Fatores associados a presença de sinais e sintomas de disfunção temporomandibular em adolescentes

Orientador: Maria Beatriz Duarte GaviãoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Estudos epidemiológicos demonstram que sinais e sintomas de disfunção temporomandibular são comuns em adultos, constatando-se também, sua presença em crianças e adolescentes. O propósito deste estudo foi verificar a prevalência de sinais clínicos e sintomas de disfunção emporomandibular (DTM) em 217 adolescentes entre 12 e 18 anos, pertencentes a escolas da rede pública da cidade de Piracicaba e, também, as associações existentes com gênero (masculino e feminino), ansiedade, depressão e força de mordida. Os sinais clínicos foram avaliados através do Craniomandibular Index (CMI), o qual é composto de duas sub-escalas: Dysfunctional Index (DI) e Palpation Index (PI). Os sintomas subjetivos foram avaliados através de questionário. A escala Hospital Anxiety and Depression Scale (HADS) foi utilizada para avaliação dos níveis de ansiedade (HADSa) e depressão (HADSd). A força de mordida foi determinada em 40 voluntários, que apresentavam valores extremos (mínimo e máximo) para o CMI, os quais foram distribuídos em dois grupos: Grupo I ¿ 20 adolescentes sem DTM (valores extremos mínimos do CMI e ausência de sintoma) e Grupo II ¿ 20 adolescentes com DTM (valores extremos máximos do CMI e presença de pelo menos 1 sintoma). Para a obtenção da força de mordida foi utilizado um tubo pressurizado de fibra reforçada, conectado a um sensor de pressão. Os resultados para os sinais clínicos mostraram que (1) para sensibilidade à palpação dos músculos da cabeça e pescoço ocorreu grande variação na amostra total (0,9%-32,25%); (2) 10,6%, 10,6% e 7,83% dos adolescentes apresentaram sensibilidade à palpação nas regiões superior, dorsal e lateral da articulação temporomandibular, respectivamente; (3) 19,8% e 14,7% da amostra apresentaram ruído articular durante a abertura e fechamento bucal, respectivamente. Ruído articular (26,72%) e dor de cabeça (21,65%) foram os sintomas subjetivos mais prevalentes nos adolescentes. Não foram encontradas diferenças entre os gêneros na prevalência de sinais e sintomas de DTM, exceção feita à sensibilidade à palpação do pterigóideo lateral. As correlações entre os valores dos índices (DI, PI, CMI) e HADSa e HADSd foram estatisticamente significativas apenas entre CMI, PI e HADSa (p<0,01). O número de sintomas subjetivos associou-se significativamente tanto com HADSa quanto para o HADSd (p<0,01). A força de mordida foi estatisticamente maior no grupo I (325,90 N) do que no grupo II (301,51 N), sendo que as meninas deste grupo apresentaram valores significativamente menores. Ocorreu correlação negativa significativa entre CMI e PI e a magnitude da força de mordida (p<0,01). Não houve correlações significativas nas variáveis corporais e etárias com a força de mordida. Concluiu-se que os sinais e sintomas de DTM, presentes em indivíduos jovens, podem ser influenciados pela ansiedade e depressão, bem como comprometer as funções do sistema estomatognático, como se comprovou com a redução da força de mordida, principalmente no gênero femininoAbstract: Epidemiologic studies have demonstrated that signs and symptoms of temporomandibular dysfunction (TMD) are common in adults, evidencing also its presence in children and adolescents. The aim of this study was to verify the prevalence of clinical signs and subjective symptoms of TMD in 217 adolescents aged from 12 to 18 years old from public schools in the city of Piracicaba and the associations with gender, anxiety, depression and bite force magnitude. The clinical signs were evaluated using the Craniomandibular Index (CMI), which is divided into two sub-scales: Dysfunction Index (DI) and Palpation Index (PI). The subjective symptoms were evaluated through a questionnaire. The levels of anxiety (HADSa) and depression (HADSd) were verified using the Hospital Anxiety and Depression Scale (HADS). Bite force was determined in 40 volunteers with lower and upper extremity values of CMI who were distributed in two groups: Group I ¿ 20 adolescents without TMD (lower extremes values of CMI and absence of subjective symptoms) and Group II ¿20 adolescents with TMD (upper extremes values of CMI and at least one subjective symptom) Bite force was obtained with a transducer, which consisted of a pressurized rubber tube connected to a sensor element. The results for clinical signs showed that (1) tenderness in head and neck muscles, demonstrated a great variability (0.9%-32.25%); (2) temporomandibular joint tenderness, in the superior, dorsal and lateral condyle regions, occurred in 10.6%, 10.6% and 7.83% respectively, (3) the percentage of joint sounds in mouth opening and closing was 19.8% and 14.7% respectively. Joint sounds (26.72%) and headache (21.65%) were the most prevalent symptoms in the total sample. Gender differences were not found in the prevalence of TMD signs and symptoms, except for the lateral pterygoid muscle tenderness. The correlations between indexes values (DI, PI, CMI) and HADSa and HADSd were statistically significant only with CMI, PI and HADSa (p<0.01). The number of subjective symptoms showed a significant association with HADSa and HADSd (p<0.01). Bite force was statistically higher in group I (325.90 N) than in group II (301.51 N). Girls in Group II had the smallest bite force values (p<0.05). There was a significant negative correlation between CMI and PI and bite force magnitude. There were not significant correlations between bite force and body variables and age. It was concluded that clinical signs and symptoms of TMD present in adolescents, can be influenced by anxiety and depression, decreasing the stomathognatic system functions as demonstrated by bite force reduction, primarily in girlsDoutoradoFisiologia OralDoutor em Odontologi

Nanostructure and stability of calcitonin amyloids

Calcitonin is a 32-amino acid thyroid hormone that can form amyloid fibrils. The structural basis of the fibril formation and stabilization is still debated and poorly understood. The reason is that NMR data strongly suggest antiparallel β-sheet calcitonin assembly, whereas modeling studies on the short DFNKF peptide (corresponding to the sequence from Asp15 to Phe19 of human calcitonin and reported as the minimal amyloidogenic module) show that it assembles with parallel β-sheets. In this work, we first predict the structure of human calcitonin through two complementary molecular dynamics (MD) methods, finding that human calcitonin forms an α-helix. We use extensive MD simulations to compare previously proposed calcitonin fibril structures. We find that two conformations, the parallel arrangement and one of the possible antiparallel structures (with Asp15 and Phe19 aligned), are highly stable and ordered. Nonetheless, fibrils with parallel molecules show bulky loops formed by residues 1 to 7 located on the same side, which could limit or prevent the formation of larger amyloids. We investigate fibrils formed by the DFNKF peptide by simulating different arrangements of this amyloidogenic core sequence. We show that DFNKF fibrils are highly stable when assembled in parallel β-sheets, whereas they quickly unfold in antiparallel conformation. Our results indicate that the DFNKF peptide represents only partially the full-length calcitonin behavior. Contrary to the full-length polypeptide, in fact, the DFNKF sequence is not stable in antiparallel conformation, suggesting that the residue flanking the amyloidogenic peptide contributes to the stabilization of the experimentally observed antiparallel β-sheet packing

Efeito do tramadol e dipirona nas respostas comportamentais nociceptivas induzidas pela administração de oleo de mostarda na ATM de ratos

Orientador : Maria Cecilia Ferraz de Arruda VeigaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Embora sejam uma importante entidade clínica, as desordens da Articulação Temporomandibular (ATM), representam um problema de difícil tratamento, e principalmente, causam enorme desconforto e geralmente inflamação seguida de dor. Portanto, o desenvolvimento e a padronização de modelos experimentais que possibilitem o estudo dos mecanismos fisiológicos envolvidos nesse tipo específico de condições dolorosas são de grande relevância. Para isso, 50 jlL de óleo de mostarda (OM) (1,5%,2,5% e 4,5%) ou seu veículo óleo mineral foram administrados na região da ATM direita de ratos e as respostas comporta mentais nociceptivas caracterizadas pelo ato de coçar a região orofacial (CO) e levantar rapidamente a cabeça (LC) foram quantificadas por 45 minutos. A administração periarticular de OM produziu respostas comportamentais nociceptivas estatisticamente significativas a partir da concentração de 2,5% em relação à de óleo mineral. Com o intuito de confirmar o caráter nociceptivo das respostas comportamentais induzidas pela administração de OM na A TM, foram realizados grupos experimentais adicionais, nos quais o QX-314 (quaternário hidrofílico derivado da lidocaína) - 2% ( 25µL) foi co-administrado com o OM (5% -25µL) e a morfina foi administrada via intraperitoneal (i.p.) 30 minutos antes da administração do OM (2,5% - 50µL) na região da ATM. A seguir para se verificar o efeito de drogas analgésicas nessas respostas nociceptivas foram adiministradas, via i.p., dipirona (19; 57; 95mg/kg) e tramadol (5; 7,5; 10mg/kg) 30 minutos antes da administração de OM 2,5%. Os resultados indicam que o OM quando injetado diretamente na A TM de ratos é capaz de desencadear respostas comportamentais nociceptivas que são significativamente reduzidas pela co-administração de QX-314 - 2% e pela administração Lp. de morfina, e que este modelo comportamental é sensível aos analgésicos tramadol e dipirona, os quais reduziram de maneira dose dependente as respostas comportamentais nociceptivas avaliadas nesta pesquisaAbstract: Although they are an important clinical entity, Temporomandibular disorder (TMD), causing a lot of discomfort and usually inflammation followed by pain, requires very complex reatment. Therefore, the development and the standardization of experimental models that make the study of physiologic pain mechanisms possible are of great relevance. For this, 50 j.JL of 1.5%, 2.5% and 4.5% mustard oil (MO), as well as its vehicle, the mineral oil, was administered in the right temporomandibular joint (TMJ) of rats. Nociceptive behavioral responses characterized by the rat's both rubbing the orofacial region and flinching their heads quickly were quantified for 45 minutes. When compared to mineral oil administered in the periarticular region, MO showed nociceptive behavioral responses (statistically significant) starting at a concentration of 2.5%. With the intention of confirming the nociceptive character of the behavioral responses induced by the administration of MO in TMJ, two experimental groups were tested: group 1 - 25j.JL of QX 314 at 2% (derived from the lidocaine) CQ-administered with 5% MO (25j.JL); group 2 ¿ morphine was intraperitoneally (i.p.) administered 30 minutes before the administration of 2.5% MO (50j.JL). In order to verify the effect of analgesic drugs on behavioral responses, dipyrone (19; 57; 95mg/kg) and tramadol (5; 7.5; 10mg/kg) were administered (i.p.) 30 minutes before the administration of 2,5% MO. Results in the present study show that when rats were injected with MO directly into the TMJ, nociceptive behavioral responses could be observed and these responses were significantly reduced by the co-administration of QX-314 at 2% and by the 5 administration of morphine. Also, this behavioral model was sensitive to the analgesic tramadol and dipyrone, which reduced the nociceptive behavioral responses in dependent dose appraised in this researchMestradoFisiologia OralMestre em Odontologi

Analysis of almond (<i>Prunus amygdalus</i>) biodiversity in Sardinia

Almond (Prunus amygdalus Batsch) is the most important nut crop worldwide. Based on 2010 FAO data, the USA were the first almond producing country, followed by Spain, Iran and Italy. In Sardinia the cultivations are mainly constituted by local cultivars, used for the production of typical sweets. Several of these cvs. are under the risk of genetic erosion. Focusing on the assessment of local almond materials, the purpose of this thesis was to characterize a 20-years old collection, containing genotypes gathered from different areas of Sardinia. Chapter 1 studied, by means of eleven SSR markers, the genetic diversity between our collection and a Central-South Italian collection. Chapter 2 analyzed more deeply the genetic structure of Sardinian collection through the same SSR set. Moreover, the analysis of a four-year phenotypical data set allowed to investigate the existance of phenotypic clusters and the association between molecular and phenotypic data. Chapter 3 was focused on the molecular characterization of the self-incompatibility (SI) genotypes of the sweet almond accessions of the collection. The comprehension of crossing compatibilities for the local accessions and the identification of possible pollinators is one essential prerequisite to increase the productive levels. Chapter 4 analyzed the local germplasm for the quality of almond oil in the perspective of specific utilization/purposes (e.g. sweet productions, cosmetic/pharmaceutical uses, nutritional purposes)

Clinical hints to diagnosis of attenuated forms of Mucopolysaccharidoses

The mucopolysaccharidoses (MPS) are clinically similar but also heterogeneous in terms of major or minor involvement of different organs/systems, burden of disease, and rate of progression. The attenuated forms of MPS, due to their less severe presentations, are more difficult to diagnose and often receive a significantly delayed diagnosis. On the other hand, the diagnosis is very important since the attenuated forms may benefit from earlier treatments. The aim of this paper is to describe the natural history and the clinical signs useful to arise a suspicion of an attenuated form of MPS. MPS patients usually show a cluster of signs and symptoms, one of which may be the trigger for an evaluation by a specialist. Individuals with attenuated MPS are mostly cognitively normal, and dysmorphisms of the facies may be mild or absent. The most frequently involved organs/systems are the osteoarticular system, heart, and eyes. These patients may also have hepatosplenomegaly, hearing loss, and respiratory problems. When they are referred to a specialist (rheumatologist, cardiologist, ophthalmologist, surgeon, orthopedist, etc.) for their main complaint, the other signs and symptoms are likely to be missed in the medical history. To avoid missing data and to save time, we propose a semistructured medical history form to be filled in by the patients or their caregivers while waiting for evaluation by a specialist

Unbiased in silico design of pH-sensitive tetrapeptides

We used coarse-grain molecular dynamics simulations to screen all possible histidine-bearing tetrapeptide sequences, finding novel peptide sequences with pH-tunable assembly properties. These tetrapeptides could be used for various biological applications, such as triggered delivery of bioactive molecules

Study of Cardiac Features in Adults with Down Syndrome

Down Syndrome (DS) has a significant impact on the development of many tissues, most notably in the heart and in the brain. According to the clinical need to better investigate these aspects, the main aim of this study was to make an overview on the cardiac features in adult individuals with DS. The following data of 37 individuals with DS (range: 18-60 years) were collected and analysed: age, gender, height, weight, waist to height ratio (WHER), smoking history and cardiac parameters (heart rate and blood pressure), blood glucose level or glycaemia, cholesterol (total, high-density lipoprotein – HDL - and low-density lipoprotein - LDL - cholesterol) and triglycerides. In addition, their gait pattern were quantified with 3D Gait Analysis. BMI, WHER and cholesterol HDL results were above the upper limits of the recommended range in people with DS; on the contrary, blood pressure, heart rate, glycaemia, cholesterol-LDL and triglycerides were within the recommended range. Comparing males and females in the DS group, the females showed statistically different values for cholesterol-total, and triglycerides values, with lower values in comparison to males. In motor performance, people with DS presented abnormal gait patterns. Some significant correlations were found: age with LDL, WHER with weight and BMI, systolic with diastolic blood pressure, total cholesterol with LDL and triglycerides. Our results showed that adults with DS suffer from a high prevalence of physical disorders, including overweight and obesity, and abnormal cholesterol values, together with abnormal gait pattern

Propagazione in vitro di alcuni cloni di mirto della Sardegna meridionale

Myrtle (Myrtus communis L.) is a typical Mediterranean bush species, very spread in Sardinia. Present interest in cultivating that species is caused by the increasing demand for berries and leaves to produce the typical liqueur. Due to the high variability of biotypes in response to cutting multiplication, the objective of that paper was to evaluate five south-Sardinian myrtle clones for their micropropagation aptitude. For each clone, three multiplication media and four rooting media were tested; during multiplication, proliferation rate of each clone on each medium was also calculated. Moreover, acclimatization tests were carried out, either in growth chamber (with different types of light radiation), or in green-house (in different periods of the year). Based on proliferation rates, the most suitable multiplication medium was selected for each clone. As to rooting, data were analysed with SAS software, providing the most suitable rooting medium for each clone. Observations during acclimatization trials pointed out the requirement of a conditioned environment (either growth chamber or green-house) in allowing an effective survival of plantlets from in vitro to in vivo conditions

ATENDIMENTO EDUCACIONAL ESPECIALIZADO E EDUCAÇÃO INCLUSIVA: O CONFRONTO ENTRE A EDUCAÇÃO ESPECIAL E A PRÁTICA ESCOLAR REGULAR

O estudo do direito à educação das pessoas com deficiência, na perspectiva da política pública de inclusão escolar, desenvolve-se com o objetivo de analisar os aspectos jurídicos formais e materiais da educação inclusiva, considerando que a participação e aprendizagem dependem, sobretudo, de um sistema educacional de qualidade, não sobrepujado pelo paradigma da mera integração escolar. Os tratados e convenções internacionais, assim como o texto constitucional brasileiro, são garantidores de atendimento educacional especializado a todos aqueles que, em razão de sua condição de deficiência, necessitem de recursos educacionais especiais para seu desenvolvimento, garantindo permanência, aprendizagem escolar e efetivo exercício da cidadania