Oral health-related quality of life of older adults living in long-term care facilities and its association with dental prosthesis use and condition / Qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência: associação com o uso e condição da prótese

OBJECTIVE: This cross-sectional study aimed to evaluate the association of oral health-related quality of life with prosthetic rehabilitation status and dental prosthesis condition in residents of Brazilian long-term care facilities. METHODS: The oral health-related quality of life of older adults (n = 194; mean [standard deviation] age = 78.93 [9.10]) was assessed by the Geriatric Oral Health Assessment Index and the Oral Health Impact Profile questionnaires. Prosthetic rehabilitation status was recorded according to the absence of teeth and use of dental prostheses. Dental prosthesis condition was considered good or poor based on stability, retention, occlusion, vertical dimension, and defects. Poisson regression models were plotted to analyze the data (α = 0.05). RESULTS: Lower Geriatric Oral Health Assessment Index scores were associated with edentulism with denture use only on one jaw (B = -0.05) and poor dental prosthesis stability (B = -0.04). Similarly, edentulous participants with denture only on one jaw (B = 0.59) and those wearing dental prostheses with poor stability (B = 0.36) are more likely to achieve higher Oral Health Impact Profile scores. Also, lower Oral Health Impact Profile scores were associated with denture defects (B = -0.34). CONCLUSION: In summary, the oral health-related quality of life of older adults living in long-term care facilities is negatively impacted by edentulism with denture only on one jaw and use of dental prostheses with poor stability. Therefore, long-term care facilities should provide oral health training to caregivers, include dental professionals in the staff, and articulate demands with oral health teams in the primary care system. (AU)

OBJETIVO: Este estudo transversal objetivou avaliar a associação da qualidade de vida relacionada à saúde bucal com o status de reabilitação protética e a condição da prótese em residentes de instituições de longa permanência no Brasil. METODOLOGIA: A qualidade de vida relacionada à saúde bucal dos idosos (n = 194; média [desvio padrão] idade = 78,93 [9,10]) foi avaliada pelos questionários Geriatric Oral Health Assessment Index e Oral Health Impact Profile. O status de reabilitação protética foi registrado de acordo com a ausência de dentes e uso de próteses dentárias. A condição da prótese foi considerada boa ou ruim com base na estabilidade, retenção, oclusão, dimensão vertical e defeitos. Modelos de regressão de Poisson foram plotados para analisar os dados (α = 0,05). RESULTADOS: Como resultado, menores escores no Geriatric Oral Health Assessment Index foram associados ao edentulismo com o uso de dentadura em apenas uma arcada (B = -0,05) e ao uso de próteses com estabilidade ruim (B = -0,04). De forma similar, participantes edêntulos que usavam dentadura em apenas uma arcada (B = 0,59) e aqueles que portavam prótese com estabilidade ruim (B = 0,36) são mais propensos a ter maiores escores no Oral Health Impact Profile. Além disso, menores escores no Oral Health Impact Profile foram associados a defeitos na prótese (B = -0,34). CONCLUSÃO: Sumarizando, a qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência é negativamente impactada pelo edentulismo com o uso de dentadura em apenas uma arcada e uso de prótese com estabilidade ruim. Assim, instituições de longa permanência devem promover capacitação em saúde bucal aos cuidadores, incluir dentistas no quadro de funcionários e articular com as equipes de saúde bucal da Atenção Primária à Saúde. (AU)

Association of sociodemographic characteristics, mental health, and sleep quality with COVID-19 fear in an elderly Brazilian population

Aim: This study determined whether COVID-19 fear is correlated with sociodemographic characteristics, general health, mental health, and sleep quality in an elderly Brazilians. Methods: Elderly people aged ≥ 60 years replied to an online survey containing questions about their sociodemographic characteristics; general health; levels of stress, anxiety, and depression; sleep quality; and COVID fear. Results: Data were statistically analyzed using descriptive statistics (α = 5%). In total, 705 elderly people with mean age of 66 ± 5 years, and most (82.7%) respondents were women, graduated and from southeastern Brazil. COVID-19 fear correlated positively and moderately with sleep quality and symptoms of depression, anxiety, and stress (all p < 0.001). It was associated with females. Elderly people from northern and northeastern Brazil and diabetics had increased COVID-19 fear (all p < 0.05). Conclusion: The fear of COVID-19 exists among Brazilian female old people, diabetics, increases anxiety and stress symptoms, and worsen sleep quality in elderly people

Academic perspectives and psychosocial aspects of final-year dental students during COVID-19 pandemic

Aim: This cross-sectional observational study aimed to evaluate the influence of the Universities lockdown measures on academic perspectives and psychosocial aspects of Brazilian finalyear dental students. Methods: 268 undergraduate students regularly enrolled in a Dentistry course at public universities were asked about anxiety, depression, stress sensitivity, and their academic perspectives by using an online survey. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression, while the Perceived Stress Scale (PSS) evaluated stress levels. The academic perspective was evaluated by five affirmatives regarding possible difficulties that will be faced when school reopens and after graduation. The possible association between fear of having COVID-19 with psychosocial outcomes and COVID-19 association with academic perspectives were analyzed by ANOVA and chisquare tests, respectively, considering a significance level of 5%. Results: Considering possible associations between the fear of having COVID-19 and psychosocial aspects, significant values were found for anxiety (P = 0.018) and stress sensitivity (P = 0.002). Regarding students' academic perspectives, COVID-19 had significant impact on less opportunity to perform procedures (P = 0.023), additional expenses with personal protective equipment (P = 0.007), and concerns of consulting elderly people (P = 0.012). Conclusion: The COVID-19 pandemic led to increased psychological impairments and enlarged concerns with learning and biosecurity, which might impact academic perspectives. Thus, being aware of these apprehensions, university professors and staff can improve the clinical training of final-year dental students in an empathetic way

Effect of frozen storage on preservation of a silicone-based test food material

Aim: This study aimed to evaluate the effect of frozen storage on the physical properties of a silicone-based test food material, highly used to evaluate the masticatory performance in research settings. Methods: A total of 1,666 silicone cubes of Optosil Comfort® with 5.6-mm edges were shaped and stored at -18°C. The cubes were subsequently tested for flexural strength (maximum force, displacement, stress, and strain) before breaking (n = 136), changes in weight and size (n = 170), and masticatory performance (n = 1360) at eight timepoints: immediately after cube preparation (baseline, no freezing), and 1, 2, 3 and 4 weeks, and 2, 4 and 6 months after frozen storage. The cubes were thawed 8 h before each assessment. Results: The maximum force, stress, maximum displacement, and deformation values for the cubes were not affected by freezing (P > 0.05). At all of the time points, the cubes exhibited similar weight (P = 0.366) and size (identical values). The masticatory performance for the cubes also showed no differences from baseline through 6 months (P = 0.061). Conclusion: Freezing Optosil Comfort® silicone cubes did not alter the physical and mechanical properties of the material, being suitable to optimize the assessment of masticatory parameters for research purposes

Autocuidado e risco cardiometabólico em pessoas com hipertensão arterial em seguimento na atenção primária / Self-care and cardiometabolic risk in people with high arterial pressure following primary care

O objetivo deste estudo foi avaliar o autocuidado e o risco cardiometabólico em pessoas com hipertensão arterial (HA) em seguimento clínico regular na atenção primária à saúde. Estudo analítico e transversal conduzido entre 86 pessoas com HA no interior do Estado de São Paulo, por meio da aplicação das versões brasileiras da Escala de Autocuidado de Hipertensão e do Escore de Risco Cardiometabólico de Framingham. Os participantes demonstraram níveis satisfatórios de confiança (71,3(14,7)), níveis insatisfatórios para manutenção (59,2(14,5)) e manejo (55,1(20,3)) do autocuidado na Escala de Autocuidado e 34,6% de chance de desenvolver infarto agudo do miocárdio nos próximos dez anos. Os indivíduos com menor idade apresentaram níveis de confiança satisfatórios em relação ao manejo do autocuidado, e observou-se maior risco cardiometabólico entre pessoas com diabetes e angina. Os indivíduos possuem confiança, mas demonstram inadequados manejo e manutenção do comportamento de autocuidado, e quanto menor a idade, melhor o manejo do autocuidado.

This study aimed evaluate self-care and cardiometabolic risk in people with arterial hypertension undergoing regular clinical follow-up in primary health care. Exploratory study conducted among people with hypertension in the interior of the State of São Paulo, through the application of the Brazilian versions of the Hypertension Self-Care Scale and the Framingham Cardiometabolic Risk Score. Participants demonstrated satisfactory levels of confidence (71.3 (14.7)) and unsatisfactory levels for Self-Care maintenance (59.2 (14.5)) and management (55.1 (20.3)), domains of the Scale Self-care; and a 34.6% chance of developing acute myocardial infarction in the next 10 years. The youngest individuals had satisfactory levels of confidence in relation to the management of self-care; and higher cardiometabolic risk was observed among people with diabetes and angina. No significant associations were found between the other variables. Individuals have confidence, but demonstrate inadequate Self-Care management and maintenance and the younger the better self-care management.

Factors related to patient adherence to the use of new oral anticoagulants / Factores relacionados a la adhesión de pacientes al uso de nuevos anticoagulantes orales / Fatores relacionados à adesão de pacientes ao uso de novos anticoagulantes orais

ABSTRACT Objective: To characterize the self-reported adherence of patients with cardiovascular diseases to the use of new oral anticoagulants and to identify factors related to adherence to these drugs. Method: This is a descriptive, correlational, and cross-sectional study, carried out with outpatients. The collection of sociodemographic, clinical, and adherence data, through the Measurement of Adherence to Treatments, was made through telephone calls. Descriptive, correlation, and multiple linear regression analyses were used. Results: A total of 120 patients using new anticoagulants for 32.3 months, on average, participated in the study. More than half of the sample consisted of women, who were professionally inactive, with a mean age of 70.1 years and a mean family income of 6.7 minimum wages. The mean adherence score was 5.7, in a possible range between 1 and 6, indicating medication adherence. Inactive employment status, female sex, higher family income, and follow-up at a public outpatient clinic were related to greater adherence to these medications. Conclusion: The patients showed high adherence to new anticoagulants. Employment status, sex, family income, and type of outpatient follow-up were related to medication adherence, and should be considered in the design of interventions for this public.

RESUMEN Objetivo: caracterizar la adhesión autorrelatada de los pacientes con enfermedades cardiovasculares al uso de nuevos anticoagulantes orales e identificar los factores relacionados a la adhesión a esos medicamentos. Método: estudio descriptivo, correlacional y transversal, con paciente ingresado. La recolección de datos sociodemográficos, clínicos y de adhesión, por medio de la Medida de Adhesión a los Tratamientos, ocurrió a través del teléfono. Se utilizaron el análisis descriptivo, correlacional y de regresión lineal múltiple. Resultados: participaron del estudio 120 pacientes que utilizaron nuevos anticoagulantes por 32,3 meses, aproximadamente. Más de la mitad de la muestra estuvo compuesta de mujeres jubiladas, con edad promedia de 70,1 años y remuneración familiar promedia de 6,7 sueldos mínimos. El score promedio de adhesión fue de 5,7, dentro de un período posible entre 1 y 6, lo que indicó adhesión farmacológica. Conclusión: los pacientes presentaron elevada adhesión a los nuevos anticoagulantes. Situación laboral, sexo, renta familiar y tipo de acompañamiento en ambulatorio estuvieron relacionados a la adhesión farmacológica, debiendo ser considerados en la delineación de intervenciones para ese público.

How many could have been saved? Effects of social distancing on COVID-19 / Quantos poderiam ter sido salvos? Efeitos do distanciamento social na COVID-19 / ¿Cuántos podrían haberse salvado? Efectos del distanciamiento social en la COVID-19

Abstract What is the effect of social distancing policies on the spread of the new coronavirus? Social distancing policies rose to prominence as most capable of containing contagion and saving lives. Our purpose in this paper is to identify the causal effect of social distancing policies on the number of confirmed cases of COVID-19 and on contagion velocity. We align our main argument with the existing scientific consensus: social distancing policies negatively affect the number of cases. To test this hypothesis, we construct a dataset with daily information on 78 affected countries in the world. We compute several relevant measures from publicly available information on the number of cases and deaths to estimate causal effects for short-term and cumulative effects of social distancing policies. We use a time-series cross-sectional matching approach to match countries' observable histories. Causal effects (ATTs and ATEs) can be extracted via a dif-in-dif estimator. Results show that social distancing policies reduce the aggregated number of cases by 4,832 on average (or 17.5/100 thousand), but only when strict measures are adopted. This effect seems to manifest from the third week onwards.

Resumo Qual o efeito das políticas de distanciamento social na disseminação do novo coronavírus? As políticas de distanciamento social ganharam destaque como as mais capazes de conter contágio e salvar vidas. Nosso objetivo neste artigo é identificar o efeito causal das políticas de distanciamento social no número de casos confirmados da COVID-19 e na velocidade de contágio. Alinhamos nosso argumento principal com o consenso científico existente: políticas de distanciamento social afetam negativamente o número de casos de contaminação. Para testar esta hipótese, construímos um banco de dados com informações diárias sobre 78 países afetados no mundo. Calculamos várias medidas relevantes a partir de informações publicamente disponíveis sobre o número de casos de infectados e mortes, a fim de estimar efeitos causais para efeitos em curto prazo e cumulativos de políticas de distanciamento social. Usamos uma abordagem de time-series cross-sectional matching a fim de parear históricos observáveis dos países. Efeitos causais (ATTs e ATEs) podem ser extraídos através de um estimador dif-in-dif. Resultados mostram que as políticas de distanciamento social reduzem o número agregado de pessoas contaminadas em 4.832 em média (ou 17,5/100 mil), mas apenas quando medidas rigorosas são adotadas. Esse efeito parece se manifestar a partir da terceira semana.

Resumen ¿Cuál es el efecto de las políticas de distanciamiento social en la diseminación del nuevo coronavirus? Las políticas de distanciamiento social salieron a la fama como las más capaces de contener el contagio y salvar vidas. Nuestro objetivo en este artículo es identificar el efecto causal de las políticas de distanciamiento social en el número de casos confirmados de COVID-19 y en la velocidad de contagio. Alineamos nuestro argumento principal con el consenso científico existente: las políticas de distanciamiento social afectan negativamente el número de casos de contaminación. Para probar esta hipótesis, construimos un banco de datos con información diaria sobre 78 países afectados. Calculamos varias medidas relevantes a partir de la información disponible públicamente sobre el número de casos de infectados y muertes para estimar los efectos causales a corto plazo y acumulativos de las políticas de distanciamiento social. Utilizamos un enfoque de time-series cross-sectional matching para emparejar los historiales observables de los países. Los efectos causales (ATT y ATE) se pueden extraer a través de un estimador dif-in-dif. Los resultados muestran que las políticas de distanciamiento social reducen el número agregado de personas contaminadas en 4.832 en media (o 17,5/100 mil), pero solo cuando se adoptan medidas estrictas. Este efecto parece manifestarse desde la tercera semana.

Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial

Abstract BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey's post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P<.001). BoNT-A was not better than AC in pain reduction (P=0.05), but both therapies were more effective in reducing pain than SS (P<0.05). BoNT-A was the only treatment able to improve PPT values (P<0.05); however, a severe decrease of EMG activity was also found in this group, which is considered an adverse effect. Conclusion after one month of follow-up, all therapies reduced the self-perceived pain in myofascial TMD patients, but only BoNT-A enhanced PPT yet decreased EMG.

Factors associated with oral health-related quality of life of institutionalized elders

Abstract This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

Tecnologic Development on Pleurotus Cultivation: Specific Practices Used in Brazil

HIGHLIGHTS P. ostreatus and P. sapidus are the most productive species under the evaluated conditions. Different growing systems are suitable for the production of P. ostreatus var. Florida. Temperature control level affects differently the P. ostreatus var. Florida isolates. Environmental and strain factors affect yield and production parameters of P. ostreatus var. Florida.

Abstract In Brazil, Pleurotus is the most important mushroom produced especially P. ostreatus var. Florida. In this country as in many others, the great potential for mushroom cultivation remains unexplored. Therefore, it is very important to develop new studies that allow optimizing its production. The aims of the manuscript were: i) to evaluate the productivity of six different species of Pleurotus (P. citrinopileatus; P. djamor; P. ostreatus; P. ostreatus var. Florida; P. pulmonarius; P. sapidus); ii) to measure the effect of three different environmental conditions during cultivation of three isolates of P. ostreatus var. Florida. As results, P. ostreatus and P. sapidus were the most productive isolates under the evaluated conditions. Different environments produced variable effects according to the P. ostreatus var. Florida isolates, being possible to observe a highly plastic strain (POF 02/18), a highly sensitive strain (POF 03/18) and a strain with variable responses (POF 01/18).

Removable prostheses improve oral health-related quality of life and satisfaction of elderly people with rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P<0.05) for all OHIP-14 domains before insertion of new dentures. Group 2 showed worst means (P<0.05) compared to controls for functional limitation and physical pain domains of the OHIP-14, but not in the general score. Patients showed better outcomes of satisfaction with prostheses use only after the new rehabilitation. Conclusion: The use of new and well-fitted dentures improves all domains of OHRQoL in patients with RA and TMD and all groups were satisfied with prostheses use after the new rehabilitation with conventional dentures

Sensorial ability, mastication and nutrition of single-implant overdentures wearers

Abstract The use of two-implant overdentures improves mastication of edentulous elderly patients. However, little is known about the effects of single-implant overdentures (SIO) on oral perception and masticatory function in such elders. This study compared the effects of conventional complete dentures (CD) and SIO on the oral sensorimotor ability (OSA), masticatory function, and nutritional intake of elderly people with residual alveolar mandibular height classified as Class III or IV according to the American College of Prosthodontics. Twelve elders first received new conventional CD, which were later converted to SIO. All variables were evaluated after use of each prosthesis for 2 months. To evaluate OSA, elders closed their eyes and orally identified test pieces prepared from raw carrots. A kinesiographic device was used to measure chewing movements during mastication of a test material (Optocal). Masticatory performance (MP) was determined with the sieving method, and a 3-day food diary verified nutrient intake based on a standard Brazilian Food Composition Table. Data were analyzed using the Wilcoxon signed rank test and Student's paired t test (P < 0.05). OSA results did not differ according to prosthesis type. However, opening and closing velocities during chewing and MP increased after SIO insertion (P < 0.05). Although no difference was observed in the intake of most nutrients, sodium ingestion decreased after SIO insertion (P < 0.05). SIO use had no effect on OSA, but significantly improved mastication and sodium intake of elders with decreased residual ridges height (Brazilian Registry of Clinical Trials #RBR-3kgttj).

Resumo A utilização de overdentures suportadas por dois implantes melhora a mastigação de pacientes idosos edêntulos que apresentam rebordos residuais reabsorvidos. No entanto, pouco se sabe sobre os efeitos de overdentures suportadas por único implante central mandibular (SIO) em relação à percepção oral e função mastigatória em tais idosos. O atual estudo comparou os efeitos de próteses totais convencionais (CD) e SIO na capacidade de sensorimotora oral (OSA), função mastigatória e ingestão nutricional de idosos com altura de rebordos mandibulares tipo III e IV de acordo com a Colégio Americano de Prótese. Doze idosos receberam primeiramente novas CD convencionais, as quais, posteriormente, foram transformadas em SIO. Variáveis foram avaliadas após o uso de cada prótese durante 2 meses. Para avaliar OSA, os idosos fecharam os olhos e testaram oralmente a identificação de formatos geométricos confeccionados de cenouras cruas. Um dispositivo cinesiográfico foi utilizado para medir os movimentos durante a mastigação de material de teste (Optocal). A performance mastigatória (MP) foi determinada com o método de fracionamento de peneiras e um diário de alimentação aplicado por 3 dias consecutivos verificou a ingestão de nutrientes com base em uma Tabela Brasileira Padrão de Composição de Alimentos. Os dados foram analisados utilizando os testes Wilcoxon signed rank test e Student's paired t test (p<0,05). OSA resultados não diferiram de acordo com o tipo de prótese. No entanto, as velocidades de abertura e fechamento durante a mastigação e MP aumentaram após a inserção de SIO (p<0,05). Embora não tenha sido observada diferença na ingestão da maioria dos nutrientes, a ingestão de sódio diminuiu após a inserção de SIO (p<0,05). O uso de SIO não teve efeito sobre OSA, mas melhorou significativamente a mastigação e a ingestão de sódio de idosos com altura de rebordos residuais reduzidas (Registro Brasileiro de Ensaios Clínicos # RBR-3kgttj).

Mandibular single-implant overdenture as an alternative for full arch rehabilitations: a literature review

Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, a search was conducted in the PubMed database, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as maintenance, repair and implant failure rates. All evaluated manuscripts showed similar masticatory function and patient's satisfaction with SIO and two-implant overdenture, while results for a SIO were greater when compared to rehabilitations with CD. In addition, SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, leading to higher masticatory function, as well as improved quality of life

Retorno ao trabalho de pacientes com Síndrome Coronariana Aguda / Acute Coronary Syndrome patients' return to work

Resumo Introdução: as doenças cardiovasculares representam grande impacto de morbimortalidade para a sociedade brasileira. Objetivo: verificar o tempo para retorno ao trabalho de pacientes com Síndrome Coronária Aguda (SCA); identificar e correlacionar variáveis sociodemográficas, clínicas, psicossociais e ocupacionais que podem influenciar nesse período e no desempenho no trabalho. Métodos: estudo transversal correlacional desenvolvido em 2015-2016 com 65 pacientes com SCA que retornaram ao trabalho. Instrumentos utilizados: Questionário de Caracterização; Questionário de Avaliação do Desempenho no Trabalho; Veterans Specific Activity Questionnaire; MacNew Heart Disease Health-related Quality of Life; Escala Hospitalar de Ansiedade e Depressão; e Impacto da Doença no Cotidiano do Valvopata. Foram aplicados: o teste de Mann-Whitney; pós-teste de Dunn; e coeficiente de correlação de Spearman. Resultados: o tempo médio para retorno ao trabalho foi de 7,3 meses. Os participantes que exerciam trabalho manual apresentaram tempo maior para retorno ao trabalho. O desempenho no trabalho foi fortemente correlacionado com a qualidade de vida e inversamente com ansiedade e depressão. Conclusão: os dados apontam a necessidade de desenvolvimento de estratégias a fim de promover o retorno ao trabalho de pacientes com SCA.

Abstract Introduction: cardiovascular diseases represent a major morbidity and mortality impact on the Brazilian society. Objective: to verify the Acute Coronary Syndrome (ACS) patients' time to return to work; and to identify and correlate sociodemographic, clinical, psychosocial, and occupational variables that may influence that time and their work performance. Methods: cross-sectional correlational study conducted in 2015-2016 with 65 ACS patients who returned to work. The instruments used were: Sociodemographic Questionnaire; Work Performance Evaluation Questionnaire; Veterans Specific Activity Questionnaire; MacNew Heart Disease Health-related Quality of Life; Hospital Anxiety and Depression Scale; and Impact of Valvular Disease in Everyday Life. Mann-Whitney test, Dunn's posttest, and Spearman's correlation coefficient were applied. Results: participants took 7.3 months on average to return to work; the ones who performed manual labor took longer to do so. Professional performance was found to be strongly correlated with quality of life and, inversely, with anxiety and depression. Conclusion: data indicate the need to develop strategies to promote ACS patients' return to work.

Association between self-efficacy and sociodemographic and clinical variables in patients with Diabetes Mellitus / Associação entre autoeficácia e variáveis sociodemográficas e clínicas em pacientes com Diabetes Mellitus

Model of study: A cross-sectional study was conducted. Objective: to evaluate the association between self-efficacy and socio-demographic and clinical variables in patients with type 2 diabetes mellitus (T2DM). Method: The sample was composed by 111 patients with T2DM in use of insulin, in primary health care units and outpatient setting in the southeast region of São Paulo state, Brazil. Sociodemographic data were gathered using validated questionnaire and clinical data were obtained from medical and health records. Self-efficacy was assessed by the Brazilian version of Insulin Management Diabetes Self-Efficacy Scale (IMDSES). The data were submitted to descriptive and comparative analyses using Mann-Whitney and Kruskal-Wallis to verify association between socio-demographic/clinical variables and self-efficacy. Results: Self-efficacy was associated with schooling level and presence of comorbidities, such as coronary artery disease, dyslipidemia, obesity, peripheral arterial disease and peripheral neuropathy. Conclusion: The findings provide support to the design some specifics interventions aimed at improving the selfefficacy of patients with T2DM on insulin use. (AU)

Modelo do estudo: Foi conduzido um estudo transversal. Objetivo: verificar a associação entre autoeficácia e variáveis sociodemográficas e clínicas em pacientes com diabetes mellitus. Métodos: A amostra foi composta por 111 pacientes com diabetes mellitus tipo 2 em uso de insulina em unidade básica de saúde e em ambulatório de hospital universitário da região sudeste do Estado de São Paulo, Brasil. Os dados sociodemográficos foram coletados usando questionário validado e os dados clínicos foram obtidos dos prontuários do hospital e da unidade básica de saúde. A medida da autoeficácia foi obtida por meio da aplicação da Insulin Management Diabetes Self-Efficacy Scale ­ IMDSES. Para verificar a associação entre as variáveis sociodemográficas / clínicas e a autoeficácia foram utilizados os testes de Mann-Whitney e Kruskal-Wallis. Resultados: A autoeficácia foi associada à escolaridade, presença de comorbidades e complicações do DM, como doença arterial coronária, obesidade, doença arterial periférica e neuropatia periférica. Conclusão: Os achados subsidiam o delineamento de intervenções para otimizar a autoeficácia em pacientes com diabetes mellitus em uso de insulina. (AU)

Psychometric performance of the Brazilian version the "Insulin Management Diabetes Self-Efficacy Scale" for patient with Type 2 Diabetes Mellitus / Propriedades psicométricas da versão brasileira "Escala de auto-eficácia no manejo da insulina" em pacientes com diabetes mellitus tipo 2

Model of study: Validation study. Objective: To evaluate the psychometric performance of the Brazilian version of the Insulin Management Diabetes Self-Efficacy Scale - IMDSES. Methodology: Reliability (internal consistency - Cronbach's α), convergent and criterion validity were assessed. Data were gathered from 127 patients with type 2 diabetes mellitus (T2DM) in use of insulin through the application of sociodemographic and clinical instruments and the Brazilian versions of the Summary of Diabetes Self-Care Activities Measures - SDSCA and the IMDSES. Results: It was observed "ceiling effect" in Insulin domain. Reliability was confirmed in all IMDSES domains and Total Score (α=0.87). The convergent construct validity was supported by significant negative moderate to weak magnitude correlations between the scores of IMDSES domains and the scores of SDSCA domains. Criterion validity was partially supported by the weak magnitude correlation between the General Managements domain and the Total Score of IMDSES and serum levels of glycated hemoglobin (r=0.22; p=0.02). Conclusion: The Brazilian version of IMDSES presented satisfactory psychometric measures and may be useful to evaluate the effectiveness of nursing interventions aimed at optimizing the selfefficacy of the T2DM patient in the management of his treatment. (AU)

Modelo de estudo: estudo de validação. Objetivo: Avaliar o desempenho psicométrico da versão brasileira "Escala de Auto-eficácia no manejo da insulina" - IMDSES. Metodologia: A confiabilidade (consistência interna - α Cronbach), a validade convergente e a validade de critério foram avaliadas. Os dados foram coletados de 127 pacientes com diabetes mellitus tipo 2 (DM2) em uso de insulina por meio da aplicação de instrumentos sociodemográficos e clínicos e as versões brasileiras "Summary of Diabetes Self-Care Activities Measures" - SDSCA and the IMDSES. Resultados: Observou-se "efeito de teto" no domínio da insulina. A confiabilidade foi confirmada em todos os domínios do IMDSES obtendo pontuação total satisfatória (α=0,87). A validade convergente de constructo foi confirmada por correlações negativas significativas de magnitude moderada a fraca entre os escores dos domínios do IMDSES e os escores de domínio da SDSCA. A validade de critério foi parcialmente confimada por correlação de magnitude fraca entre o domínio de Gerenciamento Geral e o escore total do IMDSES e níveis de hemoglobina glicada (r=0.22; p=0.02). Conclusão: A versão brasileira do IMDSES apresentou medidas psicométricas satisfatórias e pode ser útil para avaliar a efetividade das intervenções de enfermagem que visam otimizar a autoeficácia do paciente com DM2 no manejo do tratamento. (AU)

Craniofacial Morphology Affects Bite Force in Patients with Painful Temporomandibular Disorders

Abstract Craniofacial morphology affects masticatory performance in healthy dentate subjects, but little is known about its effects in patients with painful temporomandibular disorders (TMDs). Forty-eight female patients (mean age of 28±5.8 years) with painful TMDs underwent lateral cephalometric radiography. Using Ricketts' cephalometric analysis and the Vert method, subjects were assigned to three groups according to their craniofacial morphology: brachyfacial (n=22), mesofacial (n=13), and dolichofacial (n=13). Research diagnostic criteria for TMD were used to confirm the TMD diagnosis for each patient. Pain intensity was reported by each patient based on a visual analog scale (VAS). Maximum bite force (MBF) was measured with pressure sensors placed on the first molar site. Masticatory performance (MP) was assessed by chewing a silicone-based artificial material and determining the resulting particle size by the sieve method. Chewing ability (CA) was evaluated for seven food types and analyzed by a VAS questionnaire. Data were analyzed by one-way ANOVA followed by a Tukey-Kramer test (p<0.05). MBF differed in each group, with brachyfacial patients having the highest MBF values. There was no difference in MP among the groups. The groups differed only in their ability to chew one of the seven evaluated food types. In summary, craniofacial morphology affects the MBF without impairing MP or CA in patients with painful TMDs.

Resumo A morfologia craniofacial afeta a performance mastigatória em individuos dentados saudáveis, mas pouco é conhecido sobre seus efeitos em pacientes com desordens temporomandibulares (DTMs) com sintomatologia dolorosa. Quarenta e oito pacientes do gênero feminino (idade média de 28±5,8 anos) com DTM e sintomatologia dolorosa foram submetidas à radiografia cefalométrica lateral. Por meio da análise cefalométrica de Ricketts e método Vert, as voluntárias foram divididas segundo a morfologia crabiofacial em: braquifaciais (n=22), mesofaciais (n=13) ou dolicofaciais (n=13). O Research Diagnostic Criteria for TMD (RDC/TMD) foi utilizado para diagnosticar a presença de DTM em cada paciente. A intensidade de dor foi reportada por cada paciente usando a escala visual analógica (EVA). A força máxima de mordida (FMM) foi medida com sensores de pressão colocados na região de primeiros molares. A performance mastigatória (PM) foi avaliada por meio da mastigação de material artificial confeccionado à base de silicone e determinada pelo tamanho da partícula, usando o método de fracionamento em peneiras. A habilidade mastigatória (HM) foi avaliada por meio de sete tipos de alimento e analisada por meio de EVA. Os dados foram analisados por ANOVA, seguido por teste de Tukey-Kramer (p<0,05). A FMM foi diferente entre cada grupo, sendo que as pacientes braquifaciais apresentaram os maiores valores. Não houve diferença na PM entre os grupos. Os grupos somente diferiram quanto à HM para mastigar apenas um dos sete tipos de alimentos avaliados. Em resumo, a morfologia craniofacial afeta a FMM sem prejudicar a PM ou HM em pacientes com DTM e sintomatologia dolorosa.

Análise de fatores do instrumento de medida do impacto da doença no cotidiano / Análisis de factores del instrumento de medición de impacto de la enfermedad en el cotidiano / Factor analysis of an instrument to measure the impact of disease on daily life

RESUMO Objetivo: verificar a estrutura de fatores do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata (IDCV) quando aplicado em coronariopatas. Método: fizeram parte deste estudo 153 coronariopatas em seguimento ambulatorial. A estrutura de fatores do IDCV foi inicialmente avaliada por meio da análise confirmatória de fatores e, subsequentemente, por meio da análise exploratória de fatores. Utilizou-se o método de estimação dos componentes principais de análise com rotação Varimax e eigenvalues acima de um para extração de fatores e carga fatorial superior a 0,40 para seleção dos itens. A consistência interna foi estimada por meio do coeficiente alfa de Cronbach. Resultados: a análise confirmatória não confirmou a estrutura original de fatores do IDCV. A análise exploratória de fatores evidenciou três dimensões que, em conjunto, explicaram 78% da variância da medida. Conclusão: estudos futuros com ampliação da casuística são necessários para confirmação da nova estrutura de fatores do IDCV.

RESUMEN Objetivo: verificar la estructura de factores del Instrumento para Medición del Impacto de la Enfermedad en el Cotidiano del Valvulópata (IDVC) aplicado a enfermos coronarios. Método: formaron parte de este estudio 153 enfermos coronarios en seguimiento ambulatorio. Estructura de factores del IDVC evaluada inicialmente mediante análisis confirmatorio de factores, y luego por análisis exploratorio de factores. Se aplicó método de estimación de componentes principales de análisis con rotación Varimax y eigenvalues por sobre 1 para extracción de factores, y carga factorial superior a 0,40 para selección de ítems. Consistencia interna estimada mediante coeficiente alfa de Cronbach. Resultados: el análisis confirmatorio no confirmó la estructura original de factores del IDCV. El análisis exploratorio de factores evidenció tres dimensiones que, en conjunto, explicaron el 78% de la diferencia de la medida. Conclusión: estudios futuros con casuística ampliada serán necesarios para confirmación de la nueva estructura de factores del IDCV.

ABSTRACT Objective: to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients. Method: the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach's alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance. Conclusion: future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.

Oral Health in Elders with Parkinson's Disease

Abstract This study aimed to evaluate objectively and subjectively the oral health of elders with Parkinson's disease (PD), using clinical oral assessments and the General Oral Health Assessment Index (GOHAI). Subjects included 37 removable prosthesis wearers, 17 with PD (mean age 69.59±5.09 years) and 20 without PD (mean age 72.00±5.69 years). The objective assessment included an evaluation of oral characteristics, including the number of remaining teeth, decayed, missing and filled teeth (DMFT), visible plaque index (VPI), salivary flow rate and removable prosthesis conditions. The subjective assessment included self-perception of oral health collected using the GOHAI index. The number of remaining teeth, DMFT, VPI, salivary flow rate and GOHAI data were compared between the groups using t-tests. Removable prosthesis conditions were analyzed using χ2 tests (p<0.05). There were no group differences in the number of remaining teeth, DMFT, VPI or salivary flow rate (p>0.05). Greater maxillary prosthesis defects were observed in the control group (p=0.037). GOHAI scores were low for the PD group and moderate for controls, yielding a group difference (p=0.04). In conclusion, elders with PD have similar oral health to controls. Although all elders had few remaining teeth, high DMFT and high VPI, PD elders had more negative self-perceptions of their oral health than did the controls.

Resumo Este estudo teve como objetivo avaliar objetiva e subjetivamente a saúde bucal em idosos com doença de Parkinson (DP), usando avaliações clínicas bucais e do General Oral Health Assessment Index (GOHAI). Os participantes foram 37 indivíduos usuários de prótese removível, 17 com DP (idade média 69,59±5,09 anos) e 20 sem DP (idade média 72,00±5,69 anos). A avaliação objetiva incluiu avaliação de características bucais,incluindo número de dentes remanescentes; dentes cariados, perdidos e obturados (CPOD); índice de placa visível (IPV), a taxa de fluxo salivar e as condições das próteses removíveis. A avaliação subjetiva incluiu autopercepção da saúde bucal, coletada usando o índice GOHAI. O número de dentes remanescentes, CPOD, IPV, fluxo salivar e os dados GOHAI foram comparadas entre os grupos utilizando o teste t . As condições das próteses removíveis foram analisadas utilizando o teste χ2 (p<0,05). Não houve diferenças entre os grupos no número de dentes remanescentes, CPOD, IPV ou fluxo salivar (p>0,05). Maiores defeitos na prótese superior foi observada no grupo controle (p=0,037). As pontuações do GOHAI foram baixa para o grupo DP e moderada para os controles, com diferença entre os grupos (p=0,04). Como conclusão, os idosos com doença de Parkinson tem saúde bucal semelhante aos controles. Embora todos os idosos tenham poucos dentes remanescentes, alto CPOD e alto IPV, os idosos com DP apresentaram autopercepção mais negativa da sua saúde bucal em relação aos controles.

Influência das características sociodemográficas e clínicas no impacto da doença em valvopatas / Influencia de las características sociodemográficas y clínicas en el impacto de la enfermedad en válvulas del corazón / Influence of sociodemographic and clinical characteristics at the impact of valvular heart disease

RESUMO Objetivo: analisar as características sociodemográficas e clínicas dos pacientes com valvopatia e verificar a influência dessas variáveis no impacto da valvopatia no cotidiano. Método: participaram do estudo 86 pacientes em seguimento ambulatorial. A coleta de dados foi realizada em duas etapas - entrevista presencial para caracterização sociodemográfica e clínica e por meio de contato telefônico para aplicação do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata (IDCV). Os dados foram analisados através de estatística descritiva e análise de regressão múltipla. Resultados: constatou-se que o escore total do IDCV e seus domínios foram influenciados pela idade, escolaridade, presença ou não de sintomatologia, uso ou não de diurético. Conclusão: o impacto da doença foi influenciado por variáveis sociodemográficas e clínicas. Os resultados fornecem subsídios para o delineamento de intervenções de enfermagem com vistas à redução do impacto da doença no cotidiano do paciente com valvopatia.

RESUMEN Objetivo: analizar las características sociodemográficas y clínicas de los pacientes con enfermedad de las válvulas del corazón y verificar la influencia de esas variables en el impacto de la enfermedad en la vida cotidiana. Método: participaron del estudio 86 pacientes con seguimiento ambulatorio. La recolección de datos fue realizada en dos etapas - entrevista presencial para caracterización sociodemográfica y clínica y por medio de contacto telefônico para aplicación del Instrumento para Medición del Impacto en lo Cotidiano de la Enfermedad de Válvula (IDCV). Los datos fueron analizados a través de estadística descriptiva y análisis de regresión múltiple. Resultados: se constató que la puntuación total del IDCV y sus dominios fueron influenciados por la edad, escolaridad, presencia o no de sintomatología, uso o no de diurético. Conclusión: el impacto de la enfermedad fue influenciado por variables sociodemográficas y clínicas. Los resultados otorgan subsidios para el delineamiento de intervenciones de enfermería con vistas a la reducción del impacto de la enfermedad en lo cotidiano del paciente con enfermedad de válvula.

ABSTRACT Objective: to analyze the sociodemographic and clinical characteristics of patients with valvular heart disease and to verify the influence of these variables on the impact of valve disease in daily life. Method: the study involved 86 outpatients. Data collection was performed in two stages - face-to-face interview for sociodemographic and clinical characterization and through telephone contact for the application of the Instrument to Measure the Impact of Valvular Heart Disease on Patient's Everyday Life (IDCV). Data were analyzed through descriptive statistics and multiple regression analysis. Results: it was noticed that the total score of IDCV and its domains were influenced by age, schooling, presence or absence of symptoms, use or not of diuretic. Conclusion: The impact of the disease was influenced by sociodemographic and clinical variables. The results provide subsidies for the design of nursing interventions aimed at reducing the impact of the disease on the patient's daily life with valve disease.