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Epidemiological implications of the molecular characterization of foot-and-mouth disease virus isolated between 1996 and 2000 in Bangladesh.

Foot-and-mouth disease virus was collected during two years throughout Bangladesh. Viral RNA from 40 samples was subjected to reverse transcription-dependent polymerase chain reactions that amplify parts of the capsid protein encoding genome region, and the products obtained were sequenced. This showed that all virus isolates up to January 1999 belonged to a genotype of serotype O, observed here already in 1987, 1996 and 1997, and elsewhere since 1990. In February 2001, this virus variant was introduced into Great Britain and then transmitted to other European countries. The capsid protein sequences of an isolate of 2001 from the Netherlands is provided. Later isolates from Bangladesh, however, belonged to a genotype of serotype A that had been transmitted to Albania in 1996. No virus of type Asia1 was found, although it circulated in Bangladesh in 1996. Instead, this genotype of Asia1 virus was observed in Iran late in 1999, and transmitted from Turkey to Greece in July 2000. The results indicate continued intercontinental transmission of foot-and-mouth disease viruses that circulate in central Asia.

Amino Acid Sequence↗

Foot and mouth disease in Brazil and its control--an overview of its history, present situation and perspectives for eradication.

The objective of eliminating foot and mouth disease (FMD) in Brazil has been mainly motivated by the constant preoccupation of Brazilian authorities, livestock breeders and the meat industry with avoiding economic losses due to export restrictions. In 1934, the first national sanitary legislation was enacted, and the Pan-American Foot and Mouth Disease Center in Rio de Janeiro was inaugurated in 1951, with international participation. An overview is given of the past campaigns against FMD, the legislation, policies and field activities. The reasons for the failure of the past campaigns are discussed. The structure of the existing campaign and the present epidemiological situation are explained, and the further possibilities of being recognized as an FMD-free country are discussed.

Animals↗

Inhibition of mouth skeletal muscle relaxation by flavonoids of Cistus ladanifer L.: a plant defense mechanism against herbivores.

Cistus ladanifer exudate is a potent inhibitor of the sarcoplasmic reticulum Ca2+-ATPase (Ca2+-pump) of rabbit skeletal muscle, a well-established model for active transport that plays a leading role in skeletal muscle relaxation. The low concentration of exudate needed to produce 50% of the maximum inhibition of the sarcoplasmic reticulum Ca2+-ATPase activity, 40-60 microg/ml, suggests that eating only a few milligrams of C. ladanifer leaves can impair the relaxation of the mouth skeletal muscle of herbivores, as the exudate reaches up to 140 mg/g of dry leaves in summer season. The flavonoid fraction of the exudate accounts fully for the functional impairment of the sarcoplasmic reticulum produced by the exudate (up to a dose of 250-300 microg/ml). The flavonoids present in this exudate impair the skeletal muscle sarcoplasmic reticulum function at two different levels: (i) by inhibition of the Ca2+-ATPase activity, and (ii) by decreasing the steady state ATP-dependent Ca2+-accumulation. Among the exudate flavonoids, apigenin and 3,7-di-O-methyl kaempferol are the most potent inhibitors of the skeletal muscle sarcoplasmic reticulum. We conclude that the flavonoids of this exudate can elicit an avoidance reaction of the herbivores eating C. ladanifer leaves through impairment of mouth skeletal muscle relaxation.

Animals↗

DNA fragment encoding human IL-1beta 163-171 peptide enhances the immune responses elicited in mice by DNA vaccine against foot-and-mouth disease.

DNA vaccine has been tested for protection against foot-and-mouth disease. However, the relatively low efficacy of DNA vaccine in inducing immune responses in large animals has restricted its practical use. Interleukin-1 plays an essential role in amplifying both the cellular and humoral immune responses to foreign antigens, and may therefore represent a good candidate as an adjuvant of DNA vaccines. Since the inflammatory activity of IL-I may restrict its application in DNA vaccine treatment, we explored the possibilities of augmenting immune responses without unwanted inflammatory effects using the IL-1beta fragment (amino acids (aa) 163-171), which is essential for IL-1 receptor-1 binding. The DNA fragment encoding the human IL-1beta fragment (aa 163-171) was fused to foot-and-mouth disease virus (FMDV) DNA vaccine, and injected into mice to analyse its immune response. Compared with control mice receiving FMDV DNA vaccine alone, significant increases in the FMDV-specific antibody response and also in T cell proliferation were observed in mice receiving IL-1beta (163-171)-FMDV. These results suggested that DNA fragment encoding IL-1beta 163-171 peptide might represent a good candidate for an adjuvant of FMDV DNA vaccine.

Adjuvants, Immunologic↗

Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy.

BACKGROUND: Burning mouth syndrome (BMS) has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. Alpha-lipoic acid is an antioxidant able to increase the levels of intracellular glutathione and eliminate free radicals. This study aimed to examine the effectiveness of alpha-lipoic acid in the therapy of BMS. METHOD: This was a double blind, controlled study conducted for two months on 60 patients with constant BMS. Comparing alpha-lipoic acid (test) with cellulose starch (placebo), there was no laboratory evidence of deficiencies in iron, vitamins or thyroid function and no hyperglycaemia. RESULTS AND CONCLUSION: Following treatment with alpha-lipoic acid, there was a significant symptomatic improvement, compared with placebo, with the majority showing at least some improvement after 2 months, thus supporting the hypothesis that burning mouth syndrome is a neuropathy. This improvement was maintained in over 70% of patients at the 1 year follow-up.

Adult↗

An inbred strain of rats with a high incidence of squamous-cell carcinomas of the mouth.

Intra-oral squamous-cell carcinomas occurred in over 50% of the HMT inbred strain of rats. In the outbred stock from which it was derived the incidence was 5% or less, both when inbreeding was begun and after the inbred strain was fully established. Various factors in food and husbandry which might have irritated the oral mucosa were investigated, but there was no signficiant evidence that they played any part in the high incidence of mouth tumours. It is concluded that there must have been an accidental selection during inbreeding in favour of rats which had an inherited tendency to develop squamous-cell carcinoma of the mouth. There are a number of similarities between the rat tumour and intra-oral squamous-cell carcinoma in man and it is suggested that the rat tumour could be used as a model of the human disease.

Animals↗

Mouth-washings with recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) do not improve grade III-IV oropharyngeal mucositis (OM) in patients with hematological malignancies undergoing stem cell transplantation. Results of a randomized double-blind placebo-controlled study.

We investigated whether daily oral washings with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) solution improved grade III-IV oropharyngeal mucositis (OM) in patients with hematological malignancies undergoing stem cell transplantation. Forty-one consecutive patients (21 males and 20 females, median age (range) 44 (16-69) years) were prospectively randomized to perform daily mouth-washes with either a 400 microg rhGM- CSF (Molgramostin, Schering-Plough) solution (group A, n = 18) or with a saline solution (group B, n = 23). Primary end-points were the intensity of OM, night rest quality and characteristics of food intake. Secondary end-points were need for and duration of parenteral nutrition, oral and intravenous analgesic requirements, incidence of viral or fungal oral infections and development of neutropenic fever. No differences were found between the placebo and rhGM-CSF-treated groups regarding overall duration of OM, maximum grade, reduction in at least one grade of OM (nine patients (56%) in group A vs 13 patients (68%) in group B), reduction of spontaneous or swallowing-induced pain, improvement in oral food intake, use of parenteral nutrition or use of systemic analgesics. In conclusion, mouth-washings with a 400 microg of rhGM-CSF solution do not improve severe OM in hematological patients undergoing stem cell transplantation.

Adolescent↗

Failure of anti-infective mouth rinses and concomitant antibiotic prophylaxis to decrease oral mucosal colonization in autologous stem cell transplantation.

Autologous stem cell transplantation has augmented treatment successes. However, high-dose chemotherapy is still accompanied by dose-limiting toxicities, for example, severe mucositis. Mucosal lesions serve as portals of entry for infections. In order to reduce the oral microbial burden, we prospectively evaluated the microbiological impact of a complex regimen of mouth rinses consisting of concomitantly applied polyene antifungals, povidone-iodine, chlorhexidine, sage tea, and prophylactic ciprofloxacin and fluconazole. A total of 15 patients were enrolled into this longitudinal evaluation. Colony-forming units (CFU) were quantitated from saliva, buccal and palatinal swabs during high-dose chemotherapy and autologous stem cell transplantation. The number of CFU did not show any significant changes after initiation of the mouth rinses and the prophylactic antibiotics. The median CFU count was 268 x 10(6)/ml saliva before chemotherapy and decreased after initiation of intravenous antibiotics only. Neither prophylactic nor therapeutic antifungals significantly reduced the number of cultures positive for yeasts. Since 90% of our patients had febrile neutropenia at some time point during the observation period, the approach evaluated cannot be recommended as prophylaxis of febrile neutropenia as such.

Adult↗

Maximal static mouth respiratory pressure in spinal cord injured patients: correlation with motor level.

STUDY DESIGN: Transversal. OBJECTIVES: The few studies concerning maximal static mouth respiratory pressures in patients with spinal cord lesions suggest a marked reduction. We studied the correlation of these parameters with the motor level of injury. SETTING: Rehabilitation Center, Brasília/DF, Brazil. METHODS: One hundred and thirty-one patients with traumatic spinal cord injury (C4-L3) were recruited. The participants were assessed by standard spirometry and maximal static mouth respiratory pressure. RESULTS: Forced vital capacity was most reduced in tetraplegics (subgroup C4-C5, 49%+/-25 predicted) and increase successively for each descending subgroup (C6-C8, 61%+/-22 predicted; T1-T6, 70%+/-15 predicted), becoming normal in low paraplegia (T7-L3, 84%+/-15 predicted). There is no evidence of an obstructive disturbance throughout all groups. The lowest average percent predicted of maximal static inspiratory pressure (MIP) was in the subgroup C4-C5 (50%+/-23). The average percent predicted of maximal static expiratory pressure (MEP) improved from 19%+/-14 in the C4-C5 subgroup to 51%+/-19 for T7-L3 subgroup. The average percent predicted of all participants for MIP was 74%+/-30 and for MEP was 37%+/-21. In patients with complete motor lesion, the correlation with the level of injury was stronger for MEP (r=0.81, P<0.0001; r (2)=0.65) than for MIP (r=0.62, P=0.004; r (2)=0.38). No correlation was found among incomplete motor lesion patients. CONCLUSIONS: The linear regression equations for the relationship of percent predicted MIP or MEP to level of injury are applicable only to complete motor lesions and may be useful to establish normative association between them.

Adult↗

The contribution of upper airway and inspiratory muscle mechanisms to the detection of pressure changes at the mouth in normal subjects.

1. With standard psychophysical techniques the ability of normal subjects to detect negative pressures applied at the mouth was estimated. 2. The ability to detect changes in pressure when confined to the upper airway by closure of the glottis was less than when the pressures were transmitted below the glottis and were actively overcome by inspiratory muscle contraction. 3. The ability to detect changes in pressure with the glottis open was also impaired by passive ventilation and vibration of the chest. 4. Our results imply that the most sensitive mechanism for the detection of negative pressures applied at the mouth involves afferent information from active inspiratory muscle contraction.

Glottis↗

Effect of facial cooling on mucosal blood flow in the mouth in humans.

1. To determine the effects of facial cooling on intraoral thermal events, we placed a thermal conductivity sensor on the buccal surface of the left cheek in six normal and six asthmatic subjects. Room temperature and cold stimuli were then applied to the integument surface of both sides of the face while mucosal surface temperature and thermal conductivity, as an index of blood flow, were recorded. 2. The room temperature challenge had no effect. Application of the cold stimulus to the exterior of the left cheek caused a monotonic decrease in temperature in the mouth in all subjects and was associated with a change in thermal conductivity in which blood flow increased and then fell to baseline despite a continued drop in temperature. These responses were purely local in that cooling of the right side of the face did not change the temperature or blood flow on the left side. No differences were noted between the asthmatic and normal subjects. 3. The data indicate that lowering the temperature of the skin of the face produces significant alterations in the thermal environment within the mouth. With facial cooling, buccal temperature falls and mucosal blood supply transiently rises. This effect appears to be a purely local thermally mediated event. Facial pressure and cutaneous reflexes do not play a role. The above changes may contribute to the conditioning of inspired air during oral breathing.

Adult↗

Influences of the breathing route on upper airway dynamics properties in normal awake subjects with constant mouth opening.

MB (mouth breathing) promotes the occurrence of sleep-disordered breathing even in non-apnoeic subjects. Considering that MO (mouth opening) contributes to an increase in UA (upper airway) collapsibility independently of MB, the aim of the present study was to assess the influence of breathing route on UA dynamics in the presence of MO. Bilateral anterior magnetic phrenic nerve stimulation was performed 2 s after expiratory onset in 12 healthy male subjects during wakefulness (age, 50+/-5 years; body mass index, 27.8+/-2.4 kg/m(2)) during MB through a mouthpiece and during exclusive NB (nasal breathing) with the same mouthpiece in place. Twitch-induced V(I) (instantaneous flow), P(ph) and P(es) (pharyngeal and oesophageal pressures respectively) were recorded and the corresponding resistances were measured. A polynomial regression model, V(I)=k(1)P(d)+k(2)P(d)(2), was used to characterize flow-pressure relationship and to determine the P(d) value at which UA collapses. There was no difference in UA dynamic properties between NB and MB when UA collapse occurred above the pharyngeal catheter. For twitches where UA collapse occurred lower in the UA, pharyngeal resistance decreased from NB to MB (2.0+/-0.3 and 1.5+/-0.2 cmH(2)Oxl(-1)xs respectively; P=0.02; values are means+/-S.D.), whereas closing pressure increased (-25.7+/-10.1 and -18.0+/-3.0 cmH(2)O respectively; P=0.04). We conclude that (i) in the presence of MO the dynamic properties of the proximal UA free of phasic activity do not differ between NB and MB, and (ii) MB decreases the upstream resistance and increases collapsibility of the distal UA.

Adult↗

Properties of athletic mouth protectors and materials.

The properties of a variety of mouth protectors and sheet materials used to fabricate custom mouth protectors were determined in order to recommend limits for a specification. Hardness, water sorption, water solubility, impact absorption, and tear strength were measured, and limits for these properties were suggested.

Absorption↗

Tremor of the mouth floor and anti-glutamic acid decarboxylase autoantibodies.

Involuntary movements of the mouth can present as palatal tremor, which is frequently associated with hypertrophy of the inferior olivary nucleus and can be accompanied by contraction of other muscles of the head. We report the case of a 39-year-old man with autoimmune thyroiditis and diabetes who complained of involuntary rhythmic tremor involving the muscles of the floor of the mouth, which interfered with breathing and swallowing. Cerebrospinal fluid (CSF) examination showed the presence of oligoclonal bands and screening for anti-neuronal antibodies revealed high titres of anti-glutamic acid decarboxylase autoantibodies (GAD-Ab). Tremor responded to treatment with benzodiazepines. The correlation between the tremor and antibody positivity is unclear although an alteration of the gabaergic system mediated by the antibodies may be hypothesised on the basis of an inflammatory CSF profile.

Adult↗

Residual foot-and-mouth disease virus antibodies in French cattle and sheep six years after the vaccination ban.

A serological survey was carried out on French cattle to establish a reference pattern of residual vaccine antibodies and non-specific reactions against the foot-and-mouth disease virus 6 years after the ban on vaccination and in the absence of any foot-and-mouth disease outbreak. Most of the multi-vaccinated cattle still displayed high titres of antibodies and up to 50% of those which had received a single injection still had antibodies. Non-specific reactors were also recorded among animals born during and after 1991. Most of them displayed low titres close to the threshold. Sheep were also tested and, as for cattle, 4.6% of non-specific reactors were recorded, with titres close to the threshold for two-thirds of them. As part of these animals have been resampled and retested, sera revealed negative confirming that these animals are true non-specific reactors. Serological testing as a mean of FMD control should take these facts into account.

Animals↗

Effect of step duration during incremental exercise on breathing pattern and mouth occlusion pressure.

We compared the effects of two step durations on breathing pattern, mouth occlusion pressure and "effective" impedance of the respiratory system during incremental exercise. Nine normal subjects (mean age: 27.8+/-1.21 years) performed two incremental exercise tests in randomized order: one test with step increments every 1 min 30s and the other, every 4 min. After a warm-up at 25 W for the 1 min 30 s test, the power was increased by 50 W from 50 W to exhaustion. During the last minute at each power, we measured ventilation (VE), tidal volume (VT), breathing frequency (fR), inspiratory and expiratory time (TI and TE), total time of the respiratory cycle (TTOT), TI/TTOT, mean inspiratory flow (VT/TI), mouth occlusion pressure (P0.1), "effective" impedance of the respiratory system (P0.1/(VT/ TI)) and venous blood lactate concentration ([La]). Our result showed that at maximal exercise the power was significantly higher (p < 0.01) and [La] lower (p < 0.01) in the 1 min 30 s test. At 100, 150 and 200 W, the 4 min test showed significantly higher oxygen uptake (VO2), carbon dioxide output (VCO2), VE, P0.1, fR, VT/TI and HR (p <0.001) and significantly lower TI, TE and TTOT (p<0.01). [La] was significantly higher at 150 W (p<0.05) and 200 W (p<0.001). At the same VCO2, P0.1 was not significantly different between the two tests, whereas VE showed a tendency to be higher (p = 0.08) and P0.1/(VT/TI) was significantly lower during the 4 min test. In conclusion, this study allowed us to quantify the difference in inspiratory neuromuscular output and ventilatory response between 1 min 30s and 4 min tests and showed that different step durations alter the relationship between inspiratory neuromuscular output and mean inspiratory flow.

Adult↗

Measuring a toddler's mouthful: toxicologic considerations.

The volume of a toddler's mouthful needs to be defined to estimate poisoning risk. We calculated a toddler's mouthful in 66 healthy children (1.5-4.5 years old) by measuring apple juice remaining in a cup after sipping. Mean volume was 9.3 mL (range, 3.5-29; 95% confidence interval, 8-11), twofold larger than commonly quoted values.

Child, Preschool↗

Impression procedure for patients with severely limited mouth opening.

Patients with limited mouth opening are a common occurrence in prosthodontic practice. The majority of these patients can be treated with exercise and stretching movements before impressions are made. Some will not respond to these procedures because of facial scarring and surgical manipulation of the facial muscles. This article presents an impression procedure for overcoming such reduced mouth opening.

Dental Impression Technique↗