RESUMO
OBJECTIVE: To investigate age and sex differences in orofacial sensory detection. METHODS: One hundred and twenty-six (126) healthy subjects were divided into five groups according to their ages. They were assessed with a quantitative sensory testing protocol for gustative, olfactory, thermal (cold/warm), mechanical (tactile/vibration/electric), and pain (deep/superficial) detection thresholds. The corneal reflex was also evaluated. Data were analyzed with the one-way ANOVA, chi-squared, Fisher's exact, Mann-Whitney, and Kruskal-Wallis tests. RESULTS: The groups of subjects over 61 years old had higher olfactory (P < 0.001), gustative (sweet P = 0.004, salty P = 0.007, sour P = 0.006), thermal (warm P < 0.001, cold P < 0.001), and tactile (P < 0.001) detection thresholds than the others. The vibration detection threshold was high only for subjects over 75 years old (P < 0.001). The electric and deep pain detection thresholds were different for the 61-75 years old group (P ≤ 0.001). Women in all age groups had lower gustative (sweet P = 0.020, salty P = 0.002, sour P < 0.001, and bitter P = 0.002), olfactory (P = 0.010), warm (P < 0.001) and deep (P < 0.001), and superficial pain (P = 0.008) detection thresholds than men, and men from all age groups had lower vibratory detection thresholds (P = 0.006) than women. CONCLUSION: High sensory detection thresholds were observed in subjects over the 6th decade of life, and women had a more accurate sensory perception than men.
Assuntos
Limiar Sensorial/fisiologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto JovemRESUMO
The goal of the current study was to estimate the prevalence of sleep bruxism (SB) in the general population using a representative sample of 1,042 individuals who answered questionnaires and underwent polysomnography (PSG) examinations. After PSG, the individuals were classified into 3 groups: absence of SB, low-frequency SB, and high-frequency SB. The results indicated that the prevalence of SB, indicated by questionnaires and confirmed by PSG, was 5.5%. With PSG used exclusively as the criterion for diagnosis, the prevalence was 7.4% regardless of SB self-reported complaints. With questionnaires alone, the prevalence was 12.5%. Of the 5.5% (n = 56) with confirmed SB, 26 were classified as low-frequency SB, and 30 as high-frequency. The episodes of SB were more frequent in stage 2 sleep, and the phasic bruxism events were more frequent than tonic or mixed events in all sleep stages in individuals with SB. A positive association was observed between SB and insomnia, higher degree of schooling, and a normal/overweight body mass index (BMI). These findings demonstrate the prevalence of SB in a population sampled by PSG, the gold standard methodology in the investigation of sleep disorders, combined with validated questionnaires.
Assuntos
Polissonografia/estatística & dados numéricos , Bruxismo do Sono/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Peso Corporal , Escolaridade , Eletromiografia/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Vigilância da População , Prevalência , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fases do Sono , Inquéritos e Questionários , Adulto JovemRESUMO
To explore the relationship between sleep bruxism (SB), painful temporomandibular disorders (TMD) and psychologic status in a cross-sectional study. The sample consisted of 272 individuals. The Research Diagnostic Criteria for TMD (RDC/TMD) was used to diagnose TMD; SB was diagnosed by clinical criteria proposed by The American Academy of Sleep Medicine. The sample was divided into four groups: (1) patients without painful TMD and without SB, (2) patients without painful TMD and with SB, (3) patients with painful TMD and without SB and (4) patients with painful TMD and with SB. Data were analysed by Odds Ratio test with a 95% confidence interval. Patients with SB had an increased risk for the occurrence of myofascial pain (OR = 5·93, 95% CI: 3·19-11·02) and arthralgia (2·34, 1·58-3·46). Group 3 had an increased risk for moderate/severe depression and non-specific physical symptoms (10·1, 3·67-27·79; 14·7, 5·39-39·92, respectively), and this risk increased in the presence of SB (25·0, 9·65-64·77; 35·8, 13·94-91·90, respectively). SB seems to be a risk factor for painful TMD, and this in turn is a risk factor for the occurrence of higher depression and non-specific physical symptoms levels, but a cause-effect relationship could not be established.
Assuntos
Transtorno Depressivo/epidemiologia , Bruxismo do Sono/epidemiologia , Síndrome da Disfunção da Articulação Temporomandibular/epidemiologia , Adolescente , Adulto , Idoso , Artralgia/epidemiologia , Artralgia/psicologia , Estudos Transversais , Transtorno Depressivo/psicologia , Dor Facial/epidemiologia , Dor Facial/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Bruxismo do Sono/psicologia , Síndrome da Disfunção da Articulação Temporomandibular/psicologia , Adulto JovemRESUMO
OBJECTIVES: To determine somesthetic, olfactory, gustative and salivary abnormalities in patients with burning mouth syndrome (BMS), idiopathic trigeminal neuralgia (ITN) and trigeminal postherpetic neuralgia (PHN). SUBJECTS AND METHODS: Twenty patients from each group (BMS, ITN, PHN) and 60 healthy controls were evaluated with a systematized quantitative approach of thermal (cold and warm), mechanical, pain, gustation, olfaction and salivary flow; data were analyzed with ANOVA, Tukey, Kruskal-Wallis and Dunn tests with a level of significance of 5%. RESULTS: There were no salivary differences among the groups with matched ages; the cold perception was abnormal only at the mandibular branch of PHN (P = 0.001) and warm was abnormal in all trigeminal branches of PHN and BMS; mechanical sensitivity was altered at the mandibular branch of PHN and in all trigeminal branches of BMS. The salty, sweet and olfactory thresholds were higher in all studied groups; the sour threshold was lower and there were no differences of bitter. CONCLUSION: All groups showed abnormal thresholds of gustation and olfaction; somesthetic findings were discrete in ITN and more common in PHN and BMS; central mechanisms of balance of sensorial inputs might be underlying these observations.
Assuntos
Saliva/metabolismo , Sensação/fisiologia , Olfato/fisiologia , Paladar/fisiologia , Neuralgia do Trigêmeo/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome da Ardência Bucal/fisiopatologia , Temperatura Baixa , Feminino , Temperatura Alta , Humanos , Masculino , Nervo Mandibular/fisiopatologia , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/fisiopatologia , Dor/fisiopatologia , Taxa Secretória/fisiologia , Limiar Sensorial/fisiologia , Limiar Gustativo/fisiologia , Sensação Térmica/fisiologia , Tato/fisiologia , Nervo Trigêmeo/fisiopatologia , Adulto JovemRESUMO
Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.
Assuntos
Craniotomia/efeitos adversos , Cefaleia/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Feminino , Cefaleia/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Inquéritos e QuestionáriosRESUMO
Voltage-gated sodium channels have been implicated in acute and chronic neuropathic pain. Among subtypes, Nav1.7 single mutations can cause congenital indifference to pain or chronic neuropathic pain syndromes, including paroxysmal ones. This channel is co-expressed with Nav1.8, which sustains the initial action potential; Nav1.3 is an embrionary channel which is expressed in neurons after injury, as in neuropathic conditions. Few studies are focused on the expression of these molecules in human tissues having chronic pain. Trigeminal neuralgia (TN) is an idiopathic paroxysmal pain treated with sodium channel blockers. The aim of this study was to investigate the expression of Nav1.3, Nav1.7 and Nav1.8 by RT-PCR in patients with TN, compared to controls. The gingival tissue was removed from the correspondent trigeminal area affected. We found that Nav1.7 was downregulated in TN (P=0.017) and Nav1.3 was upregulated in these patients (P=0.043). We propose a physiopathological mechanism for these findings. Besides vascular compression of TN, this disease might be also a channelopathy.
Assuntos
Gengiva/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Canais de Sódio/metabolismo , Neuralgia do Trigêmeo/metabolismo , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Regulação da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Canal de Sódio Disparado por Voltagem NAV1.3 , Canal de Sódio Disparado por Voltagem NAV1.7 , Canal de Sódio Disparado por Voltagem NAV1.8 , Proteínas do Tecido Nervoso/genética , Dor/genética , Dor/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Canais de Sódio/genética , Neuralgia do Trigêmeo/genética , Adulto JovemRESUMO
OBJECTIVE: The aim of this pilot study was to investigate the psychological factors of chronic orofacial pain patients regarding hospitalization for surgical treatment. METHODS: We evaluated 30 patients (15 with temporomandibular disorder and 15 with trigeminal neuralgia) of three groups: 10 were hospitalized for surgery, 10 were newly diagnosed, and 10 had been clinically treated. Data were collected using a semi-structured interview and the Hospital Anxiety Depression Scale. RESULTS: Eighty percent reported lack of family support, 90% had important limitations in daily activities, and social aspects were the most affected (34%). Patients who were hospitalized for surgery had the highest degree of anxiety and expectation (90%; p<0.05). CONCLUSION: Surgery for chronic pain generates great expectations especially because it is considered a hope of cure. Clinically treated patients also might understand the factors associated to surgery choices and participate at the process of choosing. In general, chronic treatment for facial pain needs psychological support to cope with it.
Assuntos
Emoções , Dor Facial/psicologia , Dor Facial/cirurgia , Pacientes Internados/psicologia , Transtornos da Articulação Temporomandibular/psicologia , Transtornos da Articulação Temporomandibular/cirurgia , Neuralgia do Trigêmeo/psicologia , Neuralgia do Trigêmeo/cirurgia , Atividades Cotidianas , Adaptação Psicológica , Doença Crônica , Feminino , Hospitalização , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Apoio SocialRESUMO
PURPOSE: The objective of this pilot study was to determine pain characteristics of pregnant women immediately before and after childbirth by vaginal delivery and to compare them with the pain intensity reported by physicians. METHODS: We evaluated 20 Brazilian women between September and December 2007 with the WHOQOL-Bref instrument, VAS, McGill Pain Questionnaire, and Anxiety Adapted Scale. We interviewed the obstetrician with the VAS about the patient's pain. Data were analyzed with the chi-square test. RESULTS: Mean age was 22.35 years (SD = 6.24, range 15-39 years). It was necessary to use oxytocin in 15 (75%) patients, which had no correlation with anxiety degree. Higher intensity of pain (p < 0.05) and higher anxiety index (p < 0.05) were more common in women in the first pregnancy. CONCLUSIONS: Higher pain intensity was associated with higher anxiety levels (p < 0.05). Around half of the obstetricians' VAS scores were lower than the VAS scores of women, and probably pain at labor was underestimated and not controlled. Higher indices of anxiety and pain were associated, and were more frequent in women in the first pregnancy.
Assuntos
Medição da Dor , Dor/diagnóstico , Parto , Qualidade de Vida , Adolescente , Adulto , Ansiedade , Feminino , Humanos , Entrevistas como Assunto , Dor/psicologia , Médicos , Gravidez , Adulto JovemRESUMO
We prospectively studied headache characteristics during 6 months after craniotomy performed for treatment of cerebral aneurysms in 79 patients. Semistructured interviews, headache diaries, the Hospital Anxiety and Depression Scale and the Epworth Sleepiness Scales, the Short Form-36 Health Survey (SF-36) and McGill Pain Questionnaire were used. Seventy-two patients had headaches, half before the fifth day after surgery. Changes were observed in headache diagnosis, side and site in the postoperative period. Headache frequency increased immediately after surgery and then decreased over time. Headache frequency was associated with depressive and anxiety symptoms. Pain intensity was higher in women and in patients with more anxiety symptoms. An incidence of post-craniotomy headache of 40% was observed according to International Headache Society classification criteria, 10.7% of the acute and 29.3% of the chronic type. The bodily pain domain of the SF-36 was worse in patients with more anxiety symptoms. Greater frequencies of headache were associated with lower scores on bodily pain and social functioning.
Assuntos
Craniotomia/efeitos adversos , Cefaleia/psicologia , Aneurisma Intracraniano/cirurgia , Complicações Pós-Operatórias/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , Craniotomia/psicologia , Feminino , Seguimentos , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Aneurisma Intracraniano/epidemiologia , Aneurisma Intracraniano/psicologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Resultado do TratamentoRESUMO
Our objectives were to evaluate the oral health and the masticatory system of 48 juvenile systemic lupus erythematosus (JSLE) patients and to compare them with 48 healthy children and adolescents. Demographic data, clinical manifestations and therapies of JSLE were reviewed. The DMFT index (DMFTI), the plaque (PI) and the gingival bleeding (GI) indices, dental relationship, facial profile, clinical dysfunction and mandibular mobility indices were evaluated. The two groups were homogeneous regarding age, gender, Brazilian social-economic class and dental decay index (P > 0.05). Of note, the medians of the PI and the GI were higher in JSLE patients than in controls (61.5 versus 38.10, P = 0.003 and 26.0 versus 15.95, P = 0.014; respectively). Likewise, a linear statistical correlation was evidenced between the JSLE duration and the GI (P = 0.017, r = 0.11), cumulative dose of prednisone and the PI (P = 0.01, r = 0.385) and cumulative dose of prednisone and the GI ( P = 0.001, r = 0.471). The clinical dysfunction and mandibular mobility indices were higher in JSLE patients versus controls (P = 0.002, P = 0.025). Moreover, the median of the mandibular mobility index was higher in JSLE patients who used at least one immunosuppressive than on those who did not use this medication (P = 0.0001). These results suggest that JSLE patients had an inadequate oral hygiene, higher incidence of gingivitis and temporomandibular joint dysfunction.