Navegando por Palavras-chave "Distrofia miotônica"

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    Avaliação do comprometimento do sistema estomatognático na distrofia miotônica de Steinert
    (Universidade Federal de São Paulo (UNIFESP), 2003) Guimaraes, Antonio Sergio [UNIFESP]; Marie, Suely Kazue Nagahashi [UNIFESP]
    Objetivo: estudar o sistema da mastigacao quanto aos parametros de avaliacao odontologica, prevalencia do fenomeno miotonico nos musculos da mastigacao, forcas de mordida e de fechamento das maos e avaliar a ATM por imagens por ressonancia magnetica (IRM) em pacientes com distrofia miotonica de Steinert (DMS). Metodos: os pacientes foram submetidos ao exame clinico odontologico, mensurando-se as aberturas confortavel e total da boca, o numero de dentes faltantes, padrao oclusal, lado de preferencia da mastigacao, prevalencia de desordens temporomandibulares, tratamento ortodontico previo e fenomeno miotonico. Realizou-se mensuracao quantitativa das forcas de mordida e de fechamento das maos e analise: das articulacoes temporomandibulares (ATM) atraves de IRM, avaliando-se as corticais da fossa mandibular, tuberosidade e da cabeca da mandibula, assim como os discos articulares quanto sua forma anatomica, sinal a IRM e posicionamento nas fases de boca fechada e aberta confortavel. Resultados: os pacientes com DMS apresentaram alteracoes da musculatura da mastigacao evidenciadas pela: 1) presenca do fenomeno miotonico (62 por cento), sendo predominante na lingua, seguido de presenca deste fenomeno na abertura da boca (28 por cento), no fechamento da boca (14 por cento), abertura e fechamento da boca (4 por cento) e na bochecha (2 por cento), 2) limitacao acentuada da abertura de boca confortavel e 3) reducao da forca de mordida, associada a reducao da forca distal de fechamento das maos, ambos significativos em comparacao ao grupo normal (p<0,0001). Observaram-se a IRM das ATM alteracoes das corticais, principalmente das cabecas da mandibula e hiposinal dos discos articulares. Conclusao: Os pacientes com DMS apresentaram evidentes sinais de alteracao da musculatura da mastigacao associadas a alteracoes das estruturas das ATM, sugerindo-se que a DMS possa ser um modelo de alteracoes articulares por defiCiência de carga
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    Intraocular pressure, corneal thickness, and corneal hysteresis in Steinert's myotonic dystrophy
    (Conselho Brasileiro de Oftalmologia, 2011-06-01) Garcia Filho, Carlos Alexandre de Amorim [UNIFESP]; Prata, Tiago dos Santos [UNIFESP]; Sousa, Aline Katia Siqueira [UNIFESP]; Doi, Larissa Morimoto [UNIFESP]; Melo Jr., Luiz Alberto Soares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: Low intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT) is one of the ocular manifestations of Steinert's myotonic dystrophy. The goal of this study was to evaluate the corneal-compensated IOP as well as corneal properties (central corneal thickness and corneal hysteresis) in patients with myotonic dystrophy. METHODS: A total of 12 eyes of 6 patients with Steinert's myotonic dystrophy (dystrophy group) and 12 eyes of 6 age-, race-, and gender-matched healthy volunteers (control group) were included in the study. GAT, Dynamic Contour Tonometry (DCT-Pascal) and Ocular Response Analyzer (ORA) were used to assess the IOP. Central corneal thickness was obtained by ultrasound pachymetry, and corneal hysteresis was analyzed using the ORA device. In light of the multiplicity of tests performed, the significance level was set at 0.01 rather than 0.05. RESULTS: The mean (standard deviation [SD]) GAT, DCT, and corneal-compensated ORA IOP in the dystrophy group were 5.4 (1.4) mmHg, 9.7 (1.5) mmHg, and 10.1 (2.6) mmHg, respectively. The mean (SD) GAT, DCT, and corneal-compensated ORA IOP in the control group was 12.6 (2.9) mmHg, 15.5 (2.7) mmHg, and 15.8 (3.4) mmHg, respectively. There were significant differences in IOP values between dystrophy and control groups obtained by GAT (mean, -7.2 mmHg; 99% confidence interval [CI], -10.5 to -3.9 mmHg; P<0.001), DCT (mean, -5.9 mmHg; 99% CI, -8.9 to -2.8 mmHg; P<0.001), and corneal-compensated ORA measurements (mean, -5.7 mmHg; 99% CI, -10.4 to -1.0 mmHg; P=0.003). The mean (SD) central corneal thickness was similar in the dystrophy (542 [31] µm) and control (537 [11] µm) groups (P=0.65). The mean (SD) corneal hysteresis in the dystrophy and control groups were 11.2 (1.5) mmHg and 9.7 (1.2) mmHg, respectively (P=0.04). CONCLUSIONS: Patients with Steinert's myotonic dystrophy showed lower Goldmann and corneal-compensated IOP in comparison with healthy individuals. Since central corneal thickness and corneal hysteresis did not differ significantly between groups, the lower IOP readings documented in this dystrophy seem not to be related to changes in corneal properties.