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Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

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International Journal of Ophthalmology(English edition) 2024年第8期17卷 1483-1488页

作者： Shaikha Al Eid Hamad M AlSulaiman Sahar M Elkhamary Osama Al Sheikh Alicia Ferrero-Galindo Rajiv Kandekhar Silvana A Schellini Oculoplastic division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Radiology division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Department of Diagnostic Radiology Mansoura Faculty of MedicineMansoura 35511Egypt University hospital Rio Hortega Valladolid 47012Spain Research Department King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Ophthalmology Department Medical SchoolState University of Sao PauloBotucatu 18618-687Brazil

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic ***:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric ***-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were *** data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal *** relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

关键词： anophthalmic socket spheric implant levator palpebrae superioris superior rectus lagophthalmos fornix depth

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Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of Urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-Chung Cheng Steffi Kar-Kei Yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy Yuen-Chun Teoh Vineet Gauhar Department of Surgery United Christian HospitalHong KongChina S.H.Ho Urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de sao paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil Department of Urology Asian Institute of Nephrology and UrologyHyderabadTGIndia Department of Urology National University HospitalSingapore Department of Urology Marmara University School of MedicineIstanbulTurkey Department of Urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey Department of Urology Hospital Quiron BarcelonaBarcelonaSpain Department of Urology Clinique PasteurToulouseFrance Department of Urology Indiana University School of MedicineIndianapolisINUSA division of Urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada Department of Urology University Hospital Southampton NHS TrustSouthamptonUK Department of Urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction ***:A 36-item survey was developed with a Delphi *** on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were *** were invited globally to complete the online *** was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative *** in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery *** on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 ***:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining ***®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy Surgery Bladderoutlet obstruction

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An oxygenating colloidal bioink for the engineering of biomimetic tissue constructs

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Bio-Design and Manufacturing 2024年第3期7卷 240-261页

作者： Seol-Ha Jeong Jarno Hiemstra Patrick V.Blokzijl Rebeca Damian-Ferrara Danilo Martins dos Santos Jéssica H.L.da Fonseca Min-Ho Kang Jihyun Kim Dilara Yilmaz-Aykut Mei L.L.Cham-Pérez Jeroen Leijten Su Ryon Shin division of Engineering in Medicine Department of MedicineBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02139USA Leijten Lab Department of Developmental BioEngineeringFaculty of Science and TechnologyTechnical Medical CentreUniversity of TwenteDrienerlolaan 57522 NB EnschedeThe Netherlands Nanotechnology National Laboratory for Agriculture(LNNA) Embrapa InstrumentaçãoSao CarlosSao Paulo 13560-970Brazil Department of Biomedical-Chemical Engineering The Catholic University of Korea43 Jibong-roBucheon-siGyeonggi-do 14662Republic of Korea Department of Biotechnology The Catholic University of Korea43 Jibong-roBucheon-siGyeonggi-do 14662Republic of Korea

Ensuring a sufficient oxygen supply is pivotal for the success of bioprinting applications since it fosters tissue integration and natural *** in oxygen concentration among diverse tissues necessitates the precise recreation of tissue-specific oxygen levels in imprinted constructs to support the survival of targeted *** oxygen-releasing biomaterials,such as oxygen-generating microparticles(OMPs),have shown promise for enhancing the oxygen supply of microenvironments in injured tissues,whether this approach is scalable for large tissues and whether tissue-specific bioinks with varying OMP concentrations remain printable remain *** study addresses this critical gap by introducing an innovative class of engineered oxygenated bioinks that combine colloidal-based microgels with *** report that incorporating nanosized calcium peroxide(nCaO_(2))and manganese oxide nanosheets(nMnO_(2))into hydrophobic polymeric microparticles enables precise modulation of oxygen release while controlling hydrogen peroxide ***,the fabrication of oxygenating and cytocompatible colloidal gels is achieved using an aqueous two-phase *** study thoroughly evaluates the fundamental characteristics of the resulting bioink,including its rheological behaviors,printability,shape fidelity,mechanical properties,and oxygen release ***,this study demonstrates the macroscopic scalability and cytocompatibility of printed constructs produced via cell-laden oxygenating colloidal *** showcasing the effectiveness of extrusion-based bioprinting,this study underscores how it can be used to fabricate biomimetic tissues,indicating its potential for new *** findings presented here advance the bioprinting field by achieving scalability with both high cell viability and the possibility of mimicking specifically oxygenated *** work thereby offers a promising avenue for the development of functional tissues with e

关键词： 3D bioprinting Bioink Colloidal gels Extrusion printing Oxygen-generating microparticle

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Dysregulated microRNAs in type 2 diabetes and breast cancer:Potential associated molecular mechanisms

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World Journal of Diabetes 2024年第6期15卷 1187-1198页

作者： Alex Cleber Improta-Caria Filipe Ferrari João Lucas Penteado Gomes Paloma Brasilio Villalta Úrsula Paula RenóSoci Ricardo Stein Edilamar M Oliveira Laboratory of Biochemistry and Molecular Biology of the Exercise Physical Education and Sport SchoolUniversity of São PauloSão Paulo 05508-030Brazil Graduate Program in cardiology and Cardiovascular Sciences Federal University of Rio Grande do SulHospital de Clínicas de Porto AlegrePorto Alegre 90035003Brazil Laboratory of Metabolic Disorders(Labdime) School of Applied SciencesUniversity of Campinas-UNICAMPCampinas 13484-350Brazil Departments of Internal Medicine Molecular Pharmacology and PhysiologyCenter for Regenerative MedicineUSF Health Heart InstituteMorsani College of MedicineUniversity of South FloridaTampaFL 33602United States

Type 2 diabetes(T2D)is a multifaceted and heterogeneous syndrome associated with complications such as hypertension,coronary artery disease,and notably,breast cancer(BC).The connection between T2D and BC is established through processes that involve insulin resistance,inflammation and other *** this comprehension the specific cellular and molecular mechanisms linking T2D to BC,especially through microRNAs(miRNAs),remain *** are regulators of gene expression at the post-transcriptional level and have the function of regulating target genes by modulating various signaling pathways and biological ***,the signaling pathways and biological processes regulated by miRNAs that are associated with T2D and BC have not yet been *** review aims to identify dysregulated miRNAs in both T2D and BC,exploring potential signaling pathways and biological processes that collectively contribute to the development of BC.

关键词： Type 2 diabetes Breast cancer MicroRNAs Molecular mechanisms

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Outcomes of combined mitochondria and mesenchymal stem cellsderived exosome therapy in rat acute respiratory distress syndrome and sepsis

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World Journal of Stem Cells 2024年第6期16卷 690-707页

作者： Kun-Chen Lin Wen-Feng Fang Jui-Ning Yeh John Y Chiang Hsin-Ju Chiang Pei-Lin Shao Pei-Hsun Sung Hon-Kan Yip Department of Anesthesiology Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina division of Pulmonary and Critical Care Medicine Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung 83301TaiwanChina Department of cardiology The First Affiliated Hospital of Jinan UniversityGuangzhou 510630Guangdong ProvinceChina Department of Computer Science and Engineering National Sun Yat-sen UniversityKaohsiung 804201TaiwanChina Department of Healthcare Administration and Medical Informatics Kaohsiung Medical UniversityKaohsiung 80708TaiwanChina School of Medicine Chung Shan Medical UniversityTaichung 40201TaiwanChina Department of Nursing Asia UniversityTaichung 41354TaiwanChina division of cardiology Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 83301TaiwanChina Institute for Translational Research in Biomedicine Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina Center for Shockwave Medicine and Tissue Engineering Kaohsiung Chang Gung Memorial HospitalKaohsiung 83301TaiwanChina Department of Medical Research China Medical University HospitalChina Medical UniversityTaichung 40402TaiwanChina School of Medicine College of MedicineChang Gung UniversityTaoyuan 33302TaiwanChina

BACKGROUND The treatment of acute respiratory distress syndrome(ARDS)complicated by sepsis syndrome(SS)remains *** To investigate whether combined adipose-derived mesenchymal-stem-cells(ADMSCs)-derived exosome(EXAD)and exogenous mitochondria(mitoEx)protect the lung from ARDS complicated by *** In vitro study,including L2 cells treated with lipopolysaccharide(LPS)and in vivo study including male-adult-SD rats categorized into groups 1(sham-operated-control),2(ARDS-SS),3(ARDS-SS+EXAD),4(ARDS-SS+mitoEx),and 5(ARDS-SS+EXAD+mitoEx),were included in the present *** In vitro study showed an abundance of mitoEx found in recipient-L2 cells,resulting in significantly higher mitochondrial-cytochrome-C,adenosine triphosphate and relative mitochondrial DNA levels(Psao2%)displayed an opposite pattern of albumin among the *** findings of lung injury/fibrosis area and inflammatory/DNA-damaged markers(CD68+/γ-H2AX)displayed an identical pattern of sao2%among the groups(all P<0.0001).The pro

关键词： Acute respiratory distress syndrome Sepsis syndrome Exosomes Mitochondria Adipose tissue-derived mesenchymal stem cells Inflammation

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Peroral endoscopic myotomy vs laparoscopic myotomy and partial fundoplication for esophageal achalasia: A single-center randomized controlled trial

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World Journal of Gastroenterology 2022年第33期28卷 4875-4889页

作者： Eduardo Turiani Hourneaux de Moura Jose Jukemura Igor Braga Ribeiro Galileu Ferreira Ayala Farias Aureo Augusto de Almeida Delgado Lara Meireles Azeredo Coutinho Diogo Turiani Hourneaux de Moura Rubens Antonio Aissar Sallum Ary Nasi Sergio A Sanchez-Luna paulo Sakai Eduardo Guimaraes Hourneaux de Moura Departamento de Gastroenterologia Faculdade de MedicinaUniversidade de Sao PauloServico de Endoscopia Gastrointestinal do Hospital das Clinicas HCFMUSPSao Paulo 05403-010Brazil division of Esophageal Surgery Hospital das ClinicasUniversity of Sao Paulo School of MedicineSao Paulo 05403-010Brazil Departamento de Gastroenterologia Faculdade de MedicinaUniversidade de Sao PauloHospital das ClinicasUniversity of Sao Paulo School of MedicineSao Paulo 05403-010Brazil Department of Internal Medicine The University of Alabama at Birmingham Heersink School of MedicineBasil I.Hirschowitz Endoscopic Center of ExcellenceDivision of Gastroenterology and HepatologyBirminghamAL 35233United States

BACKGROUND Achalasia is a rare benign esophageal motor disorder characterized by incomplete relaxation of the lower esophageal sphincter(LES). The treatment of achalasia is not curative, but rather is aimed at reducing LES pressure. In patients who have failed noninvasive therapy, surgery should be considered. Myotomy with partial fundoplication has been considered the first-line treatment for non-advanced achalasia. Recently, peroral endoscopic myotomy(POEM), a technique that employs the principles of submucosal endoscopy to perform the equivalent of a surgical myotomy,has emerged as a promising minimally invasive technique for the management of this *** To compare POEM and laparoscopic myotomy and partial fundoplication(LM-PF) regarding their efficacy and outcomes for the treatment of *** Forty treatment-naive adult patients who had been diagnosed with achalasia based on clinical and manometric criteria(dysphagia score ≥ II and Eckardt score > 3) were randomized to undergo either LM-PF or POEM. The outcome measures were anesthesia time, procedure time, symptom improvement, reflux esophagitis(as determined with the Gastroesophageal Reflux Disease Questionnaire), barium column height at 1 and 5 min(on a barium esophagogram), pressure at the LES, the occurrence of adverse events(AEs), length of stay(LOS), and quality of life(QoL).RESULTS There were no statistically significant differences between the LM-PF and POEM groups regarding symptom improvement at 1, 6, and 12 mo of follow-up(P = 0.192, P = 0.242, and P = 0.242, respectively). However, the rates of reflux esophagitis at 1, 6, and 12 mo of follow-up were significantly higher in the POEM group(P = 0.014, P < 0.001, and P = 0.002, respectively). There were also no statistical differences regarding the manometry values, the occurrence of AEs, or LOS. Anesthesia time and procedure time were significantly shorter in the POEM group than in the LM-PF group(185.00 ± 56.89 and 95.70 ± 30.47 min v

关键词： Esophageal achalasia Gastroesophageal reflux Deglutition disorders Heller myotomy Fundoplication Randomized controlled trial

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Quantitative alpha-defensin testing: Is synovial fluid dilution important?

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World Journal of Orthopedics 2022年第8期13卷 760-767页

作者： Rodrigo Calil Teles Abdo Riccardo Gomes Gobbi Chilan Bou Ghosson Leite Sandra Gofinet Pasoto Elaine Pires Leon Ana Lucia Lei Munhoz Lima Eloisa Bonfa JoséRicardo Pécora Marco Kawamura Demange Instituto de Ortopedia e Traumatologia Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 05403-010Brazil Orthopaedic Department HCor-Hospital do CoraçãoSao Paulo 04004-030Brazil division of Rheumatology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 05403-010Brazil

BACKGROUND Alpha-defensin has been widely studied for the diagnosis of periprosthetic joint infection(PJI).However,there is a lack of detailed information regarding the proper laboratory technique of the enzyme-linked immunosorbent assay(ELISA)method,such as sample *** To assess the influence of dilution in the synovial fluid during ELISA for the diagnosis of knee PJI;and determine which dilution presents a better *** Forty samples of synovial fluid from arthroplasty knees were included,17 in the infected group and 23 in the aseptic group,according to Musculoskeletal Infection Society ***,five synovial fluid samples from each group were assessed for quantitative analysis of alpha-defensin using *** dilution ratios(1:10,1:100,1:500,1:1000 and 1:5000)were tested based on the predetermined cutoff value of 5.2 mg/*** dilutions that performed better were used to compare the results of all *** For infected cases,a gradual increase in the dilution of synovial fluid samples led to an equivalent increase in alpha-defensin *** same was not observed in the aseptic *** 1:1000 and 1:5000 dilutions presented satisfactory results to differentiate infected and aseptic *** analyses were performed using 1:1000 and 1:5000 for all 40 *** 1:1000 dilution resulted in a sensitivity of 88.2%(95%CI,66%-98%)and specificity of 95.7%(95%CI,79%-99%),whereas the 1:5000 dilution presented a sensitivity of 94.1%(95%CI,73%-99%)and a specificity of 100%(95%CI,86%-100%).CONCLUSION The synovial fluid dilution had an important influence on the alpha-defensin ELISA *** of 1:5000 showed the best performance for the diagnosis of knee *** results of this study set the basis for a more reliable and reproducible alpha-defensin ELISA during the investigation of PJI,contributing to the expansion of this technique in different treatment centers worldwide.

关键词： Alpha-defensin Enzyme-linked immunosorbent assay Periprosthetic joint infection Laboratory findings

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Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil

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World Journal of Hepatology 2022年第1期14卷 195-208页

作者： Mariana Sandoval Lourenço Patricia Momoyo Y Zitelli Marlone Cunha-Silva Arthur Ivan N Oliveira Cláudia P Oliveira Tiago Sevá-Pereira Flair JoséCarrilho Mario G Pessoa Daniel F Mazo division of Gastroenterology Department of Internal MedicineSchool of Medical SciencesUniversity of CampinasSao Paulo 13083-878Brazil division of Clinical Gastroenterology and Hepatology Department of GastroenterologyUniversity of São Paulo School of MedicineSao Paulo 05403-900Brazil

BACKGROUND Hepatitis C virus(HCV)treatment has undergone major changes in recent *** interferon-based therapies have been replaced by oral direct-acting antivirals(DAA)regimens,with high sustained virologic response(SVR)rates,and a lower incidence of adverse events(AEs).AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in *** This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C(CHC),undergoing treatment with interferon-free regimens from November 2015 to November *** therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of ***,anthropometric,clinical,and laboratory variables were *** were assessed at 12 to 24 wk after therapy by intention-to-treat(ITT),and modified ITT(m-ITT)*** and serious adverse events(SAEs)were *** the statistical analysis,a P value of<0.05 was considered *** The mean age was 56.88 years,with 415(78.5%)being HCV genotype 1,followed by genotype 3(20.1%).Moreover,306(57.5%)subjects had cirrhosis,and a third of them had decompensated ***(SOF)plus daclatasvir±ribavirin was the most frequently used treatment(66.9%),followed by SOF plus simeprevir(21.2%).The overall ITT SVR was 92.6%(493/532),while the m-ITT SVR was 96.8%(493/509).Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy(OR:4.320;95%CI:1.920-9.721,P=0.0004),presence of esophageal varices(OR:2.381;95%CI:1.137-4.988,P=0.0215),previous portal hypertensive bleeding(OR:2.756;95%CI:1.173-6.471,P=0.02),higher model for end-stage liver disease scores(OR:1.143,95%CI:1.060–1.233,P=0.0005),lower serum albumin levels(OR:0.528,95%CI:0.322-0.867,P=0.0115),higher serum creatinine(OR:1.117,95%CI:1.056-1.312,P=0.0033),and international normalized ratio(INR)levels(OR:5.542,95%CI:2.023-15.182,P=0.0009).AEs were reported

关键词： Chronic hepatitis C Antiviral agents Hepatitis C virus Sustained virologic response Liver cirrhosis Safety

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Status of bariatric endoscopy–what does the surgeon need to know? A review

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World Journal of Gastrointestinal Surgery 2022年第2期14卷 185-199页

作者： Diogo Turiani Hourneaux de Moura Anna Carolina Batista Dantas Igor Braga Ribeiro Thomas R McCarty Flávio Roberto Takeda Marco Aurelio Santo Sergio Carlos Nahas Eduardo Guimarães Hourneaux de Moura Departamento de Gastroenterologia Faculdade de MedicinaUniversidade de Sao PauloServiço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSPSao Paulo 05403-010Brazil Departamento de Gastroenterologia Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloUnidade de Cirurgia Bariátrica e MetabólicaDisciplina de Cirurgia do Aparelho Digestivo e ColoproctologiaSao Paulo 05403-010Brazil division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalBostonMA 021115United States

BACKGROUND Obesity is a chronic and multifactorial disease with a variety of potential treatment options ***,there are several multidisciplinary therapeutic options for its management,including conservative,endoscopic,and surgical *** To clarify indications,technical aspects,and outcomes of bariatric *** Narrative review of current literature based on electronic databases including MEDLINE(PubMed),Cochrane Library,and *** Bariatric endoscopy is in constant development and comprises primary and revisional treatment options as well as management of surgical *** devices act upon different mechanisms of action,which may be individualized to each *** favorable results for the endoscopic treatment of obesity,prospective randomized studies with long-term follow-up are required to fully validate primary and revisional endoscopic *** the management of bariatric surgery complications,endoscopic therapy may be considered the procedure of choice in a variety of ***,as there is no standardized algorithm,local experience should be considered in *** The treatment of patients with obesity is complex,and a multidisciplinary approach is *** endoscopy has shown impressive results both in the treatment of obesity and its surgical complications,and therefore,must be part of the armamentarium in the fight against this disease.

关键词： Endoscopy Gastrointestinal Surgery Obesity Bariatric Weight regain

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Acupuncture Treatment for Idiopathic Trigeminal Neuralgia:A Longitudinal Case-Control Double Blinded Study

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Chinese Journal of Integrative Medicine 2017年第11期23卷 829-836页

作者： Michelle Cristina Ichida Mariana Zemuner Jorge Hosomi Hong Jin Pai Manoel Jacobsen Teixeira JoséTadeu Tesseroli de Siqueira Silvia R D T de Siqueira Neurology Department Medical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Group of Acupuncture Interdisciplinary Pain Group of the Neurology DivisionClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Interdisciplinary Pain Center of hospital das Clinicas Neurology DepartmentMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Neurosurgery division Psychiatry InstituteClinical HospitalMedical SchoolUniversity of Sao PauloS&o Paulo(05403-010)Brazil Orofacial Pain Team Dentistry DivisionClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Group of Oral Medicine and Neuroscience of the Dentistry division Psychiatry InstituteClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil School of Arts Science and HumanitiesUniversity of Sao PauloSao Paulo(05403-010)Brazil

Objective： To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia（ITN） by case-control longitudinal blinded study. Methods： Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group（15 cases）, sham-acupuncture group（15 cases） and carbamazepine group（30 cases）, respectively. Clinical orofacial evaluation（including pain intensity and medication doses）, research diagnostic criteria for temporomandibular disorders（RDC/TMD） and Helkimo indexes（for functional evaluation of the masticatory system）, and quantitative sensory testing for sensory thresholds（gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain） were evaluated before treatment, immediately after treatment, and 6 months after treatment. Results： The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation（P=0.012）. Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions（P〈0.01）. There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months（P〈0.01, P=0.023）. There was a decrease in mechanical thresholds in the acupuncture group（tactile, P〈0.01; vibration, P=0.027） and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups（P=0.013）. Conclusion： Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.

关键词： acupuncture idiopathic trigeminal neuralgia orofacial pain temporomandibular disorders quantitative sensory testing case-control study

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