Objective: To examine modifications in sleep pattern and in craniofacial morphology of adolescents with mandibular retrognathism. Materials and Methods: Sixteen subjects at maximum pubertal growth (12.6 years [611.5 months]) were selected and treated for 12 months with maxillary expansion and mandibular advancement with a Herbst appliance. Cephalometric radiography and magnetic resonance imaging were obtained prior to and after treatment and were compared using the paired Student's t-test or the nonparametric Wilcoxon rank-sum test. Four polysomnographic recordings were obtained with pressurized nasal cannulae and were analyzed by analysis of variance. Results: The length of the mandible was increased, while the antero-posterior position of the maxilla remained stable. The posterior airway space was increased, the length of the tongue was preserved, and the hyoid bone was moved to a more anterior position. After Herbst treatment, sleep efficiency, sleep latency, rapid eye movement (REM) sleep latency, and percentage of REM sleep remained stable. We did observe a reduction (P , .05) in the relative proportions of stage 1 and stage 3-4 (from 4.30 6 1.99 to 2.61 6 1.83 for stage 1 and from 25.78 6 7.00 to 19.17 6 7.58 for stages 3-4) as well as an increase (P , .01) in the percentage of stage 2 after treatment (49.03 6 6.25 to 56.90 6 6.22). There was a reduction (P , .05) in the number of respiratory effortrelated arousals (7.06 6 5.37 to 1.31 6 1.45 per hour of sleep) due to an increase (P , .01) in airway volume. Conclusions: In the short term, the increase in airway space improved nocturnal breathing associated with the correction of mandibular retrognathism. (Angle Orthod. 2011;81:222-228.)

INTRODUCTION:Regular physical exercise has numerous benefits. However, there is a subset of the exercising population who may develop a compulsion to exercise excessively and who may, as a consequence, display physiological and psychological changes that have a direct influence on their quality of life.OBJECTIVE:Our objective was to determine if there are differences between male and female athletes' scores on measures of negative addiction symptoms, quality of life, mood and sleep. Methods: 144 female and 156 male athletes participated in this study by answering the following questionnaires: Negative Addiction Scale, Beck Depression Inventory, Trait Anxiety Inventory, Profile of Mood States, SF-36 Quality of Life, Pittsburgh Sleep Quality and Epworth Sleepiness Scale.RESULTS:Higher dedication to training sessions in the male group, and members of the female group with symptoms of negative addiction to exercise showed a lower score on vigor observed by the Profile of Mood States compared to the males in both situations. We also observed depression symptoms in both members of groups who had negative addiction symptoms when compared with their peers without symptoms, and these figures were even higher in females compared with the male group in the same situation.CONCLUSION:No differences were seen in the development of negative addiction exercise symptoms in males and females and there were no changes in the quality of life and mood of these athletes. Further studies of eating disorders associated with changes in body image perception could contribute to a better understanding of negative addiction to exercise.

In patients with severe obstructive sleep apnea, a single 50-mg dose of sildenafil at bedtime worsens respiratory and desaturation events.

We discussed two cases of symptomatic female carriers to Duchenne Muscular Dystrophy. The first case is a 20 year-old girl with classical phenotypic manifestation of the disease, similar to the condition in boys. The case 2 is a 62 year-old woman with progressive muscular weakness. The disease is much less common in woman than men so both cases described here are considered rare forms of the disease, with several clinical implications. In both cases, a progressive muscle weakness, impairment in walking and sleeping was observed, in addition to obstructive sleep apnea syndrome and alveolar hypoventilation, that required noninvasive ventilatory support.

Several studies have indicated that motivational level and prior expectations influence one’s commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (SDT, Self Determination Theory) and distal (evolutionary) explanations in the literature. This paper aims to verify if level of motivation (BREQ-2, Behavioral Regulation in Exercise Questionnaire-2) and expectations regarding regular physical exercise (IMPRAF-54) before starting a 1-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women) included a completed protocol group (CPG; n = 21) and drop-out group (n = 73). The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation). Both questionnaires were assessed before starting a regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression analysis showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability – 18.5 points – 81% sensibility/50% specificity) and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity) of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness), physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, as occurs in hunter-gathering groups, can engage people to be physically active and can provide better results in adherence exercise programs for the general population.