Therapeutic response of benzodiazepine, orphenadrine citrate and occlusal splint association in TMD pain

Loss of function, muscle inflammation, and pain are some of the signs and symptoms of temporomandibular dysfunction (TMD). Pharmacological strategies to minimize the clinical manifestation of these disorders often focus on blocking or inhibiting the pain-causing symptom. Resources such as muscle-relaxants, anxiety-relief drugs, and splint therapy are often used to reduce muscular hyperactivity related to TMD muscle pain. This study compares the effect of a randomly ordered association of occlusal splint therapy (S), nonsteroid anti-inflammatory with a muscle-relaxant drug (orphenadrine citrate) (O), and an anxiety-relief drug (benzodiazepine) (B), to ease painful TMD muscle symptoms. Clinical and anamnestic analyses were recorded in accordance with the Helkimo TMD index and applied before and after treatments. Twenty-one group two Helkimo TMD adult female patients were treated, all of whom were subjected to the three random therapeutic associations proposed: SBO, BOS, and OSB. The same operator applied the three specific associations over a period of 21 days in the proposed sequence, seven days for each therapy. The results show that all the groups presented the best results in terms of relief from pain after the therapeutic association (28.5% showed a decrease and 47.6% showed an absence of symptoms). No significant difference was observed among association therapeutic protocols. Copyright © 2003 by CHROMA, Inc.

Static lung compliance and body pressures in Tupinambis merianae with and without post-hepatic septum

The surgical removal of the post-hepatic septum (PHS) in the tegu lizard, Tupinambis merianae, significantly reduces resting lung volume (VLr) and maximal lung volume (VLm) when compared with tegus with intact PHS. Standardised for body mass (MB), static lung compliance was significantly less in tegus without PHS. Pleural and abdominal pressures followed, like ventilation, a biphasic pattern. In general, pressures increased during expiration and decreased during inspiration. However, during expiration pressure changes showed a marked intra- and interindividual variation. The removal of the PHS resulted in a lower cranio-caudal intracoelomic pressure differential, but had no effect on the general pattern of pressure changes accompanying ventilation. These results show that a perforated PHS that lacks striated muscle has significant influence on static breathing mechanics in Tupinambis and by analogy provides valuable insight into similar processes that led to the evolution of the mammalian diaphragm. © 2003 Elsevier Science B.V. All rights reserved.

Clinical evaluation of amitriptyline for the control of chronic pain caused by temporomandibular joint disorders

Temporomandibular disorder (TMD) is characterized by a combination of symptoms affecting the temporomandibular joint and/or chewing muscles. The two most common clinical TMD symptoms are pain and dysfunction. Pain is usually caused by dysfunction, and emergency therapy has focused on controlling it. Recent investigations into TMD have led to the recommendation of antidepressants as a supporting treatment against constant neuralgic pain. The aim of this double-blind study was to verify the efficiency of antidepressants (amitriptyline) as a support in the treatment of chronic TMD pain. Twelve female volunteers presenting chronic TMD pain were divided into two groups and treated for 14 days: Group 1 with 25 mg/day of amitriptyline and Group 2 with a placebo. The intensity of pain and discomfort was evaluated daily, using a visual analog scale (VAS), over a period of seven days preceding the treatment (baseline), during the 14-day treatment, and for seven days after the treatment. The results revealed a significant reduction of pain and discomfort in Group 1 (75%) compared to Group 2 (28%) during the three weeks beginning at baseline (p< 0.01). Amitriptyline proved to be an efficient alternative treatment for chronic pain in TMD patients. Copyright © 2003 by CHROMA, Inc.

Electromyographic muscle EMG activity in mouth and nasal breathing children

Mouth breathing may cause changes in muscle activity, because an upper airway obstruction leads may cause a person to extend his/her head forward, demanding a higher inspiratory effort on the accessory muscles (sternocleidomastoids). This purpose of this study is to compare, using electromyography (EMG), the activity pattern the sternocleidomastoid and upper trapezius muscles in mouth breathing children and nasal breathing children. Forty-six children, ages 8-12 years, 33 male and 13 female were included. The selected children were divided into two groups: Group I consisted of 26 mouth breathing children, and Group II, 20 nasal breathing children. EMG recordings were made using surface electrodes bilaterally in the areas of the sternocleidomastoideus and upper trapezius muscles, while relaxed and during maximal voluntary contraction. The data were analyzed using the Kruskall-Wallis statistical test. The results indicated higher activity during relaxation and lower activity during maximal voluntary contraction in mouth breathers when compared to the nasal breathers. It is suggested that the activity pattern of the sternocleidomastoid and upper trapezius muscles differs between mouth breathing children and nasal breathing children. This may be attributed to changes in body posture which causes muscular imbalance. Because of the limitations of surface EMG, the results need to be confirmed by adding force measurements and repeating the experiments with matched subjects. Copyright © 2004 by CHROMA, Inc.

Detecção de prováveis deformações neotectônicas no Vale do Rio do Peixe, Região Ocidental Paulista, mediante aplicaçao de Índices RDE (Relac̈ão Declividade-Extensão) em segmentos de drenagem

Running water is one of the most important of all the physical processes which fashion the landscape, allowing gravity to operate along the valley floors. Besides this, the streams show a fast adjustment to the crustal deformations, even to the most gentle ones. This geologic behavior turns them a potential tool for neotectonic studies, specially the analysis of morphotnetric parameters associated with hydraulic gradient and discharge, this second factor being directly proportional to the extension of the streams. Both elements, gradient and stream length, can be combined in the SL index. The purpose of this paper is to show the RDE index application in the neotectonics analysis of the Rio do Peixe hydrographic basin and to compare the obtained values with the geologic basement incised by the streams. This basement encompasses Cretaceous sedimentary rocks of post-Serra Oeral Formation magmatism (Caiuá and Bauru groups) and Quaternary deposits that include chiefly recent alluvial plains and some Pleistocene terrace deposits. In the final part of this paper, an attempt is made in order to correlate the RDE results and the neotectonic framework admitted to this portion of the São Paulo State territory, as well as with field geologic, seismologic and paleoseismologic known elements. The results indicate the presence of two groups of anomalies: The first set corresponds to the Marília-Exaporã Plateau border, and the second one, located in the central portion of the hydrographic basin, is correlated to the Presidente Prudente seimogenic zone.

Análise de superfície de tendência aplicada à chuva, medida por radar meteorológico, nas regiões de Assis e Piracicaba, SP

This paper presents the results from lineal trend surface analysis technique application. The purpose was to detect positive and negative anomalies in the rain measure distribution obtained by the meteorological radar Doppler, band S, located in Bauru, during the period of 21 of October/2004 to 29 of April/2005 in the areas of Assis and Piracicaba. Using three Z-R radar relations for rain quantification was chosen the specific equation Z = 32R1,65, as the best one. The results showed that the applied methodology was able to indicate the space distribution of the rain accumulated, identifying and locating the regions where there was rainy excess and rainy lack during each analyzed period. Such results indicate areas with larger pluvial impact and consequently more favorable for environmental damages.

Utilização do brinquedo terapêutico na assistência à criança hospitalizada

This is an exploratory and descriptive study that was jointly carried out by Nursing Care and Occupational Therapy as part of a Research Project that intended to prepare children for elective surgery at the University of São Paulo's Hospital de Reabilitação de Anomalias Craniofaciais. Objective: using toys as a therapeutic resource for relieving the child's real and unconscious tensions concerning hospitalization for surgical treatment at the HRAC - USP. Method: 44 children participated in the study. An observation form was used to collect data and it was applied at two separate times: the first time was the day before the surgery was to take place and the second on the day of the surgery just before the event. Twenty one variables were elaborated by the researchers to categorize behaviors regarding hospitalization. The resources used were: storytelling, dramatization and demonstration of nursing interventions with puppets dressed in surgical garb (gloves, surgical gown, mask and cap) with medical equipment commonly used in hospital. Results: of the 21 variables analyzed, 8 showed statistically significant differences on the McNemar Test (p<0.05). Conclusion: interactive play enables hospitalized children to interact in the hospital environment, so that they can express feelings and emotions and it contributes to humanized hospital assistance.

Influência do arcabouço hidroestratigráfico nas ocorrências de arsênio em águas subterrâneas ao longo do corredor termal do rio Uruguai (Argentina - Brasil - Uruguai)

The Thermal Corridor of Uruguay River is located in the triple border of Argentine, Brazil and Uruguay, and shows an intense economic thermal tourism activity, mainly based on groundwaters from Guarani Aquifer System (GAS). Recent studies have pointed out the occurrence of high concentrations of arsenic (>10 μg/L) in GAS groundwater in this area. The complex geological and hydrogeological framework in the area is associated to the Paraná Basin geological evolution south of the Assuncion-Rio Grande Arch; it encompass paleozoic marine sequences and continental sequences permian/eotriassic to mesozoic in age, which are covered by basaltic lavas of Serra Geral Formation. Iron oxide coatings have been described in sandstones of Buena Vista and Sanga do Cabral formations, which underlie GAS units. Arsenic occurrence is associated to sodium bicarbonate groundwater with pH values over 8.0. Arsenic is released to groundwater by desorption from iron oxides/hydroxides, as result of the higher pH of these waters, indicating that arsenic is released from the units that underlie GAS units. Increase in chromium and uranium concentrations are also related to high pH groundwaters, thus indicating special care on using groundwater from this region.

Emprego do imageamento elétrico no estudo da contaminação por cemitérios

Due to lack of environmental protection with which the process of burying the corpses was conducted over the decades, many cemeteries have become areas contaminated by organic and inorganic substances and pathogenic microrganisms. This paper presents the results of electrical imaging in delineation of areas potentially contaminated by necrochorume in the municipal cemetery of Vila Rezende, Piracicaba - SP. The results indicate a depth of water table among 3,1 and 5,1 m, with two flow directions, being one to SW and another to SE. So the probable contamination plume, that has the same directions of underground flow, as for the conductive anomalies verified at the geoelectrics sections confirm the suspicions of contamination in the area. The probable plume the SE is prolonged to out of the cemetery. The location of the conductive anomalies and likely contamination plumes demonstrated that the contamination is linked with the depth of water table level and the burial time.

Marginal resection for treatment of mandibular osteomyelitis associated with osteopetrosis: Case report

Osteopetrosis (OP) is a rare hereditary disorder characterized by a dysfunction of the osteoclasts that impairs bone resorption, which together with the normal osteoblastic activity forms intense bone sclerosis with reduction of marrow. A common complication that arises, most frequently, as a result of tooth extraction is mandibular osteomyelitis. There is no consensus on the literature about the treatment of this infection in an osteopetrotic patient, therefore, the purpose of this paper is to report a case of marginal resection for treatment of mandibular osteomyelitis in an osteopetrotic patient and discuss relevant features of this procedure. © 2010 European Association for Cranio-Maxillo-Facial Surgery.

Estudo geofísico de vazamento de combustíveis em posto de abastecimento

The geoelectrical methods have been widely used in research involving the evaluation and monitoring of areas with environmental risk. This paper presents the results of applying the Electrical Resistivity method by electrical profiling technique to investigate the fuel presence in soil and groundwater proceeding in station gas, located in an urban area Caçapava do Sul (RS), on soil in situ, from modification of Caçapava granite. The results suggest an association between low resistivity anomalies zone with potentially degraded from underground tanks worthless on the form of free phase, now represented as residual phase. The results of the model inversion are consistent with the standards expected for hydrocarbons present in the saturated zone. The electrical resistivity method proved to be an important tool for assessment and environmental monitoring in conjunction with direct methods of investigation.

Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland

The aim of this study is to report the case of a quick growing brown tumour in the jaw after a parathyroidectomy due to the presence of a rare fifth parathyroid gland. The patient had chronic renal disease and the diagnosis was tertiary hyperparathyroidism. Thirty days after the parathyroidectomy, the patient returned with a significant increase in the tumour size. The suspicion of a supernumerary gland was confirmed by parathyroid scintigraphy. The treatment of brown tumour is dependent on the treatment of the hyperparathyroidism. However, curettage should be considered if a large lesion is disturbing mastication. In conclusion, this case should attract the attention of general practitioner dentists, since they may be the first professionals who have contact with the patient with a brown tumour in the jaws. Likewise, this case emphasises the importance of knowing the type of hyperparathyroidism involved to allow for effective treatment planning. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

Oral granuloma formation after injection of cosmetic filler

The increased use of orofacial fillers in cosmetic procedures has led to new diagnostic challenges for dentists and oral pathologists. Here, we describe a case with multiple oral foreign body granulomas, which were formed after a polymethylmetacrylate injection for cosmetic purposes. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

New approaches to dental occlusion: A literature update

Because the study of occlusion is a basic area in dentistry, its components, physiology and integration with the stomatognathic system (SS) have been the subject of interest in the scientific literature. However, the focus given to this issue has changed substantially. Currently, new approaches have been proposed in order to update concepts and to demonstrate the full integration and functionality of this system within the human body. With this approach, the authors proposed the following literature review aimed at gathering recent papers (published from 2000 to 2010) with innovative study design, methodology and/or results. The authors' intention is to show the main trends in the study of occlusion and the SS. The literature review was conducted in the PubMed database, using initially the term dental occlusion as a key-word. As items of interest were found, papers were grouped by categories according to their main subject matter. Forty-seven articles were selected and the main categories obtained were: 1. functional magnetic resonance imaging (fMRI); 2. brain activation; 3. masticatory/occlusal function; 4. body function and physical performance; 5. osseoperception; 6. finite element models; and 7. occlusion and pain. Observing the current literature, the authors found that recent studies present different methodologies for the study of occlusion. These studies have allowed scientists to obtain detailed information about the physiology of occlusion and the SS, as well as about its integration in the body. Research in this area should be continued in order to clarify, in detail, the role of each component of the SS and its interaction with human physiology. © 2012 by CHROMA, Inc.

Enfisema lobar congênito: série de casos de 30 anos em dois hospitais universitários

Objetivo: Revisar os casos de enfisema lobar congênito (ELC) operados nos últimos 30 anos em dois hospitais universitários. Métodos: Foram revistos os prontuários médicos das crianças com ELC operadas no Hospital das Clínicas da Faculdade de Medicina de Botucatu e no Hospital da Universidade de Mogi das Cruzes entre 1979 e 2009. Dados sobre sintomas, exame físico, achados radiológicos, diagnóstico, tratamento cirúrgico e seguimento pós-operatório mediato e tardio foram analisados. Resultados: Durante o período estudado, 20 crianças com ELC foram submetidas a tratamento cirúrgico. A média de idade dos pacientes no momento da cirurgia foi 6,9 meses (variação, 9 dias a 4 anos). Todos os casos apresentaram sintomas ao nascimento ou nos primeiros meses de vida. Em todos os casos, a radiografia simples de tórax foi importante na definição do diagnóstico. Em casos de dificuldade respiratória moderada, a TC de tórax auxiliou no diagnóstico. Um paciente com desconforto respiratório grave foi diagnosticado erroneamente com pneumotórax hipertensivo e submetido a drenagem torácica. A broncoscopia só foi realizada nos pacientes com dificuldade respiratória moderada e não foram encontrados sinais de anomalias traqueobrônquicas. A abordagem cirúrgica foi realizada através de toracotomia lateral poupadora de músculo. O lobo superior esquerdo e o lobo médio foram os mais afetados, seguidos pelo lobo superior direito. A lobectomia foi realizada em 18 casos, enquanto a bilobectomia foi realizada em 2 casos (com ressecção de cisto broncogênico em 1 desses). Complicações pós-operatórias não foram observadas. O acompanhamento pós-operatório foi de pelo menos 24 meses (média, 60 meses) e não foram observadas complicações tardias nesta série. Conclusões: O ELC é uma doença pouco comum, ainda negligenciada, de etiologia incerta, mas de fácil diagnóstico radiológico e tratamento cirúrgico eficaz.