Temporomandibular Disorders Are Differentially Associated With Headache Diagnoses A Controlled Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

How to Investigate and Treat: Migraine in Patients with Temporomandibular Disorders

Migraine and temporomandibular disorders (TMD) are highly prevalent conditions that frequently coexist in the same patient. The relationship between migraine and TMD is complex. Migraineurs often have pain in the TMD area; TMD sufferers, in turn, often experience headaches in addition to the pain in the jaw. Finally, migraine and TMD are comorbid, and the final phenotype of patients with the comorbidity may represent the aggregated contribution of both. Herein we briefly discuss the clinical commonalities of migraine and TMD, and the differential diagnosis of these conditions with other causes of facial pain. We close by presenting our experience in the treatment of patients with the comorbidity.

Study About the Development of the Temporomandibular Joint in the Human Fetuses

The temporomandibular joint (TMJ) is a highly specialized articulation that differs from all the other synovial articulations for many reasons. In children, different from what we observe in adults, these articulations have rarely been studied under the morphofunctional aspect, mainly in the embryonary and fetal stages. In this study 10 fetuses with ages varying from 16 to 39 weeks of intrauterine life were used, and it could be observed that the fibers and thickness of the articular disc, as well as the articular capsule and the condylar process, suffer modifications according to age. It was also observed that the superior head of the lateral pterygoid muscle inserts itself in the articular disc and capsule in all the ages studied. Also, the maturation of the articular tissues, especially of the articular disc, as well as, the associated muscles, suggests that the TMJ was able to carry out mandibular movements since the 24(th) week of intrauterine life.

Myocardial dysfunction induced by food restriction is related to morphological damage in normotensive middle-aged rats

Previous works from our laboratory have revealed that food restriction (FR) promotes discrete myocardial dysfunction in young rats. We examined the effects of FR on cardiac function, in vivo and in vitro, and ultrastructural changes in the heart of middle-aged rats. Twelve-month-old Wistar- Kyoto rats were fed a control (C) or restricted diet (daily intake reduced to 50% of the control group) for 90 days. Cardiac performance was studied by echocardiogram and in isolated left ventricular (LV) papillary muscle by isometric contraction in basal condition, after calcium chloride (5.2 mM) and beta- adrenergic stimulation with isoproterenol (10(-6) M). FR did not change left ventricular function, but increased time to peak tension, and decreased maximum rate of papillary muscle tension development. Inotropic maneuvers promoted similar effects in both groups. Ultrastructural alterations were seen in most FR rat muscle fibers and included, absence and/or disorganization of myofilaments and Z line, hyper-contracted myofibrils, polymorphic and swollen mitochondria with disorganized cristae, and a great quantity of collagen fibrils. In conclusion, cardiac muscle sensitivity to isoproterenol and elevation of extracellular calcium concentration is preserved in middle-aged FR rats. The intrinsic muscle performance depression might be related to morphological damage.

Myocardial dysfunction induced by food restriction is related to calcium cycling and beta-adrenergic system changes

Food restriction (FR) has been shown to promote myocardial dysfunction in rats. The aim of this study was to verify the participation of calcium and beta-adrenergic system on myocardial mechanical alteration in rats submitted to FR. Myocardial performance was studied in isolated left ventricular papillar muscle from young Wistar-Kyoto rats (WKY) submitted to FR or to control diet. The groups subjected to FR were fed 50% less food than the control group for 90 days. Mechanical function was studied in isometric contraction at post-rest contraction of 30 seconds (PRC), calcium chloride concentration 5.20 mM, and beta-adrenergic stimulation with isoproterenol 10(-6) M. FR decreased the body weight, and left and right ventricular weight. In basal condition (1.25 MM of calcium) time to peak tension (TPT) and time from peak tension to 50% relaxation (RT50) were greater in the FR group. Muscle function was. The same in both PRC groups. TPT decrease in both high calcium groups, more in FR rats; RT50 dropped only in FR animals. TPT decreased in both Isoproterenol groups, more intensely in the FR group. This result suggests that food restriction impairs myocardial performance and these changes may be attributed to alterations in the intracellular calcium cycling and beta-adrenergic system. (C) 2003 Elsevier B.V. All rights reserved.

Severe food restriction induces myocardial dysfunction related to SERCA2 activity

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Ejaculatory dysfunction in streptozotocin-induced diabetic rats: the role of testosterone

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Toxicity of copper intake: lipid profile, oxidative stress and susceptibility to renal dysfunction

The present study was carried out to investigate the effects of copper (Cu) intake on lipid profile, oxidative stress and tissue damage in normal and in diabetic condition. Since diabetes mellitus is a situation of high-risk susceptibility to toxic compounds, we examined potential early markers of Cu excess in diabetic animals. Male Wistar rats, at 60-days-old were divided into six groups of eight rats each. The control(C) received saline from gastric tube, the no-diabetic(Cu-10), treated with 10 mg/kg of Cu(Cu(++)-CuSO(4), gastric tube), no-diabetic with Cu-60mg/kg(Cu-60), diabetic(D), diabetic low-Cu(DCu-10) and diabetic high-Cu(DCu-60). Diabetes was induced by an ip injection of streptozotocin (60mg/kg). After 30 days of treatments, no changes we're observed in serum lactate dehydrogenase, alanine transaminase and alkaline phosphatase; indicating no adverse effects on cardiac and hepatic tissues. D-rats had glucose intolerance and dyslipidemic profile. Cholesterol and LDL-cholesterol were higher in Cu-60 and DCu-60 than in C, Cu-10 and D and DCu-10 groups respectively. Cu-60 rats had higher lipid hydroperoxide (HP) and lower superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) serum activities than C and Cu-10 rats. LH was increased and GSH-Px was decreased, while no alterations were observed in SOD and catalase in serum of DCu-60 animals. DCu-60 rats had increased urinary glucose, creatinine and albumin. In conclusion, Cu intake at high concentration induced adverse effects on lipid profile, associated with oxidative stress and diminished activities of antioxidant enzymes. Diabetic animals were more susceptible to copper toxicity. High Cu intake induced dyslipidemic profile, oxidative stress and kidney dysfunction in diabetic condition. Copper renal toxicity was associated with oxidative stress and reduction at least, one of the antioxidant enzymes. (C) 2004 Elsevier Ltd. All rights reserved.

Clinical and MRI investigation of temporomandibular joint in major depressed patients

Objective: The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type.Methods: 40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and chi(2) test were applied (alpha = 0.05).Results: Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p=0.00) and between present and absent joint noises (p=0.00) were observed.Conclusion: Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs. Dentomaxillofacial Radiology (2012) 41, 316-322. doi: 10.1259/dmfr/27328352

Response activity of alveolar macrophages in pulmonary dysfunction caused by Leptospira infection

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease

OBJECTIVES: ,,,,,The prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease according to disease severity has not yet been established. The aim of this study was to assess the prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease patients according to disease severity. ,,,, ,,,, ,,,,,METHODS: ,,,,,The study included 25 mild/moderate chronic obstructive pulmonary disease patients and 25 severe/very severe chronic obstructive pulmonary disease patients. All participants underwent clinical evaluation, spirometry and electrocardiography/echocardiography. ,,,, ,,,, ,,,,,RESULTS: ,,,,,Electrocardiography and echocardiography showed Q-wave alterations and segmental contractility in five (10%) patients. The most frequent echocardiographic finding was mild left diastolic dysfunction (88%), independent of chronic obstructive pulmonary disease stage. The proportion of right ventricular overload (p<0.05) and blockage of the anterosuperior division of the left bundle branch were higher in patients with greater obstruction. In an echocardiographic analysis, mild/moderate chronic obstructive pulmonary disease patients showed more abnormalities in segmental contractility (p<0.05), whereas severe/very severe chronic obstructive pulmonary disease patients showed a higher prevalence of right ventricular overload (p<0.05), increased right cardiac chamber (p<0.05) and higher values of E-wave deceleration time (p<0.05). Age, sex, systemic arterial hypertension, C-reactive protein and disease were included as independent variables in a multiple linear regression; only disease severity was predictive of the E-wave deceleration time [r2 = 0.26, p = 0.01]. ,,,, ,,,, ,,,,,CONCLUSION: ,,,,,Chronic obstructive pulmonary disease patients have a high prevalence of left ventricular diastolic dysfunction, which is associated with disease severity. Because of this association, it is important to exclude decompensated heart failure during chronic obstructive pulmonary disease exacerbation.

Relationship between temporomandibular disorders and orthodontic treatment: a literature review

OBJETIVO: revisar a literatura mais atual, dos últimos 15 anos, em busca de estudos clínicos que relatem a relação entre a disfunção temporomandibular (DTM) e o tratamento ortodôntico e/ou a má oclusão. A intenção foi verificar se o tratamento ortodôntico aumentaria o aparecimento de sinais e sintomas de DTM, e se o tratamento ortodôntico seria um recurso para o tratamento ou prevenção dos sinais e sintomas de DTM. MÉTODOS: artigos dos tipos revisão de literatura, editorial, carta, estudo experimental em animais e comunicação foram excluídos dessa revisão. Foram incluídos artigos prospectivos, longitudinais, caso-controle ou retrospectivo com amostra maior, com relevante análise estatística. Estudos que abordassem deformidades e síndromes craniofaciais e tratamento por cirurgia ortognática também foram excluídos, bem como aqueles que relatassem apenas a associação entre má oclusão e DTM. RESULTADOS: foram encontrados 20 artigos relacionando Ortodontia à DTM, segundo os critérios adotados. Os estudos, então, associando sinais e sintomas de DTM ao tratamento ortodôntico apresentaram resultados heterogêneos. Alguns encontraram efeitos positivos do tratamento ortodôntico para os sinais e sintomas de DTM; entretanto, nenhum deles apresentou diferença estatisticamente significativa. CONCLUSÕES: todos os estudos citados nessa revisão de literatura relataram que o tratamento ortodôntico não forneceu risco ao desenvolvimento de sinais e sintomas de DTM, independentemente da técnica utilizada para tratamento, da exodontia ou não de pré-molares e do tipo de má oclusão previamente apresentada pelo paciente. Alguns estudos realizados com acompanhamento em longo prazo concluíram que o tratamento ortodôntico não seria preventivo ou uma modalidade de tratamento para DTM.

Temporomandibular joint ankylosis and salivary mucocele in a cat: case report

Relata-se o caso de um gato de aproximadamente um ano e meio de idade, macho, não castrado, que foi encaminhado por apresentar incapacidade de abrir a boca e aumento de volume flutuante na região intermandibular. As lesões estavam presentes há um ano, desde quando o gato foi encontrado e adotado. A causa não foi determinada. Baseado nos exames físicos e radiográficos diagnosticou-se anquilose da articulação temporomandibular esquerda e mucocele salivar. O aspecto lateral do processo condilar da mandíbula esquerda foi removido, e a mucocele foi tratada por ressecção das glândulas salivares mandibular e sublingual direita e por drenagem da mucocele. Após a cirurgia, o gato mostrou bom uso funcional da mandíbula, sem sinais de desconforto.