Interpretación psiquiátrica forense de la fórmula de inimputabilidad del nuevo Código Penal cubano de 2022 / Psychiatric forensic interpretation of non-imputability formula in the new 2022 Cuban Penal Code

Resumen: En 2022 el Código Penal cubano incorporó una nueva fórmula de inimputabilidad. Este artículo aborda el problema de cómo interpretarla y aplicarla durante las pericias psiquiátricas a imputados. Es su objetivo analizar desde la Psiquiatría dicha fórmula penal para su interpretación forense. Se muestran las críticas que, en publicaciones y ámbitos académicos, fueron hechas a la anterior fórmula; así como la norma complementaria del organismo rector para su interpretación pericial. Se expone y analiza la actual fórmula, elaborada con asesoría de psiquiatras al proceso legislativo, para superar aquellas críticas, pero que, precisamente por diferente, demanda actualizar su interpretación y los métodos periciales para calificar casos acertadamente, detectar simulación y ser controlable como prueba por los jueces. Un criterio de interpretación fue elaborado por el autor y se le sometió a grupos de expertos para consensuar una propuesta final normativa, consistente en considerar pericialmente pretenso inimputable a quién actuó ilícitamente por un trastorno psicótico diagnosticado que se manifestó directamente en el delito, lo que debe quedar demostrado en el informe. En su generalidad, estos criterios pueden aplicarse a valoración de inimputabilidad según otros códigos penales.

Introduction: In 2022 a new Cuban Penal Code incorporated a new requirement of non-imputability. This article approaches to the problem of how to interpret and apply this new non-imputability formula to the psychiatric examination of defendants and has the objective of analyzing it in forensic interpretation. It shows the academic and publisher's criticism made of the previous Cuban non-imputability formula and the complementary precept of the health ministry for forensic interpretation. The new non-imputability formula, elaborated with psychiatrists' assistance during a legislative process to surpass those previous criticisms, is exposed and analyzed. This new different penal requirement put under obligation to change in forensic interpretations and methods to identify criminal non-imputability, pretenders and to be a clue controlled by judges. A new forensic interpretation criterion was elaborated and submitted to groups of psychiatrist experts, to obtain a normative proposition that considered in possible non-imputability of the person who committed the crime during a diagnosed psychotic disorder that was the certain direct determinant of the fact. The psychiatric report may show all mentioned below and, in general view, according to other penal codes, these criteria can be applied in the forensic expertise relative to non-imputability.

Do racional desregramento de todos os sentidos de Rimbaud ao sentimento de racionalidade em James / From Rimbaud's rational derangement of all the senses to James' sentiment of rationality / Du raisonné dérèglement de tous les sens chez Rimbaud au sentiment de rationalité chez James / Del razonado desarreglo de todos los sentidos de Rimbaud al sentimiento de racionalidad en James

Resumo Este ensaio traz o método do racional desregramento de todos os sentidos, do poeta Arthur Rimbaud, como ponto de partida para uma reflexão sobre a relação entre razão e afeto e para um possível diálogo com a noção de sentimento de racionalidade, do psicólogo e filósofo William James, sob a perspectiva teórico-metodológica do construtivismo semiótico-cultural em psicologia. Aborda-se o experimento de inalação do óxido nitroso de James como uma experiência de desregramento dos sentidos que proporcionou a ele uma compreensão sobre a questão da unidade e da variedade, ajudando a enriquecer sua cosmovisão empirista e pluralista, em oposição ao racionalismo monista de Hegel.

Abstract This essay uses Rimbaud's rational derangement of all the senses as a starting point for its reflection on the relationship between reason and affection, and for possible dialogues with psychologist and philosopher William James' sentiment of rationality, from the perspective of semiotic-cultural constructivism in psychology. James' experiment of nitrous oxide inhalation is seen as an experience of derangement of the senses that gave him insight on the question of unity and variety, thus enriching his empiricist and pluralist worldview opposed to Hegel' s monistic rationalism.

Résumé Cet essai utilise le raisonné dérèglement de tous les sens de Arthur Rimbaud comme point de départ de sa réflexion sur la relation entre raison et l'affection, et des dialogues possibles avec le sentiment de rationalité du psychologue et philosophe William James, dans la perspective du constructivisme sémiotique-culturel en psychologie. L'expérience d'inhalation d'oxide nitreux de James est considérée comme une expérience du dérèglement des sens qui lui a donné un aperçu de la question de l'unité et de la variété, enrichissant ainsi sa vision empiriste et pluraliste du monde, opposée au rationalisme moniste de Hegel.

Resumen Este ensayo toma el método del racional desarreglo de todos los sentidos del poeta Arthur Rimbaud como punto de partida para una reflexión sobre la relación entre la razón y el afecto, y un posible diálogo con la noción del sentimiento de la racionalidad del psicólogo y filósofo William James, bajo la perspectiva teórico-metodológica del constructivismo semiótico-cultural en psicología. El experimento de la inhalación de óxido nitroso de James se aborda como una experiencia de desarreglo de los sentidos que le proporcionó una comprensión de la unidad y la variedad, contribuyendo a enriquecer su cosmovisión empirista y pluralista en oposición al racionalismo monista de Hegel.

Criminología, proceso de determinación de salud y control penal del enfermo mental inimputable / Criminology, health determination process and criminal control of the mentally ill person not subject to criminal liability

Resumen La Psiquiatría Forense tienen dentro de sus retos la disposición de evaluar a aquellas personas que de manera pre o post delictiva presenten signos o síntomas que puedan ser susceptibles de una enfermedad psiquiátrica que puede transitar desde un debut o una persona con antecedentes de ser portador de una patología crónica en fase aguda, en este ámbito lo más importante es precisar si en el momento de la comisión del delito el autor tiene o no las capacidades de discernimiento y puede dirigir su conducta entre otras, luego la administración de justicia tiene la obligación de dictar sentencia dependiendo de los resultados del peritaje psiquiátrico. En este trabajo se realiza un análisis desde diferentes ángulos del problema centrados en las personas que son inimputables de responsabilidad penal, y de la visión de diferentes legisladores y criterios de especialistas incluyendo de manera general el beneficio social, médico terapéutico del enfermo mental que se convierte en una diana luego de ser interés jurídico penal.

Abstract The Forensic Psychiatry has within its challenges the provision to evaluate those people who, pre or post crime, present signs or symptoms that may be susceptible to a psychiatric disease that can transit from a debut or a person with a history of being a carrier of a chronic pathology in acute phase, in this area the most important thing is to specify whether or not at the time of the commission of the crime the author has the ability to discern and can direct their behavior among others, then the administration of justice has the obligation to pass sentence depending on the results of the psychiatric expertise. In this work we make an analysis from different angles of the problem centered in the people who are unimputable of criminal responsibility, and of the vision of different legislators and criteria of specialists including in a general way the social, therapeutic medical benefit of the mental patient that becomes a target after being a criminal legal interest.

Effect of using Photobiomodulation, stabilization, and anterior repositioning splints on the pain level of subjects with temporomandibular joint disc displacement with reduction / Efeito do uso da terapia a laser de baixa potência, placas planas e placas reposicionadoras anterior, no nível de dor de indivíduos com deslocamento anterior do disco articular com redução

Objective: was to evaluate the effect of four conservative treatment modalities on the pain level of patients with temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Material and methods:100 subjects (64 females and 36 males) were selected, divided into four groups, 25 patients of each. Subjects of Group I have been treated with behavioral therapy. Subjects of Group II had been treated with Photobiomodulation therapy (PBMT). Subjects of Group III had been treated by anterior repositioning splint (ARS). Subjects of Group IV had been treated by a stabilization splint. The pain was evaluated by visual analog score (VAS) from 0 to 10. Statistical analysis was done using one-way ANOVA test for comparison between groups. Within each group, a comparison between baseline and after treatment was done using paired t-test (p<0.05). Results: There was a statistical difference between the pain scores of the different groups after treatment (p≤0.05). Also, there were statistical differences between all groups (p≤0.05) except that between group II and group III (p˃0.05). Conclusion: The use of stabilization splint and ARS are effective non-invasive methods for reducing the pain level in the treatment of TMJ ADDwR cases.(AU)

Objetivo: avaliar o efeito de quatro modalidades de tratamento conservador no nível de dor de pacientes com deslocamento anterior do disco articular com redução. Material e Métodos: foram selecionados 100 indivíduos(64 mulheres e 36 homens), divididos em quatro grupos, 25 pacientes cada. Os indivíduos do Grupo I foram tratados com terapia comportamental. Os indivíduos do Grupo II foram tratados com terapia de fotobiomodulação. Os indivíduos do Grupo III foram tratados com placa de reposicionamento anterior. Os indivíduos do Grupo IV foram tratados com uma placa de estabilização. A dor foi avaliada pelo escala visual analógica (EVA) de 0 a 10. A análise estatística foi feita usando o teste ANOVA de uma via para comparação entre os grupos. Dentro de cada grupo, uma comparação entre a linha de base e após o tratamento foi feita usando o teste t pareado (p <0,05). Resultados: Houve diferença estatística entre os escores de dor dos diferentes grupos após o tratamento (p ≤ 0,05). Além disso, houve diferenças estatísticas entre todos os grupos (p ≤0,05), exceto entre o grupo II e o grupo III (p˃0,05). Conclusão: O uso de placa de estabilização e reposicionadora anterior são métodos não invasivos eficazes para reduzir o nível de dor no tratamento de casos de deslocamento anterior de disco articular sem redução.(AU)

Management of internal derangement of temporomandibular joint disc displacement with reduction using two different lines of treatment / Manejo do desarranjo interno do deslocamento de disco temporomandibular com redução utilizando dois tipos diferentes de tratamento

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)

Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)

Prevalence of metabolic syndrome in euthyroid patients in Perambalur District

Background: Euthyroid diseases are frequently observed in clinical practice. They comprise both functional abnormalities such as overproduction and underproduction of thyroid hormone as a consequence of intrinsic thyroid diseases, as well as the development of structural abnormalities like goiter, adenoma or carcinoma. In community surveys, prevalence rates of elevated TSH levels – indicating impaired thyroid hormone secretion – range from 4–10% while prevalence rates of decreased TSH levels – indicating thyroid hormone overproduction – range from 0.7–1.5 %. Aim of this study: To assess the thyroid function, in euthyroid subjects, is associated with components of the metabolic syndrome parameters. Materials and methods: The study was conducted in the Department of Biochemistry at Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur District, Trichy. Total of 100 cases was included in the study homeostasis model assessment for insulin resistance (HOMA- IR) metabolic syndrome was defined according to the national cholesterol education program’s adult treatment panel III criteria. Results: The T4 (FT4) was significantly associated with total cholesterol (standardized beta (β) = - 0.059; P = 0.014), low-density lipoprotein cholesterol (β = -0.068; P = 0.004), high-density lipoprotein cholesterol (β = 0.100; P < 0.001), and triglycerides (β = -0.102; P < 0.001). Both FT4 and TSH were significantly associated with HOMA-IR (β = -0.133; P <0.001 and β = 0.055; P = 0.024, respectively). Median HOMA-IR increased from 1.42 in the highest tertile of FT4 to 1.66 in the lowest tertile of FT4. FT4 was significantly related to four of five components of the metabolic syndrome (abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and blood pressure), independent of insulin resistance.

Clinical factors affecting the outcome of arthocentesis

OBJECTIVES: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. MATERIALS AND METHODS: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (≤25 years, >25 and ≤40 years, >40 and ≤60 years), VAS pain level (≤5, >5 and ≤7, >7 and ≤10), and ROM ( 7 (OR, 11.25; P=0.039), and a maximum vertical opening of < 25 mm (OR, 7.70; P=0.038). CONCLUSION: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify “at-benefit” patients early and initiate specific treatment.

Effects and mechanism of the long-snake moxibustion on ankylosing spondylitis based on Th17/Treg/Th1 immune imbalance / 中国针灸

OBJECTIVE@#To explore the effects and mechanisms of the long-snake moxibustion on ankylosing spondylitis (AS) based on Th17/Treg/Th1 immune imbalance.@*METHODS@#A total of 60 AS patients were randomized into an observation group and a control group, 30 cases in each one. In the observation group, the long-snake moxibustion therapy was used on the acupoints of the governor vessel from Dazhui (GV 14) to Yaoshu (GV 2) as well as the bilateral Jiaji (EX-B 2) alternatively. The moxibustion was given once a day, for 7 days continuously as one course. There were 3 days at the interval between the courses and 4 courses were required. In the control group, the routine western medication was provided, the salazosulfapyridine combined with non-steroidal anti-inflammatory drugs were used, for 7 days continuous as one course. A total of 4 courses of medication were required. The enzyme linked immunosorbent assay (ELISA) was adopted to determine the levels of interleukin-6 (IL-6), interleukin-17 (IL-17), interleukin-23 (IL-23) and tumor necrosis factor-α (TNF-α). The real-time quantification polymerase chain reaction (RT-PCR) was used to determine the mRNA expressions of the specific transcription factors, FoxP3 and T-bet of the helper 17 cells (Th17), regulatory T cells (Treg) and T helper 1 cells (Th1). The flow cytometry was applied to determine the rates of Treg, Th1 and Th17, as well as the changes of the inflammatory reaction index, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The therapeutic effects were compared between the two groups.@*RESULTS@#After treatment, the total effective rate was 93.3% (28/30) in the observation group, which was better than 86.7% (26/30) in the control group (0.05).@*CONCLUSION@#The long-snake moxibustion effectively relieves the clinical symptoms in AS patients and regulates the Th17/Treg/Th1 immune imbalance. Its effect target is probably related to the modulation of the AS immune derangement and the inflammatory responses induced by immune derangement so as to achieve the dual-positive regulatory effect.

Treatment of 60 patients with temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of manipulative reduction of cervical vertebrae combined with Pi needle release for the treatment of temporomandibular joint dysfunction.</p><p><b>METHODS</b>From March 2012 to May 2017, 60 patients with temporomandibular joint dysfunction were treated by manipulative reduction of cervical vertebrae with Pi needle release, including 26 males and 34 females, ranging in age from 18 to 60 years old, with an average of 32.5 years old. The courses of the disease ranged from 1 week to 5 years, with a mean duration of 3 months. The patients were followed up before and after treatment by maximum active opening of temporomandibular joint, joint clicking and comparison of visual analogue scale (VAS) pain scores.</p><p><b>RESULTS</b>All 60 patients were followed up, and the duration ranged from 6 to 24 months, with an average of 12 months. The maximum active opening of temporomandibular joint increased from(1.99±0.47) cm before treatment to(3.17±0.19) cm. The joint clicking decreased from 100% before treatment to(27.33±13.51)% after treatment. The VAS score decreased from 4.73±0.67 before treatment to 1.80±0.53 after treatment.</p><p><b>CONCLUSIONS</b>Treatment of temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release has such advantages as easy operation, obvious curative effect, short course of treatment, which is an effective method for the treatment of temporomandibular joint dysfunction.</p>

Relationship between the mandibular hypoplasia and temporomandibular joint internal derangement in adolescents with skeletal class Ⅱ malocclusion / 中华口腔医学杂志

Mandibular hypoplasia is very common clinically. Studies have reported that temporomandibular joint internal derangement (TMJID) might manifest as mandibular retrusion, and whether there is a direct correlation between them remains controversial in academia. On the other hand, for adolescent patients with skeletal class Ⅱ malocclusion, the growth of mandible could be motivated by orthopedic force, and then the mandibular retrusion corrected. However, if TMJID is the direct cause of mandibular retrusion, orthopedic treatment will not have a significant effect on it. Base on literature review and analysis as well as our own research, this article will review the distribution of structural abnormalities of the temporomandibular joint in adolescents with mandibular hypoplasia and its association with skeletal class Ⅱ malocclusion, as well as the effect of TMJID on the treatment of skeletal class Ⅱ malocclusion in adolescents.

Correlation between gender, temporomandibular joint disc position and clinical findings in patients with temporomandibular disorder / Correlação entre sexo, posição do disco da articulação temporomandibular e os resultados clínicos em pacientes com disfunção temporomandibular

OBJECTIVE: The objective of this study was to assess gender differences in temporomandibular joint disc position using magnetic resonance imaging and to check for symptoms in patients with temporomandibular disorders. MATERIALS AND METHODS: Eighty-seven consecutive patients (70 females and 17 males) were evaluated. Bilateral magnetic resonance imaging was performed to determine the temporomandibular joint disc positions; these were divided into four diagnostic categories: no disc displacement, right disc displacement, left disc displacement and bilateral disc displacement. The clinical data assessed were pain on muscle and temporomandibular joint palpation. The data were analyzed using the Fisher's exact test, chi-square test or analysis of variance. Significance was set at p ≤ .05. RESULTS: The study population had more females (80.5%) than males (19.5%) and the mean age of females (31 ± 11 years) was lower than the mean age of males (41± 12 years). Bilateral disc displacement was significantly most frequent in females. Clinical examination showed more pain on muscle palpation for female than for male patients. CONCLUSION: Women had a higher frequency of temporomandibular joint disc displacement, as well as a larger number of painful points on muscle palpation than men.

RESUMO OBJETIVO: O objetivo deste estudo foi avaliar as diferenças de gênero na posição do disco da articulação temporomandibular usando ressonância magnética para verificar se há sintomas em pacientes com disfunção temporomandibular. MATERIAIS E MÉTODOS: Foram avaliados oitenta e sete pacientes consecutivos (70 mulheres e 17 homens); foi realizada ressonância magnética bilateral para determinar as posições do disco da articulação temporomandibular; estes foram divididos em quatro categorias diagnósticas: nenhum deslocamento de disco, deslocamento de disco a direita, deslocamento de disco a esquerda e deslocamento de disco bilateral. Os dados clínicos avaliados foram: dor a palpação no músculo e na articulação temporomandibular. Os dados foram analisados utilizando o teste exato de Fisher, teste do qui-quadrado ou análise de variância. Significância foi de p ≤ 0,05. RESULTADOS: A população do estudo tinha mais mulheres (80,5%) que homens (19,5%). O deslocamento blateral de disco foi significativamente mais frequente no sexo feminino. O exame clínico mostrou mais dor à palpação muscular para mulheres do que para homens. CONCLUSÃO: As mulheres apresentaram uma maior frequência de deslocamento de disco da articulação temporomandibular, bem como um maior número de pontos dolorosos à palpação muscular do que os homens.

Establishing better biological models to understand occlusion.I:TM joint anatomic relationships / 实用口腔医学杂志

Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ)condyle-fossa position with normal and abnormal function are still contentious issues.Clinical opinions can be strong,but support in most published data (mostly univariate)is problematic.Distribution overlap,low sensitivity and specificity are a common basis to reject any useful prediction value.Notwithstanding,a relationship of form with function is a basic tenet of biology.These are multifactor problems,but the questions mostly have not been analysed as such.This review moves the question forward by focusing on TMjoint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint.Multifactor analysis allows the data to speak for itself and reduces bias.Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated,backed up by stepwise logistic regression.Explained vari-ance,R2 ,predicting normals from pooled TMJ patients was 32.6%,sensitivity 67.9%,specificity 85.7%;37% versus disc displacement with reduction;and 28.8% versus disc displacement without reduction.Significant osseous organisational differences between TMjoints with clicking and locking suggest that this is not necessarily a single disease continuum.However,a subset of joints with clicking contained char-acteristics of joints with locking that might contribute to symptom progression versus resistance.Moderately strong models confirm there is a relationship between TMJ osseous organisation and function,but it should not be overstated.More than one model of normals and of TMde-rangement organisation is revealed.The implications to clinical decision-making are discussed.

Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint / 대한치과교정학회지

This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ.

Autismo e família: revisão bibliográfica em bases de dados nacionais / Family and autism: literature review in national databases

Os primeiros estudos envolvendo o autismo infantil atribuíam à família participação no comprometimento do desenvolvimento psicoafetivo da criança. A proposta deste estudo foi revisar a literatura relacionada ao autismo e família em duas bases de dados nacionais (Banco de Teses e Dissertações da Capes e Scientific Electronic Library Online), sem delimitação de período específico, bem como identificar as principais temáticas focadas. Foram localizados 29 estudos no Banco de Teses e Dissertações da Capes, sendo o primeiro registro em 1990 e 12 na Scientific Electronic Library Online, sendo a primeira publicação de 2001. Os resultados foram agrupados em sete categorias. As categorias "Qualidade de vida" e "Relações familiares" concentram a maioria das publicações no Banco de Teses e Dissertações da Capes. Já na Scientific Electronic Library, a maioria refere-se as "Relações familiares" e "Revisão bibliográfica". Identificou-se que nenhuma das teses ou dissertações foi publicada em formato de artigo científico, prejudicando a divulgação das pesquisas na área...

Early studies involving childhood autism attributed to family involvement in impairment of psycho-emotional development of the child. The purpose of this study was to review the literature related to autism and family in two national databases (Theses Database of Capes and Scientific Electronic Library Online) without defining a specific period as well as identify the main thematic focused. Were located 29 studies in Theses Database of Capes, the first record in 1990 and 12 in Scientific Electronic Library Online, the first publication in 2001. The results were grouped into seven categories. The categories "Quality of Life" and "Family Relations" concentrate most of publications on Theses Database. Already in Scientific Electronic Library Online, mostly refers to the "Family Relations" and "literature review". It was found that none of theses or dissertations was published in scientific paper format, hampering the dissemination of research in the area...

Low Intensity Laser Therapy in Disc Derangement Disorders of Temporomandibular Joint: A Review Article / Terapia con Láser de Baja Intensidad en Trastornos de Alteración Discal de la Articulación Temporomandibular: Un Artículo de Revisión

Temporomandibular disorders embrace a number of clinical conditions that involves the masticatory musculature, temporomandibular joint (TMJ) and associated structures. The most frequent cause of TMJ disorders are disc derangement disorders which involve progressive slipping or displacement of articular disc. Various conservative treatment strategies for disc derangement disorders includes pharmacologic therapy, psychological counselling, treatment of parafunctional habits, use of occlusal splints and acupuncture which gives short term relief only. Recently, a non traumatic introduction to dentistry can be represented by low level laser therapy or soft laser therapy. It has proved to be an effective treatment modality in management of disc derangement disorders through its analgesic and anti- inflammatory effect. Therefore, the goal of this review article is to explore the use of low level laser therapy as an emerging trend in the management of disc derangement disorders of TMJ.

Los trastornos temporomandibulares abarcan una serie de condiciones clínicas que involucran la musculatura masticatoria, la articulación temporomandibular (ATM) y estructuras asociadas. La causa más frecuente de trastornos de la ATM es la alteración discal que implica el deslizamiento o desplazamiento progresivo del disco articular. Diversas estrategias de tratamiento conservador para los trastornos de alteración discal incluyen el tratamiento farmacológico, la terapia psicológica, el tratamiento de los hábitos parafuncionales, uso de férulas oclusales y acupuntura, que solamente dan un alivio a corto plazo. Recientemente, una introducción no traumática para la odontología puede ser representada por la terapia con láser de baja frecuencia o terapia de láser blando. Esta ha demostrado ser una modalidad de tratamiento eficaz en el manejo de los trastornos de alteración discal a través de su efecto analgésico y antiinflamatorio. El objetivo de este artículo es explorar el uso de la terapia con láser de baja frecuencia como una tendencia emergente en el tratamiento de los trastornos de alteración del disco de la ATM.

Evaluation of articular eminence morphology and inclination in TMJ internal derangement patients with MRI / Evaluación de la morfología e inclinación de la eminencia articular en pacientes con trastorno interno de ATM con MRI

Articular eminence morphology and inclination are reported to be two predisposing factors for the internal derangement (ID). The purpose of this study is to investigate the relationship between the inclination and morphology of the articular eminence and ID. The study included 70 temporomandibular joints with ID in 35 patients: 51 joints had disc displacements with reduction (DDWR) and 19 joints had disc displacements without reduction (DDWOR). All subjects underwent bilateral high resolution magnetic resonance imaging scans which were performed in the sagittal and coronal planes with mouths closed and opened. Articular eminence morphology was characterized as box, sigmoid, flattened, or deformed. Articular eminence inclination was measured at three positions: steep (from 60° to 90°), moderate (from 30° to 60°) and shallow (from 15° to 30°). The images were divided into two; DDWR and DDWOR, and these two criteria were compared. The images of the two groups were compared; while flattened form was occurred with the highest incidence in the DDWOR group, sigmoid form was the most frequent in the DDWR group and articular eminence inclination was found steeper than it was for the DDWOR group. The steepness of the articular eminence may not have a predisposing effect on the development of disc displacements.

La morfología e inclinación de la eminencia articular son reportados como dos factores predisponentes para el trastorno interno (TI). El propósito de este estudio fue investigar la relación entre la inclinación y la morfología de la eminencia articular y el TI. El estudio incluyó a 70 articulaciones temporomandibulares, con TI en 35 pacientes: 51 articulaciones con desplazamiento discal con reducción (DDCR) y 19 de las articulaciones tuvieron desplazamiento discal sin reducción (DDSR). Todos los sujetos fueron sometidos a imágenes de resonancia magnética bilaterales de alta resolución que se realizaron en los planos sagital y coronal con la boca cerrada y abierta. La morfología articular la eminencia se caracterizó como una caja, sigmoide, aplanada, o deforme. La inclinación de la eminencia articular se midió en tres posiciones: empinada (de 60 ° a 90 °), moderada (entre 30 ° a 60 °) y poco profunda (entre 15 ° y 30 °). Las imágenes fueron divididos en dos; DDCR y DDSOR, y estos criterios fueron comparados. Al comparar las imágenes de ambos grupos, la forma aplanada se observó con mayor incidencia en el grupo de DDSR, la forma sigmoide fue la más frecuente en el grupo de DDCR y la inclinación de la eminencia articular se encontró más pronunciada que en el grupo DDSR. La inclinación de la eminencia articular puede no tener un efecto predisponente en el desarrollo de los desplazamientos de disco.

Progress of immune status in systemic lupus erythematosus / 国际儿科学杂志

Systemic lupus erythematosus is an autoimmune-mediated inflammatory diseases in which immunologic derangement throughout this process.There are a varriety of abnormal immunoregulation,including the disturbance of Help T cell 1,Help T cell 2,Th17 cell and regulatory T cell( Treg cell),disfunction of the B cell subsets and deficiency of the immune tolerance,lead to the disturbance of related cytokines.Recently,it was indicated that the abnormal of cross regulation existencd between Help T cell 1 and Th17 cell,and the disfunction of non-antibody-dependent B cells may play an important role in the pathogenesis of SLE,According to different immune status,appropriate and targeted treatment was given in order to improve the prognosis of the patients with systemic lupus erythematosus.

Progress of immunologic derangement in the pathogenesis of primary nephritic syndrome / 国际儿科学杂志

Help T cell 1/Help T cell 2 and some cytokines disequilibrium can give a suitable explanation for hypersensitivity and hypogammaglobulinemia in primary nephritic syndrome(PNS) patients. The disturbance of regulatory T cell(Treg cell) and Th17 cell can lead to correlated cytokines derangement, which explained the pathogenesis of PNS from another aspect. Refractory nephrotic syndrome can be effectively treated by rituximab followed the percentage of regulatory T cell increasing, which indicated that Treg may play an important role in pathogenesis of PNS.

The epidemiologic study of the patients with temporomandibular joint disorders, using Research Diagnostic Criteria for TMD (RDC/TMD): Preliminary Report

PURPOSE: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. SUBJECTS AND METHODS: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade 0~IV), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. RESULTS: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45 % of group 1, 47 % of group 2, 8 % of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57 % (n=23) and group 1 was 35 % , group 3 was 8 %, while group 1 was occupied 75 % in elderly-patients (over 40-year old, n=28) in present study (group 2: 21 % , group 3: 4 %). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal? and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58 %) of subjects were included in grade 0 and low disability (Grade I and II), and 27 % were revealed high disability (grade III, IV).

The epidemiologic study of the patients with temporomandibular joint disorders, using Research Diagnostic Criteria for TMD (RDC/TMD): Preliminary Report

PURPOSE: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. SUBJECTS AND METHODS: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade 0~IV), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. RESULTS: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45 % of group 1, 47 % of group 2, 8 % of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57 % (n=23) and group 1 was 35 % , group 3 was 8 %, while group 1 was occupied 75 % in elderly-patients (over 40-year old, n=28) in present study (group 2: 21 % , group 3: 4 %). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal? and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58 %) of subjects were included in grade 0 and low disability (Grade I and II), and 27 % were revealed high disability (grade III, IV).