Paradoxical Brain Herniation: An Unexpected Diagnosis.

Paradoxical herniation is a dreadful neurosurgical complication often underdiagnosed, which typically becomes evident over the course of weeks to months after the initial intervention. Here we present a unique case with manifestations in the post-operative period. A patient initially referred to neurosurgery for a meningioma underwent an uneventful surgical excision, followed by the transient placement of a lumbar drain for 48 hours. On the first post-operative day, the patient exhibited progressively altered neurological status, with corresponding imaging revealing a transfalcine herniation, necessitating emergent decompressive craniectomy. Despite the medical and surgical interventions, there were continuous signs of neurological and imaging worsening, with increase in herniation, which led to the diagnosis suspicion of a paradoxical brain herniation. Consequently, a rapid reversal of neurological deficits was observed after applying maneuvers to augment the intracranial pressure, followed by cranioplasty. This case illustrates the utmost importance of clinical suspicion for the uncommon complications of neurointerventions.

Epidemiology and Burden of Ventilator-Associated Pneumonia among Adult Intensive Care Unit Patients: A Portuguese, Multicenter, Retrospective Study (eVAP-PT Study).

Ventilator-associated pneumonia (VAP) is a prevailing nosocomial infection in critically ill patients requiring invasive mechanical ventilation (iMV). The impact of VAP is profound, adversely affecting patient outcomes and placing a significant burden on healthcare resources. This study assessed for the first time the contemporary VAP epidemiology in Portugal and its burden on the healthcare system and clinical outcomes. Additionally, resource consumption (duration of iMV, intensive care unit (ICU), hospital length of stay (LOS)) and empirical antimicrobial therapy were also evaluated. This multicenter, retrospective study included patients admitted to the hospital between July 2016 and December 2017 in a participating ICU, who underwent iMV for at least 48 h. Patients with a VAP diagnosis were segregated for further analysis (n = 197). Control patients, ventilated for >48 h but without a VAP diagnosis, were also included in a 1:1 ratio. Cumulative VAP incidence was computed. All-cause mortality was assessed at 28, 90, and 365 days after ICU admission. Cumulative VAP incidence was 9.2% (95% CI 8.0-10.5). The all-cause mortality rate in VAP patients was 24.9%, 34.0%, and 40.6%, respectively, and these values were similar to those observed in patients without VAP diagnosis. Further, patients with VAP had significantly longer ICU (27.5 vs. 11.0 days, p < 0.001) and hospital LOS (61 vs. 35.9 days, p < 0.001), more time under iMV (20.7 vs. 8.0 days, p < 0.001) and were more often subjected to tracheostomy (36.5 vs. 14.2%; p < 0.001). Patients with VAP who received inappropriate empirical antimicrobials had higher 28-day mortality, 34.3% vs. 19.5% (odds ratio 2.16, 95% CI 1.10-4.23), although the same was not independently associated with 1-year all-cause mortality (p = 0.107). This study described the VAP impact and burden on the Portuguese healthcare system, with approximately 9% of patients undergoing iMV for >48 h developing VAP, leading to increased resource consumption (longer ICU and hospital LOS). An unexpectedly high incidence of inappropriate, empirical antimicrobial therapy was also noted, being positively associated with a higher mortality risk of these patients. Knowledge of the Portuguese epidemiology characterization of VAP and its multidimensional impact is essential for efficient treatment and optimized long-term health outcomes of these patients.

Aortic Dissection With Cardiac Tamponade in Pregnancy: A Challenging Clinical Scenario.

Aortic dissection is the acute aortic syndrome with the highest mortality, and pregnancy and arterial hypertension are known risk factors. Its association with the perinatal period is a particularly unique and potentially devastating clinical catastrophe which is why the approach to a pregnant woman in cardiorespiratory arrest (CRA) should be multidisciplinary and early, with extraction of the fetus ideally within five minutes after the arrest. We present the case of a 39-year-old pregnant woman, who presented with a cardiorespiratory arrest in the context of an aortic dissection with cardiac tamponade and the need for an urgent perimortem cesarean section. Increasing knowledge and understanding among healthcare professionals has the potential to aid in the early detection and effective treatment of this challenging medical issue.

A identidade do "antipetismo" e do "petismo" em narrativas de simpatizantes do partido dos trabalhadores / The identity of "antipetismo" and "petismo" in narratives of the partido dos trabalhadores

As investigações da Operação Lava Jato e a mobilização de grupos de direita contra o Partido dos Trabalhadores (PT) o colocaram no momento mais crítico de sua história. Neste contexto, o objetivo deste estudo é identificar e analisar, nessa situação de conflito aberto com seus adversários políticos, a construção de atributos identitários para petistas e antipetistas em relatos de simpatizantes do Partido dos Trabalhadores. Para isso foram analisados, com o uso do método da análise de discurso proposto pela psicologia social discursiva, comentários produzidos em reposta às postagens do site Conversa Afiada do jornalista Paulo Henrique Amorim, alinhado politicamente com o Partido dos Trabalhadores no ano de 2015. Trata-se de um site muito frequentado por simpatizantes do Partido dos Trabalhadores. Na análise foram identificadas as categorias que os simpatizantes e militantes do "petismo" mobilizam quando falam de si mesmos e dos adversários políticos. Observou-se que a desonestidade, o conservadorismo e o antinacionalismo são traços centrais na identidade do "antipetismo" construída pelos petistas. O pertencimento à esquerda política, por outro lado, apresenta-se como um traço central da identidade do movimento em que se inserem esses militantes, movimento esse que estaria sendo vítima, segundo eles, de um golpe organizado por uma direita constituída pelo empresariado, a grande mídia e setores do Estado brasileiro.

The investigations of Operação Lava Jato and the mobilization of right-wing groups against the Partido dos Trabalhadores (PT) put it at the most critical moment in its history. In this context, the objective of this study is to identify and analyze, in this situation of open conflict with its political opponents, the construction of identity attributes for petistas and antipetistas in reports of sympathizers of the Partido dos Trabalhadores. For this were analyzed using the discourse analysis method proposed by discursive social psychology, comments made in response to posts site Conversa Afiada journalist Paulo Henrique Amorim, politically aligned with the Partido dos Trabalhadores in 2015. It's a site majority frequented by sympathizers of the Partido dos Trabalhadores. The analysis categories were identified that supporters and "petismo" militants mobilize when they speak of themselves and of political opponents. It was observed that dishonesty, conservatism and anti-nationalism are central features in the identity of "antipetismo" built by PT. Belonging to the political left, on the other hand, presents itself as a central feature of the movement's identity in which they operate these militants, a movement which would be the victim, they said, a coup organized by a right constituted by the business community, the media and sectors of the brazilian state.

Long-term psychological outcome after discharge from intensive care. / Desfechos psicológicos em longo prazo após alta da terapia intensiva.

OBJECTIVE: To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge. METHODS: A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods. RESULTS: Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS. CONCLUSION: Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.

Desfechos psicológicos em longo prazo após alta da terapia intensiva / Long-term psychological outcome after discharge from intensive care

RESUMO Objetivo: Investigar o desfecho psicológico em longo prazo em sobreviventes de doenças críticas, após alta da unidade de terapia intensiva. Métodos: Avaliou-se coorte prospectiva de pacientes sobreviventes após admissão a uma unidade de terapia intensiva mista entre janeiro e setembro de 2010, 6 meses e 5 anos após a alta hospitalar. Aplicaram-se em todos os momentos as seguintes escalas: Dementia Rating Scale-2, Hospital Anxiety and Depression Scale, Post-Traumatic Stress Syndrome 14-Questions Inventory, Euro Quality of Life 5 Dimensions (EQ-5-D) e Visual Analogue Scale (EQ VAS). Resultados: Dentre 267 pacientes, 25 foram avaliados após 6 meses (idade: 62 ± 16 anos). Aos 6 meses, 48% apresentavam comprometimento cognitivo; 24% ansiedade, 16% depressão e 16% transtorno de estresse pós-traumático. Foram reavaliados 5 anos após a alta 17 pacientes, com idade: 65 ± 15 anos. Dentre eles, a frequência de comprometimento cognitivo caiu de 47% para 18% (p = 0,063), em razão da melhora destes pacientes ao longo do tempo e do não surgimento desta condição em outros pacientes após a alta. Ainda após 5 anos, apenas 12% da amostra relatou ansiedade, e nenhum tinha depressão ou transtorno de estresse pós-traumático. Não se encontraram diferenças em termos das escalas EQ-5-D e EQ VAS entre as avaliações após 6 meses e 5 anos. Conclusão: Os sobreviventes não apresentaram declínio progressivo da função cognitiva ou da qualidade de vida dentro de 5 anos após a alta da unidade de terapia intensiva. Os sintomas psicopatológicos tenderam a diminuir com o tempo.

ABSTRACT Objective: To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge. Methods: A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods. Results: Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS. Conclusion: Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.

Chronic hepatitis C virus infection: it is not only about the liver.

BACKGROUND AND AIMS: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) are both hepatotropic and quite similar in terms of clinical manifestations and histopathology, their respective infections are distinct in terms of epidemiology and prognosis. Recognizing the differences between patients with HBV and HCV infection with respect to demographic characteristics, prevalence of comorbidities, and presence of lifestyle factors aids the proper treatment of these patients. We aimed to compare two populations with chronic viral liver disease (chronic HCV and chronic HBV), each of them with resolved hepatitis C. PATIENTS AND METHODS: We included patients referred to a municipal reference clinic from March 2009 through May 2012. Patient data were collected using standardized questionnaires at the patients' first visit to clinic. Questionnaires included epidemiological information, presence of comorbidities, and lifestyle. RESULTS: A total of 756 patients were included in the study, 348 (46.0%) with chronic HCV infection, 176 (23.3%) with chronic HBV infection, and 232 (30.7%) with resolved HCV infection. Multivariate analysis including patients with chronic HCV infection and chronic HBV infection indicated that age [adjusted odds ratio (AOR)=1.06; 95% confidence interval (CI): 1.03-1.08], alcohol abuse (AOR=1.58; 95% CI: 1.01-2.49), smoking (AOR=1.64; 95% CI: 1.00-2.17), and illicit drug (AOR=2.92; 95% CI: 1.69-5.02) use were associated independently with chronic HCV infection. Multivariate analyses including patients with chronic HCV infection and those patients with resolved HCV infection, presence of at least one comorbidity (AOR=1.94; 95% CI: 1.12-3.3), illicit drug use (AOR=3.24; 95% CI: 1.90-5.54), and age (AOR=1.03; 95% CI: 1.01-1.05) were independently associated with chronic HCV infection. Age (AOR=0.98; 95% CI: 0.96-0.99) and male sex (AOR=1.93; 95% CI: 1.26-2.95) were the only variables associated significantly with chronic HBV infection in the multivariate analysis between patients with chronic HBV infection and resolved HCV infection. CONCLUSION: Our results highlight that patients with chronic HCV infection are complex and require a multidisciplinary approach during patient follow-up and clinical management.

Conhecendo o cuidador: sua percepções e sentimentos em relação ao cuidado

O papel de cuidador nem sempre é algo esperado na vida de um indivíduo. O ato de cuidar de uma pessoa doente é, muitas vezes, mais difícil quando ocorre de forma inusitada, seja pelo nascimento de um filho com deficiência, por algum acidente ocorrido ou alguma doença degenerativa de um familiar. Ademais, se o cuidado dispensado ao doente se prolongar por muito tempo, o cuidador poderá ficar com a saúde comprometida. Nesse sentido, pode-se pensar que não apenas a pessoa doente necessita de cuidados, mas faz-se necessário também um olhar sobre a saúde do cuidador. Por esse motivo, o objetivo geral deste estudo é conhecer, de forma qualitativa, as percepções e sentimentos dos cuidadores familiares dos usuários inscritos no Programa de Assistência Domiciliar - PAD da Unidade de Saúde Barão de Bagé – USBB, sobre os aspectos envolvidos no cuidado. Para tanto foram entrevistados três cuidadores de pacientes que fazem parte do PAD. A partir dos dados da entrevista foi realizada uma análise de conteúdo qualitativa, de onde foram criadas categorias de análise, com base nos próprios dados, bem como em aspectos levantados na literatura.

Thyroid storm and arrhythmic storm: a potentially fatal combination.

Thyroid storm is a rare clinical emergency with a mortality rate between 20% and 30%. Cardiac arrhythmias associated with thyrotoxicosis are usually supraventricular. Ventricular arrhythmias are rarely associated with this entity and tend to occur in patients with intrinsic cardiac disease. We present a 35-year-old woman with Graves disease and a thyroid storm manifested with multiple malignant dysrhythmic episodes, without underlying cardiac disease. The mechanism for ventricular arrhythmia is not clear but seems to be due to the increased myocardial excitability directly caused by the thyroid hormones. The presence of myocarditis lesions may constitute an arrhythmogenic substratum and contribute further to this manifestation. This case emphasizes the importance of cardiac monitoring in patients with thyroid storm.

O perfil dos ortodontistas em relação aos aspectos odontolegais dos prontuários odontológicos / The profile of orthodontists in relation to the legal aspects of dental records

OBJETIVO: o objetivo deste estudo foi conhecer os principais aspectos legais relacionados ao exercício da Ortodontia que podem ser utilizados como importantes instrumentos de defesa em caso de ação ética e/ou judicial. MÉTODOS: realizou-se um estudo transversal com ortodontistas de Belo Horizonte/MG, por meio de instrumento próprio (questionário), abordando os aspectos éticos e judiciais que envolvem essa especialidade. Foi solicitado, no questionário, o preenchimento dos seguintes campos: identificação pessoal, formação acadêmica, acessórios ortodônticos, higiene bucal, plano de tratamento, prestação de serviço, documentação ortodôntica, prescrição medicamentosa e vias de comunicação com o paciente, dentre outros. RESULTADOS: um montante de 237 ortodontistas, registrados no CRO-MG e domiciliados em Belo Horizonte, receberam o instrumento de coleta de dados. Desse universo, 69 (29,11 por cento) responderam e devolveram os questionários. Dos 69 respondentes, 57,97 por cento eram do gênero masculino e 42,03 por cento do feminino. Em relação às instituições onde esses profissionais se graduaram, constatou-se que 52,17 por cento deles se formaram em Instituições de Ensino Superior (IES) privadas. Observou-se que 34,78 por cento dos ortodontistas concluíram a especialização entre 5 e 10 anos após o término da graduação. A maioria dos profissionais (94,2 por cento) registra nos prontuários as quebras dos acessórios ortodônticos utilizados pelos pacientes e 53,62 por cento desses ortodontistas arquivam, por todo o período de atividade profissional, a documentação ortodôntica dos pacientes. CONCLUSÕES: por intermédio desse estudo, ficou evidente que alguns parâmetros de análise foram bastante satisfatórios, como: a existência de modelos contratuais para a prestação de serviços, a comunicação com os pacientes e/ou os responsáveis por eles em caso de abandono de tratamento, o arquivo da documentação ortodôntica e o registro, no prontuário, de quebras ...

OBJECTIVE: The purpose of this study was to acquire knowledge about the key legal aspects of orthodontic practice, which may be used as important defense tools in the event of ethical and/or legal actions. METHODS: A cross-sectional study was conducted with dentists in Belo Horizonte, Minas Gerais State, Brazil, by means of a specific instrument (questionnaire) addressing the ethical and legal disputes that involve the orthodontic specialty. Participants were asked to fill out the following questionnaire fields: personal identification, academic background, orthodontic accessories, oral hygiene, treatment plan, service provision, orthodontic documentation, drug prescription and forms of communication with patients, among others. RESULTS: A total of 237 orthodontists, all members of the Regional Council of Dentistry, Minas Gerais State (CRO-MG) and living in Belo Horizonte, were given the data collection instrument. Out of this total, 69 (29.11 percent) answered and returned the questionnaires. Of the 69 respondents, 57.97 percent were male and 42.03 percent female. It was found that 52.17 percent of these professionals graduated from Higher Education Institutions (ISEs). It was observed that 34.78 percent of these orthodontists completed specialization between 5 and 10 years after graduation. Most professionals (94.2 percent) enter into their medical records information about any damage caused to the orthodontic accessories used by their patients and 53.62 percent of the orthodontists keep their patients' orthodontic documentation on file throughout their active professional life. CONCLUSIONS: This study revealed that some analysis parameters were very satisfactory, such as: the availability of service provision contract models, communication with patients and/or their lawful guardians in case of abandonment of treatment, orthodontic documentation files and the entering into the dental records of information concerning the breakage of ...

C5 and C6 human dermatomes: a clinical, electromyographical, imaging and surgical findings.

There is substantial controversy in literature about human dermatomes. In this work, C5 and C6 superior limb dermatomes were studied. The method consisted of comparing clinical signs and symptoms with conduction studies, electromyographical data, neurosurgical findings, and imaging findings obtained by computerized tomography (CT) or magnetic resonance imaging (MRI), for each patient. Data analysis from superior members in 18 patients suggests that C5 is located in the lateral aspect of the shoulder and arm, and C6 in the lateral aspect of the forearm and 1st, 2nd, and 3rd fingers. To our knowledge this is the first time that C5 and C6 human dermatomes have been studied by all the following methods together: clinical, electromyographical, CT and MR imaging, and surgical findings.

L4-L5-S1 human dermatomes: a clinical, electromyographical, imaging and surgical findings.

There is substantial controversy in literature about human dermatomes. We studied L4, L5, and S1 inferior limb dermatomes by comparing clinical signs and symptoms with conduction studies, electromyographical data, neurosurgical findings, and imaging data from computerized tomography (CT) or magnetic resonance imaging (MRI). After analyzing 60 patients, we concluded that L4 is probably located in the medial aspect of the leg, L5 in the lateral aspect of the leg and foot dorsus, and S1 in the posterior aspect of the backside, tight, leg and plantar foot skin. This is the first time that these human dermatomes have been evaluated by combined analysis of clinical, electromyographical, neurosurgical, and imaging data.

C5 and C6 human dermatomes: a clinical, electromyographical, imaging and surgical findings / Dermátomos humanos C5 e C6: estudo clínico, eletromiográfico, de imagem e cirúrgico

There is substantial controversy in literature about human dermatomes. In this work, C5 and C6 superior limb dermatomes were studied. The method consisted of comparing clinical signs and symptoms with conduction studies, electromyographical data, neurosurgical findings, and imaging findings obtained by computerized tomography (CT) or magnetic resonance imaging (MRI), for each patient. Data analysis from superior members in 18 patients suggests that C5 is located in the lateral aspect of the shoulder and arm, and C6 in the lateral aspect of the forearm and 1st, 2nd, and 3rd fingers. To our knowledge this is the first time that C5 and C6 human dermatomes have been studied by all the following methods together: clinical, electromyographical, CT and MR imaging, and surgical findings.

Há controvérsias na literatura sobre os dermátomos humanos. Neste estudo os dermátomos do membro superior C5 e C6 foram analisados. O método consistiu em comparar os sinais e sintomas com achados eletromiográficos, de imagem e achados cirúrgicos. Análise dos dados do membro superior de 18 pacientes sugere que o dermátomo C5 esteja localizado na região lateral do ombro e braço, e o dermátomo C6 na região lateral do antebraço e 1º, 2º e 3º dedos da mão. Este é o primeiro estudo em que os dermátomos C5 e C6 foram avaliados pelos dados clínicos, eletromiográficos, de imagem e achados cirúrgicos.

L4-L5-S1 human dermatomes: a clinical, electromyographical, imaging and surgical findings / Dermátomos humanos L4, L5 e S1: achados clínicos, eletromiográficos, de imagem e cirúrgicos

There is substantial controversy in literature about human dermatomes. We studied L4, L5, and S1 inferior limb dermatomes by comparing clinical signs and symptoms with conduction studies, electromyographical data, neurosurgical findings, and imaging data from computerized tomography (CT) or magnetic resonance imaging (MRI). After analyzing 60 patients, we concluded that L4 is probably located in the medial aspect of the leg, L5 in the lateral aspect of the leg and foot dorsus, and S1 in the posterior aspect of the backside, tight, leg and plantar foot skin. This is the first time that these human dermatomes have been evaluated by combined analysis of clinical, electromyographical, neurosurgical, and imaging data.

Há controvérsia na literatura sobre os dermátomos humanos. Estudamos dermátomos do membro inferior comparando sinais e sintomas com estudos eletromiográficos, de imagem e achados cirúrgicos. Analisando 60 pacientes, concluímos que o dermátomo L4 provavelmente está localizado na região medial da perna, o dermátomo L5 na região lateral da perna e dorso do pé, e o dermátomo S1 na nádega, região posterior da coxa e da perna e na região plantar. Este é o primeiro estudo que os dermátomos do membro inferior foram analisados através de dados clínicos, eletromiográficos, imagem e achados cirúrgicos.

Estudio histoquímico de la enzima NADH-TR en músculo frontal de conejos norfolk (Oryctolagus cuniculus) / Histochemical study of enzyme in frontal muscle of norfolk rabbit (Oryctolagus cuniculus)

RESUMEN: El músculo frontal humano posee dos vientres formando junto, al músculo occipital y la gálea aponeurótica, el músculo occipitofrontal. Como músculo estriado esquelético, el músculo frontal puede presentar fibras con alta intensidad de oxidación (tipo I) y con baja intensidad de oxidación (tipo II). El objetivo de este trabajo fue la determinación, a través de la reacción histoquímica para nicotinamide adenine dinucleotide tetra-zolium redutase (NADH-TR), la distribución de fibras de tipos I y II del músculo frontal de conejos de la raza Norfolk inglesa, del sexo femenino, con edad de seis a ocho meses, pesando de 2,8 a 3,1 Kg. De un total de 1010 fibras estudiadas, la proporción encontrada fue de 33,8% para el tipo I, de 17,4% para el tipo IIA, y de 48,8% para el tipo IIB. La mayoría de las fibras encontradas era del tipo II, revelando la intensa actividad de este músculo en la mímica facial. Las fibras de tipo II presentan baja intensidad oxidativa, pudiendo así sufrir fatiga muscular. Estas conclusiones pueden ser un aporte en estudios para entender los procesos patológicos que pueden ocurrir en este músculo.

Análise da atividade eletromiográfica de músculos mastigatórios em portadores de disfunção temporomandibular durante a mastigação / Electromyographic analysis of the masticatory muscles in subjects with temporomandibular disorders chewing

O objetivo deste trabalho foi avaliar a mastigação de indivíduos portadores de disfunção temporomandibular (DTM) por meio de exame eletromiográfico relacionado a presença de sinais e sintomas da disfunção ao lado preferencial de mastigação. Participaram do estudo 27 sujeitos do sexo feminino, divididos em dois grupos: um constituído por sujeitos portadores de DTM e, outro constituído por sujeitos clinicamente normais. O exame eletromiográfico foi realizado na porção anterior do músculo temporal e parte superficial do músculo masseter, bilateralmente, por meio de eletrodos de superfície em três dias diferentes, durante a contração isométrica em máxima intercuspidação, contração isotônica bilateral simultânea e mastigação habitual. Os resultados demonstraram que houve uma relação entre o lado de maior atividade elétrica e o lado preferencial de mastigação no grupo clinicamente normal; porém, esta relação não foi observada no grupo de portadores de DTM, tanto na mastigação habitual quanto na contração isotônica bilateral simultânea. A parte superficial do músculo masseter foi que melhor indicou o lado preferencial de mastigação em indivíduos clinicamente normais, enquanto que em portadores de DTM esta relação foi mais observada na porção anterior do músculo temporal.

The aim of this study was evaluate the mastication of the subjects with temporomandibular disorder (DTM) by means of the electromyographyc exam relating the presence of sings and symptoms of the disorder and the lateral preference masticatory. Twenty seven subjects shared in the study, all of the female sex, divided in two groups, one constituted by subjects with TMD and another constituted by clinically normal subjects. The electromyography was carried out in the anterior portion of the temporal muscle and superficial part of the masseter muscle, bilaterally, by means of surface electrodes in three different days, during maximal voluntary clenching in the intercuspal position, bilateral contraction isotonic simultaneous and habitual mastication. The results showed that there was a relation between the side with the highest level of myoelectric activity and lateral preference masticatory in the clinically normal group, but in the group of the TMD patients this relation was not observed, as in the habitual mastication as in the bilateral contraction. The superficial part of the masseter muscle was the muscle that better indicated the lateral preferential mastication in clinically normal individuals, while in TMD patients this relation was more evident in the anterior portion of the temporal muscle.

Blink reflex: comparison of latency measurements in different human races.

The blink reflex latencies and cephalometric indexes were analysed in 30 male volunteers from three different races, 10 white, 10 black, and 10 Oriental. Ages ranged from 15 to 59 years, height from 1,60 to 1,80 m, and weight from 60 to 80 kg. Blink reflexes were obtained after unilateral electric stimulation of the supraorbital nerve for quantitative analysis of 3 responses, early ipsilateral (R1), late ipsilateral (R2i) and late contralateral (R2c), obtained from the orbicularis oculi muscle. Cephalometric indexes were calculated by multiplying the ratio between the longer transverse and the longer saggital head diameters by 100. The R1, R2i and R2c latencies were consistent with other published papers revealing no differences between the different racial groups. The mean of the cephalometric indexes of each group were consistent with respective racial characteristics. This study revealed that there are no differences between R1, R2i and R2c latencies in the 3 different studied races.

Blink reflex: comparison of latency measurements in different human races

The blink reflex latencies and cephalometric indexes were analysed in 30 male volunteers from three different races, 10 white, 10 black, and 10 Oriental. Ages ranged from 15 to 59 years, height from 1,60 to 1,80 m, and weight from 60 to 80 kg. Blink reflexes were obtained after unilateral electric stimulation of the supraorbital nerve for quantitative analysis of 3 responses, early ipsilateral (R1), late ipsilateral (R2i) and late contralateral (R2c), obtained from the orbicularis oculi muscle. Cephalometric indexes were calculated by multiplying the ratio between the longer transverse and the longer sagital head diameters by 100. The R1, R2i and R2c latencies were consistent with other published papers revealing no differences between the different racial groups. The mean of the cephalometric indexes of each group were consistent with respective racial characteristics. This study revealed that there are no differences between R1, R2i and R2c latencies in the 3 different studied races

Electromyographic analysis of the trapezius and the serratus anterior muscles in shoulder and pectoral girdle movements

The upper and lower portions of the trapezius muscle and the 4th, 5th and 6th bundles of the serratus anterior muscle were studied electromyographically during shoulder and pectoral girdle movements, in ten adultmales, aged 18 to 28 years, with no history of shoulder pathology. For this study a Nicolet Electronmyograph and surface electrodes were used. The signals were recorded as root mean square (RMS) values, expressedin microvolts. Wilcoxon and Friedman tests were done to a 5 (per cent) significance level. The results showed that there were no differences in the behaviour of the serratus anterior muscle bundles. In the shoulder abduction and flexion movements, the upper portionof the trapezius acted simultaneously with the serratus anterior muscle. In horizontal abdunction and adduction movements there was no prevalence of any of the muscles studied. In shoulder elevation, the upper portion of the trapezius muscle showed preponderant activity over its lower portion and over the serratus anterior muscle bundles. In the shoulder depression the activity of the lower portion of the trapezius muscle predominated over the serratus anterior muscle bundles, and the least activity was exhibited by the upper portion of the trapezius muscle.

Miopatia do multicore: análise histoquímica de uma família / Multicore disease: histochemical analysis of a family

Neste trabalho os autores descrevem três casos de miopatia do multicore na mesma família. O caso 1 corresponde a um paciente de 77 anos, com fraqueza e atrofias proximais, hipotonia e hiporreflexia profunda globais. Estudos da cnduçäo nervosa sensitiva e motora foram normais nos quatro membros. A eletromiografia revelou padräo miopático, com atividade espontânea frequênte, tipo fibrilaçöes e ondas agudas positivas. As reaçöes histoquímicas mostraram alteraçöes oxidativas típicas de miopatia do multicore. Os casos 2 e 3 correspondem a filho e filha do paciente 1, respectivamente. Estes dois casos eram assintomáticos, mas apresentavam discretas alteraçöes eletromiográficas e à biópsia de músculo. Os três pacientes ilustram a grande variabilidade clínica desta entidade