Prevalence of orofacial injuries resulting from trauma in individuals with cerebral palsy: A systematic review and meta-analysis.

Individuals with cerebral palsy (CP) may have cognitive, sensitive, behavioral, communicative, and convulsive disorders. Because defensive reflexes are reduced by CP, the risk of orofacial trauma is greater in these individuals. This study aimed to evaluate the prevalence of orofacial injuries resulting from trauma in patients with CP. This review was reported according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO-CRD42022293570). The search was performed for articles published until January 2023 in Embase, Latin American and Caribbean Literature on Health Sciences (LILACS), PubMed/Medline, Scopus, and Web of Science databases. Gray literature was also consulted through Google Scholar, OpenGrey, ProQuest Dissertations, and Theses. Studies in which orofacial injuries due to trauma were prevalent in individuals with CP were included. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Additionally, a random-effects meta-analysis was conducted. Twelve studies were included in the synthesis, of which nine presented a low risk of bias and three presented a moderate risk. When considering the general prevalence of orofacial injuries in patients with CP, a prevalence of 34% [95% CI = 18%-52%; I2 = 98%] was observed, with enamel and dentin fractures being the most common orofacial injuries. Approximately one in three patients with CP showed at least one type of orofacial injury involving dental trauma. There is a lack of literature assessing the prevalence of these traumas in soft tissues and the evidence for this outcome remains uncertain.

The beneficial effects of Lacticaseibacillus casei on the small intestine and colon of Swiss mice against the deleterious effects of 5-fluorouracil.

Background: Intestinal mucositis is one of the most common and important side effects of 5-fluorouracil (5-FU). Currently, there are still no specific and effective protocols for its prevention and treatment. The aim of the present study was to evaluate the effect of oral administration of Lacticaseibacillus casei (L. casei) on the progression of 5-FU-induced intestinal mucositis. Methods: L. casei (1x109 CFU/ml) or saline was orally administered to Swiss mice, beginning 15 days before intestinal mucositis induction by single intraperitoneal 5-FU administration (450 mg/kg). Body weight, number of peripheral leukocytes and fecal lactic acid bacteria were monitored. After euthanasia, on day 18, tissue samples from colon and each small intestine segment were collected for histopathology. Jejunal tissues were collected and evaluated for iNOS and TNF-alpha immunoexpression, IL-1-beta, IL-6 and TNF-alpha levels, malonaldehyde (MDA) accumulation, invertase activity and factor nuclear kappa B (NFkB-P65) gene expression, toll like receptor-4 (TLR-4), mucin-2 (MUC-2), occludin and zonula occludens-1 (ZO-1). Results: The positive impact of L. casei on 5-FU-induced leukopenia was observed, but not on 5-FU-induced weight loss in mice. L. casei reduced 5-FU-induced inflammation in the colon and small intestine (p<0.05). Decreased TNF-α, IL-1ß, IL-6 (p<0.05) and MDA (p<0.05) levels, as well as decreased iNOS and TNF-alpha protein expressions (p<0.05) were found in the jejunum from L casei group. In addition, L-casei down-regulated NFKB-P65 (p<0.05) and TLR-4 (p<0.05) gene expressions and up-regulated MUC-2 and mucosal barrier proteins occludin and ZO-1 gene expressions (p<0.05). Furthermore, greater lactic acid bacteria population (p<0.05) was found in the L. casei group when compared to control groups. Conclusion: Oral L. casei administration can protect the intestine of Swiss mice from 5-FU-induced intestinal mucositis, thus contributing to overall health.