How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders?

N/

Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism. Objective: to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic. Methodology: The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders – DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p<0.016) and a 95% confidence level. Results: Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively. Conclusion: The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed

Immunolocalization of HLA-DR and metallothionein on amalgam tattoos

Despite studies concerning toxic reactions related to amalgam components in the literature, few studies have been devoted to evaluate local noxious effects of amalgam tattoos (AT) on biological tissues. In addition, little is known about activation of inflammatory cells by mucosa-implanted amalgam debris. Tissue reaction to AT depends on the particle size. Human leukocyte antigen DR (HLA-DR) is an activation marker of inflammatory cells associated with antigen presentation. Metallothioneins (MT) are proteins involved with metal detoxication, including mercury and silver. The purpose of the present study was to investigate the immunolocalization of HLA-DR and MT in AT with large or powdered particles. Paraffin-embedded AT tissue blocks were sectioned and subjected to immunohistochemistry for HLA-DR and MT localization. The results demonstrated a dense mononuclear inflammatory infiltrate associated with large and powdered debris and positivity for HLA-DR and MT in inflammatory cells. While blood vessel walls and connective fibers impregnated with powdered particles were negative for HLA-DR, they were positive for MT. In addition, wherever epithelial basement membrane impregnation by powdered amalgam particles was observed, a strong positivity for MT was detected. These findings demonstrate that residual elements of AT still have noxious local effects over tissues. ___________________________________________________________________________________________________ RESUMOPoucos estudos têm investigado a toxicidade tecidual local das tatuagens por amálgama (TA), embora diversos trabalhos demonstrem efeitos nocivos desse material restaurador. Pouco se sabe sobre a ativação de células inflamatórias nesse tipo de lesão. A reação tecidual contra os restos de amálgama varia com o tamanho das partículas implantadas. O antígeno leucocitário humano DR (HLA-DR) está associado com a ativação de células inflamatórias, sendo relacionado à apresentação de antígeno. Metalotioneínas (MT) são proteínas envolvidas com neutralização de metais pesados, tais como mercúrio e prata. O objetivo do presente trabalho foi investigar a imunolocalização de HLA-DR e MT em TA compostas por depósitos teciduais de diferentes tamanhos. Cortes histológicos de lesões fixadas em formol e embebidas em parafina foram submetidos a técnica imunoistoquímica para a detecção dos antígenos mencionados. Os resultados demonstraram denso infiltrado inflamatório associado com partículas grandes ou pulverizadas, observando-se presença de células HLA-DR e MT positivas. Paredes de vasos sangüíneos e fibras de tecido conjuntivo impregnadas por restos de amálgama foram negativas para HLA-DR, mas positivas para MT. Impregnação da membrana basal por partículas de amálgama correspondia a forte positividade para MT no epitélio. Esses resultados demonstram a existência de efeitos nocivos locais das TA sobre os tecidos

Effectiveness of sequential viscosupplementation in temporomandibular joint internal derangements and symptomatology : a case series

Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. +is case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. +is viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles

CARACTERIZAÇÃO DA DOR EM PACIENTES COM DOENÇA DE PARKINSON

FUNDAMENTO: A dor é um sintoma não motor frequente em indivíduos com doença de Parkinson (DP). Pode estar associada aos sinais motores ou surgir no início da doença. Os mecanismos subjacentes à dor na DP ainda não são bem elucidados e muitos fatores podem influenciá-la, como o uso de levodopa e a presença de outros sintomas não motores, como depressão. OBJETIVOS: Descrever a prevalência e caracterizar a dor em pacientes com DP de um centro terciário referência em pesquisa e assistência clínica. MÉTODOS: Foram recrutados pacientes com diagnóstico de DP idiopática a partir do ambulatóriode neurologia do Centro de Especialidades Médicas (CEM) da Santa Casa de Belo Horizonte/MG. Um questionário para coleta de dados sociodemográficos e clínicos foi aplicado. A função cognitiva, gravidade dos sinais e sintomas, depressão, distúrbios de sono e fadiga foram avaliados. A dor foi mensurada por meio do Questionário de McGill e Escala Visual Numérica. RESULTADOS: Participaram do estudo 45 pacientes, sendo que 19 (42,2%) apresentavam queixa de dor e, em sua maioria, após o diagnóstico de DP (74%). Não houvediferença entre os grupos com dor e sem dor para os parâmetros clínicos avaliados, com exceção da fadiga que foi mais prevalente (p=0,036) e mais grave (p=0,031) nos pacientes com dor. CONCLUSÃO: A dor é um sintoma prevalente em pacientes com DP atendidos no CEM. A partir dos resultados obtidos pelo McGill, observou-se que a dor crônica e profunda, acometendo principalmente os membros inferiores, com importantes aspectos sensoriais e afetivos, foi comum nos pacientes avaliados.

Virulence in Murine Model Shows the Existence of Two Distinct Populations of Brazilian Vaccinia virus Strains

Brazilian Vaccinia virus had been isolated from sentinel mice, rodents and recently from humans, cows and calves during outbreaks on dairy farms in several rural areas in Brazil, leading to high economic and social impact. Some phylogenetic studies have demonstrated the existence of two different populations of Brazilian Vaccinia virus strains circulating in nature, but little is known about their biological characteristics. Therefore, our goal was to study the virulence pattern of seven Brazilian Vaccinia virus strains. Infected BALB/c mice were monitored for morbidity, mortality and viral replication in organs as trachea, lungs, heart, kidneys, liver, brain and spleen. Based on the virulence potential, the Brazilian Vaccinia virus strains were grouped into two groups. One group contained GP1V, VBH, SAV and BAV which caused disease and death in infected mice and the second one included ARAV, GP2V and PSTV which did not cause any clinical signals or death in infected BALB/c mice. The subdivision of Brazilian Vaccinia virus strains into two groups is in agreement with previous genetic studies. Those data reinforce the existence of different populations circulating in Brazil regarding the genetic and virulence characteristics

PnPP-15, a Synthetic Peptide Derived from a Toxin from <i>Phoneutria nigriventer</i> Spider Venom, Alleviates Diabetic Neuropathic Pain and Acts Synergistically with Pregabalin in Mice

Diabetic neuropathic pain is one of the complications that affect a wide variety of the diabetic population and is often difficult to treat. Only a small number of patients experience pain relief, which usually comes with onerous side effects and low levels of satisfaction. The search for new analgesic drugs is necessary, given the limitations that current drugs present. Combining drugs to treat neuropathic pain has been attracting interest to improve their efficacy compared to single-drug monotherapies while also reducing dose sizes to minimize side effects. The aim of our study was to verify the antinociceptive effect of a synthetic peptide, PnPP-15, alone and combined with pregabalin, in male Swiss diabetic mice using the von Frey method. PnPP-15 is a synthetic peptide derived from PnPP19, a peptide representing a discontinuous epitope of the primary structure of the toxin PnTx2-6 from the venom of the spider Phoneutria nigriventer. The antinociceptive activity of both compounds was dose-dependent and showed synergism, which was verified by isobolographic analysis. Treatment with PnPP-15 did not cause spontaneous or forced motor changes and did not cause any damage or signs of toxicity in the analyzed organs (pancreas, lung, heart, kidney, brain, or liver). In conclusion, PnPP-15 is a great candidate for an analgesic drug against neuropathic pain caused by diabetes and exerts a synergistic effect when combined with pregabalin, allowing for even more efficient treatment

Interferon-γ induced nitric oxide mediates in vitro neuronal damage by Trypanosoma cruzi-infected macrophages.

Neuronal lesions and peripheral denervation in Chagas' disease are related to local inflammation; however, the pathogenic mechanisms of neuronal lesions in the heart and megavisceras are still unclear. We investigated the involvement of nitric oxide (NO) on neuronal lesion in co-cultures of neurons and macrophages. Trypanosoma cruzi-infected and interferon-γ (IFN-γ)-activated co-cultures of neurons and wildtype (WT) macrophages showed significant reduction of both neuronal survival and neurite density. These findings correlated with the levels of NO and the expression of inducible nitric oxide synthase (iNOS). Accordingly, neuronal survival rate in the co-cultures was recovered to control levels by treatment of the cultures with the iNOS inhibitor, aminoguanidine. Moreover, neither neuronal survival nor the neurite density was affected in the co-cultures when the macrophages were harvested from iNOS-deficient mice. These results demonstrate that iNOS-derived NO is the major molecule involved in neuronal damage mechanism in our in vitro model of Chagas' disease neuropathology