Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura

A articulação temporomandibular faz parte do sistema estomatognático que, junto com os dentes, periodonto, coluna cervical, crânio e cintura escapular, é responsável pela mastigação, fonação, deglutição, respiração e expressão facial. Exercícios terapêuticos têm sido empregados na reabilitação e prevenção das disfunções temporomandibulares (DTM). Este estudo teve como objetivo revisar a literatura a respeito, verificando a eficácia dos exercícios terapêuticos nas DTM. Foram examinados periódicos do período entre 1991 e agosto de 2008, nas bases de dados Medline, Lilacs e Pubmed, utilizando as palavras-chave "desordem temporomandibular", "terapia por exercícios" e as correspondentes em inglês. Foram selecionados relatos de caso, artigos de revisão e ensaios clínicos com mais de 20 pacientes, num total de 53 artigos. A maioria relatou efeitos positivos na redução da dor, melhora da mobilidade e dos aspectos psicológicos, sugerindo que os exercícios podem contribuir no tratamento da DTM. Entretanto, o tipo, tempo de duração, número de repetições, freqüência e intensidade dos exercícios não está bem descrita. A falta de padronização das pesquisas, bem como da forma de avaliar, dificultam a comparação dos resultados. Mais estudos com métodos padronizados devem ser estimulados.The temporomandibular joint is part of the stomatognathic system, which comprises a complex set of orofacial structures, including teeth, cervical spine, cranium and shoulder. The system is responsible for masticatory, phonation, and deglutition functions, as well as for breathing and facial expression. Physical therapy exercises have been used for rehabilitation and prevention of temporomandibular disorders (TMD). The purpose of this study was to review studies on the subject and assess the effectiveness of physical therapy exercises for TMD. Case reports, review articles, and clinical trials with more than 20 patients, published from 1991 to mid-2008, were searched for in databases Medline, Lilacs and Pubmed, by using keywords "exercise therapy" "temporomandibular disorders", and the correspondent terms in Portuguese. Fifty-three studies were selected of which most showed positive effects on pain reduction, improvement in joint mobility and psychological aspects, suggesting that physical therapy exercises may be beneficial in TMD treating. However, the type, duration time, repetitions, frequency and intensity of the therapeutic exercises are not well described. The lack of research and assessment method standardization hinder result comparison. More studies with standardized methods must be stimulated

Characterizing developing adverse pressure gradient flows subject to surface roughness

An experimental study was conducted to examine the effects of surface roughness and adverse pressure gradient (APG) on the development of a turbulent boundary layer. Hot-wire anemometry measurements were carried out using single and X-wire probes in all regions of a developing APG flow in an open return wind tunnel test section. The same experimental conditions (i.e., T?, Uref, and Cp) were maintained for smooth, k? = 0, and rough, k? = 41–60, surfaces with Reynolds number based on momentum thickness, 3,000\Reh\40,000. The experiment was carefully designed such that the x-dependence in the flow field was known. Despite this fact, only a very small region of the boundary layer showed a balance of the various terms in the integrated boundary layer equation. The skin friction computed from this technique showed up to a 58% increase due to the surface roughness. Various equilibrium parameters were studied and the effect of roughness was investigated. The generated flow was not in equilibrium according to the Clauser (J Aero Sci 21:91– 108, 1954) definition due to its developing nature. After a development region, the flow reached the equilibrium condition as defined by Castillo and George (2001), where K = const, is the pressure gradient parameter. Moreover, it was found that this equilibrium condition can be used to classify developing APG flows. Furthermore, the Zagarola and Smits (J Fluid Mech 373:33–79, 1998a) scaling of the mean velocity deficit, U?d*/d, can also be used as a criteria to classify developing APG flows which supports the equilibrium condition of Castillo and George (2001). With this information a ‘full APG region’ was defined

Etiopathogenesis and pathophysiology of malaria

Malaria is a parasitic disease caused by Plasmodium protozoan parasites and transmitted by Anopheles mosquitoes. The disease is diffused in tropical areas, where it is associated with high morbidity and mortality. P. falciparum is the most dangerous species, mainly affecting young children. The parasite cycle occurs both in humans (asexual stages) and in mosquitoes (sexual stages). In humans, Plasmodium grows and multiplies within red blood cells using hemoglobin as essential source of nutrients and energy. However, this process generates toxic heme that the parasite aggregates into an insoluble inert biocrystal called hemozoin. This molecule sequesters in various organs (liver, spleen, and brain), potentially contributing to the development of malaria immunopathogenesis. Uncomplicated falciparum malaria clinical frame ranges from asymptomatic infection to classic symptoms such as fever, chills, sweating, headache, and muscle aches. However, malaria can also evolve into severe life-threatening complications, including cerebral malaria, severe anemia, respiratory distress, and acute renal failure