Dor miofascial crônica e alimentação: Uma relação a ser considerada pelo cirurgião-dentista?

Objetivo: comparar o consumo energético, de macronutrientes e fibras por mulheres portadoras de dor miofascial crônica e não portadoras, atendidas durante o ano de 2006, em uma Clínica de Fisioterapia da cidade de Araraquara - SP. Métodos: Os grupos – controle e dor miofascial – foram definidos pelo Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares - Eixos I e II, sendo compostos por 36 e 37 indivíduos, respectivamente. As participantes foram entrevistadas para o preenchimento do recordatório alimentar de 24 horas de dois dias. A análise da ingestão de energia, macronutrientes e fibras foi realizada com auxílio do programa Virtual Nutri e os grupos foram comparados pelo teste t Student. Para o grupo com dor miofascial, foi realizado estudo de Correlação de Pearson entre os domínios propostos pelo Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares – intensidade média da dor, depressão, sintomas inespecíficos incluindo itens de dor e limitação da função mandibular – e o consumo de energia, macronutrientes e fibras. O nível de significância adotado foi de 5%. Resultados: Houve diferença estatisticamente significante entre os grupos no consumo de proteínas e lipídios, sendo este menor no grupo de mulheres portadoras de dor miofascial crônica. O consumo energético e de fibras esteve no limite de significância. Observou-se correlação não significativa entre os domínios do Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares e o consumo de energia, macronutrientes e fibras. Conclusão: O consumo de proteínas e lipídios foi diferente entre portadores e não portadores de dor miofascial crônica.ABSTRACT: Abstract: Objective: to compare the energetic consumption, of macronutrients and fibers, of chronic myofascial pain carries and non-carries women, attended during the year of 2006, in the Physiotherapy Clinic of Araraquara - SP city. Methods: Control Groups and myofascial pain were defined by the Research Diagnostic Criteria for Temporomandibular Disorders – Axis I and II, being composed by 36 and 37 individuals respectively. The food consumption of the participants were analysed by the 24 hours recall. The analysis of energy, macronutrients and fibers ingestion was realized with the support of the Virtual Nutri program and the groups were compared by the t Student test. For the group of myofascial pain carriers, it was realized the Pearson correlation’s study among the domains proposed by the Research Diagnostic Criteria for Temporomandibular Disorders (pain intensity, depression, nonspecific physical symptoms including items of pain, limitations of jaw functioning) and the consumption of energy, macronutrients and fibers. The level of significance was 5%. Results: There was significant difference between groups regarding the consumption of proteins and lipids, being observed a lower consumption in the group of carriers of the chronic myofascial pain women. The energetic and fibers consumption was in the limit of the significance. It was observed a non-significant correlation between the domains of the Research Diagnostic Criteria for Temporomandibular Disorders and the consumption of energy, macronutrients and fibers. Conclusion: The consumption of proteins and lipids were different between carries and non-carries of the chronic myofascial pain

Ética en la docencia. El profesor universitario como modelo de actuación personal y profesional

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524El profesor universitario debe ser un modelo de actuación personal y profesional para sus alumnos; un ejemplo que estimule a los estudiantes tanto en el ejercicio de la profesión, como con el respeto por su entorno. De tal modo que el conocimiento que adquieran los alumnos puedan aplicarlo a la vida cotidiana. Esta práctica se ha llevado a cabo en la asignatura de Trabajo Dirigido. El profesor debe manifestar una coherencia entre acción y el pensamiento, debe ser justo y equitativo en la evaluación y tener en cuenta las necesidades particulares de los alumnos; también debe conseguir motivarlos, de forma amigable, con el fin que ellos se esfuercen para lograr las metas académicas. El objetivo es fomentar el logro de competencias transversales tales como responsabilidad, igualdad y capacidad de trabajo en equipo; mediante la realización de sesiones de debate entre el alumno, el tutor, y/o otros investigadores. Por otra parte, también se pretende un análisis reflexivo de nuestra propia actividad docente con el fin de tener en cuenta el potencial y necesidades particulares de cada alumno para lograr una mejora continua. Para alcanzar estos objetivos, el método consiste en la colaboración directa del alumno con los investigadores de la Unidad en proyectos reales y, sesiones semanales de discusión de los resultados que se van obteniendo. De forma que los alumnos desarrollan capacidad de trabajar en equipo, responsabilidad, respeto entre géneros, pensamiento crítico y una verdadera integración. Finalmente, creemos que la ética en la docencia también se pone de manifiesto a la hora de evaluar el aprendizaje de los alumnos. Por este motivo, es de vital importancia que el profesor universitario fomente un clima de integración, de comunicación y de trabajo en equipo en las sesiones docentes. El análisis reflexivo que ha realizado el grupo docente ha permitido examinar las debilidades, las fortalezas y oportunidades acaecidas de la actividad docente para potenciar mejoras en el nuevo curso

Lupus eritematoso sistémico tardío asociado a síndrome de Sjögren

We report the case of an elderly woman, with a previous diagnosis of Sjögren´s Syndrome with renal failure and haema- temesis. During admission, she presented infectious complications (diarrhea), with detection of cytomegalovirus viremia and subsequent improvement after antibiotic and antiviral therapy. The final diagnosis was an acute kidney injury due to a prerenal component because of low water intake and anaemia, postrenal component as a result of morphological changes, and intrinsic renal component on account of suspected lupus nephropathy (because of pathological urinary sediment). The suspected diagnosis was late-onset Systemic Lupus Erythematosus and Overlap Syndrome. Furthermore, underlying gastric neoplasia was suspected.Presentamos el caso de una paciente de edad avanzada, con diagnóstico previo de síndrome de Sjögren, con ingreso por deterioro de función renal y clínica de hematemesis. Durante el ingreso, presenta diarrea, de posible causa infecciosa, con detección de viremia de citomegalovirus y posterior mejoría tras antibioterapia y antivírico. El estudio etiológico evidencia el deterioro de la función renal de causa prerrenal por anemia y deshidratación; posrenal, por cambios morfológicos; y renal, por sedimento urinario patológico sospechoso de nefritis lúpica. Se realiza diagnóstico de sospecha de Lupus Eritematoso Sistémico de inicio tardío y de síndrome de superposición con síndrome de Sjögren. También se sospecha neoplasia gástrica subyacente

Validity and reliability of the portuguese version of Mandibular Function Impairment Questionnaire

he aim of this study is to evaluate the validity and reliability of the Mandibular Function Impairment Questionnaire (MFIQ) (Portuguese version). Face and content validity of the Portuguese version were performed. To assess reproducibility of the data gathered with MFIQ, it was applied to 62 individuals who completed the questionnaire on two occasions. Validity and reliability of the data gathered with MFIQ were evaluated in a sample of 249 patients. Construct-related validity was assessed through factorial validity (by means of a confirmatory factor analysis), and convergent and discriminant validities were assessed, respectively, by the average variance extracted (AVE), composite reliability (CC) and bivariate correlations between factors. The internal consistency was estimated by the standardised Cronbachs alpha coefficient (a) and reproducibility by the intra-class correlation coefficient (ICC). All the items of MFIQ showed content validity. Reproducibility was excellent in both the functional capacity dimension (D1) (ICCD1 = 0.895, 95% CI = 0.832 to 0.935) and the feeding dimension (D2) (ICCD2 = 0.825, 95% CI = 0.726 to 0.891). Items 1, 2, 6 and 7 of D1 had factor weights below the desired cut-off (0.5), and overall fit of the original bifactorial structure of the MFIQ was poor [(confirmatory fit index) CFI = 0.850, (goodness of fit index) GFI = 0.781, (root mean square error of approximation) RMSEA = 0.118]. Thus, these items were excluded, and the new, reduced version of the MFIQ showed good fit (CFI = 0.933, GFI = 0.879, RMSEA = 0.099). The convergent validity was adequate (AVE = 0.5, CC = 0.7) for both factors. However, their discriminant validity was low (AVED1 = 0.51 and AVED2 = 0.66 < ?2D1D2 = 0.70). The internal consistency was excellent (aD1 = 0.874; aD2 = 0.918). The Portuguese version of the reduced MFIQ produced data with good validity and reliability

Validation of a measuring instrument for the perception of oral health in women

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/ General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (threefactor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the threedimensional and the unifactorial structures

Successful use of cinacalcet to treat parathyroid-related hypercalcemia in two pediatric patients

Summary Two pediatric patients with different causes of hyperparathyroidism are reported. First patient is a 13-year-old male with severe hypercalcemia due to left upper parathyroid gland adenoma. After successful surgery, calcium and phosphate levels normalized, but parathormone levels remained elevated. Further studies revealed a second adenoma in the right gland. The second patient is a 13-year-old female with uncommon hypercalcemia symptoms. Presence of pathogenic calcium-sensing receptor gene (CASR) mutation was found, resulting in diagnosis of symptomatic familial hypocalciuric hypercalcemia. Cinacalcet, a calcium-sensing agent that increases the sensitivity of the CASR, was used in both patients with successful results. Learning points: Hyperparathyroidism is a rare condition in pediatric patients. If not treated, it can cause serious morbidity. Genetic tests searching for CASR or MEN1 gene mutations in pediatric patients with primary hyperparathyroidism should be performed. Cinacalcet has been effective for treating different causes of hyperparathyroidism in our two pediatric patients. Treatment has been well tolerated and no side effects have been detected. </jats:sec

Developing Transdermal Applications of Ketorolac Tromethamine Entrapped in Stimuli Sensitive Block Copolymer Hydrogels

Purpose: In order to obtain dermal vehicles of ketorolac tromethamine (KT) for the local treatment of inflammation and restrict undesirable side effects of systemic levels hydrogels (HGs) of poloxamer and carbomer were developed. Methods: KT poloxamer based HG (KT-P407-HG) and KT carbomer based HG (KT-C940-HG) were elaborated and characterized in terms of swelling, degradation, porosity, rheology, stability, in vitro release, ex vivo permeation and distribution skin layers. Finally, in vivo anti-inflammatory efficacy and skin tolerance were also assessed. Results: HGs were transparent and kept stable after 3 months exhibiting biocompatible near neutral pH values. Rheological patterns fitted to Herschel-Bulkley for KT-C940-HG and Newton for KT-P407-HG due to its low viscosity at 25°C. Rapid release profiles were observed through first order kinetics. Following the surface the highest concentration of KT from C940-HG was found in the epidermis and the stratum corneum for P407-HG. Relevant anti-inflammatory efficacy of KT-P407-HG revealed enough ability to provide sufficient bioavailability KT to reach easily the site of action. The application of developed formulations in volunteers did not induce any visual skin irritation. Conclusions: KT-P407-HG was proposed as suitable formulation for anti-inflammatory local treatment without theoretical systemic side effect

Current treatment goals are achieved by the majority of patients with atopic dermatitis treated with tralokinumab: results from a multicentric, multinational, retrospective, cohort study

Background: Tralokinumab is a human monoclonal antibody targeting interleukin-13 that is approved for the treatment of moderate-severe atopic dermatitis. Studies analyzing the efficacy and safety of tralokinumab in a real-world setting are scarce. Research design and methods: A European, multicentric, real-world, retrospective cohort study was defined to assess the effectiveness and safeness profile of tralokinumab, investigating the achievement of pre-specified treatment goals; and to detect potential differences in terms of effectiveness and safeness across some selected patient subcohorts. Results: A total of 194 adult patients were included in this study. A significant improvement in physician-assessed disease severity was detected at each follow-up visit as compared with baseline and similar trend was observed for patient-reported outcomes and quality of life. No meaningful difference in effectiveness was found when considering patient age (&lt;65 versus ≥65 years), neither dissecting patient cohort in dupilumab-naive vs dupilumab-treated subjects. Among tralokinumabtreated patients, 88% achieved at least one currently identified real-world therapeutic goal at week 16. Conclusions: This retrospective multicenter study confirmed the effectiveness and safeness of tralokinumab throughout 32 weeks of observation, showing the achievement of therapeutic goals identified in both trial and real-world settings in a large proportion of tralokinumab-treated patients