A migrânea e a cefaléia tensional são cefaléias primárias que surgem de estruturas não-mastigatórias, porém, a presença de sintomas de DTM, como a dor, pode influenciar de modo excitatório tais condições e vice-versa, influenciando no resultado final do tratamento. Esta pesquisa tem o objetivo principal de avaliar o impacto da presença de cefaléias primárias no tratamento das Disfunções Temporomandibulares (DTMs), e testa a hipótese nula de que a presença de cefaléias primárias não interfere com o resultado do tratamento. Como objetivos secundários, de avaliar se existe diferença na presença de dor miofascial nos músculos mastigatórios e cervicais, se existe diferença entre a variação da dor medida pela Escala Analógica Visual (EAV) em relação ao gênero, estresse e hábitos parafuncionais, e se essa diferença também se apresenta entra as variáveis oclusão, tempo de dor, número de queixas e número de tratamentos indicados. Para isso foram selecionados 546 prontuários clínicos de pacientes, sendo 313 com DTM e 233 com DTM e cefaléias, e analisados segundo a EAV ao início e fim do tratamento para DTM, bem como a variação entre a dor inicial e final entre os grupos. Testes de Mann-Whitney, Correlação de Spearman e Qui-quadrado analisaram os dados, com 5% de significância. A presença de cefaléias primárias interferiu negativamente no índice de sucesso do tratamento da DTM (p<0,05) (redução de 38,70 e de 24,66 na EAV para os grupos de DTM e DTM associada a cefaleia, respectivamente). A presença de dor miofascial nas musculaturas mastigatória e cervical foi semelhante entre os grupos. A variação entre a dor inicial e final não foi afetada pela diferença entre os gêneros, assim como pelo auto-relato da presença de hábitos parafuncionais e de estresse. Da mesma forma, a presença de má-oclusão, o tempo de experiência de dor, o número de queixas relatadas e o número de tratamentos indicados pelo profissional não influenciaram os resultados finais. Conclui-se que presença de cefaléias primárias parece interferir negativamente na melhora do quadro sintomático de pacientes tratados para DTM. / Migraine and tension-type headaches are primary headaches that arise from non-masticatory structures, however, the presence of TMD symptoms, like pain, may have a excitatory effect in these conditions and vice versa, influencing the outcome of treatment. This research has the main objective of evaluating the impact of the presence of primary headache in the treatment of Temoromandibulares Disorders (TMD), and tests the null hypothesis that the presence of primary headache does not interfere with treatment outcome. As secondary objectives, to evaluate whether there are differences in the presence of myofascial pain in the masticatory and cervical muscles, if there is a difference between the change in pain measured by visual analog scale (VAS) in relation to gender, stress, and parafunctional habits. The influence of malocclusion, duration of pain, number of complaints and number of treatments given were also evaluated. For this reason, 546 medical records of patients, 313 and 233 with TMD TMD and headaches were selected, and analyzed using a VAS at the beginning and end of treatment for TMD, as well as the variation between the initial and final pain between the groups. Mann-Whitney, Spearman correlation and chi-square test analyzed the data with 5% significance level. The presence of primary headaches interfered negatively with the rate of successful treatment of TMD (p <0,05) (reduction of 38.70 and 24,66 in the VAS for groups of TMD and headache associated with TMD, respectively). The presence of myofascial pain in the masticatory and cervical muscles was similar between groups. The variation between the initial and final pain was not affected by gender differences, as well as by self-report the presence of parafunctional habits and stress. Likewise, the presence of malocclusion, time of pain experience, the number of complaints reported and the number of treatments given by the professional did not influence the final results. It is concluded that the presence of primary headache seems to have a negative effect on symptomatic improvement in patients treated for TMD.

A migrânea e a cefaléia tensional são cefaléias primárias que surgem de estruturas não-mastigatórias, porém, a presença de sintomas de DTM, como a dor, pode influenciar de modo excitatório tais condições e vice-versa, influenciando no resultado final do tratamento. Esta pesquisa tem o objetivo principal de avaliar o impacto da presença de cefaléias primárias no tratamento das Disfunções Temporomandibulares (DTMs), e testa a hipótese nula de que a presença de cefaléias primárias não interfere com o resultado do tratamento. Como objetivos secundários, de avaliar se existe diferença na presença de dor miofascial nos músculos mastigatórios e cervicais, se existe diferença entre a variação da dor medida pela Escala Analógica Visual (EAV) em relação ao gênero, estresse e hábitos parafuncionais, e se essa diferença também se apresenta entra as variáveis oclusão, tempo de dor, número de queixas e número de tratamentos indicados. Para isso foram selecionados 546 prontuários clínicos de pacientes, sendo 313 com DTM e 233 com DTM e cefaléias, e analisados segundo a EAV ao início e fim do tratamento para DTM, bem como a variação entre a dor inicial e final entre os grupos. Testes de Mann-Whitney, Correlação de Spearman e Qui-quadrado analisaram os dados, com 5% de significância. A presença de cefaléias primárias interferiu negativamente no índice de sucesso do tratamento da DTM (p<0,05) (redução de 38,70 e de 24,66 na EAV para os grupos de DTM e DTM associada a cefaleia, respectivamente). A presença de dor miofascial nas musculaturas mastigatória e cervical foi semelhante entre os grupos. A variação entre a dor inicial e final não foi afetada pela diferença entre os gêneros, assim como pelo auto-relato da presença de hábitos parafuncionais e de estresse. Da mesma forma, a presença de má-oclusão, o tempo de experiência de dor, o número de queixas relatadas e o número de tratamentos indicados pelo profissional não influenciaram os resultados finais. Conclui-se que presença de cefaléias primárias parece interferir negativamente na melhora do quadro sintomático de pacientes tratados para DTM. / Migraine and tension-type headaches are primary headaches that arise from non-masticatory structures, however, the presence of TMD symptoms, like pain, may have a excitatory effect in these conditions and vice versa, influencing the outcome of treatment. This research has the main objective of evaluating the impact of the presence of primary headache in the treatment of Temoromandibulares Disorders (TMD), and tests the null hypothesis that the presence of primary headache does not interfere with treatment outcome. As secondary objectives, to evaluate whether there are differences in the presence of myofascial pain in the masticatory and cervical muscles, if there is a difference between the change in pain measured by visual analog scale (VAS) in relation to gender, stress, and parafunctional habits. The influence of malocclusion, duration of pain, number of complaints and number of treatments given were also evaluated. For this reason, 546 medical records of patients, 313 and 233 with TMD TMD and headaches were selected, and analyzed using a VAS at the beginning and end of treatment for TMD, as well as the variation between the initial and final pain between the groups. Mann-Whitney, Spearman correlation and chi-square test analyzed the data with 5% significance level. The presence of primary headaches interfered negatively with the rate of successful treatment of TMD (p <0,05) (reduction of 38.70 and 24,66 in the VAS for groups of TMD and headache associated with TMD, respectively). The presence of myofascial pain in the masticatory and cervical muscles was similar between groups. The variation between the initial and final pain was not affected by gender differences, as well as by self-report the presence of parafunctional habits and stress. Likewise, the presence of malocclusion, time of pain experience, the number of complaints reported and the number of treatments given by the professional did not influence the final results. It is concluded that the presence of primary headache seems to have a negative effect on symptomatic improvement in patients treated for TMD.

Congenital Heart Disease (CHD) is one of the most common birth defects. It is the single most modifiable cause of infant mortality under one year of age. Therefore, the causes of CHD have been extensively researched in the past but the etiology remains largely unknown. Environmental risks, particularly maternal risk factors for congenital cardiac malformation have been evaluated in the original BWIS previously. However, in this research we examined one of the additional risk factors. We sought to determine whether maternal headache during six months prior to conception and throughout gestation until birth is a risk factor for CHD in the BWIS dataset. Among 3274 singleton cases and 3519 controls, a maternal report of headache was found to be associated with a nearly 20% increase in the risk of a congenital heart defect (OR= 1.2 p=0.001). Moreover, any medications use for headache 1-6 months prior to conception increased the risk of abnormal cardiac development by 1.3 fold (OR = 1.3, p=0.0004). Aspirin or aspirin containing analgesics were found to increase the risk for CHD at the defined risk period. According to subgroup analysis, aspirin or aspirin containing analgesics and acetaminophen or acetaminophen containing analgesics were found to be the risk factor for CTD i.e. Conotruncal defects. Furthermore, aspirin or aspirin containing analgesics increased the risk for PVSD i.e. Peri-membranous Ventricular Defect in offspring when the mother uses these drugs 1-6 months prior to conception. Additionally, the risk for CVD i.e. critical valve disease were found to be increased when women were exposed to aspirin or aspirin containing analgesics during third trimester after pregnancy. In conclusion, maternal headache increased the risk for CHD by 20% and the use of headache medications specifically pain relievers during 1-6 months prior to conception modulated type of defect was observed.