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1.
Acta Odontol Scand ; 73(2): 81-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25205230

RESUMO

IMPORTANCE AND OBJECTIVE: Reactive Oxygen Species (ROS) are oxygen-derived molecules that are unstable and highly reactive. They are important signaling mediators of biological processes. In contrast, excessive ROS generation, defective oxidant scavenging or both have been implicated in the pathogenesis of several conditions. This biological paradox of ROS function contributes to the integrity of cells and tissues. So, the aim of this review was examined for published literature related to 'reactive oxygen species and dentistry and muscle'. MATERIALS AND METHODS: A PubMed search was performed by using the following key words: 'reactive oxygen species and dentistry and muscle'. RESULTS: Involvement of ROS in pathologic conditions can be highlighted in oral diseases like periodontitis, orofacial pain, temporomandibular disorders and oral cancer. Also, several studies have correlated the increase in ROS production with the initiation of the muscle fatigue process and the process of muscle injury. However, studies evaluating the relation of ROS and orofacial muscles, which can prove very important to understand the fatigue muscle in this region during oral movements, have not yet been conducted. CONCLUSIONS: It is concluded that the data on skeletal muscles, especially those of mastication, are not commonly published in this data source; therefore, further studies in this field are strongly recommended.


Assuntos
Músculos da Mastigação/metabolismo , Doenças da Boca/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Humanos , Neoplasias Bucais/metabolismo , Fadiga Muscular/fisiologia , Estresse Oxidativo/fisiologia , Transdução de Sinais/fisiologia
2.
Brain Res Bull ; 176: 142-150, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34500037

RESUMO

Psychological stress and occlusal alterations are contributing etiologic factors for temporomandibular and muscular disorders in the orofacial area. The neural modulation recruited for this relationship, however, is not elucidated. The aim of this study was to investigate potential central mechanisms involved in the exodontia-induced occlusal instability associated with unpredictable chronic stress (UCS). Male adult Wistar rats were submitted to occlusal instability (unilateral molar teeth extraction) and/or to a UCS protocol and treated with diazepam or vehicle. The anxiety-like behavior was evaluated by elevated plus maze (EPM) and open field (OF) tests. Limbic structures such as the central nucleus of the amygdala (CeA), paraventricular nucleus of the hypothalamus (PVN), dorsal periaqueductal gray matter (dPAG) and nucleus accumbens core (NAc) were analyzed for expression of FosB/ΔFosB (immediate early genes) by immunohistochemistry. Exodontia and/or UCS decreased the time spent in the open arms at the EPM and the distance travelled at the OF, and increased the immobility time at the OF, suggesting anxiety-like behavior. In addition, exodontia induction resulted in an upregulation of FosB/ΔFosB in the CeA, PVN and dPAG, while UCS and exodontia + UCS upregulate FosB/ΔFosB immunoreactivity in the CeA, PVN, dPAG and NAc. Treatment with diazepam decreased the expression of FosB/ΔFosB in all analyzed structures of animals subject to UCS and exodontia + UCS, while promoted a reduction in the FosB/ΔFosB expression in the CeA, PVN and dPAG in animals subject to exodontia. Our findings showed an anxiogenic effect of exodontia and UCS, which is correlated with intranuclear neuron activation of limbic structures in a spatially dependent manner and that is prevented by the administration of diazepam.


Assuntos
Sistema Límbico/metabolismo , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Estresse Psicológico/metabolismo , Extração Dentária , Animais , Ansiolíticos/farmacologia , Diazepam/farmacologia , Imuno-Histoquímica , Sistema Límbico/efeitos dos fármacos , Masculino , Neurônios/efeitos dos fármacos , Ratos , Ratos Wistar , Regulação para Cima
3.
Microsc Res Tech ; 82(5): 530-537, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30741445

RESUMO

Stress is associated with orofacial pain sensitivity and is qualified as a temporomandibular disorder risk factor. During stressful periods, painful thresholds of masticatory muscles in individuals suffering muscle facial pain are significantly lower than in controls, but the exact physiologic mechanism underlying this relation remains unclear. Our hypothesis is that chronic unpredictable stress and masticatory hypofunction induce morphologic and metabolic masseter muscle changes in rats. For test this hypothesis, adult Wistar rats were submitted to chronic unpredictable stress and/or exodontia of left molars and the left masseter muscle was removed for analysis. The parameters evaluated included ultrastructure, oxidative level, metabolism activity and morphological analysis in this muscle. Our data show by histological analysis, that stress and exodontia promoted a variation on diameters and also angled contours in masseter fibers. The masticatory hypofunction increased oxidative metabolism as well as decreased reactive species of oxygen in masseter muscle. The ultrastructural analysis of muscle fibers showed disruption of the sarcoplasmic reticulum cisterns in certain regions of the fiber in stress group, and the disappearance of the sarcoplasmic reticulum membrane in group with association of stress and exodontia. Our findings clarify mechanisms by which chronic stress and masticatory hypofunction might be involved in the pathophysiology of muscular dysfunctions. Masticatory hypofunction influenced oxidative stress and induced oxidative metabolism on masseter muscle, as well as altered its fiber morphology. Chronic stress presented malefic effect on masseter morphology at micro and ultra structurally. When both stimuli were applied, there were atrophic fibers and a complete mitochondrial derangement.


Assuntos
Músculo Masseter/patologia , Músculo Masseter/fisiopatologia , Mitocôndrias/patologia , Fibras Musculares Esqueléticas/patologia , Dor/complicações , Doenças Estomatognáticas/complicações , Animais , Modelos Animais de Doenças , Estresse Oxidativo , Ratos Wistar , Extração Dentária
4.
Physiol Behav ; 185: 70-78, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29275100

RESUMO

Psychological stress is an important perpetuating, worsening and risk factor for temporomandibular disorders of muscular or articular origin. Occlusion instability, by the way, is considered a risk factor of this pathology and can be reproduced in some experimental animal models. The exact physiologic mechanism underlying these relations however, remains unclear. Our purpose was to test the hypothesis that chronic stress and unilateral exodontia induce metabolic and vascular changes in the medial pterygoid muscle of rats. Adult Wistar rats were submitted to chronic unpredictable stress and/or unilateral exodontia and their plasma and medial pterygoid muscle were removed for analysis. The parameters evaluated included plasma levels of corticosterone, metabolic activity by succinate dehydrogenase, oxidative capacity by nicotinamide adenine dinucleotide diaphorase, capillary density by laminin and alfa-CD staining and reactive oxidative species production. Chronic unpredictable stress as an isolated factor, increased oxidative metabolism, capillary density and reactive oxygen species production at medial pterygoid muscle. Conversely, exodontia has a main effect in metabolism, promoting glycolytic transformation of muscle fibers. Association of both factors induced a major glycolytic pattern in muscle and vascular changes. Our findings provide insights into the mechanisms, possibly inducing metabolic and vascular alterations on medial pterygoid muscle of rats, by which chronic stress and occlusal instabilities might be involved as risk factors in the pathophysiology of temporomandibular disorders with muscular components.


Assuntos
Músculos Pterigoides/irrigação sanguínea , Músculos Pterigoides/metabolismo , Estresse Psicológico/metabolismo , Extração Dentária , Animais , Capilares/metabolismo , Capilares/patologia , Doença Crônica , Corticosterona/metabolismo , Modelos Animais de Doenças , Masculino , Dente Molar , NAD/metabolismo , Músculos Pterigoides/patologia , Distribuição Aleatória , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Estresse Psicológico/patologia , Succinato Desidrogenase/metabolismo , Transtornos da Articulação Temporomandibular/metabolismo , Transtornos da Articulação Temporomandibular/patologia , Extração Dentária/efeitos adversos , Incerteza
5.
Microsc Res Tech ; 79(9): 806-13, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27324400

RESUMO

The opossum Monodelphis domestica presents movement of the temporomandibular joint (TMJ) reflecting adaptation to eating habits similar to movement in humans, but the structure of the TMJ is not yet known. Thus, nine young M. domestica, of both sexes were weighed, anesthetized with xylazine (10 mg kg(-1) ), and ketamine (70 mg kg(-1) ) and processed for: 1. The analyses of the macroscopic angioarchitecture after latex injection, as well as the topography of the TMJ; 2. The analysis of microvascularization after injection of Mercox resin and corrosion of soft tissue with NaOH using scanning electron microscopy and; 3. The histological evaluation of the TMJ with an optical microscope. Macroscopic analysis of the latex injected vessels revealed the distribution of the arteries from the common carotid artery, receiving branches of the superficial temporal and maxillary arteries. The mandibular condyle has the long axis in the lateral-lateral direction, and is convex in the anterior-posterior direction. Its topography was determined in relation to the eye and external acoustic meatus. With scanning electron microscopy, microvascularization consists of arterioles of varying diameter (85-15 µm) of the meandering capillary network in the retrodiscal region, and a network of straight capillaries in the TMJ anterior region. Via light microscopy the TMJ has similar histological features to those of humans. These macroscopic, microscopic and ultrastructural data from TMJ of the M. domestica could be a suitable model for TMJ physiology and pathophysiology studies for then speculate on possible human studies. Microsc. Res. Tech. 79:806-813, 2016. © 2016 Wiley Periodicals, Inc.


Assuntos
Microvasos/ultraestrutura , Monodelphis/anatomia & histologia , Articulação Temporomandibular/irrigação sanguínea , Articulação Temporomandibular/ultraestrutura , Animais , Feminino , Masculino , Microscopia Eletrônica de Varredura , Articulação Temporomandibular/anatomia & histologia
6.
Physiol Behav ; 164(Pt A): 369-75, 2016 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-27342425

RESUMO

Temporomandibular disorder (TMD) has a high prevalence in our society, characterized by a severe pain condition of the masticatory muscles and temporomandibular joint. Despite the indication of multiple factor initiators of TMD, there is still controversy about its etiology and its pathophysiology is poorly understood. Using rats as experimental animals we investigated the effect of unpredictable chronic stress with or without unilateral molar extraction on the contralateral medial pterygoid muscle. Our hypothesis is that these two factors induce changes in morphology, oxidative metabolism and oxidative stress of muscle fibers. Young adult male Wistar rats (±200g) were divided into four groups: a group with extraction and unpredictable chronic stress (E+US); with extraction and without stress (E+C); without extraction and with unpredictable chronic stress (NO+US); and a control group without either extraction or stress (NO+C). The animals were subjected to unilateral extraction of the upper left molars, under intraperitoneal anesthesia with 4% Xylazine (10mg/kg) and 10% Ketamine (80mg/kg) on day zero. The rats of groups E+US and NO+US were submitted to different protocols of stress, from the 14th day after the extraction. The protocols were different every day for five consecutive days, which were repeated from the 6th day for five days more. Contralateral medial pterygoid muscles were obtained on the 24th day after the start of the experiment for morphological, metabolic, capillary density, and oxidative stress analysis. The data from capillary density showed a decrease of capillaries in animals subjected to dental extraction, compared with those without extraction and an increase of laminin expression in the group submitted to the unpredictable chronic stress when compared to the unexposed to stress. SDH test revealed a decrease of light fibers in the group submitted to unilateral extraction of molars, compared with this area in the control group. In E+US and NO+US groups, the deeply stained fibers increased compared to NO+C.·The exodontia factor was able to increase the ROS activity in muscle, whereas the stress factor does not significantly alter ROS in this tissue. It was concluded that both unpredictable chronic stress and the extraction induce metabolic and density of capillary changes in the contralateral medial pterygoid muscle to extraction, suggesting that these factors for a longer period of this experiment could induce muscle damage related to TMD.


Assuntos
Músculos Pterigoides/metabolismo , Estresse Psicológico/metabolismo , Extração Dentária/efeitos adversos , Animais , Capilares/metabolismo , Capilares/patologia , Doença Crônica , Oclusão Dentária , Modelos Animais de Doenças , Masculino , Dente Molar , Estresse Oxidativo/fisiologia , Oxigênio/metabolismo , Músculos Pterigoides/irrigação sanguínea , Músculos Pterigoides/patologia , Distribuição Aleatória , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Estresse Psicológico/patologia , Succinato Desidrogenase/metabolismo , Transtornos da Articulação Temporomandibular/metabolismo , Incerteza
7.
PLoS One ; 10(6): e0128397, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26053038

RESUMO

Clinical evidence has shown that stress may be associated with alterations in masticatory muscle functions. Morphological changes in masticatory muscles induced by occlusal alterations and associated with emotional stress are still lacking in the literature. The objective of this study was to evaluate the influence of acute stress on metabolic activity and oxidative stress of masseter muscles of rats subjected to occlusal modification through morphological and histochemical analyses. In this study, adult Wistar rats were divided into 4 groups: a group with extraction and acute stress (E+A); group with extraction and without stress (E+C); group without extraction and with acute stress (NO+A); and control group without both extraction and stress (NO+C). Masseter muscles were analyzed by Succinate Dehydrogenase (SDH), Nicotinamide Adenine Dinucleotide Diaphorase (NADH) and Reactive Oxygen Species (ROS) techniques. Statistical analyses and two-way ANOVA were applied, followed by Tukey-Kramer tests. In the SDH test, the E+C, E+A and NO+A groups showed a decrease in high desidrogenase activities fibers (P < 0.05), compared to the NO+C group. In the NADH test, there was no difference among the different groups. In the ROS test, in contrast, E+A, E+C and NO+A groups showed a decrease in ROS expression, compared to NO+C groups (P < 0.05). Modified dental occlusion and acute stress--which are important and prevalent problems that affect the general population--are important etiologic factors in metabolic plasticity and ROS levels of masseter muscles.


Assuntos
Músculo Masseter/metabolismo , Estresse Fisiológico , Extração Dentária , Animais , Di-Hidrolipoamida Desidrogenase/metabolismo , Masculino , Músculo Masseter/enzimologia , NAD/metabolismo , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Succinato Desidrogenase/metabolismo
8.
Biomed Res Int ; 2014: 506051, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24616895

RESUMO

Low level laser therapy (LLLT) has been used to relieve pain, inflammation, and wound healing processes. Thus, the skin is overexposed to laser and this effect is not completely understood. This study analyzed the effects of the number of laser applications (three, six, and 10) on the intact skin of the masseteric region in mice of strain HRS/J. The animals (n = 30) were equally divided into control (0 J/cm(2)) and irradiated (20 J/cm(2)), and each of these groups was further equally divided according to the number of laser applications (three, six, and 10) and underwent LLLT on alternate days. Samples were analyzed by light microscopy and transmission electron microscope (TEM). The animals receiving applications exhibited open channels more dilated between the keratinocytes and photobiomodulation effect on endothelial cells and fibroblasts by TEM. Under the light microscope after 10 laser applications, the type I collagen decreased (P < 0.05) compared to the three and six applications. Under these experimental conditions, all numbers of applications provided photobiomodulatory effect on the epidermis and dermis, without damage. More studies are needed to standardize the energy density and number of applications recommended for laser therapy to have a better cost-benefit ratio associated with treatment.


Assuntos
Terapia com Luz de Baixa Intensidade , Pele/citologia , Pele/ultraestrutura , Animais , Colágeno Tipo I/metabolismo , Camundongos , Pele/efeitos da radiação , Coloração e Rotulagem
9.
Biomed Res Int ; 2013: 597863, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23936823

RESUMO

This study analyzed the effects of a low-level laser therapy (LLLT, 15 J/cm(2), 780 nm wavelength) and the natural latex protein (P1, 0.1%) in sciatic nerve after crush injury (15 Kgf, axonotmesis) in rats. Sixty rats (male, 250 g) were allocated into the 6 groups (n = 10): CG-control group; EG-nerve exposed; IG-injured nerve without treatment; LG-crushed nerve treated with LLLT; PG-injured nerve treated with P1; and LPG-injured nerve treated with LLLT and P1. After 4 or 8 weeks, the nerve samples were processed for morphological, histological quantification and ultrastructural analysis. After 4 weeks, the myelin density and morphological characteristics improved in groups LG, PG, and LPG compared to IG. After 8 weeks, PG, and LPG were similar to CG and the capillary density was higher in the LG, PG, and LPG. In the ultrastructural analysis the PG and LPG had characteristics that were similar to the CG. The application of LLLT and/or P1 improved the recovery from the nerve crush injury, and in the long term, the P1 protein was the better treatment used, since only the application of LLLT has not reached the same results, and these treatments applied together did not potentiate the recovery.


Assuntos
Terapia com Luz de Baixa Intensidade , Nervo Isquiático/efeitos dos fármacos , Nervo Isquiático/lesões , Animais , Hevea/química , Látex/administração & dosagem , Látex/química , Masculino , Compressão Nervosa , Proteínas de Plantas/administração & dosagem , Proteínas de Plantas/química , Proteínas de Plantas/isolamento & purificação , Ratos , Ratos Wistar , Nervo Isquiático/efeitos da radiação , Nervo Isquiático/ultraestrutura
10.
Micron ; 40(4): 413-8, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19269186

RESUMO

Low level laser therapy (LLLT) is known for its positive results but studies on the biological and biomodulator characteristics of the effects produced in the skeletal muscle are still lacking. In this study the effects of two laser dosages, 5 or 10 J/cm(2), on the lesioned tibial muscle were compared. Gerbils previously lesioned by 100 g load impact were divided into three groups: GI (n=5) controls, lesion non-irradiated; GII (n=5), lesion irradiated with 5 J/cm(2) and GIII (n=5), lesion irradiated with 10 J/cm(2), and treated for 7 consecutive days with a laser He-Ne (lambda=633 nm). After intracardiac perfusion, the muscles were dissected and reduced to small fragments, post-fixed in 1% osmium tetroxide, dehydrated in increasing alcohol concentrations, treated with propylene oxide and embedded in Spurr resin at 60 degrees C. Ultrafine cuts examined on a transmission electron microscope (Jeol 1010) revealed in the control GI group a large number of altered muscle fibers with degenerating mitochondria, intercellular substance containing degenerating cell fragments and budding blood capillaries with underdeveloped endothelial cells. However, groups GII and GIII showed muscle fibers with few altered myofibrils, regularly contoured mitochondria, ample intermembrane spaces and dilated mitochondrial crests. The clean intercellular substance showed numerous collagen fibers and capillaries with multiple abluminal processes, intraluminal protrusions and several pinocytic vesicles in endothelial cells. It was concluded that laser dosages of 5 or 10 J/cm(2) delivered by laser He-Ne (lambda=633 nm) during 7 consecutive days increase mitochondrial activity in muscular fibers, activate fibroblasts and macrophages and stimulate angiogenesis, thus suggesting effectivity of laser therapy under these experimental conditions.


Assuntos
Terapia com Luz de Baixa Intensidade , Músculo Esquelético/lesões , Músculo Esquelético/efeitos da radiação , Animais , Fibroblastos/efeitos da radiação , Gerbillinae , Macrófagos/efeitos da radiação , Microscopia Eletrônica de Transmissão , Mitocôndrias/efeitos da radiação , Fibras Musculares Esqueléticas/efeitos da radiação , Músculo Esquelético/ultraestrutura , Neovascularização Fisiológica/efeitos da radiação , Manejo de Espécimes/métodos
11.
J Bras Pneumol ; 35(12): 1190-7, 2009 Dec.
Artigo em Inglês, Português | MEDLINE | ID: mdl-20126920

RESUMO

OBJECTIVE: To determine the effectiveness of oscillating positive expiratory pressure (OPEP) using predetermined expiratory pressures on the viscosity and transportability of sputum in patients with bronchiectasis. METHODS: The study involved 15 stable patients with bronchiectasis (7 males; mean age = 53 +/- 16 years), submitted to two consecutive OPEP interventions, with a 24-h interval between the two, using positive expiratory pressures set at 15 cmH2O (P15) and 25 cmH2O (P25). The protocol consisted of a voluntary cough; another voluntary cough 20 min later, designated time zero (T0); a 10-min rest period; and two 10-min series (S1 and S2, using OPEP at P15 and P25 in both), with a 10-min interval between the two. The viscosity and transportability of sputum were evaluated by viscometry, relative transport velocity on frog palate, transport in a simulated cough machine and contact angle. Sputum samples were collected at T0, after S1 and after S2. Specific statistical tests were performed depending on the type of data distribution. RESULTS: In comparison with the values obtained at T0, sputum viscosity decreased significantly after S1 at P15 and after S2 at P25. There were no significant differences among all of the samples in terms of transportability. CONCLUSIONS: The fact that sputum viscosity decreased whether OPEP was performed at P15 or at P25 suggests that there is no need to generate high expiratory pressure to achieve the desired result.


Assuntos
Bronquiectasia/terapia , Depuração Mucociliar/fisiologia , Respiração com Pressão Positiva/normas , Escarro/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração com Pressão Positiva/métodos , Escarro/química , Viscosidade
12.
J. bras. pneumol ; 35(12): 1190-1197, dez. 2009. ilus, tab
Artigo em Português | LILACS | ID: lil-537081

RESUMO

OBJETIVO: Verificar a efetividade da técnica de pressão expiratória positiva oscilante (PEPO) utilizando pressões expiratórias pré-determinadas sobre a viscosidade e a transportabilidade do escarro em pacientes com bronquiectasia. MÉTODOS: Foram incluídos no estudo 15 pacientes estáveis com bronquiectasia (7 homens; média de idade = 53 ± 16 anos), submetidos a duas intervenções PEPO consecutivas, com 24 h de intervalo entre si, utilizando pressões expiratórias de 15 cmH2O (P15) e 25 cmH2O (P25). O protocolo consistiu de tosse voluntária; nova expectoração voluntária após 20 min, denominado tempo zero (T0); repouso de 10 min; e utilização da técnica em duas séries de 10 min (S1 e S2) de PEPO em P15 e P25, com intervalo de 10 min entre si. A viscosidade e transportabilidade do escarro foram avaliadas pela viscosimetria, velocidade relativa de transporte no palato de rã, deslocamento em máquina simuladora de tosse e ângulo de adesão. As amostras de escarro foram coletadas em T0, após S1 e após S2. Testes estatísticos específicos foram aplicados de acordo com a distribuição dos dados. RESULTADOS: Houve diminuição significante da viscosidade do escarro após S1 em P15 e após S2 em P25. Não houve diferenças significantes entre todas as amostras para a transportabilidade. CONCLUSÕES: Houve diminuição da viscosidade do escarro quando a PEPO foi realizada em P15 e P25, o que sugere que não seja necessário gerar alta pressão expiratória para obter o resultado desejado.


OBJECTIVE: To determine the effectiveness of oscillating positive expiratory pressure (OPEP) using predetermined expiratory pressures on the viscosity and transportability of sputum in patients with bronchiectasis. METHODS: The study involved 15 stable patients with bronchiectasis (7 males; mean age = 53 ± 16 years), submitted to two consecutive OPEP interventions, with a 24-h interval between the two, using positive expiratory pressures set at 15 cmH2O (P15) and 25 cmH2O (P25). The protocol consisted of a voluntary cough; another voluntary cough 20 min later, designated time zero (T0); a 10-min rest period; and two 10-min series (S1 and S2, using OPEP at P15 and P25 in both), with a 10-min interval between the two. The viscosity and transportability of sputum were evaluated by viscometry, relative transport velocity on frog palate, transport in a simulated cough machine and contact angle. Sputum samples were collected at T0, after S1 and after S2. Specific statistical tests were performed depending on the type of data distribution. RESULTS: In comparison with the values obtained at T0, sputum viscosity decreased significantly after S1 at P15 and after S2 at P25. There were no significant differences among all of the samples in terms of transportability. CONCLUSIONS: The fact that sputum viscosity decreased whether OPEP was performed at P15 or at P25 suggests that there is no need to generate high expiratory pressure to achieve the desired result.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bronquiectasia/terapia , Depuração Mucociliar/fisiologia , Respiração com Pressão Positiva/normas , Escarro/metabolismo , Respiração com Pressão Positiva/métodos , Escarro/química , Viscosidade
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