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PubMed2005

Relationship between oral parafunctional/nutritive sucking habits and temporomandibular joint dysfunction in primary dentition.

UNLABELLED: The aim of this study was to evaluate the relationship between nutritive and parafunctional habits and the presence of temporomandibular dysfunction (TMD) in children with primary dentition. METHODS: Ninety nine children, aged 3-5 years, were examined to check for the presence or absence of signs and symptoms of TMD (headache, preauricular pain, earache, masticatory muscle tenderness, deviation on opening, occlusal interference and asymmetric movement of the mandible), oral parafunctions (bruxism, nail biting, finger/thumb sucking, speech alteration, mouth breathing, pacifier and atypical swallowing) and nutritive habits (breast- or bottle-feeding) through interview and clinical examination. The results were submitted to descriptive statistical analysis and Fisher's exact test. RESULTS: The results showed that only atypical swallowing was positively related to TMD (P < 0.0001); other oral parafunctional and nutritive habits were not related to TMD. CONCLUSIONS: It was concluded that parafunctional habits, with the exception of atypical swallowing, and feeding methods were not determinants for the presence of signs and/or symptoms of TMD in the sample of children included in the study.

Bottle Feeding↗
PubMed2003

Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period.

AIMS: To analyze predictors of bruxism, other oral parafunctions, and tooth wear in a group of subjects who had been examined 20 years earlier. METHODS: Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire. Twenty years after the first examination, 94% of the original group could be traced, and 320 (85%) completed and returned the questionnaire. Of the oldest group, 100 (81%) also underwent a clinical examination focusing on occlusal factors and function and dysfunction of the masticatory system. For analyses of predictors of some oral parafunctions and tooth wear registered at the 20-year follow-up, logistic regression was used with recordings at the first examination as independent variables. RESULTS: Subjective reports in childhood of bruxism (defined as tooth clenching during daytime and/or tooth grinding at night), clenching only, grinding at night only, nail biting, and/or other parafunctions were predictors of the same oral parafunctions 20 years later. There were different predictors of the 2 components of bruxism, daytime tooth clenching and tooth grinding at night. Postnormal occlusion (Angle Class II malocclusion) and tooth wear in childhood predicted increased tooth wear in adulthood. Subjects with nonworking-side interference had less anterior tooth wear than those without such interference. CONCLUSION: Oral parafunctions in childhood may be a persistent trait in many subjects. Postnormal occlusion and tooth wear in childhood predicted increased anterior tooth wear 20 years later, whereas nonworking-side interference reduced the risk for such wear in 35-year-old subjects.

Adolescent↗
PubMed2005

Causative microorganisms in surgically treated pediatric hand infections.

PURPOSE: The causative organisms in many pediatric musculoskeletal infections are distinct from their adult counterparts. We investigated the organisms found in surgically treated hand infections in the pediatric population. METHODS: We reviewed the hospital charts and computer records of all patients who had surgical intervention for infections of the forearm, wrist, and hand from 1996 through 2002 at The Children's Hospital of Boston. RESULTS: Thirty-eight surgical procedures were performed on 31 children for 32 different upper-extremity infections. One patient was treated for 2 separate infections. In the 32 primary procedures 7 cultures grew mixed aerobic/anaerobic organisms, 19 grew aerobic organisms only, 6 grew no organisms, and 2 patients had no cultures. One culture from a secondary surgery was positive for Candida parapsilosis. Staphylococcus aureus was isolated in 15 of the primary cases and was the primary organism in 12. Five of 7 mixed infections were associated with paronychia; 2 of the paronychial infections were complicated by flexor tenosynovitis. Chronic nail biting caused 2 infections and 1 was associated with thumb sucking. CONCLUSIONS: In the adult population S aureus is the primary organism cultured in 50% to 80% of cases and anaerobic or mixed infection may occur in upward of 29% of patients. In this series S aureus was the primary organism in only 37%. Group A Streptococcus pyogenes was present in 20% of cases. The percentage of children with a mixed aerobic/anaerobic infection was similar to that found in adults; however, the presumed route of introduction was digital sucking/biting. Based on the number of anaerobic/mixed infections without predisposing factors we recommend a broad-spectrum antibiotic regimen including anaerobic coverage as the initial antibiotic in the setting of pediatric hand infections.

Adolescent↗
PubMed2003

The identification of OCD-related subgroups based on comorbidity.

BACKGROUND: Individuals with obsessive-compulsive disorder (OCD) frequently have other psychiatric disorders. This study employed latent class analysis (LCA) to explore whether there are underlying clinical constructs that distinguish "OCD-related" subgroups. METHODS: The study included 450 subjects, case and control probands and their first-degree relatives, and LCA was used to derive empirically based subgroups of 10 disorders: OCD, obsessive-compulsive personality disorder (OCPD), recurrent major depressive disorder (RMDD), separation anxiety disorder, panic disorder or agoraphobia (PD/AG), tic disorders (TD), generalized anxiety disorder (GAD), somatoform disorders (hypochondriasis or body dysmorphic disorder), pathologic skin picking or nail biting (PSP/NB), and eating disorders (EDs). The derived classes were compared on several clinical variables. RESULTS: The best fitting model is a four-class structure: minimal disorder, predominant RMDD and GAD, "highly comorbid," and PD/AG and TD. The nature and number of disorders represented suggests that the first classes are distributed ordinarily on a dimension of severity, and the fourth class is qualitatively distinct. Support for this structure is based on the number of disorders, age at onset of OCD, neuroticism, and extraversion. CONCLUSIONS: In this OCD enriched sample, LCA identified four classes of disorder. These classes appear to conform to two subgroups that may prove useful in investigating the etiology of OCD.

Age of Onset↗
PubMed1995

Association between CMD signs and symptoms, oral parafunctions, race and sex, in 4-6-year-old African-American and Caucasian children.

The associations between oral parafunctions, signs and symptoms of craniomandibular disorders (CMD), race, and sex were analysed in recordings from 203 4-6-year-old African-American and Caucasian children. Significant correlations were found between bruxism, nail biting, thumb sucking and most of the CMD signs and symptoms. There were also significant associations between most of the signs and symptoms and race, while significant association with sex was found only regarding headache, TMJ sounds and chewing pain. Significant associations were found between most CMD signs and TMJ sounds supporting the view that joint sound recordings have diagnostic value. There were also significant associations between the pain variables recorded by questionnaire and those recorded by palpation, which indicates that reliable data can be obtained by interviewing children as young as five. The results of this study support the concept that oral parafunctions have a significant role in the aetiology of CMD. The results also show that race and sex need to be considered when analysing the possible aetiological role of oral parafunctions in CMD. Longitudinal studies, beginning with low age groups are needed to better determine the role of childhood oral parafunctions in CMD aetiology.

Black People↗
PubMed1964

[ONYCHOPHAGIA].

Explore the source record for details and available documents.

Humans↗
PubMed2001

Warts of the nail unit: surgical and nonsurgical approaches.

BACKGROUND: Warts are the most common nail tumor and mostly affect children and young adults. Periungual warts are usually due to HPV-1, 2, and 4. Development of periungual warts is favored by maceration and trauma, especially nail biting. OBJECTIVE: To discuss the biology, clinical features, and medical and surgical treatment of periungual warts. METHODS: Review of the literature and personal experience. RESULTS: The natural course of warts makes aggressive approaches restricted to selected cases. Medical treatments, usually topical, include keratolytic agents, virucidal agents, and immunomodulators. All choices have been utilized successfully, but keratolytic agents are the best first-line approach. Surgical treatments include cryotherapy, surgical excision, electrosurgery, infrared coagulation, localized heating with a radio-frequency heat generator and laser therapy, especially the Er:YAG laser, which has an excellent safety profile. CONCLUSIONS: Definitive cure is not guaranteed by any therapy and periungual warts can recur and become larger after correct treatment.

Diagnosis, Differential↗
PubMed1980

Nail growth. Thirty-five years of observation.

A 35-year observation of the growth of my nails indicates the slowing of growth with increasing age. The average daily growth of the left thumbnail, for instance, has varied from 0.123 mm a day during the first part of the study when 1 was 32 years of age to 0.095 mm a day at the age of 67.

Adult↗
PubMed1981

Anaerobic paronychia.

During 1 year 116 patients with paronychia had bacteriological cultures of the pus. Aerobic bacteria, predominantly Staphylococcus aureus were isolated from 81. Anaerobic bacteria were isolated from 35, and in 31 of these aerobes were also present. Anaerobic paronychias were less acute that those caused by aerobes but otherwise the clinical features and management were the same. The anaerobes isolated were those found as oro-pharyngeal commensals and did not include the colonic commensal Bacteroides fragilis. They were, with few exceptions, sensitive to penicillin.

Adolescent↗
PubMed2005

Effects of monoamine oxidase inhibitors on methamphetamine-induced stereotypy in mice and rats.

In male ICR mice, a single intraperitoneal administration of methamphetamine (METH) (10 mg/kg) induced stereotyped behavior such as continuous sniffing, circling, and nail biting, reaching a plateau level 20 min after the injection. Subcutaneous pretreatment with clorgyline, a monoamine oxidase (MAO)-A inhibitor, at a dose of 0.1 mg/kg 2 h prior to the drug challenge significantly decreased the initial (first 20 min) intensity of stereotypies and increased the latency to onset. The effect was not observed with either higher doses of clorgyline (1 and 10 mg/kg) or l-deprenyl, a MAO-B inhibitor, at doses of 0.1-10 mg/kg. In male Wistar rats, the inhibitory effect of clorgyline on METH-induced stereotypy was not observed. Pretreatment of the mice with clorgyline (0.1 mg/kg) had no effect on apparent serotonin and dopamine turnover in the striatum, although the higher doses of clorgyline (1 and 10 mg/kg) significantly decreased the turnover. These results suggest that a low dose of clorgyline tends to increase the latency and decrease the intensity of stereotypies induced by METH in a dopamine metabolism-independent manner in mice.

Animals↗
PubMed1991

A simple method for reducing autotomy in rats after peripheral nerve lesions.

Experiments using peripheral nerve lesions (crush or transection) in rats to study repair processes are hampered by the tendency for the animals to attack the limb in which the peripheral nerves are damaged (autotomy). In this paper we describe a simple method which significantly reduces the incidence of autotomy after peripheral nerve lesions. The method consists of painting the hind paws of operated rats with a commercially available non-toxic lotion, which is used to discourage nail-biting and thumb-sucking in humans. Although the method is not absolute, it was extremely beneficial in our experiments, since the number of animals that had to be taken out of the experiment due to severe autotomy was greatly reduced. We believe that this method may prove to be as beneficial to other investigators who are using experimental peripheral nerve lesions to study the regenerative aspects of the nervous system.

Animals↗
PubMed1996

Compulsive targeted self-injurious behaviour in humans with neuropathic pain: a counterpart of animal autotomy? Four case reports and literature review.

Four cases of compulsive self-injurious behaviour (SIB) with variable degrees of tissue damage targeted to the painful body part are reported in humans with neuropathic pain. Review of human literature revealed several cases, primarily after central nervous system (CNS) lesions, during which non-psychotic verbally communicating humans (mostly with intact mental status) target specifically the painful part which is usually analgesic or hypoalgesic. In few instances, however, the involved part is not only sentient but also hyperalgesic in part or as a whole. The act is characterized by uncontrollable urge and compulsion, aggravated under conditions of stress, isolation, confusion or depression, and occasionally occurring in patients with personality disorders, ongoing drug abuse and pre-existing compulsive habits (i.e., habitual nail biting or picking). It fails to be deterred by the appearance of the injured part, social mores or even the experience of pain. Successful treatment of underlying painful dysesthesiae with specific medications, neurostimulation or surgery has resulted in marked improvement of dysesthesiae accompanied by wound healing in several cases. The four presented cases and the human literature experience provide evidence that compulsive targeted SIB in humans with neuropathic pain and painful dysesthesiae is consistent with the concept that animal autotomy may result from chronic neuropathic pain after experimental peripheral or CNS lesions.

Adult↗
PubMed2006

Childhood nail diseases.

The diagnosis of pediatric nail populations is complicated because a large proportion of pediatric nail presentations involve parents bringing in their children with questions regarding nail appearance rather than the plain presentation of a disease or functional problem. Parents are concerned whether the nails are normal, if they are uncomfortable for the baby or child, if the nails will affect walking or other future function, or if the changes are of wider significance and suggest more sinister medical problems than are yet apparent. To address these concerns, the clinician needs a good grasp of what is normal.

Antifungal Agents↗
PubMed2006

Impulse control disorders in adults with obsessive compulsive disorder.

Little is known about impulse control disorders (ICDs) in individuals with obsessive compulsive disorder (OCD). Although studies have examined ICD comorbidity in OCD, no previous studies have examined clinical correlates of ICD comorbidity in a large sample of individuals with a primary diagnosis of OCD. We examined rates and clinical correlates of comorbid ICDs in 293 consecutive subjects with lifetime DSM-IV OCD (56.8% females; mean age=40.6+/-12.9 years). Comorbidity data were obtained with the Structured Clinical Interview for DSM-IV. ICDs were diagnosed with structured clinical interviews using DSM-IV criteria. OCD severity was assessed with the Yale-Brown Obsessive-Compulsive Scale. Quality of life and social/occupational functioning were examined using the Quality of Life Enjoyment and Satisfaction Questionnaire and the Social and Occupational Functioning Assessment Scale. All variables were compared in OCD subjects with and without lifetime and current ICDs. Forty-eight (16.4%) OCD subjects had a lifetime ICD, and 34 (11.6%) had a current ICD. Skin picking was the most common lifetime (10.4%) and current (7.8%) ICD, followed by nail biting with lifetime and current rates of 4.8% and 2.4%, respectively. OCD subjects with current ICDs had significantly worse OCD symptoms and poorer functioning and quality of life. These preliminary results suggest that there is a low prevalence of ICDs among individuals with OCD, although certain ICDs (skin picking) appear to be more common.

Adult↗
PubMed2006

Multidimensional approach to the differences between muscular and articular temporomandibular patients: coping, distress, and pain characteristics.

OBJECTIVE: This study analyzes the differences in psychological variables and symptomatology between temporomandibular disorder diagnosis subgroups. STUDY DESIGN: The sample included 114 temporomandibular disorder patients that were evaluated in coping, distress, and temporomandibular characteristics. Diagnostic muscular (n = 58) and articular (n = 56) subgroups were compared in these variables through a MANCOVA. RESULTS: Muscular patients show a higher level of general distress, specifically in the anxiety and somatization subscales and a more active coping style, with a tendency of a minor use of humor and a higher number of parafunctional habits, specifically, biting nails, hangnails, and lips. CONCLUSION: We discuss the differences found in order to design the targets of the psychological intervention of temporomandibular patients.

Adaptation, Psychological↗
PubMed2002

Hoarding in obsessive compulsive disorder: results from a case-control study.

Hoarding occurs relatively frequently in obsessive-compulsive disorder (OCD), and there is evidence that patients with hoarding symptoms have more severe OCD and are less responsive to treatment. In the present study, we investigated hoarding symptoms in 126 subjects with OCD. Nearly 30% of the subjects had hoarding symptoms; hoarding was twice as prevalent in males than females. Compared to the 90 non-hoarding subjects, the 36 hoarding individuals had an earlier age at onset of, and more severe, obsessive-compulsive symptoms. Hoarders had greater prevalences of symmetry obsessions, counting compulsions, and ordering compulsions. Hoarders also had greater prevalences of social phobia, personality disorders, and pathological grooming behaviors (skin picking, nail biting, and trichotillomania). Hoarding and tics were more frequent in first-degree relatives of hoarding than non-hoarding probands. The findings suggest that the treatment of OCD patients with hoarding symptoms may be complicated by more severe OCD and the presence of co-occurring disorders. Hoarding appears to be transmitted in some OCD families and may differentiate a clinical subgroup of OCD.

Adolescent↗
PubMed2000

The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study.

BACKGROUND: The familial relationship between obsessive-compulsive disorder (OCD) and "obsessive-compulsive spectrum" disorders is unclear. This study investigates the relationship of OCD to somatoform disorders (body dysmorphic disorder [BDD] and hypochondriasis), eating disorders (e.g., anorexia nervosa and bulimia nervosa), pathologic "grooming" conditions (e.g., nail biting, skin picking, trichotillomania), and other impulse control disorders (e.g., kleptomania, pathologic gambling, pyromania) using blinded family study methodology. METHODS: Eighty case and 73 control probands, as well as 343 case and 300 control first-degree relatives, were examined by psychiatrists or Ph.D. psychologists using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety version. Two experienced psychiatrists independently reviewed all diagnostic information and made final consensus diagnoses using DSM-IV criteria. RESULTS: Body dysmorphic disorder, hypochondriasis, any eating disorder, and any grooming condition occurred more frequently in case probands. In addition, BDD, either somatoform disorder, and any grooming condition occurred more frequently in case relatives, whether or not case probands also had the same diagnosis. CONCLUSIONS: These findings indicate that certain somatoform and pathologic grooming conditions are part of the familial OCD spectrum. Though other "spectrum" conditions may resemble OCD, they do not appear to be important parts of the familial spectrum.

Adult↗