxygen may decrease capnographic measurement but still provide sufficient reading for interpretation.

Alfaxalone TIVA bij de chirurgische excisie van een tracheaal adenocarcinoma bij een kat

Een tien jaar oude, vrouwelijke, Europese korthaar werd aangeboden met klachten van progressief verergerende dyspnee, ademen met open muil en inspiratoire en expiratoire stridor. Met behulp van tracheoscopie met bioptname kon de histopathologische diagnose van een intraluminaal tracheaal adenocarcinoma gesteld worden. Computertomografie (CT) toonde aan dat er geen metastasen waren, waarna tijdens dezelfde anesthesie werd overgegaan tot excisie van de tumor. Omwille van de moeilijke hanteerbaarheid van de patiënt was intraveneuze premedicatie niet mogelijk en gebeurde de inductie van de anesthesie aan de hand van een intramusculaire injectie met alfaxalone. De anesthesie werd verder onderhouden met twee verschillende protocollen: initieel werd gebruik gemaakt van een inhalatieanesthesie -protocol, waarbij isofluraan via een laryngeaal masker werd verdampt in 100% zuurstof via een cirkelsysteem, waarna er werd overgeschakeld naar totale intraveneuze anesthesie (TIVA) met alfaxalone tijdens de eigenlijke excisie van de tumor. Door het verwijderen van zeven trachearingen kon de tumor volledig verwijderd worden.

Effect of shade on animal welfare, growth performance, and carcass characteristics in large pens of beef cattle fed a beta agonist in a commercial feedlot.

Feedlot cattle ( = 1,395; BW = 568 ± 43 kg) were used to evaluate the effects of shade on animal welfare, growth performance, and carcass quality during the summer of 2013 in a Kansas commercial feedlot. Seven lots of predominately black steers and heifers (4 and 3, respectively) visually determined to be approaching the final mo on feed were identified, randomly gate-sorted, and allocated to pens located across the feed alley from each other to receive 1 of 2 treatments: 1) Shade (mean shade area = 1.5 m/ animal) or 2) No shade. Shade was provided using a 13-ounce polyethylene fabric and pens were oriented northwest to southeast. The mean starting date was June 13 and the mean days on feed for lots while on the study was 38 d. Cattle were fed a 77.67% DM steam-flaked corn-based diet and had ad libitum access to water throughout the duration of the trial. Zilpaterol hydrochloride (ZIL) was included in the finishing ration at an inclusion rate of 8.3 mg/kg of DM for the last 20 d on feed with a 3 d withdrawal period. Pen floor temperatures (PFT) were measured using an infrared thermometer and prevalence of cattle open-mouth breathing (OMB) was recorded on a pen basis. In addition to shade treatment, the effect of temperature humidity index (THI) on PFT and OMB was analyzed by classifying days as either "Alert" (THI < 79) or "Danger" (THI > 79). On the day of slaughter, pens within a replicate were kept separate through all stages of the marketing channel from loading at the feedlot until stunning at the plant. Pen served as the experimental unit for all measurements. There was a THI × shade treatment interaction for PFT and OMB ( < 0.001) where days classified as "Danger" increased PFT and prevalence of OMB compared to "Alert" days in unshaded but not shaded cattle. Shaded cattle had greater DMI ( = 0.01); however, unshaded cattle had greater G:F ( = 0.05) and therefore no differences were observed in ADG ( = 0.39). Shaded cattle had greater dressing percentage ( = 0.01), although HCW, LM area, fat thickness, marbling score, and quality grade did not differ between treatments ( > 0.05). Heat stress, a significant animal welfare concern and cause of reduced performance in feedlot cattle during the final phase of the feeding period, was alleviated in shaded cattle and illustrates the importance of shade provision as 1 tool to protect the welfare and increase feed consumption in large pens of feedlot cattle during hot summer months.

Single and mixed feline lungworm infections: clinical, radiographic and therapeutic features of 26 cases (2013-2015).

Objectives The aim of this study was to retrospectively describe clinical, radiographic and therapeutic features of feline lungworm infection. Methods Medical records of cats with lungworm diagnosis, thoracic radiography and without concurrent diseases between 2013 and 2015 were reviewed. Collection of data included physical examination, haematology, serum biochemistry, therapy with a variety of anthelmintics and outcomes. Results Thirty-seven records were recovered and 26 were included in the study. Single infections by Aelurostrongylus abstrusus (n = 15), Troglostrongylus brevior (n = 3) and Capillaria aerophila (n = 1) and coinfections by T brevior/ A abstrusus (n = 6) and T brevior/ C aerophila (n = 1) were diagnosed. The most common respiratory signs were coughing (n = 12), increased vesicular sounds (n = 10), dyspnoea (n = 9), such as laboured breathing, orthopnoea or open-mouth breathing, and tachypnoea (n = 6). Two cats were subclinically infected. The most common laboratory abnormality was anaemia (n = 7). Radiographic patterns recorded were interstitial (n = 24), bronchial (n = 21), alveolar (n = 10) and vascular (n = 2). Twenty-five cats had a complete recovery within 2-6 weeks of therapy. One kitten died 7 days after the diagnosis. Conclusions and relevance Lungworms should always be included in the differential diagnosis in cats living in endemic areas and presenting with respiratory signs and radiographic abnormalities. A copromicroscopic examination should be considered as the first diagnostic step for all cats at risk of lungworm infections. In most cases, timely therapy with a variety of anthelmintics guarantees recovery.

Use of a frameless computed tomography-guided stereotactic biopsy system for nasal biopsy in five dogs.

5 dogs (median age, 9 years; median body weight, 31 kg [68.2 lb]) with undefined nasal masses were examined after undergoing CT of the head and nasal biopsy via a rostral rhinoscopic or unaided (blind) approach because histologic results for collected biopsy specimens (inflammatory, necrotic, or hemorrhagic disease) suggested the specimens were nonrepresentative of the underlying disease process identified via CT (aggressive or malignant disease). Clinical signs at the time dogs were evaluated included open-mouth breathing, sneezing, or unilateral epistaxis. Histologic findings pertaining to the original biopsy specimens were suggestive of benign processes such as inflammation. In an attempt to obtain better representative specimens, a frameless CT-guided stereotactic biopsy system (CTSBS) was used to collect additional biopsy specimens from masses within the nasal and sinus passages of the dogs. The second set of biopsy specimens was histologically evaluated. Histologic evaluation of biopsy specimens collected via the CTSBS revealed results suggestive of malignant neoplasia (specifically, chondrosarcoma, hemangiopericytoma, or undifferentiated sarcoma) for 3 dogs, mild mixed-cell inflammation for 1 dog, and hamartoma for 1 dog. No complications were reported. These findings resulted in a change in treatment recommendations for 3 dogs and confirmed that no additional treatment was required for 1 dog (with hamartoma). For the remaining dog, in which CT findings and clinical history were strongly suggestive of neoplasia, the final diagnosis was rhinitis. Biopsy specimens were safely collected from masses within the nasal and sinus passages of dogs by use of a frameless CTSBS, allowing a definitive diagnosis that was unachievable with other biopsy approaches.

Pulmonary Mycobacterium tuberculosis infection with giant tubercle formation in a dog: a case report

An eight-year-old, 4.9 kg, intact male mongrel dog presented with progressive weight loss, anorexia, vomiting, diarrhoea, and open-mouth breathing. A thoracic radiograph showed significant pleural effusion. Upon removal of the pleural effusion, an oval-shaped soft-tissue density mass was identified above the heart base. Two months later, the dog's condition worsened severely, and he was euthanised. A complete necropsy showed all intrathoracic structures were encapsulated by a fibrinous material. A large granuloma was attached between the right cranial lung lobe and the trachea. The cytological evaluation of the pleural effusion showed numerous negative-staining rod structures. Ziehl-Neelsen staining confirmed the presence of acid-fast bacilli. A polymerase chain reaction test confirmed Mycobacterium tuberculosis infection. This work is the first case report of canine pulmonary M. tuberculosis infection in South Korea. To the best of our knowledge, the formation of giant tubercles in canine pulmonary tuberculosis has not been reported recently.

English

Abstract Myiasis is a rare condition caused due to larvae infestation of body tissues. This can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Common predisposing factors for oral myiasis are incompetent lips, poor oral hygiene, severe halitosis, anterior open bite, mouth breathing, facial trauma, extraction wounds, ulcerative lesions and carcinoma. Here, we describe a case of oral myiasis in the anterior palatal region in a mentally challenged patient caused by the larvae of Musca Nebulo whose clinical features, management and treatment outcome are discussed and case was followed up periodically. Keywords: Oral myiasis; House fly; Necrosis Introduction The term myiasis (Greek: myi= fly, asis= disease) is applied to infestation of living tissues of humans and animals, by dipterous larvae [1]. Zumpt descriptively defined myiasis as “the infestation of live human and vertebrate animals with dipterous larvae, which, at least for a certain period, feed on the host’s dead or living tissue, liquid body substances, or ingested food” [2]. Myiasis is well recognized in the animals, but rare in humans [2,3]. Human myiasis is extremely rare in developed countries, but it is not an uncommon parasitic infestation in the tropics and subtropics [4]. Myiasis can target any body tissue or cavity that is accessible to egg-laying and development of larvae, but most common anatomic sites involved are the nose, eye, lung, ear, anus, vagina, and more rarely, the mouth [3,5].Oral myiasis was first described by Laurence in 1909 [5]. Predisposing factors for development of oral myiasis are anterior open bite, mouth breathing, neglected mandibular fractures, Cancrum Oris, extraction sockets and patient with neurologic deficit, diabetes, and peripheral vascular disease [3].In this article a case of oral myiasis in the anterior palatal region in a patient with neurological deficit is presented.

Impact of rare diseases in oral health.

BackgroundRare diseases (RD) are those that present a lower prevalence than 5 cases per 10.000 population. The main objective of this review was to study the effect on oral health in rare diseases, while the secondary objective of the study is theme upgrade.Material and MethodsComparative observational case-control studies were analysed and a systematic review was conducted in PubMed. Each rare disease listed on the statistical data record of the Health Portal of the Ministry of Equality, Health and Social Policies Board of Andalusia was associated with “oral health”. The variables studied included dental, oral mucosa and occlusion alterations, oral pathologies (caries, periodontal disease) and other alterations (mouth breathing, parafunctional habits, etc). A bias analysis of the variable caries was conducted.ResultsSix RD were selected through our inclusion and exclusion criteria (hypogammaglobulinemia, Rett syndrome, Marfan syndrome, Prader-Willi syndrome, cystic fibrosis and Cri du chat syndrome) in a total of 8 publications, of which four trials were classified as high risk of bias and one of them as medium risk. There were not trials with low risk of bias.ConclusionsThe main statistically significant differences found by Syndrome compared to a control group were in Hypogammaglobulinemia with a greater tendency to enamel hypoplasia and dry mouth. The Rett syndrome had, as well, a greater tendency to an anterior open bite, ogival palate, bruxism, mouth breathing and tongue thrusting. Prader-Willi syndrome had a tendency of dental erosion, and Cri du chat syndrome showed a higher association to Tannerella forsythia. Key words:Rare diseases, oral health.

Tracheal and Colonic Resection and Anastomosis in a Boa Constrictor (Boa constrictor) with T-Cell Lymphoma

Abstract An eight-year-old, female intact, boa constrictor (Boa constrictor) was presented for a 1.5- month history of wheezing, open-mouth breathing, and hyperextension of the neck. Radiographs, ultrasound (US), computed tomography (CT), and tracheal endoscopy revealed an intra- and extraluminal tracheal mass occluding approximately 95% of the tracheal lumen. Complete blood count and biochemistry panel were unremarkable, except for a moderate elevation of the hematocrit. A caudal saccular lung cannulation was placed as an emergency procedure because of worsening respiratory distress. Resection of 22 tracheal rings, inclusive of the mass, followed by anastomosis of the trachea was performed. Histopathology, immunohistochemistry, and electronic microscopy (EM) were consistent with a tracheal round cell neoplasia. Eleven months after the initial surgery, the snake presented for a caudal coelomic mass associated with constipation. Radiographs, US and CT findings were consistent with an infiltrating circumfer...