Photobiostimulation activity of different low-level laser dosage on masticatory muscles and temporomandibular joint in an induced arthritis rat model.

This study aimed to investigate the anti-inflammatory effects of different dosage of low-level laser therapy (LLLT) in an experimental model of temporomandibular joint (TMJ) arthritis. One hundred male Wistar rats were used and divided into the following groups: CG, control group; AG, animals group with left TMJ arthritis induced by intra-articular injection of Complete Freund's adjuvant - CFA; LG5, LG10 and LG20 - animals with arthritis and treated with LLLT at doses 5, 10, and 20 J/cm2, respectively. Morphological analysis was performed by TMJ histological sections stained with hematoxylin-eosin (HE), picrosirius (PSR), and toluidine blue (TB), as well as histomorphometric evaluation of cartilage, articular disc, and masticatory muscles. The amount of feed consumed within 3 weeks was evaluated, and biochemical analysis of TMJ tissues included measurement of sulfated glycosaminoglycans (GAGs), matrix metalloproteinases (MMPs) 2 and 9 zymography, and ELISA for cytokines IL-6, TNF-α, and IL-1ß. Only the 20 J/cm2 dose promoted higher feed intake compared to AG. On the other hand, all LLLT doses promoted better organization of articular disc collagen fibers, greater number of proteoglycans in articular cartilage, increased area and diameter of left lateral pterygoid fibers, reduced latent and active MMP 9 and 2 activity, and lower IL-1ß concentration compared to AG. Considering the study limitations, it was observed that LLLT treatments were effective in protecting and tissue cleansing joint structures, accelerating tissue repair, especially at lower doses.

Experimental model of temporomandibular joint arthritis: Evaluation of contralateral joint and masticatory muscles.

OBJECTIVE: To investigate morphological and biochemical changes in an experimental model of temporomandibular joint (TMJ) arthritis, as well as examine contralateral joint involvement and morphometric aspects of masticatory muscles in affected animals. DESIGN: Forty Wistar rats were allocated into three groups, as follows: a healthy control group (HG); and a group with arthritis induced in the left TMJ (IG); and a contralateral group with noninflamed right TMJ (CG). Arthritis was induced by intra-articular injection of 50 µL of Complete Freund's Adjuvant (CFA). Morphological analysis was performed using histological sections of TMJs stained with hematoxylin-eosin, picrosirius and toluidine blue. In addition, histomorphometric analyses of the articular cartilage, articular disc and masticatory muscles, were performed. Biochemical analysis of TMJ tissues included dosage of sulfated glycosaminoglycans (GAGs), zymography of the Matrix Metalloproteinases (MMPs) 2 and 9 and ELISA for the cytokines IL-6, TNF-α and IL-1ß. The data were analyzed by paired and unpaired t-tests, with a p < 0.05. RESULTS: IG animals presented morphological and biochemical changes in their TMJ, including synovial membrane hyperplasia; chronic inflammatory infiltrate; collagen fiber disorganization in the disc; reduced proteoglycans in the cartilage; greater disc thickness; lower cartilage thickness; lower feed intake; higher activity of MMP-9 and MMP-2, and higher concentration of IL-6, TNF-α, and IL-1ß, as compared to HG. CG animals showed posterior disc thickening; reduced proteoglycans in the cartilage; lower collagen fiber organization of the disc; active MMP-9, and higher concentration of IL-6 and TNF-α compared to HG animals. Articular inflammation reduced the area and diameter of fibers of the temporal (right), medial pterygoid (left), and lateral pterygoid (right and left) muscles as compared to HG animals. CONCLUSION: TMJ arthritis reduced the area and diameter of masticatory muscle fibers and caused morphological and molecular changes in the contralateral joint.

An improved approach for measuring the tonic stretch reflex response of spastic muscles.

We propose a new method for detecting the onset of the stretch reflex response for assessment of spasticity based on the Tonic Stretch Reflex Threshold (TSRT). Our strategy relies on a three-stage approach to detect the onset of the reflex EMG activity: (i) Reduction of baseline activity by means of Empirical Mode Decomposition; (ii) Extraction of the complex envelope of the EMG signal by means of Hilbert Transform (HT) and; iii) A double threshold decision rule. Simulated and real EMG data were used to evaluate and compare our method (TSRT-EHD) against three other popular methods described in the literature to assess TSRT ('Kim', 'Ferreira' and 'Blanchette'). Four different groups of signals containing simulated evoked stretch reflex EMG activities were generated: groups A and B without spontaneous EMG activity at rest and signal-to-noise ratio (SNR) of 10dB and 20dB respectively; groups C and D with spontaneous EMG activity at rest, as observed frequently in spastic muscles, and SNR of 10dB and 20dB respectively. The results with simulated data showed a significantly higher accuracy of TSRT-EHD for detecting the onset of the reflex EMG activity in groups C and D when compared to the other methods. Analyses using real data from five post stroke spastic subjects demonstrated that the TSRTs generated by each method were dramatically different from one another. Nevertheless, only TSRT-EHD provided valid measures across all subjects.

Infraclavicular topography of the brachial plexus fascicles in different upper limb positions / Topografía infraclavicular de los fascículos del plexo braquial en diferentes posiciones del miembro superior

Brachial plexus neuropathies are common complaints among patients seen at orthopedic clinics. The causes range from traumatic to occupational factors and symptoms include paresthesia, paresis, and functional disability of the upper limb. Treatment can be surgical or conservative, but detailed knowledge of the brachial plexus is required in both cases to avoid iatrogenic injuries and to facilitate anesthetic block, preventing possible vascular punctures. Therefore, the objective of this study was to evaluate the topography of the infraclavicular brachial plexus fascicles in different upper limb positions adopted during some clinical procedures. A formalin-preserved, adult, male cadaver was used. The infraclavicular and axillary regions were dissected and the distance of the brachial plexus fascicles from adjacent bone structures was measured. No anatomical variation in the formation of the brachial plexus was observed. The metric relationships between the brachial plexus and adjacent bone prominences differed depending on the degree of shoulder abduction. Detailed knowledge of the infraclavicular topography of neurovascular structures helps with the diagnosis and especially with the choice of conservative or surgical treatment of brachial plexus neuropathies.

Las neuropatías del plexo braquial son quejas comunes entre los pacientes atendidos en las clínicas ortopédicas. Las causas van desde traumas a factores ocupacionales y los síntomas incluyen parestesias, paresia e incapacidad funcional del miembro superior. El tratamiento puede ser quirúrgico o conservador, pero se requiere un conocimiento detallado del plexo braquial en ambos casos para evitar lesiones iatrogénicas y para facilitar el bloqueo anestésico, evitando posibles lesiones vasculares. Por lo tanto, el objetivo de este estudio fue evaluar la topografía de los fascículos del plexo braquial infraclavicular en diferentes posiciones de los miembros superiores adoptadas durante algunos procedimientos clínicos. Se llevó a cabo la disección de las regiones infraclavicular y axilar de un cadáver adulto, de sexo masculino, conservado en formaldehído. Se midió la distancia de los fascículos del plexo braquial en relación a las estructuras óseas adyacentes. No se observó variación anatómica en la formación del plexo braquial. Las relaciones métricas entre el plexo braquial y las prominencias óseas adyacentes difieren en función del grado de abducción del hombro. El conocimiento detallado de la topografía infraclavicular de las estructuras neurovasculares ayuda con el diagnóstico y sobre todo con la elección del tratamiento conservador o quirúrgico de las neuropatías del plexo braquial.

Low-level laser therapy stimulates tissue repair and reduces the extracellular matrix degradation in rats with induced arthritis in the temporomandibular joint.

The objective of this study was to characterize morphological and biochemistry action of low-level laser therapy (LLLT) on induced arthritis in the temporomandibular joint (TMJ) of rats. Twenty-four male Wistar rats were randomly divided into groups with 12 animals each: (AG) group with arthritis induced in the left TMJ and (LG) group with arthritis induced in the left TMJ and treated with LLLT (830 nm, 30 mW, 3 J/cm(2)). Right TMJs in the AG group were used as noninjected control group (CG). Arthritis was induced by intra-articular injection of 50 µl Complete Freund's Adjuvant (CFA) and LLLT began 1 week after arthritis induction. Histopathological analysis was performed using sections stained with hematoxylin-eosin, Toluidine Blue, and picrosirius. Biochemical analysis was determined by the total concentration of sulfated glycosaminoglycans (GAGs) and evaluation of matrix metalloproteinases (MMP-2 and MMP-9). Statistical analysis was performed using paired and unpaired t tests, with p < 0.05. Compared to AG, LG had minor histopathological changes in the TMJ, smaller thickness of the articular disc in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001), high birefringence of collagen fibers in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001) on the articular disc, and statistically lower activity of MMP-2 latent (p < 0.0001), MMP-2 active (P = 0.02), MMP-9 latent (p < 0.0001), and MMP-9 active (p < 0.0001). These results suggest that LLLT can increase the remodeling and enhancing tissue repair in TMJ with induced arthritis.

Joint immobilization: effects on muscular tissue of obese and malnourished mice / Imobilização articular: efeitos sobre o tecido muscular de camundongos obesos e desnutridos

Abstract Although it is a widely used resource for the treatment of musculoskeletal injuries, immobilization causes deleterious effects in muscle tissue after a short period of time. This study aimed to evaluate the gastrocnemius and tibialis anterior muscles of obese and protein malnourished animals under joint immobilization condition. Overall, 28 adult male mice were used (C57 / BL6), being divided into four groups (N = 7): Control Group (CG), Immobilized Control Group (ICG), Immobilized Obese Group (IOG) and Immobilized Malnourished Group (IMG). The immobilization protocol was performed by the use of adhesive tape and plaster. The conditions and obesity and protein malnutrition have been developed through the ingestion of diets specific for each group of animals. The histomorphometric analysis of muscles evaluated area and the diameter of muscle fibers. All immobilized groups showed reduction in the area and diameter of muscle fibers when compared to GC. Comparisons among immobilized groups showed that the area and diameter of muscle fibers of IOG and IMG were lower than ICG. The immobilization protocol caused reduction in muscle trophism in animals, and obese and malnourished animals suffered high losses under condition of muscle atrophy.

Resumo Embora seja um recurso muito utilizado para tratamento de lesões musculoesqueléticas, a imobilização causa efeitos deletérios no tecido muscular após curto período de tempo. O presente estudo teve como objetivo avaliar os músculos gastrocnêmio e tibial anterior de animais obesos e desnutridos proteicamente sob a condição de imobilização articular. Foram utilizados 28 camundongos (C57/BL6) machos adultos, distribuídos em quatro grupos (N=7): Grupo controle (GC), Grupo Controle Imobilizado (GCI), Grupo Obeso imobilizado (GOI) e Grupo Desnutrido Imobilizado (GDI). O protocolo de imobilização foi realizado por meio da utilização de tiras de esparadrapo e faixa gessada. As condições de obesidade e desnutrição proteica foram desenvolvidas por meio da ingestão de dietas específicas para cada grupo de animais. A análise histomorfométrica dos músculos avaliou a área e o diâmetro das fibras musculares. Todos os grupos imobilizados apresentaram redução na área e no diâmetro das fibras musculares quando comparados ao GC. As comparações entre os grupos imobilizados mostraram que os valores do diâmetro e área de fibras dos grupos GOI e GDI foram menores do que o GCI. O protocolo de imobilização provocou redução do trofismo muscular nos animais estudados e os animais obesos e desnutridos sofreram prejuízo elevado na condição de atrofia muscular.

Effects of high molecular weight hyaluronic acid on induced arthritis of the temporomandibular joint in rats.

High molecular weight hyaluronic acid (HMWHA) has been used to treat temporomandibular joint (TMJ) disorders, but controversial results have been described. This study aimed to characterize the morphological and biochemical actions of HMWHA on induced arthritis of the TMJ. Twenty-four male Wistar rats were used, and arthritis of the TMJ was induced through an intra-articular injection of Complete Freund's Adjuvant (CFA) (50 µl). One week after arthritis induction, the animals were treated with HMWHA (once per week for three weeks). Histological analyses were performed using sections stained with hematoxylin-eosin, toluidine blue and Picrosirius. Were also performed histomorphometric analysis and birefringence of collagenous fibers (polarization microscopy). Biochemical analyses of TMJ tissues were carried out through measurements of sulfated glycosaminoglycans and zymography for evaluation of metalloproteinase-2 and -9 (MMP-2 and -9). Data were analyzed using paired t-test and unpaired t-test, with a 5% significance level. HMWHA reduced histologic changes and thickness of the articular disc, led to a greater arrangement of collagenous fibers, lower concentration of sulfated glycosaminoglycans and lower activity in all isoforms of MMP-2 and -9 in TMJs with induced arthritis. These findings suggest that HMWHA may exert a protective effect on the TMJ.

Sphenomandibular muscle or deep bundle of temporal muscle? / ¿Músculo esfenomandibular o fascículo profundo del músculo temporal?

The muscle designated by a group of authors as the sphenomandibular or, according to recent studies, the deep bundle of the temporal muscle, presents important anatomical relationships, especially in a medical-odontological context. In view of this divergence, the aim of the present study was to observe the morphology by means of dissection of the formaldehyde-preserved heads, using two different techniques to access the muscle region in question, designated as trans-zygomatic and frontal access routes. The results permitted, by observation of the dissections frontally, the presence of fascicles standing apart from the deep bundle muscle venter, which was named intermediary bundle. This bundle presented two portions, a meaty upper portion and a tendinous lower portion, which continues with the tendinous part of the superficial bundle present on the internal surface of the coronoid process. In view of the material observations, it can be concluded that, due to the total absence of muscular fascia between its bundles, the temporal muscle is a unique entity presenting three bundles ­ the deep, the intermediate and the superficial.

El músculo denominado como esfenomandibular por un grupo de autores o de acuerdo con estudios recientes, de fascículo profundo del músculo temporal, presenta importantes relaciones anatómicas, especialmente en un contexto médico-odontológico. En vista de esta discusión, el objetivo fue observar la morfología mediante la disección de cabezas conservadas en formaldehído, utilizando dos técnicas diferentes para acceder a la región del músculo, designadas como vías de acceso trans-cigomáticas y frontales. Los resultados mostraron, por la observación de las disecciones frontales, la presencia de fascículos que se ubican independientemente al vientre muscular del fascículo profundo, denominado fascículo intermediario. Este fascículo presentó dos porciones, una superior carnosa y una inferior tendinosa, que continuó con la parte tendinosa del fascículo superficial presente en la superficie interna del proceso coronoides. En vista de las observaciones realizadas, se puede concluir que debido a la ausencia total de la fascia muscular entre sus paquetes, el músculo temporal es una entidad única que presenta tres fascículos, el profundo, intermedio y superficial.

Ultra-structural alterations of the palatal mucosa in rats subject to a diet of alcohol / Alterações ultraestruturais da mucosa palatina de ratos submetidos a dieta alcoólica

Objective: To evaluate the possible morphological alterations of the palatal mucosa in rats subject to a diet of alcohol. Methods: Twelve adult male animals were used, divided into two groups: control and treated. The control group received food and water ad libitum, while the treated group received the same solid diet and a solution of water and ethanol diluted to 25%. After 160 days, the animals were sacrificed and the samples of palatal mucosa were submitted to methods of transmission electronic microscopy. Results: In the macroscopic results, a coloring alteration was seen in the palatal mucosa in the alcoholic group. In addition, the control animals presented a greater gain in body mass in relation to the treated animals (p<0.05). However, the treated animals did not lose weight during the experiment; on the contrary, they gained body mass, despite gaining less when compared to the control. In the ultra-structure of the treated group, an increase in inter-cellular space, fusion of the secretory granules and the presence of cells in a degenerative state were observed.Conclusion: It may be deduced that there were serious morphological alterations in the palatal mucosa of rats subject to an alcoholic diet.

Objetivo: Avaliar as possíveis alterações morfológicas da mucosa palatina de ratos submetidos a uma dieta alcoólica. Métodos: Foram utilizados doze animais adultos, machos, divididos em dois grupos sendo um controle e outro tratado. O grupo controle recebeu ração e água ad libitum, enquanto o grupo tratado recebeu a mesma dieta sólida e uma solução de água e etanol diluído a 25%. Após 160 dias, os animais foram sacrificados e as amostras da mucosa palatina foram submetidas aos métodos de microscopia eletrônica de transmissão. Resultados: Nos resultados macroscópicos, notou alteração da coloração da mucosa palatina do grupo alcoolizado. Além disso, os animais controle apresentaram maior ganho de massa corporal em relação aos animais tratados (p<0,05). Todavia, os animais tratados não perderam peso durante o período de experimento, ao contrário, os mesmos ganharam massa corporal, apesar de menor quando comparado com o controle. Na ultra-estrutura do grupo tratado, notou aumento dos espaços intercelulares, fusão dos grânulos secretores e presença de células em processo degenerativo.Conclusão: Pode inferir que houve graves alterações morfológicas na mucosa palatina de ratos submetidos à dieta alcoólica.

Median Nerve Behavior in Different Upper Limb Positions / Comportamiento del Nervio Mediano en Diferentes Posiciones del Miembro Superior

The neural compression syndromes peripheral upper limb are common in clinical medicine and the causes range from trauma and occupational factors. Technical evaluation manuals as neural tension at different positions of the upper limb as well as knowledge of the topography of the affected nerve are essential for accurate diagnosis. The objective of this study was to analyze the behavior of the median nerve in different positions of the upper limb. Fifteen formalin-fixed cadavers were used for morphometric and topographic evaluation of the median nerve in different positions of the right upper limb. In all cases analyzed, the median nerve originated from the lateral and medial fascicles of the brachial plexus and attended by the arm and forearm in accordance with the classical descriptions in the literature. Measurement of the length of the nerve in different positions of the upper limb showed greater stretching during the position that combined extension and external rotation of the shoulder and extension of the elbow/wrist/fingers. In conclusion, the metric landmarks and positions studied are important for the precise diagnosis of median nerve neurobiomechanics in nerve compression syndromes.

Los síndromes de compresión de los nervios periféricos del miembro superior son comunes en la medicina clínica, y sus causas comprenden traumas y factores ocupacionales. Manuales de evaluación técnica y la tensión neural en diferentes posiciones del miembro superior, así como el conocimiento de la topografía del nervio afectado, son esenciales para un diagnóstico preciso. El objetivo de este estudio fue analizar el comportamiento del nervio mediano en diferentes posiciones del miembro superior. Fueron utilizados 15 cadáveres fijados en formol. Se realizó la evaluación morfométrica y topográfica del nervio mediano en diferentes posiciones del miembro superior derecho. En todos los casos analizados, el nervio mediano se originó desde los fascículos lateral y medial del plexo braquial, y recorrieron el brazo y el antebrazo de acuerdo con las descripciones clásicas. La medición de la longitud del nervio en las diferentes posiciones mostró un mayor estiramiento durante la posición combinada de extensión y rotación lateral del hombro y extensión del codo/muñeca/dedos. En conclusión, los puntos de referencia y posiciones métricas estudiadas son importantes para un diagnóstico sdrcusdo de la neurobiomecánica del nervio mediano en los síndromes de compresión nerviosa.

Protocol on induction of TMJ articular disc degeneration in rats by utilization of botulinum toxin.

OBJECTIVE: To develop a model of experimental degeneration in the articular disc of the TMJ of rats through the use of botulinum toxin that can be used in future studies of degenerative diseases on fibrocartilage. METHODS: Aiming at the above-mentioned objective, 12 Lewis male rats were used and divided into two groups: CG, control group and DG, group of animals to which the botulinum toxin was administered (6 units/kg). The morphological analysis was carried out utilizing histological cuts stained with hematoxyline-eosine, toluidine blue and Picrosirius; the biochemical analysis was made by SDS-polyacrylamide gel electrophoresis. RESULTS: The DG showed peculiar characteristics regarding a degeneration joint disk, compatible with those described in literature as: reduction of cells number, general disorganization of cells direction and extracellular matrix, increase in glycosaminoglycans content and degradation of the tissue collagen. CONCLUSIONS: Based on the morphological and biochemical results, it was concluded that the proposed degeneration model showed to be satisfactory for futures studies of injuries and fibrocartilage regeneration processes.

Análise eletromiográfica do músculo trapézio descendente durante a oclusão cêntrica forçada / Electromyographic analyses of the upper trapezius muscle during maximal clenching effort

Introdução: A alteração da oclusão e a posição da mandíbula podem afetar os músculos do pescoço, devido à relaçãoexistente entre os sistemas mastigatório e cervical. Assim, realizamos um estudo do comportamento da atividade eletromiográfica (EMG) do músculo trapézio descendente em indivíduos com oclusão clinicamente normal, durante a mordida em esforço máximo com posicionamento de dois parafilmes de algodão (10 mm de espessura). Método: Fizeramparte do estudo, 19 indivíduos normais sendo 14 mulheres (média de idade: 25,4 ± 4,14 anos) e 5 homens (média de idade: 24,11± 3,28 anos). Para a análise da amplitude do sinal EMG foi utilizado 40% e 60% da contração voluntária máxima (CVM) do músculo trapézio descendente. O sinal EMG foi coletado com freqüência de amostragem de 2 kHz e o valor em RMS (root mean square) foi obtido por janela móvel de 200 ms. Para comparar a amplitude do sinal em RMS nas condições pré e pós oclusão cêntrica forçada, foi utilizado o teste-t de Student, com nível de significânciaadotado de p < 0.05. Resultados: A comparação entre os valores em RMS nas condições pré e pós a oclusão cêntrica forçada, não alteram a amplitude do sinal EMG do músculo trapézio descendente com 40% (t=1.1, p=O,36) e 60% (t=0.91, p=O,ll) da CVM. Conclusão: Nesse estudo foi possível concluir que a oclusão cêntrica forçada não exerce influência sobre a atividade do músculo trapézio descendente em indivíduos com oclusão clinicamente normais.

Introduction: Alteration of the occlusion and the position of the jaw can affect the muscles of the neck, due to a relationship between the masticatory and cervical systems. This study evaluated the performance of theelectromyographic (EMG) activity of the upper trapezius muscle in individuais displaying clinically normal occlusionduring a bite at maximum effort, with positioning of two cotton parafilm (10 mm thick). Method: A total of nineteennormal individuais participated in the study, 14 of which were women (average age of 25.4 ± 4.14 years), and 5 were men (average age of 24.11 ± 3.28 years). The root mean square (RMS) amplitude of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction were analyzed under pre- and post-maximal clenching effort conditions in centric occlusion. The EMG signal was collected with a sampling frequency of 2 kHz and the value in RMS (root mean square) was obtained by a moving window of 200 ms. The paired Student's t-test was used to compare RMS under pre and post-maximal c1enching effort conditions. In this exploratory study, the levei of significance of each eomparison was set to p < 0.05. Results: The values obtained in RMS demonstrated that a post-maximal elenehing effort, as eontrasted with a pre-maximal clenching effort, as contrasted with a pre-maximal clenching effort, does not alter the amplitude of EMG signal of upper trapezius muscle under conditions with 40% (t=1.1, p=O,36) and 60% (t=0.91, p=O,l1) of maximal voluntary contraction as demonstrated. Conclusion: This study concluded that the forced centric occlusion does not affect the activity of the upper trapezius muscle in normal individuals.

Determinação radiológica do índice e do tamanho craniano por mensuração dos diâmetros cranianos em uma população infantil brasileira / Radiological determination of cranial size and index by measurement of skull diameters in a population of children in Brazil

OBJETIVO: Realizar as medidas dos diâmetros cranianos obtidos por método radiológico e elaborar, por meio delas, o índice e o tamanho craniano, para comparar com as medidas dos diâmetros e os índices propostos por alguns trabalhos da literatura, principalmente os do estudo de Haas. MATERIAIS E MÉTODOS: Foram avaliados 732 pacientes sem doenças cranianas, medidos seus diâmetros cranianos e, posteriormente, formulados o índice e o tamanho craniano, que mostram as diferentes fases do crescimento do crânio, pelas medidas de tábua interna a tábua interna. RESULTADOS: O estudo comparativo das médias dos diâmetros, por medidas de tábuas internas, mostrou aumento do crescimento francamente progressivo no primeiro ano de vida para ambos os sexos e aumento menor a partir do segundo ano de vida. As médias globais dos diâmetros não apresentaram diferença significativa entre os sexos feminino e masculino. CONCLUSÃO: O índice e o tamanho craniano são bons indicadores do crescimento craniano, principalmente nos quatro primeiros anos de vida, quando o crescimento aumenta vertiginosamente no primeiro ano e, posteriormente, ocorre aumento moderado até os quatro anos de idade. Após esta idade, ocorre um leve e estável aumento e seu valor estatístico diminui. Não houve diferença estatisticamente significante, no crescimento, para ambos os sexos. Recomenda-se o uso dos valores médios dos diâmetros para ambos os sexos e sugere-se o uso do índice craniano, até os quatro anos de idade, e o tamanho craniano, após os quatro anos, sendo ideal para o acompanhamento do crescimento do crânio.

OBJECTIVE: To measure radiologically obtained skull diameters and, based on these data, calculating the cranial index and size to compare with diameter measurements and indices reported in the literature, particularly those reported by Haas. MATERIALS AND METHODS: The present study evaluated 732 individuals with no cranial disease, whose skull diameters were measured, Subsequently, the authors calculated the cranial index and size which demonstrate the different phases of the skull growth by inner-table to inner-table measurements. RESULTS: The comparative study of diameters averages by inner-table measurements has demonstrated a clearly progressive skull growth in the first year of life for both genders, and a slower growth as from the second year. Overall diameters averages did not present any significant difference between male and female individuals. CONCLUSION: Cranial index and size are good skull growth indicators, especially in the first four years of life, a period characterized by an accelerated growth in the first year and a moderate growth until the fourth year. After this age, a slight and stable growth occurs with a decrease in the statistical value. No statistically significant difference was found for both genders. It is recommended that mean diameters are utilized for both genders; and it is suggested that the cranial index is utilized until four years of age, and the cranial size after the age of four, as the ideal parameter for following up the skull growth.

Análise eletromiográfica e da força do músculo deltóide em indivíduos com síndrome do impacto do ombro / Electromyographic and force analysis of the deltoid muscle in subjects with shoulder impingement syndrome

Este estudo visou verificar se existe diferença, na força gerada durante a abdução do ombro e a atividade eletromiográfica da porção clavidular, acromial e espinhal do músculo deltóide, entre indivíduos saudáveis e portadores da síndrome do impacto do ombro...

This staudy aimed at comparing electromyographic activity of the pars clavicularis, acromialis, and spinalis of the deltoideus muscle, as well as the force exercet during abduction, in helath individuals snd in thodr wilth shoulder impigemen...