Characterization of Salivary Gland Pain: A Review of the Literature / Caracterización del Dolor de Glándulas Salivales: Revisión de la Literatura

SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.

Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.

Mecanismos de modulación central del dolor: revisión de la literatura / Mechanisms of central pain modulation: literature review

RESUMEN: La percepción del dolor resulta de múltiples y dinámicos mecanismos en el sistema nervioso central (SNC) y periférico que inhiben o facilitan el estímulo y respuesta nociceptiva. Sin embargo, la principal capacidad de modulación esta a cargo del SNC. Los estímulos nociceptivos son detectados por terminaciones nerviosas libres de neuronas periféricas que sinaptan con neuronas aferentes secundarias de la médula espinal. Luego estas fibras decusan para formar las vías nociceptivas ascendentes. Una vez alcanzadas las estructuras subcorticales, se activan las neuronas del tálamo, quienes envían el estímulo hacia la corteza somatosensorial, desencadenando la percepción consciente del dolor y activando el sistema inhibitorio descendente. Para que la modulación nociceptiva se realice, es necesaria la participación de diversas sustancias o neurotransmisores que conectan áreas del SNC especializadas. Por lo tanto, el objetivo de este estudio fue realizar una revisión de la literatura respecto de los mecanismos que participan en los procesos de modulación central del dolor.

SUMMARY: Pain perception results from multiple and dynamic mechanisms in the central nervous system (CNS) and peripheral nervous system that inhibit or facilitate stimulation and nociceptive response. However, neuromodulation is mainly a function of the CNS. Nociceptive stimulus is detected by peripheral neurons receptors that synapse with the secondary afferent neurons of the spinal cord. These fibers cross to conform the ascending nociceptive pathways. Once the subcortical structures are reached, the thalamus`s neurons are activated; the thalamus send the stimulus to the somatosensory cortex, triggering the conscious perception of pain and activating the descending inhibitory system. For the nociceptive modulation to be carried out, the participation of various substances or neurotransmitters that connect specialized CNS areas is necessary. Therefore, the aim of this study was to review the literature regarding the mechanisms involved in central pain modulation processes.

Effect of music at 432 Hz and 440 Hz on dental anxiety and salivary cortisol levels in patients undergoing tooth extraction: a randomized clinical trial

Abstract Objective The aim of this study was to compare the effects of music at 432 Hz, 440 Hz, and no music on the clinical perception of anxiety and salivary cortisol levels in patients undergoing tooth extraction. Methodology A parallel-group randomized clinical trial was conducted. Forty-two patients (average age: 23.8±7.8 years, 27 women) with a moderate level of anxiety were distributed in three groups: use of music for 15 minutes at a frequency of 432 Hz (n=15), at 440 Hz (n=15) and a control group without music (n=12). The CORAH Dental Anxiety Scale and salivary cortisol levels, estimated by the solid phase enzyme-linked immunosorbent assay (ELISA), were measured and compared before and after the music intervention between groups (two-way ANOVA-Tukey p<0.05, RStudio). Results Significantly lower anxiety level values were observed at 432 Hz (8.7±2.67) and 440 Hz (8.4±2.84) compared to the control group (17.2±4.60; p<0.05). The salivary cortisol level at 432 Hz (0.49±0.37 μg/dL) was significantly lower than 440 Hz (1.35±0.69 μg/dL) and the control group (1.59±0.7 μg/dL; p<0.05). Conclusion The use of music significantly decreased clinical anxiety levels, and the frequency of 432 Hz was effective in decreasing salivary cortisol levels before tooth extraction.

Relación entre indicadores antropométricos regionales de masa muscular y potencia de extremidades inferiores en deportistas juveniles de proyección

El propósito del estudio fue determinar el nivel de relación entre indicadores antropométricos segmentarios de muscularidad con los niveles de potencia expresados en la fuerza explosiva y elástico-explosiva. Para ello se evaluó a 31 deportistas varones (edad = 15,5 ± 1,7 años; peso = 61,4 ± 11,5 kg) de diversas disciplinas del Programa de Proyección Deportiva Nacional de la Región de Aysén, Chile, a través de los protocolos de la ISAK para las evaluaciones antropométricas y test de Bosco para la valoración de potencia de salto, tras lo cual se observó una alta intensidad de asociación entre potencia absoluta de los saltos SJ y CMJ, y todos los parámetros antropométricos de muslo (r >0,8). Con ello se logró establecer un modelo predictivo del rendimiento en salto mediante 3 mediciones antropométricas.

Abstract The purpose of this study was determined the level of relation between anthropometric segmental indicators of muscularity with the power levels expressed in the explosive and elastic strength, to carry it out 31 male athletes were (Age = 15.5 ±1.7 years; Weight = 61.4 ±11.5 kg) of diverse disciplines from the Program of National Sportive Projection of the Region of Aysén-Chile, were evaluated. The protocols of the ISAK for the anthropometric evaluations and Test of Bosco for the assessment of power of jump were followed. Results: An association between absolute power of the jumps SJ and CMJ and all the anthropometric variables of thigh (r > 0,8) it was able to establish a predictive model of the performance in jump by means of 3 anthropometric measurements has been established.

Resumo O objetivo deste trabalho foi determinar o nível de relação entre indicadores antropométricos segmentários de muscularidade com os níveis de potência expressados na força explosiva e elástico explosiva. Para tal, avaliaram-se a 31 esportistas varões (idade = 15,5 ± 1,7 anos; peso = 61,4 ±11,5 kg) de diversas disciplinas do Programa de Projeção Esportiva Nacional da Região de Aysén, Chile. Seguiram-se os protocolos da ISAK para as avaliações antropométricas e teste de Bosco para a valoração de potência de salto. Observa-se uma alta intensidade de associação entre potência absoluta dos saltos SJ e CMJ e todas as variáveis antropométricas da coxa (r > 0,8). Estabeleceu-se um modelo preditivo do rendimento em salto mediante três medidas antropométricas.

Luchas urbanas en barrios populares de la ciudad de Quito: territorialidad e historicidad desde las voces de sus protagonistas / Urban struggles in popular neighborhoods of the city of Quito: territoriality and historicity from the voices of its protagonists / Lutas urbanas em bairros populares da cidade de Quito: territorialidade e historicidade desde as falas dos seus protagonistas

Resumen: En la literatura psicosocial desarrollada en América Latina se ha venido configurando un debate reflexivo hacia dentro y hacia fuera, en torno a las tensiones conceptuales, sentidos y formas institucionalizadas de las praxis comunitarias, que han sido fundamentadas por la Psicología Social Comunitaria (PSC) a la luz de los problemas sociales contemporáneos. El presente estudio, situado en este marco, se propuso comprender las luchas populares por-el-lugar, a partir de los factores psicosociales que median la construcción de territorialidad e historicidad, en la producción social del hábitat popular en la periferia urbana de Quito. Para esto, se aplicaron 33 entrevistas cualitativas a mujeres y hombres dirigentes sociales de 30 barrios populares. A través de esta aproximación exploratoria al proceso de lucha popular, logramos identificar ciertas limitaciones conceptuales de la categoría de "comunidad" ampliamente utilizada en PSC. A su vez, reflexionamos sobre la potencial ampliación de los marcos comprensivos de las categorías: historicidad y territorialidad. Concluimos que hay un déficit teórico importante en la disciplina, la que se construye principalmente a partir de categorías descriptivas tendientes a la homogenización de los fenómenos. Esta cuestión supone el desafío de revitalizar el corpus de conocimientos existentes en la región, y capturar la diversidad y complejidad de formas de apropiación social y territorial a escala barrial.

Abstract: In the psychosocial literature developed in Latin America, a reflexive debate has been taking place both inward and outward, around the conceptual tensions, meanings and institutionalized forms of community praxis, which have been supported by Community Social Psychology (PSC) at the light of contemporary social problems. The present study, based on this framework, sought to understand the popular struggles for-the-place, based on the psychosocial factors that mediate the construction of territoriality and historicity, in the social production of the popular habitat in the urban periphery of Quito. For this, 33 qualitative interviews were applied to social leaders, women and men of 30 popular neighborhoods. Through this exploratory approach to the process of popular struggle, we managed to identify certain conceptual limitations of the category of "community" widely used in PSC. At the same time, we reflect on the potential extension of the comprehensive frameworks of the categories: historicity and territoriality. We conclude that there is an important theoretical deficit in the discipline, which is constructed mainly from descriptive categories tending to the homogenization of the phenomena. This supposes the challenge of revitalizing the corpus of existing knowledge in the region, and capturing the diversity and complexity of forms of social and territorial appropriation on a neighborhood scale.

Resumo: Na literatura psicossocial desenvolvida na América Latina tem vindo configurando um debate reflexivo para dentro e para fora, ao redor à tensões conceituais, sentidos e formas institucionalizadas das práxis comunitárias que tinham sido fundamentadas pela Psicologia Social Comunitária (PSC), à luz dos problemas sociais contemporâneos. A seguinte pesquisa, situada neste contexto, se propus compreender as lutas populares pelo-lugar, a partir dos fatores psicossociais me mediam a construção de territorialidade e historicidade, na produção social do habitat popular na periferia urbana de Quito. Para isto, se aplicaram 33 entrevistas qualitativas a mulheres e homens lideranças sociais de 30 bairros populares. Através de essa aproximação exploratória do processo de luta popular, lograrmos identificar certos limites conceituais da categoria "comunidade" amplamente utilizada em PSC. Mesmo assim, refletirmos sobre a potencial ampliação dos marcos compreensivos das categorias: historicidade e territorialidade. Concluirmos que há um déficit teórico importante na disciplina, a qual se constrói principalmente a partir de categorias descritivas tendentes à homogeneização dos fenômenos. Essa questão supõe o desafio de revitalizar os corpus de conhecimentos existentes na região, e captar a diversidade e complexidade de formas de apropriação social e territorial na escala do bairro.