Bruxismo do sono e disfunção temporomandibular: avaliação clínica e polissonográfica

O objetivo deste estudo foi buscar um melhor entendimento sobre a dor músculo-esquelética crônica da face e sua relação com o bruxismo do sono. Quarenta pacientes foram avaliados de acordo com o Research Diagnostic Criteria for Temporomandibular Disorders: Grupo A - 20 pacientes com DTM, com média de idade de 32,7 anos e duração média da dor de 4,37 anos; Grupo B - 20 pacientes sem DTM, com média de idade de 30,8 anos. As variáveis do sono e do bruxismo foram avaliadas em exame polissonográfico. As características clínicas foram estatisticamente diferentes entre os dois grupos: o grupo A apresentou maior freqüência de auto-relato de dor matinal (p=0,0113) e estalido articular (p=0,0269), maior grau de sintomas físicos não específicos (p=0,001) e de limitações da função mandibular (p=0,001). Não houve diferença estatisticamente significativa para as variáveis do bruxismo: número de episódios de bruxismo por hora, número de surtos por episódio e por hora, duração total, porcentagem em cada estágio do sono, tipo e amplitude dos episódios. A arquitetura do sono mostrou-se dentro dos parâmetros de normalidade, sem nenhuma diferença estatisticamente significativa entre os dois grupos. Conclusões: as características clínicas dos pacientes com bruxismo do sono, com e sem DTM, são diferentes, mas as características do sono e do bruxismo são similares. Mais estudos são necessários para esclarecer as razões pelas quais alguns pacientes com bruxismo do sono desenvolvem dor milfascial crônica e outros não.

Correlação entre autoestima e grau de severidade da disfunção temporomandibular em sujeitos controle e afetados

INTRODUCTION: Temporomandibular disorders (TMD) have association with psychological manifestations. OBJECTIVE: The aims of this study were to correlate the severity of TMD and the level of self-esteem, and to investigate sex‑related differences. MATERIAL AND METHOD: We evaluated 57 subjects of both gender, with mean age of 20.28 ± 2.07 years, through the Fonseca Anamnesis Index (FAI) and Rosenberg Self-esteem Scale (RSS). Correlations between variables were performed using the Spearman correlation coefficient; comparisons between the genders were performed using the Mann-Whitney test. It was considered a significance level of 5%. RESULT: No differences were found for the comparisons between the gender in the FAI (p = 0.79) and the RSS (p = 0.90). RSS correlates with the FAI in women (p = 0.01), but in men this result does not occur (p = 0.07). CONCLUSION: We concluded that women are more likely to have emotional disturbances resulting from changes in the temporomandibular joint than men.

Cardiomiopatia hipertrófica felina: revisão bibliografica

Hypertrophic cardiomyopathy (HCM) is the most common heart disease in the feline specie, more frequently affecting pure-breed males such as Ragdolls and Maine Coons. HCM can be primary (idiopathic) or secondary, when other diseases such as hyperthyroidism are involved. The disease is characterized by an increase in the diameter and thickness of the left ventricular wall, with consequent diastolic dysfunction. Mitral regurgitation happens due to compromised ventricular filling, leading to an increased left atrium size and consequent cardiogenic pulmonary edema. Along with the progress of modern veterinary medicine, many diseases could be addressed more successfully on small animal internal medicine, such as feline HCM. This article brings a literature review of the feline hypertrophic cardiomyopathy, focusing on its etiology, physiopathology, clinical presentations, diagnostic methods, therapeutics and prognosis

Ecodopplercardiografia em equinos submetidos à obstrução de cólon descendente

Pós-graduação em Cirurgia Veterinária - FCAV

Prevalência de alterações locais e sistêmicas em indivíduos com disfunção temporomandibular

Temporomandibular disorder describes a variety of conditions including joint and muscle in the stomatognathic system, characterized by pain, TMJ sounds, functions irregular jaw and represent the leading cause of nondental pain in the orofacial region. The objective of this research was to evaluate the prevalence of ophthalmological, otological and cognitive-behavioral changes, parafunctional habits in individuals with temporomandibular disorders (TMD). A total of 117 medical records of female and male individuals, aged 18 to 60 years, from the Occlusion, Temporomandibular Dysfunction and Orofacial Pain of the Ribeirão Preto School of Dentistry – USP, between 2010 and 2011. The anamnesis index proposed by Helkimo was used to classify the individuals according to TMD severity degree and to divide them into two groups: AiI (mild to moderate) with 69 individuals and AiII (severe) with 48 individuals. The groups were then subdivided with respect to gender (72.64% female and 27.36% male) and age. There was predominance in the 18-40 year age group (60.68%) when compared to the 41-60 year age group (39.32%). Data were collected through an interview with questions about the presence of parafunctional habits, otological, ophthalmological and behavioral changes. Data were subjected to the statistical analysis using the Kruskal-Wallis test. The prevalence of each change was also evaluated. The results showed statistically significant for all groups according to gender, age and degree of severity. Individuals with temporomandibular disorders exhibited high prevalence of systemic and local dysfunctions.

Fatores de risco associados à disfunção temporomandibular dolorosa em adolescentes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Remodelação ventricular após infarto agudo do miocárdio. Conceitos, fisiopatologia e abordagem terapêutica

Após o infarto agudo do miocárdio (IAM), ocorrem alterações complexas na arquitetura ventricular, envolvendo tanto a região infartada como a não infartada. Nos últimos anos, estas adaptações, que podem ser identificadas na fase aguda do IAM, ou mais tardiamente, passaram a ser estudadas com o nome de remodelação ventricular (RV) pós-IAM 1 . O reconhecimento e entendimento deste processo é crítico, pois a RV pode estar associada a um pior prognóstico, pós-infarto, na dependência de diversos fatores. Outro aspecto relevante é que sua evolução pode ser modificada, por meio de diversas intervenções terapêuticas. Assim, abordaremos aspectos fisiopatológicos que envolvem a RV, bem como os efeitos das medicações comumente usadas no tratamento do infarto, nesse processo adaptativo.

Spironolactone is secure and reduces left ventricular hypertrophy in hemodialysis patients

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

Desenvolvimento de um modelo experimental de hidrocefalia por neurocisticercose

Pós-graduação em Bases Gerais da Cirurgia - FMB

Acupuntura em disfunção temporomandibular: relato de caso clínico

A técnica milenar da Acupuntura vem sendo empregada na Odontologia e obtendo bons resultados em diversas situações. Analgesia, relaxamento muscular e inflamação vêm sendo controlados, demonstrando assim conexão entre Acupuntura e redução de certas sintomatologias. As reações locais e à distância necessitam de correto posicionamento das agulhas assim como integridade do sistema nervoso, e são decorrentes da liberação de neurotransmissores (noradrenalina, acetilcolina, serotoninas e dopamina). Dentro da Odontologia, podemos nos utilizar dos seus efeitos no pré e pós operatório, em xerostomia, cefaléias, trismos, disfunção de ATM por estresse, parestesias, paresias, ansiedade, entre outras condições. Nos casos de disfunção de Articulação Temporomandibular por hiperatividade muscular, podemos utilizar a Acupuntura ao invés de relaxante muscular e antiinflamatório. Nesse trabalho, apresentaremos um caso clínico (paciente MCH, 23 anos, gênero feminino), a qual apresentava crises de dor de cabeça (região temporal), fazendo uso constante de medicação analgésica e antiinflamatória, o diagnóstico estabelecido foi Dor Muscular Local associado à hiperatividade muscular. Através do uso da Acupuntura, após aplicações semanais por 3 meses, houve remissão da dor por completo.

Prótese de palato em sujeitos com disfunção velofaríngea: expectativa e ansiedade

Cleft lip and palate (CLL) is a very common craniofacial anomaly. The cleft is usually corrected with surgery which may fail resulting in velopharyngeal dysfunction (VPD). The use of palatal prosthesis is an alternative treatment for correcting both, CLP and VPD. This study evaluated anxiety symptoms expectations of subjects of both genders, with velopharyngeal dysfunction, referred to palatal prosthesis program for VPD treatment. In this cross sectional and descriptive study 30 subjects with velopharyngeal dysfunction, aged 15 to 64 years old (mean age of 28) were interviewed at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC). All subjects referred to the palatal prosthesis program at HRAC in the year of 2005 were considered for participation in the study but only the first 30 candidates were included. A questionnaire addressing expectation elaborated by the researcher and the Beck Scale on anxiety were used. All subjects showed expectation regarding speech modification. Changes in professional and affective aspects of their lives after changes in speech were obtained with palatal prosthesis were the most reported expectations. Subjects’ age and gender influenced anxiety levels significantly which were minimum across subjects. High levels of expectation were more frequent than anxiety in the sample population.

Efeito do treinamento aquático no perfil lipídico e na hipertrofia ventricular esquerda de camundongos hiperlipidêmicos

This study assessed the effects of Water training on the lipid profile and left ventricular structures in hyperlipidemic mice. Twenty-eight male LDLr-/- mice were randomly separated into 4 groups: sedentary, fed a standard diet (C); exercising, fed a standard diet (C+TRE); sedentary, fed a hyperlipidic diet (C+HL); and exercising, fed a hyperlipidic diet (E+HL). The exercising mice trained daily for 60 minutes during 60 days. After 48 hours of the end of the training period and 12 hours of rest fasting the animals were underwent euthanasia and the blood was collected for measuring the plasma levels of triglycerides, total cholesterol and its fractions (LDL, HDL, VLDL). The heart was removed and the left ventricle was weighed fresh to calculate the ratio left-ventricle weight (mg)/body weight (g). The results showed that the training was more effective in improving lipid plasma levels when combined with a balanced diet, thereby confirming that it is essential to associate physical exercise and diet. The training protocol resulted in eccentric left ventricular hypertrophy in the standard-diet group and decreased interstitial collagen deposition in the myocardium of the high-fat-diet animals, which may indicate an improved diastolic function with consequent improvement in the systolic function. It was concluded that regular moderate aerobic exercise induce beneficial and prophylactic adaptations to heart which promoted a better health condition and prevention to diseases.

Efeitos da administração de eritropoietina na dislipidemia e na hipertrofia ventricular esquerda de camundongos hiperlipidêmicos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Metalloproteinases-2 and -9 predict left ventricular remodeling after myocardial infarction

Background: The role of serum metalloproteinases (MMP) after myocardial infarction (MI) is unknown. Objective: The aim of this study was to evaluate the role of serum MMP-2 and -9 as predictors of ventricular remodeling six months after anterior MI. Methods: We prospectively enrolled patients after their first anterior MI. MMP activity was assayed 12 to 72 hours after the MI. An echocardiogram was performed during the hospitalization and six months later. Results: We included 29 patients; 62% exhibited ventricular remodeling. The patients who exhibited remodeling had higher infarct size based on creatine phosphokinase (CPK) peak values (p = 0.037), higher prevalence of in-hospital congestive heart failure (p = 0.004), and decreased ejection fraction (EF) (p = 0.007). The patients with ventricular remodeling had significantly lower serum levels of inactive MMP-9 (p = 0.007) and significantly higher levels of the active form of MMP-2 (p = 0.011). In a multivariate logistic regression model, adjusted by age, CPK peak, EF and prevalence of heart failure, MMP-2 and -9 serum levels remained associated with remodeling (p = 0.033 and 0.044, respectively). Conclusion: Higher serum levels of inactive MMP-9 were associated with the preservation of left ventricular volumes, and higher serum levels of the active form of MMP-2 were a predictor of remodeling 6 months after MI. (Arq Bras Cardiol. 2013;100(4):315-321).

Síndrome da disfunção cognitiva em cães

Cognitive dysfunction syndrome (CDS) is a progressive degenerative disorder of older dogs, characterized by a decline in cognitive function. The main clinical signs consistent with CDS are: disorientation, changes in socio-environmental interaction, sleep-wake cycle disturbance, changes in hygiene habits, urinate and/or defecate in unusual places, decreased physical activity, anxiety and eating disorders. There are no specific diagnostic tests for this condition in vivo, but alterations in neurological examination, cognitive tests and magnetic resonance imaging can be observed. The diagnosis is confirmed by histopathological examination of brain tissue. Diets rich in antioxidants, environmental enrichment with exercise and the use of selegiline and L-deprenyl have been recommended for the treatment of CDS.