Synergistic induction of blood-brain barrier properties.

Blood-brain barrier (BBB) models derived from human stem cells are powerful tools to improve our understanding of cerebrovascular diseases and to facilitate drug development for the human brain. Yet providing stem cell-derived endothelial cells with the right signaling cues to acquire BBB characteristics while also retaining their vascular identity remains challenging. Here, we show that the simultaneous activation of cyclic AMP and Wnt/ß-catenin signaling and inhibition of the TGF-ß pathway in endothelial cells robustly induce BBB properties in vitro. To target this interaction, we present a small-molecule cocktail named cARLA, which synergistically enhances barrier tightness in a range of BBB models across species. Mechanistically, we reveal that the three pathways converge on Wnt/ß-catenin signaling to mediate the effect of cARLA via the tight junction protein claudin-5. We demonstrate that cARLA shifts the gene expressional profile of human stem cell-derived endothelial cells toward the in vivo brain endothelial signature, with a higher glycocalyx density and efflux pump activity, lower rates of endocytosis, and a characteristic endothelial response to proinflammatory cytokines. Finally, we illustrate how cARLA can improve the predictive value of human BBB models regarding the brain penetration of drugs and targeted nanoparticles. Due to its synergistic effect, high reproducibility, and ease of use, cARLA has the potential to advance drug development for the human brain by improving BBB models across laboratories.

MTOR gene variants are associated with severe COVID-19 outcomes: A multicenter study.

BACKGROUND: The worst outcomes linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been attributed to the cytokine storm, which contributes significantly to the immunopathogenesis of the disease. The mammalian target of rapamycin (mTOR) pathway is essential for orchestrating innate immune cell defense including cytokine production and is dysregulated in severe Coronavirus Disease 2019 (COVID-19) individuals. The individual genetic background might play a role in the exacerbated immune response. OBJECTIVE: In this study, we aimed to investigate the association between MTOR genetic variants and COVID-19 outcomes. METHODS: This study enrolled groups of individuals with severe (n = 285) and mild (n = 207) COVID-19 from Brazilian states. The MTOR variants, rs1057079 and rs2536, were genotyped. A logistic regression analysis and Kaplan-Meier survival curves were performed. We applied a genotyping risk score to estimate the cumulative contribution of the risk alleles. Tumor necrosis factor (TNF) and interleukin-6 (IL-6) plasma levels were also measured. RESULTS: The T allele of the MTOR rs1057079 variant was associated with a higher likelihood of developing the most severe form of COVID-19. In addition, higher levels of IL-6 and COVID-19 death was linked to the T allele of the rs2536 variant. These variants exhibited a cumulative risk when inherited collectively. CONCLUSIONS: These results show a potential pathogenetic role of MTOR gene variants and may be useful for predicting severe outcomes following COVID-19 infection, resulting in a more effective allocation of health resources.

Handgrip strength as a diagnostic tool for frailty risk in elderly patients with moderate to severe asthma / Força de preensão manual como ferramenta diagnóstica de risco de fragilidade em pacientes idosos com asma moderada a grave

ABSTRACT Objective: To evaluate handgrip strength (HGS) as a diagnostic tool for frailty risk in elderly patients with asthma, as well as to investigate the prevalence of frailty in this population. Methods: This was a cross-sectional study including 96 patients ≥ 60 years of age diagnosed with moderate to severe asthma and treated at a tertiary referral center in Brazil. We measured HGS using a calibrated hydraulic hand dynamometer. We used a frailty scale and the AUC to assess the diagnostic accuracy of the HGS test. Results: The median age of participants was 67 years. Most (78%) were women and non-White (91%) of low socioeconomic status. HGS identified those at risk for frailty, with an AUC of 71.6% (61.5-80.4%; p < 0.002), as well as a sensitivity of 73.58% and a specificity of 67.53%, on the basis of a cutoff of ≤ 19 kgf. Conclusions: HGS appears to be a simple, reliable tool for clinicians to determine frailty risk in older asthma patients in a point-of-care setting.

RESUMO Objetivo: Avaliar a força de preensão manual (FPM) como ferramenta diagnóstica de risco de fragilidade em pacientes idosos com asma e investigar a prevalência de fragilidade nessa população. Métodos: Estudo transversal com 96 pacientes com idade ≥ 60 anos e diagnóstico de asma moderada a grave, atendidos em um centro terciário de referência no Brasil. Medimos a FPM com um dinamômetro hidráulico manual calibrado. Usamos uma escala de fragilidade e a ASC para avaliar a precisão diagnóstica do teste de FPM. Resultados: A mediana da idade dos participantes foi de 67 anos. A maioria eram mulheres (78%) não brancas (91%) cujo nível socioeconômico era baixo. O ponto de corte de FPM ≤ 19 kgf identificou os participantes que apresentavam risco de fragilidade, com ASC = 71,6% (61,5-80,4%; p < 0,002), sensibilidade = 73,58% e especificidade = 67,53%. Conclusões: A FPM parece ser uma ferramenta simples e confiável para determinar, no próprio local de atendimento médico, o risco de fragilidade em pacientes idosos com asma.

Ultrasonic circular cyclocoagulation prospective safety and effectiveness study.

PURPOSE: To evaluate the efficacy and safety of ultrasound cycloplasty procedures (UCP) in patients with uncontrolled glaucoma. METHODS: Prospective longitudinal study with UCP was performed by EyeOP1© probe with 8 s duration on 6 or 8 sectors, according to baseline intraocular pressure (IOP). Complete ophthalmic examination was performed pre- and post-operatively at 1st day, 1st week, 1st, 3rd, 6th, 9th and 12th months. UCP was repeated beyond 3rd month if IOP was > 21 mmHg, under maximum therapy, without major complications. Primary outcomes were complete (IOP reduction ≥ 20% or reduction in number of antiglaucomatous drugs and IOP ≥ 5 mmHg without occurrence of major complications) and qualified (IOP reduction ≥ 20% or reduction in number of antiglaucomatous drugs and IOP ≥ 5 mmHg) surgical success rates at 12 months. Secondary outcomes were mean IOP reduction, mean number of drugs reduction, rates of failure, number of repeated procedures, mean time to failure and occurrence of complications. RESULTS: Fourteen eyes of 13 patients (11 male) with advanced glaucoma (Hoddap classification) were included. Six were surgically naïve. Mean age was 68.29 ± 10.66 years. Four eyes were treated in 8 sectors (28.5%). Patients were followed for 12 months after first UCP procedure. Overall surgical success was achieved in 92.9% at 6 months and in 100% of cases at 12 months. Mean IOP significantly reduced from 28.50 ± 7.61 mmHg to 13.79 ± 6.97 at 1 month, 17.36 ± 8.58 at 3 months, 17.79 ± 6.29 at 6 months, 16.3 ± 4.6 at 9 months and to 15.23 ± 5.09 at 12 months (p < 0.01). Mean number of drugs reduced from 3.71 ± 0.61 to 2.43 ± 1.51 at 3 months, 2.86 ± 1.1 at 6 months, 2.64 ± 0.93 at 9 months and to 2.92 ± 0.86 at 12 months (p < 0.05). Major reversible complications included choroidal detachment in 2 (14.29%) and corneal edema in 1 eye (7.14%), without permanent visual acuity reduction. Minor reversible complications included anterior chamber reaction (92.25%), conjunctival hyperemia (71.43%) and superficial keratitis (57.4%). Four eyes (28.57%) had indication for repeating UCP, with mean period to failure of 8.1 ± 3.95 months. CONCLUSION: UCP procedures are effective in reducing IOP in severe glaucoma. Its application and repetition seem to be a medium-long term acceptable alternative to cyclodestructive surgery. However, long-term efficacy and safety require yet further investigation.

Flow induces barrier and glycocalyx-related genes and negative surface charge in a lab-on-a-chip human blood-brain barrier model.

Microfluidic lab-on-a-chip (LOC) devices allow the study of blood-brain barrier (BBB) properties in dynamic conditions. We studied a BBB model, consisting of human endothelial cells derived from hematopoietic stem cells in co-culture with brain pericytes, in an LOC device to study fluid flow in the regulation of endothelial, BBB and glycocalyx-related genes and surface charge. The highly negatively charged endothelial surface glycocalyx functions as mechano-sensor detecting shear forces generated by blood flow on the luminal side of brain endothelial cells and contributes to the physical barrier of the BBB. Despite the importance of glycocalyx in the regulation of BBB permeability in physiological conditions and in diseases, the underlying mechanisms remained unclear. The MACE-seq gene expression profiling analysis showed differentially expressed endothelial, BBB and glycocalyx core protein genes after fluid flow, as well as enriched pathways for the extracellular matrix molecules. We observed increased barrier properties, a higher intensity glycocalyx staining and a more negative surface charge of human brain-like endothelial cells (BLECs) in dynamic conditions. Our work is the first study to provide data on BBB properties and glycocalyx of BLECs in an LOC device under dynamic conditions and confirms the importance of fluid flow for BBB culture models.

Polar Infection of Echovirus-30 Causes Differential Barrier Affection and Gene Regulation at the Blood-Cerebrospinal Fluid Barrier.

Echovirus-30 (E-30) is responsible for the extensive global outbreaks of meningitis in children. To gain access to the central nervous system, E-30 first has to cross the epithelial blood-cerebrospinal fluid barrier. Several meningitis causing bacteria preferentially infect human choroid plexus papilloma (HIBCPP) cells in a polar fashion from the basolateral cell side. Here, we investigated the polar infection of HIBCPP cells with E-30. Both apical and basolateral infections caused a significant decrease in the transepithelial electrical resistance of HIBCPP cells. However, to reach the same impact on the barrier properties, the multiplicity of infection of the apical side had to be higher than that of the basolateral infection. Furthermore, the number of infected cells at respective time-points after basolateral infection was significantly higher compared to apical infection. Cytotoxic effects of E-30 on HIBCPP cells during basolateral infection were observed following prolonged infection and appeared more drastically compared to the apical infection. Gene expression profiles determined by massive analysis of cDNA ends revealed distinct regulation of specific genes depending on the side of HIBCPP cells' infection. Altogether, our data highlights the polar effects of E-30 infection in a human in vitro model of the blood-cerebrospinal fluid barrier leading to central nervous system inflammation.

Contribution of brain pericytes in blood-brain barrier formation and maintenance: a transcriptomic study of cocultured human endothelial cells derived from hematopoietic stem cells.

Formation, maintenance, and repair of the blood-brain barrier (BBB) are critical for central nervous system homeostasis. The interaction of endothelial cells (ECs) with brain pericytes is known to induce BBB characteristics in brain ECs during embryogenesis and can be used to differentiate human ECs from stem cell source in in vitro BBB models. However, the molecular events involved in BBB maturation are not fully understood. To this end, human ECs derived from hematopoietic stem cells were cultivated with either primary bovine or cell line-derived human brain pericytes to induce BBB formation. Subsequently, the transcriptomic profiles of solocultured vs. cocultured ECs were analysed over time by Massive Analysis of cDNA Ends (MACE) technology. This RNA sequencing method is a 3'-end targeted, tag-based, reduced representation transcriptome profiling technique, that can reliably quantify all polyadenylated transcripts including those with low expression. By analysing the generated transcriptomic profiles, we can explore the molecular processes responsible for the functional changes observed in ECs in coculture with brain pericytes (e.g. barrier tightening, changes in the expression of transporters and receptors). Our results identified several up- and downregulated genes and signaling pathways that provide a valuable data source to further delineate complex molecular processes that are involved in BBB formation and BBB maintenance. In addition, this data provides a source to identify novel targets for central nervous system drug delivery strategies.

Evaluation of systemic inflammatory response and lung injury induced by Crotalus durissus cascavella venom.

This study investigated the systemic inflammatory response and mechanism of pulmonary lesions induced by Crotalus durissus cascavella venom in murine in the state of Bahia. In order to investigate T helper Th1, Th2 and Th17 lymphocyte profiles, we measured interleukin (IL) -2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor (TNF) and interferon gamma (IFN-γ) levels in the peritoneal fluid and macerated lungs of mice and histopathological alterations at the specific time windows of 1h, 3h, 6h, 12h, 24h and 48h after inoculation with Crotalus durissus cascavella venom. The data demonstrated an increase of acute-phase cytokines (IL-6 and TNF) in the first hours after inoculation, with a subsequent increase in IL-10 and IL-4, suggesting immune response modulation for the Th2 profile. The histopathological analysis showed significant morphological alterations, compatible with acute pulmonary lesions, with polymorphonuclear leukocyte (PMN) infiltration, intra-alveolar edema, congestion, hemorrhage and atelectasis. These findings advance our understanding of the dynamics of envenomation and contribute to improve clinical management and antiophidic therapy for individuals exposed to venom.

Tinnitus and event related potentials: a systematic review / Zumbido e potenciais evocados auditivos relacionados a eventos: uma revisão sistemática

Abstract Introduction Tinnitus is sound perception in the absence of a sound source. Changes in parameters of latency and amplitude on the auditory event related potentials or long latency potentials waves have been cited in tinnitus patients when compared to a control group. Objective To perform an assessment of scientific evidence that verifies the possibility of alterations in latency or amplitude of the waves of event related potentials in individuals with tinnitus. Methods By using SciELO, Lilacs, ISI Web and PubMed, scientific databases, a review was performed. Articles published in English, Portuguese, French and Spanish that correlated tinnitus with changes in event related potentials were included in this review. Results Twelve articles were located, however only eight fulfilled the criteria for inclusion. Conclusion The sample of selected studies demonstrate that the long latency auditory evoked potentials related to events between the control and tinnitus patients showed some changes in latency and or amplitude in tinnitus patients. There are changes in event-related potentials when comparing patients with tinnitus and the control group. These changes take place considering the severity of tinnitus, tinnitus site of lesion, and capacity for changes after interventions. The event related potentials can help to determine the neurotransmitter involved in tinnitus generation and evaluate tinnitus treatments.

Resumo Introdução O zumbido é a percepção de um som na ausência de uma fonte sonora. Mudanças nos parâmetros de latência e amplitude nas ondas dos potenciais evocados auditivos relacionados a eventos ou potenciais de longa latência foram citadas em pacientes com zumbido quando comparados a um grupo controle. Objetivo Realizar uma avaliação de evidências científicas que verifiquem a possibilidade de alterações na latência ou amplitude das ondas de potenciais evocados auditivos relacionados a eventos em indivíduos com zumbido. Método Foi feita uma revisão a partir dos bancos de dados científicos SciELO, Lilacs, ISI Web e PubMed. Artigos publicados em inglês, português, francês e espanhol que correlacionavam zumbido com alterações nos potenciais evocados auditivos relacionados a eventos foram incluídos. Resultados Foram localizados 12 artigos, porém apenas oito preencheram os critérios de inclusão. Conclusão A amostra de estudos selecionados demonstra que os potenciais evocados auditivos de longa latência relacionados a eventos entre os pacientes-controle e com zumbido apresentaram algumas alterações na latência e/ou amplitude nos pacientes com zumbido. Há mudanças nos potenciais relacionados a eventos ao comparar pacientes com zumbido e o grupo controle. Essas alterações consideram a gravidade do zumbido, o local da lesão do zumbido e a capacidade de alterações após as intervenções. Os potenciais evocados auditivos relacionados a eventos podem ajudar a determinar o neurotransmissor envolvido na geração do zumbido e avaliar os tratamentos para o zumbido.

Pesticides in the surface waters of the Camanducaia River watershed, Brazil.

Camanducaia River is part of the Piracicaba watershed responsible for pumping water into the Cantareira System, which is one of the main water sources for the metropolis of São Paulo and Campinas, Brazil. Intensive use of pesticides and hilly topography represents a situation of high risk for river water contamination. Therefore, water samples from 12 locations were collected along the Camanducaia River and its tributaries, over a period of 4 mo during the rainy season, and analyzed by GC-MS/MS or UPLC- MS/MS for the presence of 46 pesticides. Seven pesticides (fipronil, methyl parathion, metolachlor, atrazine, carbofuran, diuron, and simazine) were positively detected. Only atrazine (the most frequently detected) and diuron were present at concentrations above the limit of quantification of the analytical method (0.32 and 0.57 µg L-1 for atrazine and diuron, respectively). Pesticides detection frequency was higher than expected for a river system where only 11.8% of the land area is under agriculture. The vulnerability of the Camanducaia basin to pesticide contamination is attributed to the high annual precipitation (> 1.5 m y-1 in the headwaters), associated with topographical features (steep terrain) and soil types that favor surface runoff, which has been exacerbated by poor soil management practices.

Pigmented paravenous retinochoroidal atrophy associated with unilateral cystoid macular oedema.

A 65-year-old man was referred to our department with complaints of blurred vision in the left eye. Funduscopic examination revealed areas of retinochoroidal atrophy along the retinal veins bilaterally and bone spicule pigmentation along the nasal and superior temporal venous branches, as well as macular oedema in the left eye. Fluorescein angiography, visual field test, optical coherence tomography and electrophysiological examination were performed, and results were compatible with the diagnosis of pigmented paravenous retinochoroidal atrophy (PPRCA). Treatment with topical dorzolamide and intravitreal bevacizumab in the left eye resulted in poor anatomical and visual response. There is scarce documentation of macular involvement with non-inflammatory unilateral cystoid macular oedema in PPRCA in the literature. Further investigation is required to elucidate the pathogenesis of PPRCA and to properly manage these patients.

Hormonal stimulation in 4 to 7 months old Nelore (Bos taurus indicus) females improved ovarian follicular responses but not the in vitro embryo production.

The inclusion of pre-pubertal bovine females in reproductive management could allow in vitro embryo production and reduce generation interval, thereby causing faster genetic gain of the herd. However, oocytes of pre-pubertal females have lower competence, blastocyst production, and pregnancy rates than those collected from pubertal animals. This study aimed to evaluate the effect of an induced hormonal stimulation on the serum concentrations of Anti-Mullerian hormone (AMH) and FSH, ovarian responses, ovum pick up (OPU), and in vitro produced embryos (IVP) from oocytes obtained from four-to seven-months old Nelore female cattle. In a crossover design, these females were randomly allocated into: 1) Treated Group (TG, n = 9): the animals were subjected to a hormonal protocol (implanted progesterone device, estradiol benzoate, LH, and FSH) from Day 0 (the start of the treatment) to Day 7 (OPU day), and 2) Control Group (CG, n = 9): the females did not receive any hormonal stimulation, but they had ablation of their largest follicles on Day 2 of experiment. Blood collection for serum FSH measurements was done on Days 5, 6, 7, and 8, and collection for serum AMH measurements was done on Days 5 and 8. As hypothesized, TG had higher serum FSH concentrations (p < 0.05) on Day 5 (1.16 ±â€¯0.31 ng/mL), Day 6 (1.21 ±â€¯0.45 ng/mL), and Day 7 (0.95 ±â€¯0.26 ng/mL) than CG (0.56 ±â€¯0.17 ng/mL on Day 5, 0.60 ±â€¯0.25 ng/mL on Day 6, and 0.60 ±â€¯0.14 ng/mL on Day 7). However, serum AMH concentrations were neither significantly different (p > 0.05) between CG and TG, nor between the collection days. Hormonal stimulation also increased (p < 0.05) total follicular population (20.0 ±â€¯4.95 CG vs 26.66 ±â€¯4.24 TG), ovarian diameter (13.08 ±â€¯1.0 mm CG vs 14.81 ±â€¯1.38 mm TG) and number of follicles ≥2.5 mm (6.88 ±â€¯2.14 CG vs 11.55 ±â€¯4.09 TG). In TG, grades I and II oocytes predominated, whereas, in CG grades III and IV oocytes were more abundant (p < 0.05). No significant increases (p > 0.05) in the cleavage (49.33% CG vs 51.42% TG), cleavage > 4 cells (9.33% CG vs 16.19% TG), and blastocysts rates (1.33% CG vs 8.57% TG) were seen in TG. This hormonal protocol increased serum FSH concentrations that possibly contributed to increases in the observed follicle, as well as improving oocyte quality. This exogenous hormonal stimulation increased available oocytes numbers for IVP, despite no increase in the in vitro embryo production efficiency.

Tinnitus and sound intolerance: evidence and experience of a Brazilian group / Zumbido e intolerância a sons: evidência e experiência de um grupo brasileiro

Abstract Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.

Resumo Introdução Zumbido e intolerância a sons são queixas frequentes e subjetivas que podem ter impacto na qualidade de vida do paciente. Objetivo Apresentar uma revisão dos principais pontos, inclusive conceitos, fisiopatologia, diagnóstico e abordagem do paciente com zumbido e sensibilidade a sons. Método Revisão da literatura com levantamento bibliográfico na base de dados da LILACS, SciELO, Pubmed e MEDLINE. Foram selecionados artigos e capítulos de livros sobre zumbido e sensibilidade a sons. Os diversos tópicos foram discutidos por um grupo de profissionais brasileiros e as conclusões, descritas. Resultado A prevalência de zumbido tem aumentado ao longo dos anos, muitas vezes associado a perda auditiva, fatores metabólicos e erros alimentares. A avaliação médica deve ser feita minuciosamente no sentido de orientar a solicitação de exames subsidiários. Os tratamentos disponíveis atualmente variam de medicamentos ao uso de sons com características específicas e técnicas de meditação, com resultados variáveis. Conclusão Foi apresentada uma revisão sobre os temas que permitindo ao leitor uma visão ampla da abordagem dos pacientes com zumbido e sensibilidade auditiva baseada em evidências científicas e experiência nacional.

Água e saúde no município de Igarapé-Açu, Pará / Water and health in Igarapé-Açu, Pará, Brazil

Resumo Este artigo visa analisar e compreender a relação entre água e saúde em comunidades rurais situadas na microbacia do igarapé Cumaru, município de Igarapé-Açu (PA), nordeste paraense. São avaliados a captação e o tratamento de água para o consumo humano, considerando as práticas de esgoto sanitário realizadas cotidianamente pela população rural dessa microbacia, visto que têm implicação direta na saúde da população local. Este trabalho baseia-se em pesquisa de campo com uma abordagem quali-quantitativa. Utilizou-se questionário fechado para o levantamento das fontes de captação, saneamento rural e usos de insumos agrícolas. Foram consideradas observações feitas por agricultores familiares da região ao focar o funcionamento do estabelecimento agrícola, a fim de observar de diversos ângulos a relação entre água e saúde no seu entendimento. Observou-se que a vulnerabilidade das fontes de água acessadas pela população é um fator que contribui para a contaminação das fontes, caracterizando consequentemente uma ameaça à saúde da população rural. Entretanto, nota-se a percepção da população quanto às fontes de água mais profundas, como poços tubulares, sendo estes prioritários para captação de água para ingestão.

Abstract This article aims to analyze and understand the relationship between water and health in rural communities located in the watershed of Cumaru stream, in the municipality Igarapé-Açu, Northeast of Pará state. The harvesting and treatment of the water conducted by the rural population for human consumption were assessed, considering their practices of sanitary sewer, since these aspects have direct impact on their health. This study is based on field research with a quantitative approach. Closed questionnaire was used to raise the sources of water harvesting, rural sanitation, and use of agricultural inputs. We used participant observation, when focusing on the functioning of the agricultural establishment, to observe from various angles the relationship between water and health. We noted that the vulnerability of the water resources accessed by the population is a factor that contributes to the contamination of the sources, therefore a threat to the health of the rural population. However, the perception of the population is notable regarding deeper water sources, such as tube wells, which are priorities for water harvesting.

Evaluation of depressive symptoms and qualit y of life in individuals with tinnitus and temporomandibular disorders / Avaliação da presença de sintomas depressivos e qualidade de vida de indivíduos portadores de zumbido e desordens temporomandibulares

Various etiologies are attributed to the development of subjective tinnitus, but their inter-relationship with the presence of temporomandibular disorders and depression is still poorly understood. To assess the presence of depressive symptoms in individuals with TMD and subjective tinnitus, assessing the impact on their quality of life. This is a cross-sectional observational descriptive study. We evaluated 44 patients in a public University. For TMD diagnosis as well as assessment of depressive symptoms, the RDC/TMD questionnaire was used. Otolaryngological assessment was conducted by means of pure tone, speech, and immitance audiometry. The "Tinnitus Handicap Inventory" questionnaire was also administered. 84% of the individuals with tinnitus had myofascial pain, with the masseter muscle being the most prevalent area of pain, and 16% exclusively had painful and/or degenerative TMJ changes. Among the patients with myofascial pain, 86,5% had depressive symptoms, while among those without myofascial pain, only 42,8% presented these symptoms. Eleven (11) patients (25%) reported slight impact of tinnitus on quality of life, 15 (34%) mild impact, 7 (16%) moderate, 7 (16%) severe, and 4 (9%) catastrophic impact. There was a positive association between the presence of myofascial pain and depressive symptoms (p=0,02), as the intensity of tinnitus increases and the severity of depressive symptoms (p<0,01).

Diversas etiologias são atribuídas ao desenvolvimento do zumbido subjetivo, contudo sua inter-relação com a presença das desordens temporomandibulares e depressão é ainda pouco compreendida. Avaliar a presença de sintomas depressivos em indivíduos portadores de DTM e zumbido subjetivo, avaliando o impacto da presença do zumbido na qualidade de vida dos mesmos. Tipo de estudo: trata-se de um estudo descritivo observacional transversal. Foram avaliados 44 pacientes do Serviço ATM da Faculdade de Odontologia da Universidade Federal de Juiz de Fora. Para diagnóstico das DTM assim como avaliação dos sintomas depressivos, foi utilizado o questionário do RDC/TMD. Foi realizada avaliação otorrinolaringológica, sendo feitas a audiometria tonal, vocal e imitanciometria. Também foi aplicado o questionário "Tinnitus Handicap Inventory". Dos 84% indivíduos com zumbido apresentaram dor miofascial, sendo o músculo masseter a região mais prevalente de dor, e 16% possuíram exclusivamente alterações álgicas e/ou degenerativas da ATM. Dentre os portadores de dor miofascial, 86,5% apresentaram sintomas depressivos, enquanto naqueles sem dor miofascial a presença destes sintomas estava presente em apenas 42,8%. 11 indivíduos (25%) relataram impacto do zumbido na qualidade de vida desprezível, 15 (34%) impacto leve, 7 (16%) moderado, 7 (16%) severo e 4 (9%) impacto catastrófico. Houve associação positiva entre a presença de sintomas depressivos e dor miofascial (p=0,02), assim como relação direta entre o aumento da intensidade do zumbido e a severidade dos sintomas depressivos (p<0,01).