Impact of chronic orofacial pain of temporomandibular disorder and anxiety on the academic performance of dental students / Impacto da dor orofacial crônica da disfunção temporomandibular e ansiedade no desempenho acadêmico de estudantes de odontologia

Introduction: The presence of chronic pain and mood disorders can be related to the performance of intellectual and technical tasks. Objective: This study evaluated the correlation between anxiety level, chronic orofacial pain of temporomandibular disorders (TMD), and academic performance in dental students. Methods: One hundred ninety-five students (74 men and 121 women) answered the Spielberger's trait­state anxiety inventory to evaluate the level of anxiety; the Research Diagnostic Criteria for TMD (RDC/TMD) was used to analyze chronic orofacial pain of TMD, and the academic performance was evaluated through the average grade of all college subjects concluded by the students. Correlations between the presence of chronic orofacial pain of TMD, trait, and state anxiety levels, chronic pain grade (CPG), chronic pain intensity (CPI), and academic performance were tested using Pearson's correlation test. Results: The mean age of the students was 21.8 years (SD=2.3). Chronic TMD was observed in 37.5% of the students. The majority of students had moderate trait and state anxiety. A significant correlation was observed between traitanxiety level and CPG (r=0.148, p=0.044), and CPI (r=0.187, p=0.009). No significant correlation was found between academic grade and presence of chronic pain of TMD (r=0.041, p=0.571), trait (r=0.079, p=0.273) and state-anxiety (r=0.107, p=0.136). Conclusion: The CPG and CPI increase in participants with higher trait-anxiety levels, however, no significant correlation was found between academic performance and trait/state anxiety or chronic orofacial pain of TMD.

Abdominal Actinomycosis misdiagnosed as liposarcoma

Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula's tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient's full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.

Stress hormones promote DNA damage in human oral keratinocytes / Hormônios do estresse promovem dano no DNA de queratinócitos humanos de boca

O estresse crônico aumenta os níveis sistêmicos dos hormônios do estresse norepinefrina e cortisol. Assim como o carcinógeno específico do tabaco NNK (4- (metilnitrosamina)-1-(3-piridil)-1-butanona), estes hormônios podem induzir danos expressivos no DNA, o que contribui para o desenvolvimento do câncer. No entanto, é desconhecido se os hormônios do estresse possuem efeitos genotóxicos em queratinócitos de boca. Este estudo investigou os efeitos dos hormônios do estresse sobre o dano no DNA de uma linhagem celular de queratinócitos humanos de boca (NOK-SI). Células NOK-SI estimuladas com norepinefrina ou cortisol apresentaram maior dano no DNA que as células não tratadas. O dano induzido pela norepinefrina foi revertido pelo pré-tratamento das células com um beta-bloqueador. Células tratadas com NNK combinado à norepinefrina apresentaram níveis reduzidos das caspases 3 e 7. O cortisol também reduziu a atividade das enzimas pro-apoptóticas em relação às células não estimuladas. O dano no DNA promovido pelo NNK e cortisol e pela combinação de ambos levou ao acúmulo de γH2AX intracelular. Os efeitos causados pelo NNK e cortisol foram bloqueados com propranolol e com o antagonista do receptor de glicorcorticoide RU486, respectivamente. As quebras no DNA induzidas pela norepinefrina, na presença ou ausência de NNK, resultaram em maiores níveis celulares de 8OHdG. Este efeito também foi induzido via receptores beta-adrenérgicos. Os hormônios do estresse induzem danos no DNA de queratinócitos de boca e poderiam contribuir para a carcinogênese bucal(AU)

Chronic stress increases the systemic levels of stress hormones norepinephrine and cortisol. As well tobacco-specific carcinogen NNK (4-(methylnitrosamine)-1-(3- pyridyl)-1-butanone), they can induce expressive DNA damage contributing to the cancer development. However, it is unknown whether stress hormones have genotoxic effects in oral keratinocytes. This study investigated the effects of stress hormones on DNA damage in a human oral keratinocyte cell line (NOK-SI). NOK-SI cells stimulated with norepinephrine or cortisol showed higher DNA damage than untreated cells. Norepinephrine-induced DNA damage was reversed by pretreatment with beta-adrenergic blocker propranolol. Cells treated with NNK combined to norepinephrine displayed reduced levels of caspases 3 and 7. Cortisol also reduced the activity of pro-apoptotic enzymes. DNA damage promoted by NNK or cortisol and carcinogen combined to the hormone led to intracellular γH2AX accumulation. The effects caused by NNK and cortisol were abolished by propranolol and glucocorticoid receptor antagonist RU486, respectively. DNA breaks induced by norepinephrine in the presence or absence of NNK resulted in higher 8OHdG cellular levels. This effect was also induced through beta-adrenergic receptors. Stress hormones induce DNA damage of oral keratinocytes and could contribute to oral carcinogenesis(AU)

Location of the mandibular foramen according to the amount of dental alveoli / Localización del foramen mandibular según la cantidad de los alvéolos dentales

The aim of this study was to analyze the anatomotopographic location of the mandibular foramen in the right and left ramus, and to verify the influence of the amount of dental alveoli on the foramen position. Thirty-five adult dry human mandibles of Araraquara Dental School, UNESP - São Paulo State University were assessed, with or without dental alveoli. Measurements were obtained, using a ruler and a digital caliper. The following distances were measured: FI - distance between the lowest point of the mandibular incisure and the mandibular foramen (F point); FB - distance between the mandibular base and F point; FP - distance between the posterior margin of the ramus and F point; FA - distance between the anterior margin of the ramus and F point; FT - distance between the apex of the retromolar trigone and F point. The Mann-Whitney test was used to compare each measurement according to hemi-arch, and the Kruskal-Wallis test was used to analyze the influence of the presence of alveoli on the measures. For multiple comparison, Dunn's method was used. There was no statistically significant difference in the location of the mandibular foramen when compared to the right and left hemi-arches. The amount of dental alveoli influenced, significantly, only on FA and FP distances. Thus, it was concluded that the right and left mandibular ramus showed symmetry in the location of the mandibular foramen, and the amount of alveoli influenced on the distances of the anterior and posterior margins of the mandibular ramus, in relation to the mandibular foramen.

El objetivo de este trabajo fue evaluar la posición anátomo-topográfica del foramen mandibular en ambas ramas de la mandíbula y verificar la influencia de la cantidad de alvéolos dentales en la posición del foramen. Se evaluaron 35 mandíbulas humanas secas de individuos adultos de la Facultad de Odontología de Araraquara, Universidade Estadual Paulista - UNESP, con o sin alvéolos dentales. Se utilizó regla y calibrador digital para realizar las mediciones de las distancias entre: el punto más profundo de la incisura de la mandíbula y el foramen mandibular (FI); base de la mandíbula y el foramen (FB); margen posterior de la rama mandibular y el foramen mandibular (FP); margen anterior de la rama mandibular y el foramen (FA) y la distancia entre el vértice del trígono retromolar y el foramen mandibular (FT). Para la comparación de cada medida según hemiarcada se realizó el test de Mann-Whitney y para la influencia de la presencia de alvéolos en las medidas se utilizó el test de Kruskal-Wallis y para comparación múltiple el método de Dunn. No hubo diferencia estadística significativa en la localización del foramen mandibular al comparar el hemiarco mandibular derecho con el izquierdo. La cantidad de alvéolos dentales interfirió, de manera significativa, sólo en las distancias FA y FP. Se concluyó que las ramas mandibulares derecha e izquierda presentan simetría en el posicionamiento del foramen mandibular y la cantidad de alvéolos interfirió en las distancias de las márgenes anterior y posterior de la rama mandibular en relación con el foramen de la mandíbula.