Signos y Síntomas en 3557 Pacientes con Trastornos Temporomandibulares

Los trastornos temporomandibulares (TTM) tienen una alta frecuencia en la población y pueden presentar síntomas en la región de la cabeza, el oído y la región cervical. Este estudio evalúa la presencia de signos y síntomas en la región de la cabeza y el cuello, incluyendo: cefalea, trastornos del oído, y de la columna vertebral, en una población de 3557 pacientes con TTM. Para este estudio los datos consistieron en los registros de 3557 pacientes consecutivos de TTM referidos a una clínica privada de trastornos temporomandibulares y dolor craneofacial, en Santiago de Chile entre 1998 y 2019. El examen y los registros fueron efectuados por uno los autores (RW), en un programa computacional previamente diseñado. Los resultados fueron analizaron utilizando la distribución de la frecuencia de los datos para evaluar la prevalencia. En esta serie 72.67 % correspondieron a pacientes de sexo femenino. Los síntomas más prevalentes reportados por los 3557 pacientes estudiados fueron rigidez en el cuello 65,25 %, cefaleas 61,01 % y dolor lumbar 57,16 %. Los síntomas relacionados con el oído fueron: mareos en el 46,70 %, dolor de oídos en 32,64 % y tinnitus en el 33,60 % de los pacientes. La asimetría facial estuvo presente en el 74.08 % de los 3557 pacientes. Se observó desviación mandibular en apertura bucal, en el 74.44 % de los 3557 pacientes. Se presentó dolor a la palpación muscular en un alto porcentaje de los pacientes, en los músculos temporales, maseteros, esternocleidomastoideo y trapecio, Este estudio nos permite describir la frecuencia de los signos y síntomas que presentan los pacientes con TTM en una amplia casuística.

Temporomandibular disorders (TMD) are frequently associated with other conditions in the head, ear and neck region, including cervical spine disorders and headache. This study evaluates the presence of signs and symptoms in the head and neck region, including headache, ear disorders, cervical and spine disorders, on a population of 3557 patients with TMD. For this study data consisted of the records of 3557 consecutive TMD patients referred to a temporomandibular disorder and craniofacial pain private clinic in Santiago, Chile between 1998 and 2019. The examination and recordings were made by all the authors. The results were analyzed using the distribution of frequency of the data to asses prevalence. The most prevalent symptoms reported by the 3557 subjects were neck stiffness 65.25 %, headaches 61.01 % and low back pain 57.16 %, the most frequent ear symptom was dizziness 46.70 %. The present study analize the frecuency of signs and symptons presented in a big casuistic of patients with TMD.

Comparación de sistemas de evaluación diagnóstica de la severidad de la osteoartrosis en imágenes de TAC de las ATM

Objetivo: Comparar y validar sistemas diagnósticos de severidad de Osteoartrosis (OA) de las articulaciones temporomandibulares (ATM) en imágenes de tomografía computada (TAC). Método: Se efectuó un estudio observacional, retrospectivo, analítico y ciego. Se evaluaron 99 pacientes (198TAC-ATM), aplicando los criterios de siete diferentes sistemas diagnósticos. Un clínico calibrado (K=0,7) efectuó las evaluaciones. La validez de contenido se efectuó bajo los criterios Ahmad. La consistencia interna se determinó con Alpha de Cronbach. Se correlacionaron los datos con Rho de Spearman. Resultados: La severidad de la erosión condilar presenta alta correlación positiva entre las clasificaciones Alexiou/Arayasantiparb (rho=0,986) y baja entre Cömert/Alexiou (rho=0,421) y Cömert/Arayasantiparb (rho=0,422). La esclerosis condilar presentó fuerte correlación entre las clasificaciones de Cömert/Alexiou, Masilla/Alexiou y Cömert/Masilla (rho=857;rho=0,853;rho=0,998). Los datos presentaron alta consistencia interna (Alfa Cronbach=0,897) y baja validación de contenido (36,2%). Conclusiones: Las mediciones de los 7 sistemas presentan alta fiabilidad. La erosión ósea, esclerosis y osteofitos son medidos en cuatro niveles de severidad y con similar escala en tres sistemas de diagnóstico (Alexiou, Arayasantiparb y Cömert), sugiriendose complementar con determinación del espacio articular y movilidad condilar, como propone RDC/TMD para TTM. La validación de contenido fue baja, solo los sistemas diagnósticos de Cömert y Alexiou superaron el 50%.

Objective: To compare and validate diagnostic systems for the severity of Osteoarthrosis (OA) of the temporomandibular joints (TMJ) in computed tomography (CT) images. Method: An observational, retrospective, analytical, blinded, retrospective study was performed. Ninety-nine patients (198MSCT-ATM) were evaluated, applying the criteria of seven different diagnostic systems. A calibrated clinician (K=0.7) performed the evaluations. Content validity was performed under the Ahmad criteria. Internal consistency was determined with Cronbach's Alpha. Data were correlated with Spearman's Rho. Results: For condylar erosion severity, there was a high positive correlation between Alexiou/Arayasantiparb (rho=0.986) and a low one between Cömert/Alexiou (rho=0.421) and Cömert/Arayasantiparb (rho=0.422) classifications. For condylar sclerosis, we found a strong correlation between Cömert/Alexiou, Masilla/Alexiou and Cömert/Masilla classifications (rho=857; rho=0.853; rho=0.998). The data presented high internal consistency (Cronbach's alpha=0.897) and low content validation (36.2%). Conclusions: The measurements of the 7 systems have a high reliability. Bone erosion, sclerosis and osteophytes are measured at four levels of severity and with a similar scale in three diagnostic systems (Alexiou, Arayasantiparb and Cömert). We suggest to complement it with the determination of joint space and condylar mobility, as proposed by RDC/TMD. Content validity was low, only the Cömert and Alexiou diagnostic systems were higher than 50%.

Loss of ATM activity induces GADD45α-dependent apoptosis in cerebellar granular neurons / 中山大学学报(医学科学版)

objectiveTo explore the specific molecular mechanism of neuronal apoptosis induced by ATM inactivation. MethodsCGNs matured 7 days in vitro were cultured 8 h with 25 K， 5 K or 25 K medium containing ATM-specific inhibitors （Ku55933， 10 µmol/L； Ku60019， 15 µmol/L） for Hoechst stain and apoptosis analysis， or cultured for different lengths of time （2， 4， 8 h） to detect the protein expression levels of ATM， caspase-3 and cleaved caspase-3 by Western blotting. ATM and GADD45α specific siRNA was transfected into C6 cells and CGNs， and its interference efficiency was verified by q-PCR and Western blotting. CGNs matured for 5 days in vitro were transfected with ATM specific siRNA and pCMV-EGFP by calcium phosphate for 48 h， Hoechst staining and apoptosis analysis were performed. CGNs matured for 7 days in vitro were treated with 25 K medium containing ATM specific inhibitors for 8 h， transcriptome sequencing， differential expression gene identification and pathway enrichment analysis were performed. CGNs matured for 5 days in vitro were co-transfected with GADD45α specific siRNA and pCMV-EGFP by calcium phosphate for 48 h， then treated with 5 K or 25 K medium containing 15 µmol/L Ku6 for 8 h. Hoechst staining and apoptosis analysis were performed. ResultsCompared with the 25 K， CGNs nuclear pyknosis rate， cleaved Caspase-3 and ATM protein expression level were increased in the 5 K and ATM-specific inhibitor groups. The mRNA and protein expression levels of ATM and GADD45α were effectively reduced after transfection of ATM and GADD45α specific siRNA in C6 cells and CGNs. Compared with control， CGNs transfected with ATM specific siRNA showed a higher nuclear pyknosis rate. Totally 835 genes were identified to be up-regulated and 848 genes to be down-regulated in the Ku55933 treatment group； 454 genes were identified to be up-regulated and 314 genes to be down-regulated in the Ku6 treatment group； 274 genes were co-up regulated in the Ku5 and Ku60019 treatment groups， while 179 genes were co-down-regulated in the Ku5 and Ku6 treatment groups and the expression of ATM downstream target GADD45α was upregulated. The enrichment results showed that TNF signaling pathway， NF-κB signaling pathway and Apoptosis signaling pathway were significantly enriched. Compared with control， mRNA and protein expression levels of GADD45α were increased in inhibitor treatment and 5 K， while knocking down GADD45α resulted in a decrease in nuclear pyknosis rate in the Ku60019 and 5 K treatment group. ConclusionLoss of ATM activity induces GADD45α-dependent cerebellar granular neuronal apoptosis.

Effectiveness of the therapeutic laser in the syndrome of dysfunction of the temporomandibular joint of arthrogenic origin / Eficacia del láser terapéutico en el síndrome de disfunción de la articulación temporomandibular de origen artrogénico

Abstract Temporomandibular joint dysfunction syndrome (TMD), is a collective term characterized by symptoms involving chewing muscles, temporomandibular joint and orofacial structures. The efficacy of low intensity laser (LLLT) Gallium arsenide, in combination with a non-steroidal anti-inflammatory drug (NSAID) was evaluated. The main objective was to evaluate the maximum mouth opening without pain (ABM), arthralgia in the joint capsule through visual analog scale (VAS), laterality, protrusion, joint noises and count of tablets ingested per group. A controlled clinical trial (double-blind-randomized) was carried out in 30 subjects, who presented DTM of arthrogenic etiology; 5 applications of LLLT were made with wavelength of 810 nm, output optical power of 100-200 mw, emission PW=Pulsed (1-10,000Hz), dose of 10 jouls-cm², time of 1.44 minutes in mouth closed and with the mouth half open. One more follow-up appointment per month. There were two groups: experimental and control group, where different variables were analyzed (ABM, laterality, protrusion, VAS and sociodemographic). In the control group, a supposed LT application (not active) was made, for later comparison. Pain-free ABM was assessed in all appointments in addition to the other clinical parameters. Repeated measures analysis was performed with mixed models. Thirty patients were included of which 28 finished the treatment, two of them were lost during follow-up. The groups were similar in all their baseline variables. There were no statistically significant differences when applying the final multiple regression analysis, in the ABM, or in any other of the clinical parameters analyzed. LT was not effective in treating arthrogenic DTM.

Resumen El síndrome de disfunción de la articulación temporomandibular (DTM) es un término colectivo caracterizado por síntomas que involucran músculos de la masticación, articulación temporomandibular y estructuras orofaciales. Se evaluó la eficacia del láser de baja intensidad (LLLT) Arseniuro de galio, en combinación con un antiinflamatorio no esteroideo (AINE). El objetivo principal fue evaluar la apertura bucal máxima sin dolor (ABM), la artralgia en cápsula articular a través de escala visual análoga (EVA), lateralidades, protrusión, ruidos articulares y conteo de tabletas ingeridas por grupo. Se realizó un ensayo clínico controlado (doble ciego-aleatorizado) en 30 sujetos, que presentaban DTM de etiología artrogénica; se les realizaron 5 aplicaciones de LLLT con longitud de onda de 810 nm, potencia óptica de salida de 100-200 mw, emisión PW=Pulsed (1-10,000Hz), dosis de10 jouls-cm², tiempo de1.44 minutos a boca cerrada y con la boca semiabierta. Una cita más de seguimiento al mes. Se tuvieron dos grupos: experimental y grupo control, donde se analizaron diferentes variables (ABM, lateralidades, protrusión, EVA y sociodemográficas). En el grupo control se hizo una supuesta aplicación LT (no activo), para posterior comparación. En todas las citas se valoró la ABM sin dolor además de los otros parámetros clínicos. Se realizó análisis de medidas repetidas con modelos mixtos. Se incluyeron 30 pacientes de los cuales 28 finalizaron el tratamiento, dos de ellos se perdieron en el seguimiento. Los grupos fueron similares en todas sus variables basales. No hubo diferencias estadísticas significativas al aplicar los análisis de regresión múltiple finales, en la ABM, ni tampoco en ningún otro de los parámetros clínicos analizados. El LT no fue eficaz en el tratamiento de la DTM de origen artrogénico.

A Study On Customer Satisfaction Towards E-Banking Services With Special Reference To Axis Bank In Ramanathapuram Town

In traditional banking, the products and services handed by bank branches are not acceptable to meet the customer needs and solicitation. Customers are the king in any business. Every business should know the customer perception and satisfy their requirements. Customers are precipitously more demanding with precious services customized to their exact requirements, at least bring and instantly done. It is possible by the use of Information technology in banking sector. In Moment's script E-Banking service plays a vital part in attracting new customers and retaining old customers. Without e-banking service no banks can survive in this competitive banking business. E-Banking means the provision of information about a bank and its services through a home runner on the World Wide Web (WWW). E-Banking services give customer access to accounts, the capability to transfer their plutocrat between different accounts, and making payments or applying for loans through E- Channels. Electronic Banking is else called as Internet Banking or Virtual Banking or Online Banking or Web Banking. E – Banking is the medium and rearmost delivery channel to be offered by the retail banks. It handed number of benefits to customer in term of easy to use and at least cost of deals; it may be either through internet, telephone or other electronic delivery channels. Nationalization was a structural change in the performance of marketable banks which redounded in to the emergence of public sector banks. Privatization leads to the emergence of private sector banks and globalization which eased the entry of foreign banks in India. This super study helps to know the satisfaction position of customers towards e – banking services handed by Axis Bank in Ramanathapuram Town. Then E – Banking services includes ATM service, POS using benefit card and credit services, mobile banking and EFT etc.

Biomarcadores inflamatorios en líquido sinovial de trastornos intraarticulares de la articulación temporomandibular. Revisión sistemática

RESUMEN Objetivo: Determinar los biomarcadores inflamatorios del líquido sinovial (LS) de pacientes adultos con trastornos intraarticulares (TI) de la articulación temporomandibular (ATM) y su capacidad diagnóstica. Métodos: Se realizó búsqueda electrónica/manual de artículos (2010-2019) en paralelo por dos investigadores. La calidad de los estudios, se determinó por medio de CONSORT y STROBE y el sesgo según criterios Cochrane RoB 2 en ensayos clínicos aleatorizados y Escala Newcastle-Ottawa en estudios observacionales. Se estudiaron pacientes con TI de la ATM y determinación de biomarcadores del LS. Resultados: De 264 artículos encontrados, 6 cumplieron los criterios inclusión-exclusión, incluyendo 262 pacientes, [OA=153, 93 con desplazamientos discales (DD) y 16 con OA+DD]. Todas las muestras fueron obtenidas por artrocentesis y detectadas por ELISA. Se determinaron 19 biomarcadores en pacientes con OA; 9 en DD y 2 en diagnosticados con OA+DD. El incremento de biomarcadores en el LS de la ATM se asocia con TI. Conclusión: Los biomarcadores detectados con mayor frecuencia en LS de pacientes con TI de ATM fueron IL-1β, IL-6 y TNF-α y en segunda frecuencia TGF-β1, MMP-3 e IFN-γ. Dada la inconsistencia de los protocolos utilizados la evidencia fue débil, imposibilitando asociar biomarcadores con diagnóstico de TI determinado, ni efectuar análisis estadístico.

ABSTRACT: Objective: To determine the evidence of inflammatory biomarkers present in the synovial fluid (SF) of adult patients with intra-articular disorders (ID) of the temporomandibular joint (TMJ) and their diagnostic ability. Methods: Electronic/manual search of articles (2010-2019) was performed. Data were extracted in duplicate. The quality of the studies was determined by CONSORT, STROBE and risk of bias was determined by Cochrane RoB 2 and Newcastle-Ottawa Scale. The populations studied were patients with TMJ ID and with studies of SF biomarkers. Results: Out of 264 articles found, 6 met the inclusion-exclusion criteria, including 262 patients, 93 with disc displacements (DD) and 16 with OA+DD. All samples were obtained by arthrocentesis and detected by ELISA. Nineteen biomarkers were evaluated in patients with OA, 9 in patients with DD and 2 in those diagnosed with OA+DD. Increased inflammatory biomarkers in the SF of TMJ are associated with ID. Conclusion: The most frequent biomarkers detected in SF of patients with TMJ ID were IL-1β, IL-6 and TNF-α and in second frequency TGF-β1, MMP-3 and IFN-γ. Given the inconsistency of the protocols used, the evidence was weak, making it impossible to associate biomarkers with a given IT diagnosis, or to perform statistical analysis.

Factores Asociados a Trastornos Temporomandibulares en el Servicio de Estomatología Quirúrgica de un Hospital Peruano

RESUMEN: El objetivo de este estudio fue determinar los factores asociados a Trastornos Temporomandibulares (TTM) en pacientes del servicio de Estomatología Quirúrgica de un Hospital Peruano. La muestra del estudio estuvo conformado por 132 pacientes diagnosticados con Trastornos Temporomandibulares por cirujanos dentistas especialistas en Cirugía Bucal y Maxilofacial del servicio de Estomatología Quirúrgica. Se realizó una anamnesis complementaria y una evaluación clínica. Del total de pacientes evaluados, se encontró que el 84,09 % pertenecía al sexo femenino y el 20,45 % tenía entre 50-59 años. Además, el 72,73 % refirieron haber recibido atención previa por otro servicio, el 52,27 % presentaron hábito parafuncional de bruxismo, el 58,33 % presentaron patrón oclusal alterado, el 25,76 % presentaron pérdida de 5 dientes o más por arcada con prevalencia en ambas arcadas y el 54,55 % presentaron atrición. Se concluyó que el sexo predominante fue el femenino y el grupo etario prevalente en pacientes con diagnóstico de TTM, se ubicó en el rango de edad de 50-59 años. Respecto a la sintomatología dolorosa en pacientes con diagnóstico de TTM del servicio de Estomatología Quirúrgica del HNAL fue prevalente el dolor al masticar o hablar.

ABSTRACT: The objective of this study was to determine the factors associated with Temporomandibular Disorders (TMD) in patients of the Surgical Stomatology service of a Peruvian Hospital. The study sample consisted of 132 patients diagnosed with Temporomandibular Disorders by dental surgeons specializing in Oral and Maxillofacial Surgery of the Surgical Stomatology service. A complementary anamnesis and a clinical evaluation were carried out. Of the total of patients evaluated, it was found that 84.09 % belonged to the females and 20.45 % were between 50-59 years old. In addition, 72.73 % reported having received prior care from another service, 52.27 % had a parafunctional habit of bruxism, 58.33 % had an altered occlusal pattern, 25.76 % had loss of 5 or more teeth due to arch with prevalence in both arches and 54.55 % presented attrition. It was concluded that the predominant sex was female and the prevalent age group in patients diagnosed with TMD was in the age range of 50-59 years. Regarding the painful symptoms in patients with a diagnosis of TMD from the Surgical Stomatology Service of the HNAL, pain when chewing or speaking was prevalent.

Relación entre contactos mediotrusivos con la articulación temporomandibular y la oclusión / Relationship between mediotrusive contacs, the temporomandibular joint and occlusion

Los contactos mediotrusivos son aquellos contactos oclusales que se encuentran entre las vertientes in- ternas de las cúspides linguales maxilares y las inter- nas de las cúspides bucales mandibulares del lado de no trabajo durante los movimientos de lateralidad. Estos contactos mediotrusivos podría desencadenar trastornos temporomandibulares, afectando la oclu- sión y la articulación temporomandibular. El objetivo de este estudio es analizar las caracterís- ticas y la relación entre los contactos mediotrusivos con la articulación temporomandibular y la oclusión en pacientes que consultan al Servicio de Oclusión y ATM del Hospital Odontológico de la Facultad de Odontología de la Universidad Nacional del Nordeste (AU)

Mediotrusive contacts are those occlusal contacts that are found between the internal slopes of the maxillary lingual cusps and the internal slopes of the mandibular buccal cusps on the non-working side during laterality movements. These mediotrusive contacts could trigger temporomandibular disorders affecting occlusion and temporomandibular joint. The objective of this study was to analyze the characteristics and relationship of mediotrusive contacts with occlusion and the temporomandibular joint, in patients who consult the Occlusion and TMJ Service of the Dental Hospital of the Faculty of Dentistry of the National University of the Northeast (AU)

Chemical screen identifies shikonin as a broad DNA damage response inhibitor that enhances chemotherapy through inhibiting ATM and ATR

DNA damage response (DDR) is a highly conserved genome surveillance mechanism that preserves cell viability in the presence of chemotherapeutic drugs. Hence, small molecules that inhibit DDR are expected to enhance the anti-cancer effect of chemotherapy. Through a recent chemical library screen, we identified shikonin as an inhibitor that strongly suppressed DDR activated by various chemotherapeutic drugs in cancer cell lines derived from different origins. Mechanistically, shikonin inhibited the activation of ataxia telangiectasia mutated (ATM), and to a lesser degree ATM and RAD3-related (ATR), two master upstream regulators of the DDR signal, through inducing degradation of ATM and ATR-interacting protein (ATRIP), an obligate associating protein of ATR, respectively. As a result of DDR inhibition, shikonin enhanced the anti-cancer effect of chemotherapeutic drugs in both cell cultures and in mouse models. While degradation of ATRIP is proteasome dependent, that of ATM depends on caspase- and lysosome-, but not proteasome. Overexpression of ATM significantly mitigated DDR inhibition and cell death induced by shikonin and chemotherapeutic drugs. These novel findings reveal shikonin as a pan DDR inhibitor and identify ATM as a primary factor in determining the chemo sensitizing effect of shikonin. Our data may facilitate the development of shikonin and its derivatives as potential chemotherapy sensitizers through inducing ATM degradation.

WSB1 regulates c-Myc expression through β-catenin signaling and forms a feedforward circuit

The dysregulation of transcription factors is widely associated with tumorigenesis. As the most well-defined transcription factor in multiple types of cancer, c-Myc can transform cells by transactivating various downstream genes. Given that there is no effective way to directly inhibit c-Myc, c-Myc targeting strategies hold great potential for cancer therapy. In this study, we found that WSB1, which has a highly positive correlation with c-Myc in 10 cancer cell lines and clinical samples, is a direct target gene of c-Myc, and can positively regulate c-Myc expression, which forms a feedforward circuit promoting cancer development. RNA sequencing results from Bel-7402 cells confirmed that WSB1 promoted c-Myc expression through the β-catenin pathway. Mechanistically, WSB1 affected β-catenin destruction complex-PPP2CA assembly and E3 ubiquitin ligase adaptor β-TRCP recruitment, which inhibited the ubiquitination of β-catenin and transactivated c-Myc. Of interest, the effect of WSB1 on c-Myc was independent of its E3 ligase activity. Moreover, overexpressing WSB1 in the Bel-7402 xenograft model could further strengthen the tumor-driven effect of c-Myc overexpression. Thus, our findings revealed a novel mechanism involved in tumorigenesis in which the WSB1/c-Myc feedforward circuit played an essential role, highlighting a potential c-Myc intervention strategy in cancer treatment.

Therapeutic regulation of autophagy in hepatic metabolism

Metabolic homeostasis requires dynamic catabolic and anabolic processes. Autophagy, an intracellular lysosomal degradative pathway, can rewire cellular metabolism linking catabolic to anabolic processes and thus sustain homeostasis. This is especially relevant in the liver, a key metabolic organ that governs body energy metabolism. Autophagy's role in hepatic energy regulation has just begun to emerge and autophagy seems to have a much broader impact than what has been appreciated in the field. Though classically known for selective or bulk degradation of cellular components or energy-dense macromolecules, emerging evidence indicates autophagy selectively regulates various signaling proteins to directly impact the expression levels of metabolic enzymes or their upstream regulators. Hence, we review three specific mechanisms by which autophagy can regulate metabolism: A) nutrient regeneration, B) quality control of organelles, and C) signaling protein regulation. The plasticity of the autophagic function is unraveling a new therapeutic approach. Thus, we will also discuss the potential translation of promising preclinical data on autophagy modulation into therapeutic strategies that can be used in the clinic to treat common metabolic disorders.

Modelo lineal vs. vectorial: estimación del movimiento mandibular y trabajo mecánico / Linear vs. vector model: estimation of mandible motion and mechanical work

Objetivo: Determinar los momentos de fuerza del haz superficial del masetero (SMH) obtenidos por modelos lineal y vectorial. Métodos: Investigación comparati-va in silico. Se obtuvo la fuerza del SMH con dinamó-metro en 12 pacientes varones adultos jóvenes para calcular el momento de la fuerza y trabajo mecánico a través de simulaciones en JAVA+ con NetBeans8.2. La descomposición de la fuerza fue F.cos α(x,y) y F.cos α(x,y,z) en el modelo lineal y vectorial respectivamen-te. Los momentos de fuerza fueron comparados por ANOVA (p<0,05). Resultados: La fuerza del SMH unila-teral obtenida con dinamómetro (2,5±0,1N) no difirió significativamente del modelo lineal (2,6±0,05N), pero difirió (p<0,001) del vectorial: 1,7, 2,2, 4,2N en x,y,z (general 2,7±0,02N). El momento medio de la fuerza en el modelo vectorial fue -17,9, -15,5, +14,3N.m-2, apuntando a la inclinación mandibular en el eje lateral en dirección caudal anterior, movimiento de inclina-ción en el eje lateral en la dirección cráneo-medial, e inclinación en el eje craneal en la dirección lateral-an-terior. El modelo lineal mostró momento de fuerza de 13,5N.m-2 apuntando un movimiento traslacional en dirección caudal-craneal en el eje anterior-posterior y menor trabajo mecánico del SMH (p=0,012). Con-clusión: Los modelos vectoriales son más eficientes proporcionando datos detallados para estimar los momentos de fuerza y el trabajo mecánico del SMH, y deben incluirse en los algoritmos de cálculo utilizados por dinamómetros (AU)

Objective: to determine the moments of force exerted by the superficial masseter head (SMH) obtained through linear models and vector ones. Methods: comparative in silico research. Data of SMH force obtained with dynamometer in 12 young adult male patients was used to calculate the moment of the force and mechanical work through simulations in JAVA+ performed with NetBeans8.2. Force decomposition was F.cos α(x,y) and F.cos α(x,y,z) in the linear and vector model respectively. The moments of force were compared by ANOVA (p<0.05). Results: Dynamometrical unilateral SMH force (2.5±0.1N) did not differ significantly from the linear model (2.6±0.05N), but differed (p<0.001) from the vector model: 1.7, 2.2, 4.2N on x,y,z (overall 2.7±0.02N). The mean moment of the force in the vector model was -17.9, -15.5, +14.3N.m-2, pointing to mandible's inclination on the lateral axis in anterior-caudal direction, inclination movement on the lateral axis in the cranio-medial direction and inclination on the cranial axis in the lateral-anterior direction. The linear model showed a moment of force of 13.5N.m-2 pointing to translational motion on caudal-cranial direction on the anterior-posterior axis and lower SMH mechanical work (p=0,012). Conclusion: Vector models are more efficient to provide detailed data to estimate the moments of force and mechanical work of SMH and should be included in the calculation algorithms used by dynamometers (AU)

Cambios Clínicos e Imagenológicos en Terapias no Invasivas en Articulaciones Temporomandibulares con Alteraciones Óseas Degenerativas

RESUMEN: El objetivo del presente estudio fue describir los cambios clínicos e imagenológicos de las terapias no invasivas aplicadas a pacientes con alteraciones óseas degenerativas de las articulaciones temporomandibulares (ATM). Metodología: Se evaluaron 25 pacientes con alteraciones óseas degenerativas de las ATM, sin tratamiento previo de trastornos temporomandibulares (TTM) al momento del diagnóstico. Se realizó tratamiento no invasivo y un año después fueron evaluados según criterios clínicos e imagenológicos DC/TMD y Ahmad. Los resultados fueron presentados por medio de estadística descriptiva, odds ratio con sus respectivos intervalos de confianza, comparaciones de medianas y correlaciones. Se estudiaron 50 ATM, 72 % mujeres (32,2 años promedio). Se observó mejora significativa en los parámetros: dolor (p=0,0001), sinovitis (p=0,001) e incremento de la esclerosis del trabeculado óseo (p=0,051) a un año post-tratamiento. Después de un año del establecimiento de terapias no invasivas en pacientes con alteraciones óseas degenerativas de las ATM, se observaron cambios positivos tanto clínicos como imagenológicos, reduciéndose significativamente la sintomatología dolorosa, limitándose la progresión del daño óseo degenerativo, y observándose recuperación de los casos de sinovitis.

ABSTRACT: The objective of this study was to describe clinical and imaging changes of non-invasive therapies applied to patients with degenerative bone disorders of the temporomandibular joints (TMJ). To carry out this study, 25 patients with degenerative bone disorders of TMJ without previous treatment at the time of diagnosis, were evaluated. Non-invasive treatment was performed and one year later they were evaluated according to clinical and imaging criteria DC/TMD and Ahmad. Results were presented by descriptive statistics, odds ratio, confidence interval, comparisons of means, and correlations. 50 TMJs, 72 % women, (32.2 years mean of age) were studied. Significant improvement was observed in the parameters: pain (p=0.0001), synovitis (p=0.001), and increased sclerosis of the bone trabeculae (p=0,051) at one-year post-treatment. After one year of the establishment of non-invasive therapies in patients with degenerative joint disease of TMJ, it was observed positive changes, both clinical and imaging, reducing painful symptomatology, limiting effect on the progression of degenerative bone damage, and recovery of synovitis cases.

A cirurgia ortognática no tratamento da DTM em pacientes classe II / The orthognatic surgery in treatment of TMJ in class II patients

Introdução: A má oclusão Classe II pode influenciar negativamente na qualidade de vida dos pacientes, tanto na aparência facial, quanto função oral ou até ambas. Atualmente, o tratamento ortodôntico-cirúrgico é comumente utilizado em pacientes com discrepâncias esqueléticas graves. Objetivo: Este estudo tem como objetivo analisar os resultados da cirurgia ortognática associada ao tratamento ortodôntico nos pacientes que possuem DTM e má oclusão de Classe II por retrognatismo mandibular. Metodologia: Foi realizada uma pesquisa bibliográfica nas plataformas de buscas científicas Google Acadêmico, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, e nas revistas AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) e The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), utilizando as seguintes palavras chave: retrognatismo, cirurgia ortognática e transtornos da ATM. Conclusão: A maioria dos pacientes que apresentam sinais e sintomas de DTM pré-operatórios melhoram a disfunção e diminuem os níveis de dor com o tratamento ortognático. Além disso, o tratamento ortodôntico é de suma importância para se obter o sucesso do procedimento cirúrgico, assim como na estabilidade pós-cirúrgica.(AU)

Introduction: Class II malocclusion can negatively influence patients in quality of life, in the facial and oral appearance or both. Currently, orthodontic-surgical treatment is commonly used in patients with severe skeletal discrepancies. Objective: The objective of this study was to analyze the results of orthognathic surgery associated with orthodontic treatment in patients who have TMD and Class II malocclusion due to mandibular retrognathism. Methodology: A bibliographic search was performed in the scientific search platforms Google Scholar, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) and in The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), using the keywords: retrognathism, orthognathic surgery and TMJ disorders. Conclusion: With orthognathic treatment, most patients who had preoperative DTM signs and symptoms showed an improvement and a decrease in pain levels. In addition, orthodontic treatment is important for the success of the surgical procedure, as well as for post-surgical stability.(AU)

Osteoartrosis de ATM: recuperar la función / TMJ Osteoarthrosis: recover function

Objetivo: evaluar la rehabilitación funcional de la ATM en pacientes con osteoartrosis, con abordaje neuromuscular. La osteoartrosis se caracteriza por la degeneración del cartílago articular y la cortical ósea, que conduce a dolor e inmovilidad. Se incluyó a 8 mujeres entre 20 y 42 años de edad con dolor en la región orofacial, signos de oclusión disfuncional e imágenes compatibles con trastornos degenerativos en ATM. Clínicamente se evaluó el dolor y la oclusión y, mediante tecnología electrónica, se obtuvieron datos objetivos de los movimientos de apertura-cierre y lateralidades, la velocidad de apertura-cierre mandibulares y de los ruidos articulares. Las mediciones fueron realizadas al inicio y al finalizar el tratamiento de estabilización mandibular con una ortosis neuromuscular. Para determinar la significación estadística se utilizaron el Student`s test de comparaciones múltiples y el análisis de varianza, ANOVA, de un factor. Las diferencias entre medias se consideraron significativas con p <0.05. Los resultados demostraron ausencia de dolor en el 100% de los casos al primer mes de tratamiento. Se incrementaron la apertura bucal (6,73 mm promedio), ambas lateralidades (P=0.0023), velocidad en apertura y en cierre (no estadísticamente significativo). Después de estabilizar la mandíbula se redujo la frecuencia de los ruidos. En conclusión, la oclusión dental disfuncional es el principal factor etiológico de la artrosis de la ATM. El establecimiento de una oclusión fisiológica produce la descompresión de la ATM, aumenta el rango de los movimientos mandibulares y disminuye significativamente el dolor (AU)

Objective: to evaluate the functional rehabilitation of the TMJ in patients with osteoarthritis, with a neuromuscular approach. Osteoarthrosis is characterized by degeneration of articular cartilage and bone cortex, which leads to pain and immobility. Eight women between 20 and 42 years of age with pain in the orofacial region, signs of dysfunctional occlusion, and images consistent with degenerative TMJ disorders were included. Clinically, pain and occlusion were evaluated and, using electronic technology, objective data were obtained on the opening-closing movements and lateralities, the opening-closing speed of the jaws and joint noises. Measurements were made before and at the end of the mandibular stabilization treatment with a neuromuscular orthosis. To determine the statistical significance, the Student`s multiple comparisons test and the analysis of variance, ANOVA, of one factor were used. The differences between means were considered significant with p <0.05. The results showed absence of pain pain in 100% of cases in the first month of treatment. Mouth opening (6.73 mm average), both lateralities (P = 0.0023), opening and closing speed (not statistically significant) were increased. After stabilizing the jaw the noise frequency value was reduced. In conclusion, dysfunctional dental occlusion is the main etiologic factor of TMJ osteoarthritis. Establishing a physiological occlusion causes TMJ decompression, increases the range of mandibular movements, and significantly decreases pain (AU)

Alterations of DNA damage response pathway: Biomarker and therapeutic strategy for cancer immunotherapy

Genomic instability remains an enabling feature of cancer and promotes malignant transformation. Alterations of DNA damage response (DDR) pathways allow genomic instability, generate neoantigens, upregulate the expression of programmed death ligand 1 (PD-L1) and interact with signaling such as cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling. Here, we review the basic knowledge of DDR pathways, mechanisms of genomic instability induced by DDR alterations, impacts of DDR alterations on immune system, and the potential applications of DDR alterations as biomarkers and therapeutic targets in cancer immunotherapy.

Morfología y Fisiopatología del Fibrocartílago de la ATM. Revisión sistemática / Morphology and Pathophysiology of the TMJ Fibrocartilage. Systemic review

RESUMEN: El objetivo: del presente estudio fue efectuar una revisión actualizada de la morfología, fisiopatología y aspectos moleculares de la capa fibrocartilaginosa de las ATM en humanos. Método: se realizó búsqueda electrónica y manual con los términos MeSH "TMJ" y "fibrocartilage", sin límite de fecha o idioma. Los desenlaces definidos fueron: morfología del fibrocartílago, fisiopatología del fibrocartílago articular, modeladores moleculares del fibrocartílago y deterioro del fibrocartílago. Resultados: Se identificaron 1.071 títulos de artículos que después de las exclusiones, fueron seleccionados 16 a texto completo para la revisión. El fibrocartílago (FC) que cubre las superficies de las ATM es un tejido crítico en el establecimiento y la tasa de progresión de las alteraciones óseas degenerativas, clínicamente sus discontinuidades se asocian a patologías que provocan dolor, ruidos y limitación funcional. Conclusiones: A pesar de la diversidad metodológica, heterogeneidad de objetivos y diferentes características de los estudios incluidos en la revisión, el fibrocartílago de la ATM, como tejido avascular, determina fisiología de baja capacidad reparativa y mayor frecuencia de patología del FC en mujeres en edad fértil, asociado a receptores hormonales. La fisiopatología muestra reacciones inmunitarias que incrementan la acción de MMPs, interleucinas y FNTα, responsables de la degradación de la matriz extracelular, destrucción celular y morfológica del fibrocartílago, que conducen a sintomatología inflamatoria y degenerativa de pacientes que presentan artralgias y sinovitis en las ATM.

ABSTRACT: The aim: of the present study was to carry out an updated review of the morphology, physiopathology and molecular aspects of the TMJ fibrocartilage in humans. Method: electronic/manual search was performed with the MeSH terms "TMJ" and "fibrocartilage", with no date or language limit. The defined outcomes were: morphology of the fibrocartilage, physiopathology of the articular fibrocartilage, fibrocartilage molecular modelers and fibrocartilage deterioration. Results: 1071 articles were identified and after exclusions, 16 full-texts were selected for review. The fibrocartilage (FC) that covers the surfaces of the TMJ is a critical tissue in the establishment and progression rate of degenerative bone diseases; clinically, its discontinuities are associated with pain, noise and functional limitation. Conclusions: In spite of the methodological diversity, heterogeneity of objectives and different characteristics of the patients included in the review, TMJ fibrocartilage, as avascular tissue, determines a physiology of low reparative capacity, observed with greater frequency of FC damage in women of fertile age, associated with a greater amount of hormonal receptors. The physiopathology shows that the immune reactions increase some MMPs, interleukins and FNTα, which are linked to the degradation of the extracellular matrix, FC cellular and morphological destruction and define the inflammatory and degenerative symptomatology of patients who present TMJ arthralgia´s and synovitis.

A panoramic study of the morphology of mandibular condyle in a sample of population from Basrah City / Estudio panorámico de la morfología del cóndilo mandibular en una muestra de población de la ciudad de Basora

SUMMARY: The study aims to evaluate the morphological variation of mandibular condyle This analysis was composed of 450 digital orthopantomograms taken for routine investigation to assess the morphology of 900 condylar heads. Condylar morphology was classified into four types (oval, bird beak, diamond and crooked finger). Most common occurring shape were evaluated, symmetry of condylar shape and most common combinations of the condylar shapes present in population were assessed. Out of 900 mandibular condyle, type 1(oval) of condyle was the most commonly appearing shape (56 %), followed by type 3 (diamond), type 2(bird beak) and finally type 4 (crooked finger). Symmetry was seen in 74.2 % of the total sample with the oval-oval was the most commonly occurring. Routine use of orthopantomography can assist dentist in assessment of condylar morphology alterations. Oval shape was the most common in all age groups in males and females. More studies on Iraqi population evaluating mandibular condyle are needed to provide standardized values for mandibular anatomical parts.

RESUMEN: El objetivo del presente estudio fue evaluar la variación morfológica del cóndilo mandibular. El análisis se realizó en 450 ortopantomogramas digitales en una investigación de rutina para evaluar la morfología de 900 cabezas condilares. La morfología condilar se clasificó en cuatro tipos (ovalada, pico de pájaro, diamante y dedo torcido). Se evaluó la forma más común de ocurrencia, la simetría de la forma condilar y las combinaciones más comunes en la población. De 900 cóndilos mandibulares, el tipo 1 (ovalado) de cóndilo apareció con mayor frecuencia (56 %), seguido del tipo 3 (diamante), el tipo 2 (pico de pájaro) y finalmente el tipo 4 (dedo torcido). Se observó simetría en el 74,2 % de la muestra total, siendo el óvalo-óvalo el que se presentó con mayor frecuencia. El uso rutinario de la ortopantomografía puede ayudar al dentista a evaluar las alteraciones de la morfología condilar. La forma ovalada fue la más común en todos los grupos etarios en hombres y mujeres. Se necesitan más estudios sobre la población iraquí que evalúen el cóndilo mandibular para proporcionar valores estandarizados para evaluar la anatomía mandibular.

Concordancia entre los criterios diagnósticos RDC/TMD y su actualización DC/TMD, aplicados a la patología inflamatoria de la articulación temporomandibular / Agreement between Diagnostic Criteria RDC/TMD and its update DC/TMD, applied to the inflammatory pathology of the Temporomandibular Joint

RESUMEN: Objetivo: Evaluar el grado de concordancia entre las prevalencias de trastornos articulares inflamatorios (TAI) de las Articulaciones Temporomandibulares (ATM), obtenidas con los Criterios Diagnósticos de Investigación para Trastornos Temporomandibulares (RDC/TMD) y los Criterios Diagnósticos para Trastornos Temporomandibulares (DC/TMD). Materiales y métodos: 59 pacientes adultos chilenos fueron examinados según el Eje I de los RDC/TMD y el Eje I de los DC/TMD para determinar la prevalencia de TAI. Luego se compararon los resultados obtenidos de cada protocolo con el test Kappa de Cohen para evaluar la concordancia entre ambos. Resultados: La prevalencia de TAI para ambos criterios fue de 22%, con una concordancia casi perfecta (kappa=0,91). Al comparar las prevalencias de TAI por articulación, se obtuvo un grado de acuerdo sustancial (kappa=0,77) para la ATM derecha y un grado de acuerdo casi perfecto (kappa=0,94) para la ATM izquierda. Al comparar las prevalencias de TAI según género y edad se obtuvo una concordancia estadísticamente significativa en la mayoría de los casos. Conclusión: Hay concordancia estadísticamente significativa entre los datos obtenidos con los RDC/TMD y los DC/TMD, en el diagnóstico de trastornos articulares inflamatorios.

ABSTRACT: Aim: To assess the agreement between the prevalence of inflammatory joint disorders (IJD) obtained with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Materials and methods: 59 Chilean adult patients were examined according to Axis I of the RDC/TMD and Axis I of the DC/TMD to determine prevalence of IJD. Then, the results obtained from each protocol were compared with Cohen's Kappa test to assess the agreement between them. Results: The prevalence of IJD for both criteria was 22%, with almost perfect agreement (kappa = 0.91). When comparing the prevalences of IJD per joint, a substantial agreement (kappa = 0.77) was obtained for the right TMJ and an almost perfect agreement (kappa = 0.94) for the left TMJ. When comparing the prevalences of IJD according to gender and age, a statistically significant agreement was obtained in the majority of cases. Conclusion: There is statistically significant agreement between the data obtained with the RDC/TMD and the DC/TMD, in the diagnosis of inflammatory joint disorders.

Inhibition of ATM Promotes Neuronal Apoptosis through Upregulating Bim Expression / 中山大学学报(医学科学版)

@#【Abstract】 【Objective】To investigate the mechanisms implicated in ataxia telangiectasia mutated(ATM)inhibitioncaused apoptosis in the cultured cerebellar granule neurons.【Methods】Primary cerebellar granule neurons(CGN)isolated from neonatal Sprague Dawley rats of 7-8 days were divided into the following groups:25 K group(survival group),5 K group(apoptosis group)and 25 K + KU-55933 treatment group(ATM inhibition group),25 K + KU-55933 + Mithramycin A treatment group(MMA group),25 K + KU-55933 + Chromonycin A3 treatment group(CMA3 group). The protein expression of p-ATM,ATM,Bim and Caspase 3 were detected by Western Blot. The apoptotic cells with nuclear pyknosis were detected by Hoechst-staining.【Results】Compared with 25 K group,the result of western blot showed that the protein expression of Bim and Caspase 3 were increased in the ATM inhibition group(P < 0.05). Compared with 25 K group,the nuclear pyknosis rate of 5 K group and ATM inhibition group were significantly increased(P < 0.05). Inhibition of Bim by Mithramycin A or Chromomycin A3 remarkably reversed ATM inhibition-caused apoptosis.【Conclusion】Inhibition of ATM induce Bim dependent apoptosis in cultured cerebellar granule neurons.