Evanisi Teresa Palomari

Determinação radiológica do índice e do tamanho craniano por mensuração dos diâmetros cranianos em uma população infantil brasileira

OBJETIVO: Realizar as medidas dos diâmetros cranianos obtidos por metodo radiologico e elaborar, por meio delas, o indice e o tamanho craniano, para comparar com as medidas dos diâmetros e os indices propostos por alguns trabalhos da literatura, principalmente os do estudo de Haas. MATERIAIS E METODOS: Foram avaliados 732 pacientes sem doencas cranianas, medidos seus diâmetros cranianos e, posteriormente, formulados o indice e o tamanho craniano, que mostram as diferentes fases do crescimento do crânio, pelas medidas de tabua interna a tabua interna. RESULTADOS: O estudo comparativo das medias dos diâmetros, por medidas de tabuas internas, mostrou aumento do crescimento francamente progressivo no primeiro ano de vida para ambos os sexos e aumento menor a partir do segundo ano de vida. As medias globais dos diâmetros nao apresentaram diferenca significativa entre os sexos feminino e masculino. CONCLUSAO: O indice e o tamanho craniano sao bons indicadores do crescimento craniano, principalmente nos quatro primeiros anos de vida, quando o crescimento aumenta vertiginosamente no primeiro ano e, posteriormente, ocorre aumento moderado ate os quatro anos de idade. Apos esta idade, ocorre um leve e estavel aumento e seu valor estatistico diminui. Nao houve diferenca estatisticamente significante, no crescimento, para ambos os sexos. Recomenda-se o uso dos valores medios dos diâmetros para ambos os sexos e sugere-se o uso do indice craniano, ate os quatro anos de idade, e o tamanho craniano, apos os quatro anos, sendo ideal para o acompanhamento do crescimento do crânio.

The use of surface electromyography for the study of auricular acupuncture

The advancement of knowledge in neurophysiology has demonstrated that acupuncture is a method of peripheral neural stimulation that promotes local and systemic reflexive responses. The purpose of this study was to determine if surface electromyography can be used as a tool to study the action of auricular acupuncture on striated skeletal muscle. The electromyographic amplitudes of the anterior, middle and posterior deltoid muscle and the upper trapezium muscle with 20%, 40% and 60% of maximal voluntary contraction of 15 healthy volunteers, were analyzed after the individuals were submitted to the auricular acupuncture treatment. The non-parametric Friedman test was used to compare Root Mean Square values estimated by using a 200 ms moving window. Significant results were further analyzed using the Wilcoxon signed rank test. In this exploratory study, the level of significance of each comparison was set to p<0.05. It was concluded in this study that a surface electromyography can be used as a tool to investigate possible alterations of electrical activity in muscles after auricular acupuncture. However there is still a lack of adequate methodology for its use in this type of study, being that the method used to record the electromyographic signal can also influence the results.

Correspondence of the auricular acupoint with the upper trapezius muscle: A electromyographic study

Presently, acupuncture is a technique considered to be capable of stimulating the regulatory systems of the organism, such as the central nervous system, the endocrine system and the immunological system. The median frequency of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction (MVC) of 15 healthy volunteers, was analyzed after the individuals were submitted to the AA treatment. The non-parametric Friedman test was used to compare median frequency values. In this exploratory study, the level of significance of each comparison was set to p<0.05. The intraclass analyses indicate a significant increase of the median frequency muscle at 60% of the MVC (Wicoxon test). Based on the results found, the AA peripheral stimulus can act as a modulator mechanism of muscle activity and was possible to verify correspondence of the auricular acupoint with the trapezius muscle.

Protocol on induction of TMJ articular disc degeneration in rats by utilization of botulinum toxin

OBJECTIVE To develop a model of experimental degeneration in the articular disc of the TMJ of rats through the use of botulinum toxin that can be used in future studies of degenerative diseases on fibrocartilage. METHODS Aiming at the above-mentioned objective, 12 Lewis male rats were used and divided into two groups: CG, control group and DG, group of animals to which the botulinum toxin was administered (6 units/kg). The morphological analysis was carried out utilizing histological cuts stained with hematoxyline-eosine, toluidine blue and Picrosirius; the biochemical analysis was made by SDS-polyacrylamide gel electrophoresis. RESULTS The DG showed peculiar characteristics regarding a degeneration joint disk, compatible with those described in literature as: reduction of cells number, general disorganization of cells direction and extracellular matrix, increase in glycosaminoglycans content and degradation of the tissue collagen. CONCLUSIONS Based on the morphological and biochemical results, it was concluded that the proposed degeneration model showed to be satisfactory for futures studies of injuries and fibrocartilage regeneration processes.

Effects of high molecular weight hyaluronic acid on induced arthritis of the temporomandibular joint in rats

High molecular weight hyaluronic acid (HMWHA) has been used to treat temporomandibular joint (TMJ) disorders, but controversial results have been described. This study aimed to characterize the morphological and biochemical actions of HMWHA on induced arthritis of the TMJ. Twenty-four male Wistar rats were used, and arthritis of the TMJ was induced through an intra-articular injection of Complete Freunds Adjuvant (CFA) (50 μl). One week after arthritis induction, the animals were treated with HMWHA (once per week for three weeks). Histological analyses were performed using sections stained with hematoxylin-eosin, toluidine blue and Picrosirius. Were also performed histomorphometric analysis and birefringence of collagenous fibers (polarization microscopy). Biochemical analyses of TMJ tissues were carried out through measurements of sulfated glycosaminoglycans and zymography for evaluation of metalloproteinase-2 and -9 (MMP-2 and -9). Data were analyzed using paired t-test and unpaired t-test, with a 5% significance level. HMWHA reduced histologic changes and thickness of the articular disc, led to a greater arrangement of collagenous fibers, lower concentration of sulfated glycosaminoglycans and lower activity in all isoforms of MMP-2 and -9 in TMJs with induced arthritis. These findings suggest that HMWHA may exert a protective effect on the TMJ.

Maximal clenching effort influence on the electromyographic activity of the trapezius muscle in healthy subjects

SUMMARY Alteration of the occlusion and the position of the jaw can affect the muscles of the neck, due to a relationship between the masticatory and cervical systems. Thus, the objective of this study was to verify whether the bite in maximal clenching effort, in centric occlusion, in individuals with clinically normal occlusion, and without a history of dysfunction in the masticatory system, influences the electromyographic activity of the upper trapezius muscle. A total of 19 normal individuals participated in the study, 14 of which were women (average age of 25.4 ± 4.14 years), and 5 were men (average age of 24.11 ± 3.28 years). The root mean square (RMS) amplitude and median frequency (MF) of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction were analyzed under pre- and post-maximal clenching effort conditions in centric occlusion. The electromyographic signal was collected with a sampling frequency of 2 kHz and the value in RMS was obtained by a moving window of 200 ms. The paired Students t-test was used to compare RMS amplitude and MF under pre- and post-maximal clenching effort conditions. The level of significance for each comparison was set to p<0.05. This study concluded that in individuals without a history of dysfunction of the masticatory system, maximum clenching effort in centric occlusion does not alter the electromyographic signal of the upper trapezius.

Sphenomandibular Muscle or Deep Bundle of Temporal Muscle

El musculo denominado como esfenomandibular por un grupo de autores o de acuerdo con estudios recientes, de fasciculo profundo del musculo temporal, presenta importantes relaciones anatomicas, especialmente en un contexto medico-odontologico. En vista de esta discusion, el objetivo fue observar la morfologia mediante la diseccion de cabezas conservadas en formaldehido, utilizando dos tecnicas diferentes para acceder a la region del musculo, designadas como vias de acceso trans-cigomaticas y frontales. Los resultados mostraron, por la observacion de las disecciones frontales, la presencia de fasciculos que se ubican independientemente al vientre muscular del fasciculo profundo, denominado fasciculo intermediario. Este fasciculo presento dos porciones, una superior carnosa y una inferior tendinosa, que continuo con la parte tendinosa del fasciculo superficial presente en la superficie interna del proceso coronoides. En vista de las observaciones realizadas, se puede concluir que debido a la ausencia total de la fascia muscular entre sus paquetes, el musculo temporal es una entidad unica que presenta tres fasciculos, el profundo, intermedio y superficial.

Median Nerve Behavior in Different Upper Limb Positions

Los sindromes de compresion de los nervios perifericos del miembro superior son comunes en la medicina clinica, y sus causas comprenden traumas y factores ocupacionales. Manuales de evaluacion tecnica y la tension neural en diferentes posiciones del miembro superior, asi como el conocimiento de la topografia del nervio afectado, son esenciales para un diagnostico preciso. El objetivo de este estudio fue analizar el comportamiento del nervio mediano en diferentes posiciones del miembro superior. Fueron utilizados 15 cadaveres fijados en formol. Se realizo la evaluacion morfometrica y topografica del nervio mediano en diferentes posiciones del miembro superior derecho. En todos los casos analizados, el nervio mediano se origino desde los fasciculos lateral y medial del plexo braquial, y recorrieron el brazo y el antebrazo de acuerdo con las descripciones clasicas. La medicion de la longitud del nervio en las diferentes posiciones mostro un mayor estiramiento durante la posicion combinada de extension y rotacion lateral del hombro y extension del codo/muneca/dedos. En conclusion, los puntos de referencia y posiciones metricas estudiadas son importantes para un diagnostico sdrcusdo de la neurobiomecanica del nervio mediano en los sindromes de compresion nerviosa.

Experimental model of temporomandibular joint arthritis: Evaluation of contralateral joint and masticatory muscles

OBJECTIVE To investigate morphological and biochemical changes in an experimental model of temporomandibular joint (TMJ) arthritis, as well as examine contralateral joint involvement and morphometric aspects of masticatory muscles in affected animals. DESIGN Forty Wistar rats were allocated into three groups, as follows: a healthy control group (HG); and a group with arthritis induced in the left TMJ (IG); and a contralateral group with noninflamed right TMJ (CG). Arthritis was induced by intra-articular injection of 50 μL of Complete Freunds Adjuvant (CFA). Morphological analysis was performed using histological sections of TMJs stained with hematoxylin-eosin, picrosirius and toluidine blue. In addition, histomorphometric analyses of the articular cartilage, articular disc and masticatory muscles, were performed. Biochemical analysis of TMJ tissues included dosage of sulfated glycosaminoglycans (GAGs), zymography of the Matrix Metalloproteinases (MMPs) 2 and 9 and ELISA for the cytokines IL-6, TNF-α and IL-1β. The data were analyzed by paired and unpaired t-tests, with a p < 0.05. RESULTS IG animals presented morphological and biochemical changes in their TMJ, including synovial membrane hyperplasia; chronic inflammatory infiltrate; collagen fiber disorganization in the disc; reduced proteoglycans in the cartilage; greater disc thickness; lower cartilage thickness; lower feed intake; higher activity of MMP-9 and MMP-2, and higher concentration of IL-6, TNF-α, and IL-1β, as compared to HG. CG animals showed posterior disc thickening; reduced proteoglycans in the cartilage; lower collagen fiber organization of the disc; active MMP-9, and higher concentration of IL-6 and TNF-α compared to HG animals. Articular inflammation reduced the area and diameter of fibers of the temporal (right), medial pterygoid (left), and lateral pterygoid (right and left) muscles as compared to HG animals. CONCLUSION TMJ arthritis reduced the area and diameter of masticatory muscle fibers and caused morphological and molecular changes in the contralateral joint.

Infraclavicular Topography of the Brachial Plexus Fascicles in Different Upper Limb Positions

Las neuropatias del plexo braquial son quejas comunes entre los pacientes atendidos en las clinicas ortopedicas. Las causas van desde traumas a factores ocupacionales y los sintomas incluyen parestesias, paresia e incapacidad funcional del miembro superior. El tratamiento puede ser quirurgico o conservador, pero se requiere un conocimiento detallado del plexo braquial en ambos casos para evitar lesiones iatrogenicas y para facilitar el bloqueo anestesico, evitando posibles lesiones vasculares. Por lo tanto, el objetivo de este estudio fue evaluar la topografia de los fasciculos del plexo braquial infraclavicular en diferentes posiciones de los miembros superiores adoptadas durante algunos procedimientos clinicos. Se llevo a cabo la diseccion de las regiones infraclavicular y axilar de un cadaver adulto, de sexo masculino, conservado en formaldehido. Se midio la distancia de los fasciculos del plexo braquial en relacion a las estructuras oseas adyacentes. No se observo variacion anatomica en la formacion del plexo braquial. Las relaciones metricas entre el plexo braquial y las prominencias oseas adyacentes difieren en funcion del grado de abduccion del hombro. El conocimiento detallado de la topografia infraclavicular de las estructuras neurovasculares ayuda con el diagnostico y sobre todo con la eleccion del tratamiento conservador o quirurgico de las neuropatias del plexo braquial.