Avaliação da qualidade de vida, ansiedade, estresse e depressão de cuidadores de pessoas com ou sem Síndrome de Down / Evaluation of quality of life, anxiety, stress and depression of caregivers of people with or without Down's Syndrome

A qualidade de vida é a percepção do indivíduo sobre sua posição na vida e em relação aos seus objetivos, expectativas, padrões e preocupações representando seu grau de satisfação. Cuidar de pacientes com Sídrome de Down (SD) demanda tarefas complexas, delicadas e sofridas que somadas as responsabilidades diárias, podem gerar um impacto na qualidade de vida. Além disso, toda sobrecarga, pode causar estresse social e trazer sentimentos de ansiedade e depressão, em longo prazo, ao cuidador de um portador da SD. Assim, o objetivo foi avaliar a qualidade de vida, ansiedade, estresse e depressão de cuidadores de pacientes com ou sem síndrome de Down. O estudo foi conduzido com uma amostra de 144 participantes, que serão divididos entre dois grupos denominados GC (Grupo Controle) e GSD (Grupo Síndrome de Down). No GC, participou do estudo cuidadores de crianças com desenvolvimento normal de uma escola pública, numa faixa etária de 4 a 8 anos e no GSD, participou do estudo cuidadores principais de pacientes com SD, numa faixa etária de 4 a 30 anos de idade. Para coleta de dados foram utilizados 5 questionários para identificação do cuidador, avaliação da qualidade de vida (WHOQOL-Bref), avaliação de depressão (BDI), avaliação de ansiedade (BAI) e avaliação de estresse (LIPP). Para a análise dos dados foram identificadas categorias referentes ao perfil do cuidador, e foi utilizado teste Quiquadrado com post hoc Bonferroni modificado com nível de significância de p ≤ 0,05, para comparação entre os grupos e os testes de correlação de Rank e Pearson. Não houve diferença significativa entre os grupos na avaliação do BDI. Houve correlação maior e significativa do nível de ansiedade com os cuidadores do grupo C. A intensidade dos sintomas físicos de estresse foi significativamente maior no grupo SD, no qual 37,8% estavam na fase de exaustão do estresse. Na avaliação da qualidade de vida, o grupo SD teve correlação significativa menor referente ao domínio psicológico do que o grupo C e maior referente ao domínio do meio ambiente do que o grupo C. No grupo SD, houve correlação positiva entre sintomas físicos do estresse e o grau de dependência do portador de SD, (Correlação de Pearson=0,23; p=0,04). Também foi mostrado que a auto avaliação da qualidade de vida foi melhor entre os cuidadores de SD que tinham uma maior renda familiar (correlação de Pearson=0,53; p=0.02). Assim conclui-se que os cuidadores de pessoas com SD apresentaram piores sintomas de estresse físico e pior qualidade de vida no domínio psicológico do que os cuidadores de crianças sem SD. Os sintomas de estresse físico estão relacionados com o maior grau de dependência do portador de SD, enquanto que a qualidade de vida dos cuidadores de SD tem relação direta com uma maior renda familiar(AU)

Quality of life is the individual's perception of their position in life and in relation to their goals, expectations, standards and concerns representing their degree of satisfaction. Caring for patients with Down's Syndrome (DS) demands complex, delicate and painful tasks that, added to the daily responsibilities, can have an impact on quality of life. In addition, any overload can cause social stress and bring long-term feelings of anxiety and depression to the caregiver of a patient with DS. Thus, the objective was to assess the quality of life, anxiety, stress and depression of caregivers of patients with or without Down syndrome. The study was conducted with a sample of 144 participants, who will be divided between two groups called GC (Control Group) and GSD (Down Syndrome Group). In the CG, caregivers of children with normal development in a public school, aged 4 to 8 years, participated in the study and in the GSD, the main caregivers of patients with DS, aged 4 to 30 years, participated in the study. For data collection, 5 questionnaires were used to identify the caregiver, assess quality of life (WHOQOL-Bref), assess depression (BDI), assess anxiety (BAI) and assess stress (LIPP). For data analysis, categories related to the caregiver's profile were identified, and a Chi-square test with modified post-hoc Bonferroni was used, with a significance level of p ≤ 0.05, for comparison between groups and Rank and correlation tests. Pearson. There was no significant difference between groups in the BDI assessment. There was a greater and more significant correlation of the level of anxiety with the caregivers of group C. The intensity of the physical symptoms of stress was significantly higher in the DS group, in which 37.8% were in the phase of stress exhaustion. In assessing quality of life, the SD group had a significantly lower correlation with regard to the psychological domain than group C and a greater correlation with the environment domain than group C. In the SD group, there was a positive correlation between physical symptoms of stress and the degree of dependence of the DS patient, (Pearson's correlation = 0.23; p = 0.04). It was also shown that selfrated quality of life was better among DS caregivers who had a higher family income (Pearson's correlation = 0.53; p = 0.02). Thus, it is concluded that caregivers of people with DS had worse symptoms of physical stress and worse quality of life in the psychological domain than caregivers of children without DS. Symptoms of physical stress are related to a higher degree of dependence on the DS patient, while the quality of life of DS caregivers is directly related to a higher family income(AU)

Systematic review of the effects of excessive occlusal mechanical load on the periodontum of rats

This study aims to systematically evaluate the effects of traumatic occlusion on the periodontal tissue of rats. The set of questions to be answered were–Can traumatic occlusion acting on a healthy and an unhealthy periodontium cause periodontal destruction? Design: The protocols for systematic review were all developed, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and applied to animal research. Reporting of In vivo experiment guidelines for reporting animal research to assess the risk of bias of the studies. Materials and Methods: A literature search was conducted using MEDLINE through PubMed and manual search from the reference lists of main articles related to the theme. Results: This search strategy identified 65 references, of which 33 were considered inappropriate. The full texts of 32 articles were read, 31 of which did not meet the eligibility criteria and were excluded. The final selection included 1 article for which data was extracted for further evaluation. The article included shows a strongest reaction in the periodontium in front of a secondary occlusal trauma as inflammation and apical migration of the junctional epithelium, bone degradation, and decrease in the quantity of collagen fiber. However, primary occlusal trauma also presents these alterations, with the exception of apical migration of the junctional epithelium. Conclusions: Although only one study was included in the systematic review of traumatic occlusion, there is some evidence from experimental studies on animals that shows a coherent picture of the effects of traumatic occlusion on the periodontium. However, new studies are needed to fully answer the questions posed by this systematic review.

Immediate tooth replantation: root canal filling for delayed initiation of endodontic treatment

Abstract The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.

The effect of traumatic dental occlusion on the degradation of periodontal bone in rats.

Context: A better understanding of the relation between traumatic dental occlusion and periodontal changes is needed. Aims: This study aimed to evaluate the pattern of osteoclastic activity in the periodontal bone in front of the traumatic dental occlusion in rat molars. Patients and Methods: Traumatic dental occlusion (TO) was induced in twenty rats, which were sacrificed after periods of 2, 5, 7, and 14 days. Transversal histological sections of both jaws were stained with tartrate‑resistant acid phosphatase and hematoxylin and eosin. Mann– Whitney U‑test was used for group comparison, and Pearson’s correlation test was applied for the number of osteoclasts and bone area (BA). Results: Traumatic dental occlusion caused an increase in the number of osteoclasts in the bone of the upper and lower right first molar from days 2–5 to 2–14, respectively. In the TO groups, the number of osteoclasts on the lamina dura and in the center of the alveolar bone septum, respectively, increased almost 4‑fold and 9‑fold in the lower jaw; and 3‑fold and 5‑fold in the upper jaw, during all periods. In the TO groups, the BA of the alveolar bone septum was substantially reduced. There was a negative correlation between the number of osteoclasts and BA in both jaws during all experimental periods. Conclusions: Traumatic dental occlusion increases osteoclast activity in the alveolar lamina dura and in the center of alveolar bone and stimulates a higher degradation in the center of the alveolar bone septum.