Desordens dos músculos mastigatórios / Masticatory muscle disorders

O sistema mastigatório humano é constituído por uma complexa estrutura muscular, nervosa, óssea e articular. A estrutura muscular é responsável pela movimentação da mandíbula durante a mastigação, fala e também deglutição, necessitando estar em perfeitas condições, para que o individuo consiga exercer essas funções de maneira correta e saudável. No entanto, podem ocorrer alterações no funcionamento muscular do sistema mastigatório muitas vezes gerando patologias de origem muscular. O objetivo do presente estudo foi discorrer sobre distúrbios funcionais dos músculos mastigatórios, agrupados em uma ampla categoria denominada como Desordens dos Músculos Mastigatórios, apresentando seus respectivos sinais e sintomas, suas possíveis origens, formas de evolução, gravidade, diagnóstico, além de seus adequados tratamentos. Na presente pesquisa bibliográfica abordou-se sobre tais desordens que, clinicamente, representam a queixa mais comum entre pacientes com disfunções temporomandibulares (DTM), podendo ser analisadas e denominadas como: co-contração protetora (imobilização muscular), dor muscular local, dor miofacial (ponto de gatilho), mioespasmo, mialgia crônica mediada centralmente e a fibromialgia que também deve ser analisada.  Fatores etiológicos como traumas, estresse emocional e hiperatividade muscular, são possíveis desencadeadores dessas disfunções, que podem incluir desde um leve desconforto, a intensas dores que comprometem funções cotidianas. Após análise de fatores etiológicos ficou claro que as disfunções musculares podem apresentar várias origens, sendo, portanto classificadas como de etiologia multifatorial, exigindo um tratamento que aborde várias modalidades terapêuticas sejam elas fisioterápicas, comportamentais ou medicamentosas. Cabe ao cirurgião dentista, o conhecimento anatômico e fisiológico das estruturas orofaciais para um correto diagnóstico e a realização de um tratamento eficaz, a fim de evitar que um simples evento causador de desconforto ou dor aguda, evolua para uma patologia crônica, viabilizando sempre a saúde e o bem-estar do paciente. 

Cuidados y acompañamiento educativo durante el confinamiento en los hogares por COVID 19. La perspectiva de las familias de escuelas públicas

La suspensión de la presencialidad escolar durante el período de confinamiento por motivo de la pandemia por COVID 19 alteró la vida cotidiana de las familias uruguayas y generó desafíos para el acompañamiento educativo de las infancias. Este artículo analiza las experiencias de las familias en este período, haciendo énfasis en la organización de los cuidados y las actividades de acompañamiento y sostén del tránsito escolar de niñas y niños, identificando obstáculos y oportunidades. Se trata de un estudio cualitativo, que utilizó como técnica inicial, un cuestionario autoadministrado que permitió identificar aspectos de las experiencias de las familias tomados como guía para la realización de grupos de discusión. Aquí se comparten los resultados del cuestionario online respondido por un total de 278 referentes familiares de niños y niñas que cursaron de 1ero a 3er año escolar en instituciones públicas durante los años 2020 y 2021. Como principales conclusiones se destaca que las familias participantes perciben como satisfactorio el acompañamiento realizado. Las dificultades halladas se relacionan principalmente con el tipo de propuesta educativa y modo de comunicación establecido con las maestras, las condiciones materiales del hogar (disponibilidad de dispositivos electrónicos, conectividad, espacio físico, etc.), disponibilidad de tiempo, afectiva y cognitiva para enseñar o motivar al aprendizaje de sus hijos e hijas. Rescatando la oportunidad que significó compartir más tiempo con los niños y niñas, se presenta la preocupación por manifestaciones de malestar físico y psíquico ante la situación de distancia de la cotidianeidad escolar y sus exigencias

Natural history of KBG syndrome in a large European cohort

KBG syndrome (KBGS) is characterized by distinctive facial gestalt, short stature and variable clinical findings. With ageing, some features become more recognizable, allowing a differential diagnosis. We aimed to better characterize natural history of KBGS. In the context of a European collaborative study, we collected the largest cohort of KBGS patients (49). A combined array- based Comparative Genomic Hybridization and next generation sequencing (NGS) approach investigated both genomic Copy Number Variants and SNVs. Intellectual disability (ID) (82%) ranged from mild to moderate with severe ID identified in two patients. Epilepsy was present in 26.5%. Short stature was consistent over time, while occipitofrontal circumference (median value: -0.88 SD at birth) normalized over years. Cerebral anomalies, were identified in 56% of patients and thus represented the second most relevant clinical feature reinforcing clinical suspicion in the paediatric age when short stature and vertebral/dental anomalies are vague. Macrodontia, oligodontia and dental agenesis (53%) were almost as frequent as skeletal anomalies, such as brachydactyly, short fifth finger, fifth finger clinodactyly, pectus excavatum/carinatum, delayed bone age. In 28.5% of individuals, prenatal ultrasound anomalies were reported. Except for three splicing variants, leading to a premature termination, variants were almost all frameshift. Our results, broadening the spectrum of KBGS phenotype progression, provide useful tools to facilitate differential diagnosis and improve clinical management. We suggest to consider a wider range of dental anomalies before excluding diagnosis and to perform a careful odontoiatric/ear-nose-throat (ENT) evaluation in order to look for even submucosal palate cleft given the high percentage of palate abnormalities. NGS approaches, following evidence of antenatal ultrasound anomalies, should include ANKRD11.</p

25th annual computational neuroscience meeting: CNS-2016

The same neuron may play different functional roles in the neural circuits to which it belongs. For example, neurons in the Tritonia pedal ganglia may participate in variable phases of the swim motor rhythms [1]. While such neuronal functional variability is likely to play a major role the delivery of the functionality of neural systems, it is difficult to study it in most nervous systems. We work on the pyloric rhythm network of the crustacean stomatogastric ganglion (STG) [2]. Typically network models of the STG treat neurons of the same functional type as a single model neuron (e.g. PD neurons), assuming the same conductance parameters for these neurons and implying their synchronous firing [3, 4]. However, simultaneous recording of PD neurons shows differences between the timings of spikes of these neurons. This may indicate functional variability of these neurons. Here we modelled separately the two PD neurons of the STG in a multi-neuron model of the pyloric network. Our neuron models comply with known correlations between conductance parameters of ionic currents. Our results reproduce the experimental finding of increasing spike time distance between spikes originating from the two model PD neurons during their synchronised burst phase. The PD neuron with the larger calcium conductance generates its spikes before the other PD neuron. Larger potassium conductance values in the follower neuron imply longer delays between spikes, see Fig. 17.Neuromodulators change the conductance parameters of neurons and maintain the ratios of these parameters [5]. Our results show that such changes may shift the individual contribution of two PD neurons to the PD-phase of the pyloric rhythm altering their functionality within this rhythm. Our work paves the way towards an accessible experimental and computational framework for the analysis of the mechanisms and impact of functional variability of neurons within the neural circuits to which they belong

Human mobility in response to COVID-19 in France, Italy and UK

The COVID-19 pandemic is one of the defining events of our time. National Governments responded to the global crisis by implementing mobility restrictions to slow down the spread of the virus. To assess the impact of those policies on human mobility, we perform a massive comparative analysis on geolocalized data from 13 M Facebook users in France, Italy, and the UK. We find that lockdown generally affects national mobility efficiency and smallworldness—i.e., a substantial reduction of long-range connections in favor of local paths. The impact, however, differs among nations according to their mobility infrastructure. We find that mobility is more concentrated in France and UK and more distributed in Italy. In this paper we provide a framework to quantify the substantial impact of the mobility restrictions. We introduce a percolation model mimicking mobility network disruption and find that node persistence in the percolation process is significantly correlated with the economic and demographic characteristics of countries: areas showing higher resilience to mobility disruptions are those where Value Added per Capita and Population Density are high. Our methods and findings provide important insights to enhance preparedness for global critical events and to incorporate resilience as a relevant dimension to estimate the socio-economic consequences of mobility restriction policies

Bradycardia associated with Multisystem Inflammatory Syndrome in Children with COVID-19: A case series

Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare life-threatening clinical condition that can develop in patients younger than 21 years of age with a history of infection/exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cardiovascular system is a main target of the inflammatory process that frequently causes myocardial dysfunction, myopericarditis, coronary artery dilation, hypotension, and shock. Multisystem inflammatory syndrome in children-associated myocarditis is usually characterized by fever, tachycardia, non-specific electrocardiogram abnormalities, and left ventricular dysfunction, but serious tachyarrhythmias may also occur. We report two cases of patients with MIS-C-associated myocarditis who developed severe bradycardia. Case summary: Two female adolescents with recent history of coronavirus disease 2019 (COVID-19) were initially hospitalized for long-lasting high-grade fever and severe gastrointestinal symptoms. Both patients were diagnosed with MIS-C-associated myocarditis for elevation of markers of myocardial injury (mean highly-sensitive cardiac troponin 2663 pg/mL, mean N-terminal-pro-brain natriuretic peptide 5097 pg/mL) and left ventricular dysfunction, which was subsequently confirmed by cardiac magnetic resonance. Both patients developed a severe sinus bradycardia (lowest heart rate 36 and 42, respectively), which appeared refractory to the treatment with intravenous Methylprednisolone and Immunoglobulins, despite a clinical and biochemical improvement. The use of Anakinra (a recombinant interleukin-1 receptor antagonist), was associated with a rapid improvement of cardiac rhythm and excellent clinical outcome at 6 months of follow-up. Discussion: In patients with MIS-C-associated myocarditis, a continuous cardiac monitoring is mandatory to promptly identify potential conduction abnormalities. Adolescents may present bradycardia as a rhythm complication. We experienced a rapid recovery after treatment with Anakinra, to be considered as add-on therapy in cases refractory to standard anti-inflammatory treatment