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1.
Phys Rev Lett ; 127(19): 192501, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34797155

RESUMO

The changes in the mean-square charge radius (relative to ^{209}Bi), magnetic dipole, and electric quadrupole moments of ^{187,188,189,191}Bi were measured using the in-source resonance-ionization spectroscopy technique at ISOLDE (CERN). A large staggering in radii was found in ^{187,188,189}Bi^{g}, manifested by a sharp radius increase for the ground state of ^{188}Bi relative to the neighboring ^{187,189}Bi^{g}. A large isomer shift was also observed for ^{188}Bi^{m}. Both effects happen at the same neutron number, N=105, where the shape staggering and a similar isomer shift were observed in the mercury isotopes. Experimental results are reproduced by mean-field calculations where the ground or isomeric states were identified by the blocked quasiparticle configuration compatible with the observed spin, parity, and magnetic moment.

2.
J Dent Res ; 100(8): 810-816, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33973494

RESUMO

It is important for dental care professionals to reliably assess carbon dioxide (CO2) levels and ventilation rates in their offices in the era of frequent infectious disease pandemics. This study was to evaluate CO2 levels in dental operatories and determine the accuracy of using CO2 levels to assess ventilation rate in dental clinics. Mechanical ventilation rate in air change per hour (ACHVENT) was measured with an air velocity sensor and airflow balancing hood. CO2 levels were measured in these rooms to analyze factors that contributed to CO2 accumulation. Ventilation rates were estimated using natural steady-state CO2 levels during dental treatments and experimental CO2 concentration decays by dry ice or mixing baking soda and vinegar. We compared the differences and assessed the correlations between ACHVENT and ventilation rates estimated by the steady-state CO2 model with low (0.3 L/min, ACHSS30) or high (0.46 L/min, ACHSS46) CO2 generation rates, by CO2 decay constants using dry ice (ACHDI) or baking soda (ACHBV), and by time needed to remove 63% of excess CO2 generated by dry ice (ACHDI63%) or baking soda (ACHBV63%). We found that ACHVENT varied from 3.9 to 35.0 in dental operatories. CO2 accumulation occurred in rooms with low ventilation (ACHVENT ≤6) and overcrowding but not in those with higher ventilation. ACHSS30 and ACHSS46 correlated well with ACHVENT (r = 0.83, P = 0.003), but ACHSS30 was more accurate for rooms with low ACHVENT. Ventilation rates could be reliably estimated using CO2 released from dry ice or baking soda. ACHVENT was highly correlated with ACHDI (r = 0.99), ACHBV (r = 0.98), ACHDI63% (r = 0.98), and ACHBV63% (r = 0.98). There were no statistically significant differences between ACHVENT and ACHDI63% or ACHBV63%. We conclude that ventilation rates could be conveniently and accurately assessed by observing the changes in CO2 levels after a simple mixing of household baking soda and vinegar in dental settings.


Assuntos
Dióxido de Carbono , Ventilação , Assistência Odontológica , Humanos
3.
JDR Clin Trans Res ; 5(3): 202-210, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32330078

RESUMO

KNOWLEDGE TRANSFER STATEMENT: This commentary provides a timely evidence-based overview on the impact of COVID-19 on dental care and oral health and identifies gaps in protection of patients and staff in dental settings. Oral symptoms are prominent before fever and cough occur. Dental professionals may play an important role in early identification and diagnosis of patients with COVID-19.


Assuntos
Betacoronavirus , Saúde Bucal , COVID-19 , Infecções por Coronavirus , Assistência Odontológica , Humanos , Pandemias , Pneumonia Viral , SARS-CoV-2
4.
Phys Rev Lett ; 120(23): 232503, 2018 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-29932712

RESUMO

Until recently, ground-state nuclear moments of the heaviest nuclei could only be inferred from nuclear spectroscopy, where model assumptions are required. Laser spectroscopy in combination with modern atomic structure calculations is now able to probe these moments directly, in a comprehensive and nuclear-model-independent way. Here we report on unique access to the differential mean-square charge radii of ^{252,253,254}No, and therefore to changes in nuclear size and shape. State-of-the-art nuclear density functional calculations describe well the changes in nuclear charge radii in the region of the heavy actinides, indicating an appreciable central depression in the deformed proton density distribution in ^{252,254}No isotopes. Finally, the hyperfine splitting of ^{253}No was evaluated, enabling a complementary measure of its (quadrupole) deformation, as well as an insight into the neutron single-particle wave function via the nuclear spin and magnetic moment.

5.
Eur J Pain ; 22(5): 875-888, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29350446

RESUMO

BACKGROUND: The mechanisms underlying sex-based differences in pain and analgesia are poorly understood. In this study, we investigated gene expression changes in trigeminal ganglia (TG) of male and female rats exposed to infraorbital nerve chronic constriction injury (IoN-CCI). METHODS: Somatosensory assessments were performed prior to IoN-CCI and at selected time points postsurgery. Selected gene expression changes were examined with real-time quantitative polymerase chain reaction (RT-PCR) in ipsilateral TG at 21 days postsurgery. RESULTS: Rats exposed to IoN-CCI developed significant mechanical allodynia and hyperalgesia on days 19 and 21 postsurgery. During this period, females developed significantly more allodynia but not hyperalgesia compared to males. At 21 days postsurgery, expression levels of 44 of the 84 investigated pain-related genes in ipsilateral TG were significantly regulated relative to naïve rats in either sex. Csf1 and Cx3cr1 were up-regulated in both sexes, but the magnitude of regulation was significantly higher in females (p = 0.02 and p = 0.001, respectively). Htr1a and Scn9a were down-regulated in both sexes, but the down-regulation was significantly more pronounced in males (p = 0.04 and p = 0.02, respectively). Additionally, Cck, Il1a, Pla2g1b and Tnf genes were significantly regulated in females but not in males, and Chrna4 gene was significantly down-regulated in males but not in females. CONCLUSIONS: Our findings suggest sex-dependent gene regulation in response to nerve injury, which may contribute to sex dimorphism of trigeminal neuropathic pain. Further studies are needed to establish gene expression changes over time and correlate these with hormonal and other physiological parameters in male and female. SIGNIFICANCE: We present novel sex-specific transcriptional regulation in trigeminal ganglia that may contribute to male-/female-based differences in trigeminal neuropathic pain. These findings are expected to open new research horizons, particularly in male versus female targeted therapeutic regimens.


Assuntos
Expressão Gênica , Hiperalgesia/genética , Síndromes de Compressão Nervosa/genética , Caracteres Sexuais , Gânglio Trigeminal/metabolismo , Animais , Feminino , Hiperalgesia/metabolismo , Masculino , Síndromes de Compressão Nervosa/metabolismo , Medição da Dor , Ratos , Ratos Sprague-Dawley
6.
Phys Rev Lett ; 118(2): 023002, 2017 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-28128629

RESUMO

The first ionization potential (IP) and electron affinity (EA) of the gold atom have been determined to an unprecedented accuracy using relativistic coupled cluster calculations up to the pentuple excitation level including the Breit and QED contributions. We reach meV accuracy (with respect to the experimental values) by carefully accounting for all individual contributions beyond the standard relativistic coupled cluster approach. Thus, we are able to resolve the long-standing discrepancy between experimental and theoretical IP and EA of gold.

7.
Phys Rev Lett ; 114(15): 150801, 2015 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-25933300

RESUMO

We measure optical spectra of Nd-like W, Re, Os, Ir, and Pt ions of particular interest for studies of a possibly varying fine-structure constant. Exploiting characteristic energy scalings we identify the strongest lines, confirm the predicted 5s-4f level crossing, and benchmark advanced calculations. We infer two possible values for optical M2/E3 and E1 transitions in Ir^{17+} that have the highest predicted sensitivity to a variation of the fine-structure constant among stable atomic systems. Furthermore, we determine the energies of proposed frequency standards in Hf^{12+} and W^{14+}.

8.
Nature ; 520(7546): 209-11, 2015 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-25855457

RESUMO

The chemical properties of an element are primarily governed by the configuration of electrons in the valence shell. Relativistic effects influence the electronic structure of heavy elements in the sixth row of the periodic table, and these effects increase dramatically in the seventh row--including the actinides--even affecting ground-state configurations. Atomic s and p1/2 orbitals are stabilized by relativistic effects, whereas p3/2, d and f orbitals are destabilized, so that ground-state configurations of heavy elements may differ from those of lighter elements in the same group. The first ionization potential (IP1) is a measure of the energy required to remove one valence electron from a neutral atom, and is an atomic property that reflects the outermost electronic configuration. Precise and accurate experimental determination of IP1 gives information on the binding energy of valence electrons, and also, therefore, on the degree of relativistic stabilization. However, such measurements are hampered by the difficulty in obtaining the heaviest elements on scales of more than one atom at a time. Here we report that the experimentally obtained IP1 of the heaviest actinide, lawrencium (Lr, atomic number 103), is 4.96(+0.08)(-0.07) electronvolts. The IP1 of Lr was measured with (256)Lr (half-life 27 seconds) using an efficient surface ion-source and a radioisotope detection system coupled to a mass separator. The measured IP1 is in excellent agreement with the value of 4.963(15) electronvolts predicted here by state-of-the-art relativistic calculations. The present work provides a reliable benchmark for theoretical calculations and also opens the way for IP1 measurements of superheavy elements (that is, transactinides) on an atom-at-a-time scale.

9.
J Chem Phys ; 141(8): 084301, 2014 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-25173008

RESUMO

The structure and energetics of eight diatomic heavy-atom molecules are presented. These include the species MAu, M2, and MHg, with M standing for the Hg, Cn (element 112), and Fl (element 114) atoms. The infinite-order relativistic 2-component Hamiltonian, known to closely reproduce 4-component results at lower computational cost, is used as framework. High-accuracy treatment of correlation is achieved by using the coupled cluster scheme with single, double, and perturbative triple excitations in large converged basis sets. The calculated interatomic separation and bond energy of Hg2, the only compound with known experimental data, are in good agreement with measurements. The binding of Fl to Au is stronger than that of Cn, predicting stronger adsorption on gold surfaces. The bond in the M2 species is strongest for Fl2, being of chemical nature; weaker bonds appear in Cn2 and Hg2, which are bound by van der Waals interactions, with the former bound more strongly due to the smaller van der Waals radius. The same set of calculations was also performed using the relativistic density functional theory approach, in order to test the performance of the latter for these weakly bound systems with respect to the more accurate coupled cluster calculations. It was found that for the MAu species the B3LYP functional provides better agreement with the coupled cluster results than the B88/P86 functional. However, for the M2 and the MHg molecules, B3LYP tends to underestimate the binding energies.

10.
Nat Commun ; 4: 1835, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23673620

RESUMO

The radioactive element astatine exists only in trace amounts in nature. Its properties can therefore only be explored by study of the minute quantities of artificially produced isotopes or by performing theoretical calculations. One of the most important properties influencing the chemical behaviour is the energy required to remove one electron from the valence shell, referred to as the ionization potential. Here we use laser spectroscopy to probe the optical spectrum of astatine near the ionization threshold. The observed series of Rydberg states enabled the first determination of the ionization potential of the astatine atom, 9.31751(8) eV. New ab initio calculations are performed to support the experimental result. The measured value serves as a benchmark for quantum chemistry calculations of the properties of astatine as well as for the theoretical prediction of the ionization potential of superheavy element 117, the heaviest homologue of astatine.

11.
J Chem Phys ; 138(12): 124302, 2013 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-23556718

RESUMO

Static dipole polarizabilities of element 119 and its singly charged cation are calculated, along with those of its lighter homologs, Cs and Fr. Relativity is treated within the 4-component Dirac-Coulomb formalism and electron correlation is included by the single reference coupled cluster approach with single, double, and perturbative triple excitations (CCSD(T)). Very good agreement with available experimental values is obtained for Cs, lending credence to the predictions for Fr and element 119. The atomic properties in group-1 are largely determined by the valence ns orbital, which experiences relativistic stabilization and contraction in the heavier elements. As a result, element 119 is predicted to have a relatively low polarizability (169.7 a.u.), comparable to that of Na. The adsorption enthalpy of element 119 on Teflon, which is important for possible future experimental studies of this element, is estimated as 17.6 kJ/mol, the lowest among the atoms considered here.


Assuntos
Césio/química , Frâncio/química , Teoria Quântica , Politetrafluoretileno/química , Termodinâmica
12.
Oral Dis ; 18(4): 317-32, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22212350

RESUMO

The aim of this article is to review the clinical, pathophysiological, and therapeutic aspects of traumatically induced trigeminal nerve pain. We introduce a new and, in our view, more accurate terminology: peripheral painful traumatic trigeminal neuropathy (PPTTN) to define this patient group. The proposed pathophysiology of PPTTN is largely based on studies in spinal nerve injury models. However, trigeminal nerve injury studies have shown some subtle differences in response to physical and inflammatory insults, and these are discussed. The treatment of painful neuropathies is difficult and carries a poor prognosis. Based on the available literature on efficacy and side effects, we propose a treatment algorithm for traumatic trigeminal neuropathies.


Assuntos
Doenças do Nervo Trigêmeo/etiologia , Traumatismos do Nervo Trigêmeo/complicações , Neuralgia do Trigêmeo/etiologia , Algoritmos , Protocolos Clínicos , Humanos , Terminologia como Assunto , Doenças do Nervo Trigêmeo/diagnóstico , Doenças do Nervo Trigêmeo/terapia , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/terapia
13.
Oral Dis ; 17 Suppl 1: 23-41, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21382137

RESUMO

The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; 'persistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.


Assuntos
Dor Facial/etiologia , Músculos da Mastigação/fisiopatologia , Adaptação Fisiológica/fisiologia , Adaptação Psicológica/fisiologia , Sistema Nervoso Central/fisiopatologia , Transtornos Craniomandibulares/etiologia , Transtornos Craniomandibulares/fisiopatologia , Oclusão Dentária , Dor Facial/fisiopatologia , Humanos , Músculos da Mastigação/inervação , Neuropeptídeos/fisiologia , Nociceptores/fisiologia , Síndrome da Disfunção da Articulação Temporomandibular/etiologia , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia
14.
J Oral Rehabil ; 38(5): 366-94, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21241350

RESUMO

The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management.


Assuntos
Dor Facial/fisiopatologia , Limiar Sensorial , Distúrbios Somatossensoriais/diagnóstico , Fatores Etários , Humanos , Exame Neurológico , Estimulação Física , Reprodutibilidade dos Testes , Relatório de Pesquisa , Fatores Sexuais
15.
J Chem Phys ; 129(14): 144106, 2008 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-19045133

RESUMO

The interaction of the inert gases Rn and element 118 with various surfaces has been studied on the basis of fully relativistic ab initio Dirac-Coulomb CCSD(T) calculations of atomic properties. The calculated polarizability of element 118, 46.3 a.u., is the largest in group 18, the ionization potential is the lowest at 8.91 eV, and the estimated atomic radius is the largest, 4.55 a.u. These extreme values reflect, in addition to the general trends in the Periodic Table, the relativistic expansion and destabilization of the outer valence 7p(3/2) orbital. Van der Waals coefficients C(3) and adsorption enthalpies DeltaH(ads) of Ne through element 118 on noble metals and inert surfaces, such as quartz, ice, Teflon, and graphite, were calculated in a physisorption model using the atomic properties obtained. The C(3) coefficients were shown to steadily increase in group 18, while the increase in DeltaH(ads) from Ne to Rn does not continue to element 118: The large atomic radius of the latter element is responsible for a decrease in the interaction energy. We therefore predict that experimental distinction between Rn and 118 by adsorption on these types of surfaces will not be feasible. A possible candidate for separating the two elements is charcoal; further study is needed to test this possibility.

16.
J Phys Chem A ; 112(51): 13712-6, 2008 Dec 25.
Artigo em Inglês | MEDLINE | ID: mdl-19049424

RESUMO

Fully relativistic ab initio Dirac-Coulomb Fock-space coupled cluster calculations were performed on Tl and element 113. The calculated polarizabilty of element 113, 29.85 au, is the smallest in group 13, except for B. The estimated atomic and van der Waals radii of element 113 are also the smallest among these elements. Using the calculated atomic properties and an adsorption model, adsorption enthalpies of elements Al through 113 on inert surfaces, such as Teflon and polyethylene, are predicted. The trends in the atomic properties and DeltaH(ads) in group 13 were found to reverse from In to element 113, reflecting the strong relativistic contraction and stabilization of the outer np(1/2) orbital, which are largest for element 113. The small values of DeltaH(ads) for element 113 on Teflon (14 kJ/mol) and polyethylene (16 kJ/mol) guarantee its transport from the target chamber to the chemistry set up, and the 6 kJ/mol difference relative to Tl values makes possible the separation and identification of the superheavy element on the inert surfaces.

17.
Cephalalgia ; 28(7): 752-62, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18498396

RESUMO

The aim was to apply diagnostic criteria, as published by the International Headache Society (IHS), to the diagnosis of orofacial pain. A total of 328 consecutive patients with orofacial pain were collected over a period of 2 years. The orofacial pain clinic routinely employs criteria published by the IHS, the American Academy of Orofacial Pain (AAOP) and the Research Diagnostic Criteria for Temporomandibular Disorders (RDCTMD). Employing IHS criteria, 184 patients were successfully diagnosed (56%), including 34 with persistent idiopathic facial pain. In the remaining 144 we applied AAOP/RDCTMD criteria and diagnosed 120 as masticatory myofascial pain (MMP) resulting in a diagnostic efficiency of 92.7% (304/328) when applying the three classifications (IHS, AAOP, RDCTMD). Employing further published criteria, 23 patients were diagnosed as neurovascular orofacial pain (NVOP, facial migraine) and one as a neuropathy secondary to connective tissue disease. All the patients were therefore allocated to predefined diagnoses. MMP is clearly defined by AAOP and the RDCTMD. However, NVOP is not defined by any of the above classification systems. The features of MMP and NVOP are presented and analysed with calculations for positive (PPV) and negative predictive values (NPV). In MMP the combination of facial pain aggravated by jaw movement, and the presence of three or more tender muscles resulted in a PPV = 0.82 and a NPV = 0.86. For NVOP the combination of facial pain, throbbing quality, autonomic and/or systemic features and attack duration of > 60 min gave a PPV = 0.71 and a NPV = 0.95. Expansion of the IHS system is needed so as to integrate more orofacial pain syndromes.


Assuntos
Dor Facial/diagnóstico , Transtornos da Cefaleia/diagnóstico , Classificação Internacional de Doenças/normas , Adolescente , Adulto , Idoso , Benchmarking , Diagnóstico Diferencial , Neuralgia Facial/classificação , Neuralgia Facial/diagnóstico , Neuralgia Facial/etiologia , Dor Facial/classificação , Dor Facial/etiologia , Feminino , Transtornos da Cefaleia/classificação , Transtornos da Cefaleia/etiologia , Humanos , Masculino , Mastigação , Pessoa de Meia-Idade , Transtornos de Enxaqueca/classificação , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/etiologia , Transtornos da Articulação Temporomandibular/classificação , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/etiologia , Neuralgia do Trigêmeo/classificação , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/etiologia
18.
J Chem Phys ; 128(2): 024707, 2008 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-18205466

RESUMO

The interaction of elements 112 and 114 with inert surfaces has been studied on the basis of fully relativistic ab initio Dirac-Coulomb CCSD(T) calculations of their atomic properties. The calculated polarizabilities of elements 112 and 114 are significantly lower than corresponding Hg and Pb values due to the relativistic contraction of the valence ns and np(12) orbitals, respectively, in the heavier elements. Due to the same reason, the estimated van der Waals radius of element 114 is smaller than that of Pb. The enthalpies of adsorption of Hg, Pb, and elements 112 and 114 on inert surfaces such as quartz, ice, and Teflon were predicted on the basis of these atomic calculations using a physisorption model. At the present level of accuracy, -DeltaH(ads) of element 112 on these surfaces is slightly (about 2 kJ/mol) larger than -DeltaH(ads)(Hg). The calculated -DeltaH(ads) of element 114 on quartz is about 7 kJ/mol and on Teflon is about 3 kJ/mol smaller than the respective values of -DeltaH(ads)(Pb). The trend of increasing -DeltaH(ads) in group 14 from C to Sn is thus reversed, giving decreasing values from Sn to Pb to element 114 due to the relativistic stabilization and contraction of the np(12) atomic orbitals. This is similar to trends shown by other atomic properties of these elements. The small difference in DeltaH(ads) of Pb and element 114 on inert surfaces obtained within a picture of physisorption contrasts with the large difference (more than 100 kJ/mol) in the chemical reactivity between these elements.

19.
J Dent Res ; 86(6): 491-505, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17525348

RESUMO

The mechanisms involved, and possible treatment targets, in orofacial pain due to cancer are poorly understood. The aim of the first of this two-part series is to review the involved pathophysiological mechanisms and explore their possible roles in the orofacial region. However, there is a lack of relevant research in the trigeminal region, and we have therefore applied data accumulated from experiments on cancer pain mechanisms in rodent spinal models. In the second part, we review the clinical presentation of cancer-associated orofacial pain at various stages: initial diagnosis, during therapy (chemo-, radiotherapy, surgery), and in the post-therapy period. In the present article, we provide a brief outline of trigeminal functional neuro-anatomy and pain-modulatory pathways. Tissue destruction by invasive tumors (or metastases) induces inflammation and nerve damage, with attendant acute pain. In some cases, chronic pain, involving inflammatory and neuropathic mechanisms, may ensue. Distant, painful effects of tumors include paraneoplastic neuropathic syndromes and effects secondary to the release of factors by the tumor (growth factors, cytokines, and enzymes). Additionally, pain is frequent in cancer management protocols (surgery, chemotherapy, and radiotherapy). Understanding the mechanisms involved in cancer-related orofacial pain will enhance patient management.


Assuntos
Dor Facial/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Animais , Doença Crônica , Modelos Animais de Doenças , Dor Facial/fisiopatologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Dor Referida/etiologia , Dor Referida/fisiopatologia , Síndromes Paraneoplásicas/etiologia , Síndromes Paraneoplásicas/fisiopatologia , Nervo Trigêmeo/fisiopatologia , Neuralgia do Trigêmeo/etiologia , Neuralgia do Trigêmeo/fisiopatologia
20.
J Dent Res ; 86(6): 506-18, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17525349

RESUMO

Cancer-associated pain is extremely common and is associated with significant physical and psychological suffering. Unfortunately, pain associated with cancer or its treatment is frequently under-treated, probably due to several factors, including phobia of opioids, under-reporting by patients, and under-diagnosis by healthcare workers. The most common etiology of cancer pain is local tumor invasion (primary or metastatic), involving inflammatory and neuropathic mechanisms; these have been reviewed in Part I. As malignant disease advances, pain usually becomes more frequent and more intense. Additional expressions of orofacial cancer pain include distant tumor effects, involving paraneoplastic mechanisms. Pain secondary to cancer therapy varies with the treatment modalities used: Chemo-radiotherapy protocols are typically associated with painful mucositis and neurotoxicity. Surgical therapies often result in nerve and tissue damage, leading, in the long term, to myofascial and neuropathic pain syndromes. In the present article, we review the clinical presentation of cancer-associated orofacial pain at various stages: initial diagnosis, during therapy (chemo-, radiotherapy, surgery), and in the post-therapy period. As a presenting symptom of orofacial cancer, pain is often of low intensity and diagnostically unreliable. Diagnosis, treatment, and prevention of pain in cancer require knowledge of the presenting characteristics, factors, and mechanisms involved.


Assuntos
Dor Facial/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Dor Facial/fisiopatologia , Dor Facial/terapia , Neoplasias de Cabeça e Pescoço/fisiopatologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Terapia Neoadjuvante/efeitos adversos , Síndromes Paraneoplásicas/etiologia
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