Effectiveness of pharmacological interventions for managing ADHD symptoms in individuals with autism spectrum disorder: A systematic review and meta-analysis.

OBJECTIVES: This systematic review sought to provide evidence for the effectiveness of common pharmacological interventions used for treating attention deficit hyperactivity disorder (ADHD) symptoms in the autism spectrum disorder (ASD) population, considering studies attempting to find safe and effective drugs. METHODS: We searched for randomized controlled trials describing the effectiveness and/or safety profile of pharmacological interventions for treating ASD and ADHD or ASD with ADHD symptoms using three bibliographic databases: PubMed, Cochrane Library, and Embase. We have chosen ADHD symptoms measured by any clinical scale as the primary outcome. As additional outcomes, we have used other symptoms of aberrant behavior measured by the aberrant behavior checklist, satisfaction with treatment, and peer satisfaction. RESULTS: Twenty-two publications met the inclusion criteria for the systematic review and eight for the meta-analysis. In our investigation, we found a few articles using clonidine, modafinil, and bupropion as interventions when compared to methylphenidate (MPH). Our meta-analysis showed that MPH had positive changes compared to placebo in symptoms such as hyperactivity, irritability, or inattention. However, no effect was found in stereotyped symptoms, and our data's quantitative analysis revealed a large effect of MPH-induced adverse effects on the dropout rate. On the other hand, atomoxetine initiation had positive effects when compared to placebo on symptoms of hyperactivity and inattention. We have found no effect of atomoxetine on stereotypes or irritability. Furthermore, atomoxetine did not influence side effects that caused dropouts from studies. CONCLUSION: Our results indicated that atomoxetine has a modest effect on hyperactivity and inattention symptoms, with a relatively benign profile of side effects. MPH appears to be effective in handling hyperactivity, inattention, and irritability symptoms. However, our results on atomoxetine revealed increased dropouts due to adverse effects when compared to MPH or placebo. Evidence for other substances such as guanfacine, clonidine, bupropion, or modafinil is either preliminary or nonexistent.

Learned Attentional Strategies in Word Holistic Processing.

Previous research has shown that, like faces, words are processed either holistically or through the automatic representation of their parts combined. The automaticity assumed to underlie the holistic processing of words presupposes that individuals have a relatively low level of control over these processes. However, they may also be capable of learning from their environments whether processing words as a whole is the most efficient processing strategy-which would require at least some control over the corresponding processes. In fact, previous research supports this latter account in the context of the holistic processing of faces: when provided a task in which participants should ignore half of a stimuli (the irrelevant part) and pay selective attention to the other half (the target part), the participants become better at ignoring the irrelevant part when it is commonly misleading (i.e., this suggests a response that is different from that of the relevant part in the context of the task). In the present work, we extend these considerations to holistic word processing. Our results support a learned attentional account in the context of holistic word processing. When an irrelevant word part is systematically helpful for the judgment of a target word half, participants engage more in holistic processing (vs. when the irrelevant word half is misleading). This reflects an incidental statistical learning process in which individuals identify the irrelevant word half as either providing helpful or misleading information about the target half.

Evaluation of Anxiety and Vital Signs in Adults Undergoing Different Dental Procedures: A Prospective Study

The aim of this study was to evaluate the vital signs related with different dental treatments, and correlate with demographic data and participants' anxiety level. This is a prospective clinical study with 60 participants, divided into 3 groups of dental procedures: (1) restorative treatment, (2) extractions and biopsies, and (3) gingival treatment. A level of anxiety questionnaire before dental procedure proposed by Corah's Dental Anxiety Scale was collected. Respiratory rate, systolic and diastolic pressure, temperature and oxygenation were measured before, during and after the procedures. 31 (51.7 %) women and 29 (48.3 %) men were included, with mean age of 41.75 years old. Most participants (50 %) were classified as very little anxious. Diastolic pressure before the procedure was higher for slightly anxious patients when compar ed with very little anxious patients (p=0.028). Systolic pressure before, during and after the procedure was higher for participan ts above 40 years old (p=0,001). Heart rate (p=0,050) and temperature (p=0,041) was higher before the restorative treatment. Anxiety can promote changes in vital signs in the dental environment. Vital signs, sex, age and level of anxiety do influence the blood pressure at different clinical moments. Dental procedures have association with variations in temperature, heart and respiratory rate.

El objetivo de este estudio fue evaluar los signos vitales relacionados con diferentes tratamientos dentales y correlacionarlos con datos demográficos y el nivel de ansiedad de los participantes. Este es un estudio clínico prospectivo con 60 participantes, divididos en 3 grupos de procedimientos dentales: (1) tratamiento restaurador, (2) extracciones y biopsias, y (3) tratamiento gingival. Se recogió un cuestionario de nivel de ansiedad antes del procedimiento odontológico propuesto por la Escala de Ansiedad Dental de Corah. Se midieron la frecuencia respiratoria, la presión sistólica y diastólica, la temperatura y la oxigenación antes, durante y después de los procedimientos. Se incluyeron 31 (51,7 %) mujeres y 29 (48,3 %) hombres, con edad media de 41,75 años. La mayoría de los participantes (50 %) fueron clasificados como muy poco ansiosos. La presión diastólica antes del procedimiento fue mayor en los pacientes ligeramente ansiosos en comparación con los pacientes muy poco ansiosos(p=0,028). La presión sistólica antes, durante y después del procedimiento fue mayor para los participantes mayores de 40 años (p=0,001). La frecuencia cardíaca (p=0,050) y la temperatura (p=0,041) fueron mayores antes del tratamiento restaurativo. La ansiedad puede promover cambios en los signos vitales en el entorno dental. Los signos vitales, el sexo, la edad y el nivel de ansiedad sí influyen en la presión arterial en los diferentes momentos clínicos. Los procedimientos dentales tienen asociación con variaciones de temperatura, frecuencia cardíaca y respiratoria.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019.

OBJECTIVE: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. METHODS: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. RESULTS: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. CONCLUSION: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil.

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF's overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF's overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

RESUMEN: La mejora en las opciones de tratamiento ha aumentado la supervivencia de las personas que viven con el VIH (PVVIH). Por lo tanto, evaluamos los factores asociados con una mejor calidad de vida relacionada con la salud (CVRS) entre las PVVIH en Brasil. Se trata de un estudio transversal realizado con 349 PVVIH. Los datos se recopilaron mediante un cuestionario basado en entrevistas y la CVRS se evaluó mediante la versión brasileña del instrumento WHOQOL VIH BREF. Usamos un análisis de conglomerados no jerárquico (K-medias) para compilar las puntuaciones generales y de dominios del WHOQOL HIV BREF en una medida única más multidimensional para la CVRS que consta de tres conglomerados: deficiente, regular y bueno; y las asociaciones con grupos de mejor CVRS se evaluaron mediante modelos de regresión logística multinomial. Las puntuaciones de la CVRS global media y mediana fueron 15,13 (DE = 3,39) y 16. La confiabilidad y validez del WHOQOL VIH BREF versión brasileña fue confirmada entre personas que viven con el VIH en un municipio no metropolitano de mediana población de Brasil, lo que reafirma la validez transcultural de este instrumento. Los factores sexo masculino; orientaciones heterosexuales y asexuales; mayores ingresos individuales; carga viral indetectable; ausencia de comorbilidad y presencia de comorbilidad infecciosa o crónica, teniendo como referencia la enfermedad mental; y nunca haber consumido sustancias ilegales se asociaron de forma independiente con una buena CVRS. Por lo tanto, la compilación de las puntuaciones generales y de dominio del WHOQOL HIV BREF en una medida multidimensional única para la CVRS, que este estudio propuso por primera vez, puede facilitar interpretaciones y modelos de predictores más robustos. Estos diferenciales podrían simplificar la HRQoL como un indicador de salud y bienestar para ser utilizado de forma rutinaria como un resultado clave en el manejo clínico de los pacientes y en el monitoreo global de las respuestas del sistema de salud al VIH.

Letters away from the looking glass: Developmental trajectory of mirrored and rotated letter processing within words.

Discrimination of reversible mirrored letters (e.g., d and b) poses a challenge when learning to read as it requires overcoming mirror invariance, an evolutionary-old perceptual tendency of processing mirror images as equivalent. The present study investigated when, in reading development, mirror-image discrimination becomes automatic during visual word recognition. The developmental trajectory of masked priming effects was investigated from 2nd to 6th grade and in adults, by manipulating letter type (nonreversible; reversible) and prime condition (control; identity; mirrored; rotated). Standardized identity priming increased along reading development. Beginning readers showed mirror invariance during reversible and nonreversible letter processing. A mirror cost (slower word recognition in mirrored-letter than identity prime condition) was found by 5th-grade but only for reversible letters. By 6th grade, orthographic processing was no longer captive of mirror invariance. A multiple linear regression showed that letter representations, but not phonological processes or age, were a reliable predictor of the rise of mirror-image discrimination in 2nd-4th-graders. The present results suggest a protracted development of automatic mirror-image discrimination during orthographic processing, contingent upon the quality of abstract letter representations. RESEARCH HIGHLIGHTS: We traced the developmental trajectory of mirrored-letter and rotated-letter priming effects (e.g., ibea and ipea as primes of IDEA) in visual word recognition. Beginning readers (2nd-4th-graders) showed mirror invariance and plane-rotation sensitivity in orthographic processing, thus still being susceptible to the perceptual biases in charge in object recognition. A mirror cost was found in 5th-graders but only for reversible letters; orthographic processing was no longer captive of mirror invariance by 6th-grade. The automation of mirror-image discrimination during orthographic processing depends on the quality of letter representations but not on phonological processes or age.

Oral manifestations of syphilis: Knowledge and skills of senior dental students and newly graduated dentists.

OBJECTIVES: To evaluate the knowledge of senior dental students and newly graduated dentists about the prevention, diagnosis and treatment of oral manifestations of syphilis. MATERIALS AND METHODS: A 32-question questionnaire was designed with three domains: (I) demographic, academic and professional data of the participants, (II) attitudes, practices and self-perception regarding training about syphilis and (III) knowledge about syphilis. All knowledge responses were classified as correct or incorrect. Scores ranging from 1 to 14 were calculated, and grades were assigned to each participant according to their level of knowledge. RESULTS: The sample comprised 408 dental students and 339 newly graduated dentists. The mean score was 7.70 ± 3.35 for undergraduates and 9.09 ± 3265 for dentists. The highest frequency of correct answers (>70%) was attributed to questions about the aetiology, transmission and treatment of syphilis. The questions with the lowest frequency of correct answers (<50%) were about the identification of oral manifestations and stages of syphilis. CONCLUSIONS: The knowledge of dental practitioners and academics about the oral manifestations of syphilis was unsatisfactory. The lack of understanding of these aspects can delay the diagnosis and treatment of patients with this disease, which is concerning given the steady increase in cases in recent years.

Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019 / Análise espacial da assistência a pacientes em terapia dialítica no Estado de Minas Gerais, Brasil, entre 2015 e 2019

ABSTRACT Objective: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. Methods: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. Results: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. Conclusion: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.

RESUMO Objetivo: Analisar o fluxo espacial da assistência de pacientes em terapia dialítica nas regionais de saúde do estado de Minas Gerais. Métodos: Estudo ecológico que teve como população pacientes incidentes em terapia dialítica em instituições públicas, filantrópicas ou que tiveram seu tratamento custeado pelo Sistema Único de Saúde em clínicas privadas conveniadas, no estado de Minas Gerais. Os pacientes foram agregados por regional de saúde de residência. Foram calculadas as proporções de pacientes que fizeram diálise, bem como a inscrição na lista de transplante renal em sua própria região de residência ou fora dela. Estimadas as correlações de Person destas proporções com indicadores socioeconômicos e assistenciais das regionais de saúde. Técnicas exploratórias espaciais estimaram coeficientes de correlação espacial geral (I de Moran) e local (LISA). Resultados: Regiões com maior PIB apresentaram maior razão de nefrologistas e maior proporção de inscrições na própria região de residência. Identificou-se um cluster de regiões com PIB baixo mais ao nordeste do estado (também com valores mais baixos de razão de nefrologistas), um cluster de alta proporção de inscritos na lista de transplante no centro do estado, e um cluster de baixa proporção de diálise na mesma região de residência mais ao sudeste. Conclusão: Evidenciou-se disparidades regionais em relação à proporção de inscritos na lista de espera para o transplante renal, proporção de pacientes que realizavam diálise na mesma região de residência e proporção de pacientes inscritos na lista de espera para o transplante renal na mesma região de residência.

Expectativas pós-cárcere de mulheres privadas de liberdade: condição de saúde e trabalho / Post-prison expectations of women deprived of liberty: Health and work conditions / Expectativas post carcelarias de las mujeres privadas de libertad: condiciones de salud y trabajo

Objetivo: estimar as expectativas negativas sobre a vida pós-cárcere com relação à condição de saúde e de trabalho e os fatores associados à essas duas variáveis em mulheres privadas de liberdade. Método: estudo transversal, por meio de censo com 99 mulheres que estivessem em cumprimento de pena nos regimes provisório, fechado e semiaberto. Na análise dos dados, foram empregados o teste qui-quadrado e a regressão de Poisson. Na análise múltipla dos fatores associados ao desfecho, foi construído um modelo teórico de determinação com blocos hierarquizados. Resultados: o modelo final ajustado mostrou que a expectativa negativa pós-cárcere em relação à condição de saúde se associou à autoavaliação negativa de saúde (RP: 6,14; IC95%: 2,27-16,60). A expectativa negativa pós-cárcere sobre a condição de trabalho se associou com as expectativas negativas pós-cárcere em relação a vida pessoal (RP: 7,65; IC95%: 2,82-20,79) e ao padrão de vida. Conclusão: as associações encontradas no estudo demonstram a importância de investimento em políticas de saúde e trabalho para melhores condições futuras pós-encarceramento(AU)

Objective: to estimate negative expectations about post-prison life in relation to health and work conditions and the factors associated with these two variables in women deprived of liberty. Method: cross-sectional study, through a census with 99 women who were serving sentences in the provisional, closed and semi-open regimes. In data analysis, the chi-square test and Poisson regression were used. In the multiple analysis of the factors associated with the outcome, a theoretical model of determination with hierarchical blocks was built. Results: the final adjusted model showed that post-prison negative expectations regarding health conditions were associated with negative self-rated health (PR: 6.14; 95%CI: 2.27-16.60). Negative post-prison expectations about work conditions were associated with post-prison negative expectations about personal life (PR: 7.65; 95%CI: 2.82-20.79) and standard of living. Conclusion: the associations found in the study demonstrate the importance of investing in health and work policies for better post-incarceration future conditions(AU)

Objetivo: estimar las expectativas negativas sobre la vida después de la cárcel en relación con las condiciones de salud y de trabajo y los factores asociados a esas dos variables en mujeres privadas de libertad. Método: Estudio transversal mediante censo con 99 mujeres que cumplían condena en regímenes temporal, cerrado y semiabierto. En el análisis de los datos, se utilizó la prueba de chi-cuadrado y la regresión de Poisson. En el análisis múltiple de los factores asociados al resultado, se construyó un modelo teórico de determinación con bloques jerárquicos. Resultados: El modelo final ajustado mostró que la expectativa negativa después del periodo en la cárcel, con respecto al estado de salud, se asoció con la autoevaluación negativa de salud (RP: 6,14; IC 95%: 2,27-16,60). La expectativa negativa post carcelaria sobre las condiciones de trabajo se asoció con las expectativas negativas post carcelarias sobre la vida personal (RP: 7,65; IC 95%: 2,82-20,79) y el nivel de vida. Conclusión: Las asociaciones encontradas en el estudio demuestran la importancia de invertir en políticas de salud y trabajo para mejorar las condiciones futuras después del encarcelamiento(AU)

Qualidade de vida: sobrecarga e depressão entre cuidadores de idosos em atendimento domiciliar / Quality of life: overload and depression between caregivers of elderly people in home care / Calidad de vida: sobrecarga y depresión en cuidadores de ancianos en atención domiciliaria

Objetivo: avaliar prevalência e impacto da sobrecarga e da depressão na qualidade de vida de 102 cuidadores de idosos cadastrados no Programa Melhor em Casa. Método: estudo analítico transversal aprovado pelo Comitê de Ética e Pesquisa. Realizado entre junho e novembro 2022, em Juiz de Fora (MG/Brasil), com amostra censitária e aplicação de formulário sociodemográfico, da Escala de Zarit, do Inventário de Depressão de Beck e do questionário de qualidade de vida da Organização Mundial de Saúde (WHOQOL-bref). Foram utilizados Teste t de Student, Mann-Whitney e regressão linear múltipla, com nível de significância de 5%. Resultados: observou-se sobrecarga em 69,6% dos cuidadores, além da presença de sintomas sugestivos de depressão em 41,1% da população em estudo. Conclusão: a sobrecarga esteve associada a piora da qualidade de vida nos domínios físico, psicológico e de relação social, enquanto a depressão esteve associada a piora da qualidade de vida nos domínios psicológico e de avaliação geral(AU)

Objective: to evaluate the prevalence and impact of overload and depression on the quality of life of 102 caregivers of elderly people registered in the Melhor em Casa Program. Method: cross-sectional analytical study approved by the Research Ethics Committee. Carried out between June and November 2022, in Juiz de Fora (MG/Brazil), with a census sample and application of a sociodemographic form, the Zarit Scale, the Beck Depression Inventory and the World Health Organization's quality of life questionnaire (WHOQOL-bref). Student's t-test, Mann-Whitney test and multiple linear regression were used, with a significance level of 5%. Results: overload was observed in 69.6% of caregivers, in addition to the presence of symptoms suggestive of depression in 41.1% of the study population. Conclusion: overload was associated with worsening quality of life in the physical, psychological and social relationship domains, while depression was associated with worsening quality of life in the psychological and general evaluation domains(AU)

Objetivo: evaluar la prevalencia y el impacto de la sobrecarga y la depresión en la calidad de vida de 102 cuidadores de ancianos registrados en el Programa Melhor em Casa (Mejor en casa). Método: estudio analítico transversal aprobado por el Comité de Ética en Investigación. Realizado entre junio y noviembre de 2022, en Juiz de Fora (MG/Brasil), con muestra censal y aplicación de un formulario sociodemográfico, la Escala de Zarit, el Inventario de Depresión de Beck y el cuestionario de calidad de vida de la Organización Mundial de la Salud (WHOQOL-bref). Se utilizó la prueba t de Student, la prueba de Mann-Whitney y la regresión lineal múltiple, con un nivel de significancia del 5%. Resultados: se observó que el 69,6% de los cuidadores sentían sobrecarga, además de algunos síntomas sugestivos de depresión en el 41,1% de la población de estudio. Conclusión: la sobrecarga se asoció con un empeoramiento de la calidad de vida en los dominios físico, psicológico y de relaciones sociales, mientras que la depresión se asoció con un empeoramiento de la calidad de vida en los dominios psicológico y de evaluación general(AU)

Prevalência e fatores associados à ansiedade e depressão em mulheres adultas privadas de liberdade: revisão integrativa / Prevalence and associated factors of anxiety and depression in adult women deprived of liberty: an integrative review

Objetivo: identificar a prevalência e fatores associados à ansiedade e depressão em mulheres adultas privadas de liberdade. Métodos: trata-se de uma revisão integrativa, orientada por uma questão de pesquisa e conduzida nas bases BDENF, IBECS, LILACS e Medline, acessadas via BVS, além da SciELO. Foi elaborada uma estratégia de busca única contemplando descritores, palavras-chave e fazendo uso de operadores booleanos. Os critérios de inclusão foram estudos primários publicados em português ou inglês; que responderam à questão de pesquisa; realizados com a população do sexo feminino adulta (18 anos ou mais) privada de liberdade; publicados entre 2015 a 2020. Para a seleção, foi realizada leitura do título, do resumo e do manuscrito como um todo. Resultados: de 157 artigos encontrados, 11 foram selecionados, sendo que desses, cinco (45,5%) estudos trouxeram dados apenas sobre depressão, três (27,8%) sobre ansiedade e sobre depressão e dois (18,2%) apenas sobre ansiedade. Verificou-se elevadas prevalências de transtornos depressivos e ansiosos, com fatores associados às condições de vida, de encarceramento e de saúde. Conclusão: o conhecimento dos fatores associados aos dois transtornos mentais mais prevalentes faz-se essencial para que as equipes da Rede de Atenção à Saúde, em especial às da Atenção Primária à Saúde lotadas em unidades prisionais, possam ampliar e qualificar os serviços ofertados, visando garantia de atenção integral.

Objective: to identify the prevalence and factors associated with anxiety and depression in adult women deprived of their liberty. Methods: this is an integrative review, guided by a research question and conducted in the BDENF, IBECS, LILACS and Medline databases, accessed via the VHL, in addition to SciELO. A single search strategy was developed, contemplating descriptors, keywords and makinguse of Boolean operators. Inclusion criteria were primary studies published in Portuguese or English; that answered the research question; carried out with the adult female population (18 years and over) deprived of liberty; published between 2015 and 2020. For selection, the title, abstract and manuscript as a whole. Results: Of the 157 articles found, 11 were selected, and of these, five (45.5%) studies brought data only on depression, three (27.8%) on anxiety and depression and two (18.2%) only about anxiety. There was a high prevalence of depressive and anxiety disorders, with factors associated with living, incarceration and health conditions. Conclusion: knowledge of the factors associated with the two most prevalent mental disorders is essential so that the teams of the Health Care Network, especially those of Primary Health Care located in prison units, can expand and qualify the services offered, aiming at comprehensive care guarantee.

Realização do pré-natal odontológico e seus reflexos no novo financiamento da Atenção Básica: Programa Previne Brasil / Carrying out dental prenatal care and its effects on the new financing of Primary Care: Prevent Brazil Program

Para garantia da integralidade do cuidado é importante ressaltar a participação dos Cirurgiões-Dentistas no contexto da atenção básica, incluindo a realização do Pré-natal odontológico, permitindo a assistência odontológica durante esse período. O objetivo deste estudo é avaliar a realização do Pré-natal odontológico pelos Cirurgiões-Dentistas da Atenção Primária à Saúde pertencentes às microrregiões de saúde de jurisdição da Superintendência Regional de Saúde de Juiz de Fora (SRS-JF/MG) e discutir possíveis impactos do novo financiamento da Atenção Básica. Trata-se de um estudo transversal observacional, realizado por meio do web survey com aplicação de um questionário sociodemográfico e de prática de pré-natal odontológico. Foi direcionado para 170 Cirurgiões-Dentistas pertencentes aos 37 municípios da microrregião mineira. Os dados foram analisados utilizando o software estatístico Jamovi, adotando um intervalo de confiança de 95% e nível de significância de 5%. Dentre os respondentes,69,1% realizam o Pré-natal odontológico, sendo a sua carga horária de trabalho na Unidade Básica de Saúde o principal fator inviabilizador dessa atividade. Portanto, conclui-se que os Cirurgiões-Dentistas da APS pertencentes aos municípios que integram a SRS-JF/MG realizam o Pré-natal odontológico, sendo a carga horária de trabalho, o principal limitador para o alcance de melhoras nesse indicador.

To guarantee the integrality of care, it is important to emphasize the participation of Dental Surgeons in the context of primary care, including the completion of Dental Prenatal, allowing dental care during this period. The objective of this study is to evaluate the performance of dental prenatal care by Dental Surgeons of Primary Health Care belonging to the health micro-regions under the jurisdiction of the Regional Health Superintendence of Juiz de Fora (SRS-JF/MG) and to discuss possible impacts on the new primary care funding. This is an observational cross-sectional study, carried out through a web survey with the application of a sociodemographic and dental prenatal practice questionnaire. It was directed to 170 Dental Surgeons belonging tothe 37 municipalities of the Minas Gerais micro-region. Data were analyzed using the Jamovi statistical software, adopting a 95% confidence interval and significance level of 5%. Among the respondents, 69.1% perform the Dental Prenatal, and their workloadat the Basic Health Unit is the main limiting factor for carrying out this activity. Therefore, it is concluded that the Dental Surgeons of the APS belonging to the municipalities that make up the SRS-JF/MG perform dental prenatal care, with the workload being the main limiting factor for the achievement of improvements in this indicator.

Randomized clinical trial with fractional CO2 laser and Clobetasol in the treatment of Vulvar Lichen Sclerosus: a clinic study of feasibility.

OBJECTIVES: The main objective of the study was to describe and compare the feasibility of using fractional CO2 laser to the usual treatment with Clobetasol. Randomized clinical trials brought together 20 women from a Brazilian university hospital, 9 of them were submitted to Clobetasol treatment and 11 to laser therapy. Sociodemographic data were obtained and quality of life parameters, vulvar anatomy, self-perception and histopathological analysis of vulvar biopsies were evaluated. Evaluations were made before the beginning of the treatment, during its implementation, right after its completion (3 months), and 12 months after. The SPSS 14.0 software was used, obtaining descriptive measurements. The level of significance adopted was 5%. RESULTS: The clinical/anatomical characteristics of the vulva did not differ between the treatment groups, as much before as after its performance. There was no statistically significant difference between the treatments performed regarding the impact on the life quality of the patients. A higher satisfaction degree with the treatment was obtained with the patients in the Laser group in the third month of evaluation. Laser therapy also revealed higher occurrence of telangiectasia after treatment completion. Fractional CO2 laser has proven to be well accepted and is a promising therapeutic option. Registration number and name of trial registry The institutional review board status was approved by the Research Ethics Committee of HU/ UFJF under advisory number 2881073 and registered in the Brazilian Clinical Trials, with consent under registration RBR-4p9s5y. Access link: https://ensaiosclinicos.gov.br/rg/RBR-4p9s5y.

Avaliação da integralidade e do acesso de primeiro contato em saúde bucal na Atenção Primária, sob a perspectiva de cirurgiões-dentistas / Evaluation of integrality and first contact access to oral health in Primary Care, from the perspective of dentists

Introdução: A análise dos serviços primários quanto ao seu grau de orientação à Atenção Primária à Saúde (APS), a partir da mensuração de seus atributos, é essencial para a efetividade da assistência. Objetivo: Avaliar a presença e a extensão dos atributos integralidade e acesso de primeiro contato nos serviços odontológicos primários do município de Juiz de Fora (MG), sob a perspectiva de cirurgiões-dentistas. Métodos: Trata-se de um estudo transversal realizado por meio da aplicação online do Instrumento de Avaliação da Atenção Primária (PCATool-Brasil Saúde Bucal) para dentistas.Resultados: O atributo acesso de primeiro contato obteve baixo desempenho (5,2), enquanto a integralidade obteve alto desempenho em seus dois componentes. Conclusão: Concluiu-se que os serviços odontológicos primários de Juiz de Fora (MG) estão orientados à APS sob ponto de vista da integralidade. Contudo, carecem de melhor planejamento e novas políticas que garantam acesso, haja vista a sua baixa orientação.

Introduction: The analysis of primary services regarding their degree of orientation to Primary Health Care (PHC), based on the measurement of their attributes, is essential for the effectiveness of care. Objective: To evaluate the presence and extent of the integrality and first-contact access attributes in primary dental services in the city of Juiz de Fora (MG), from the perspective of dentists. Method: This is a cross-sectional study carried out through the online application of the Primary Care Assessment Tool (PCATool-Brazil Oral Health) for dentists. Results: The first contact access attribute had low performance (5.2), while integrality had high performance in its two components. Conclusion: It was concluded that the primary dental services in Juiz de Fora (MG) are oriented to PHC from the point of view of integrality. However, they lack better planning and new policies that guarantee access, given their low orientation.

Avaliação do conhecimento e da percepção de cirurgiões-dentistas e estudantes de odontologia acerca de desordens potencialmente malignas / Knowledge assessment and perception among dentists and dental students about potentially malignant disorders

Introdução: As desordens potencialmente malignas (DPM) são condições da cavidade oral que apresentam risco significativo para o desenvolvimento do câncer. Desse modo, o diagnóstico precoce torna-se essencial no prognóstico de lesões orais. Para isso, analisar o perfil de conhecimento acerca dessas desordens é fundamental ao identificar lacunas na educação e promover alternativas para melhorar a qualidade no diagnóstico. Objetivo: Avaliar a percepção de cirurgiões-dentistas (CDs) e estudantes de Odontologia brasileiros acerca de seu conhecimento e capacidade de identificar DPM. Métodos: Foi realizado um estudo transversal através de aplicação de questionário online. Foram aplicados dois questionários com 24 questões, um para estudantes e outro para CDs, divididos em três seções: dados demográficos e acadêmicos, treinamento, atitudes e autopercepção sobre DPM e conhecimento de DPM. A análise estatística envolveu os testes de Pearson, Mann-Whitney e Kruskal-Wallis. Resultados: O estudo foi composto por 209 participantes, 76 CDs e 133 estudantes de odontologia. A maioria dos participantes nunca realizou curso que envolvia o diagnóstico de desordens potencialmente malignas. A pontuação sobre o conhecimento de DPM variou de 0 a 10 pontos, sendo a média entre estudantes de 6,29±1,77 e entre CDs de 7,01±1,82. A maior taxa de acertos foi para as questões que discutiam a conduta clínica e a definição das desordens. Já as questões com menor taxa de acertos foram sobre lesões que não são consideradas potencialmente malignas, potencial de malignização e definição de Carcinoma in Situ. Conclusão: Há lacunas no conhecimento de estudantes de odontologia e CDs na identificação das desordens potencialmente malignas. Logo, essa deficiência reforça a necessidade de mais treinamentos e investimentos em educação, bem como de acompanhamento periódico de pacientes com tais desordens, a fim de prevenir potenciais transformações malignas.

Introduction: Potentially malignant disorders (PMD) are conditions of the oral cavity that present a significant risk for the development of cancer. Thus, early diagnosis becomes essential in the prognosis of oral lesions. Therefore, assessing the knowledge profile of these disorders is essential to identify gaps in education and to promote alternatives to improve the quality of their diagnosis. Objective: Evaluate the perception of brazilian dentists and dental students about their knowledge and ability to identify PMD. Methods: A cross-sectional study was carried out using an online questionnaire. Two questionnaires with 24 questions were applied, one for students and other for dentists, divided into three sections: demographic and academic data, training, attitudes and self-perception about potentially malignant disorders and knowledge of potentially malignant disorders. Statistical analysis involved Pearson, Mann-Whitney and Kruskal-Wallis tests. Results: The study consisted of 209 participants, 76 dentists and 133 dentistry students. Most participants never attended a course that involved the diagnosis of potentially malignant disorders. The score of knowledge about potentially malignant disorders ranged from 0 to 10 points, with a mean of 6.29±1.77 among students and 7.01±1.82 among dentists. The highest rate of correct answers was for questions that discussed clinical management and the definition of disorders. The questions with the lowest rate of correct answers were about lesions that are not considered potentially malignant, malignancy potential and the definition of Carcinoma in Situ. Conclusion: There are gaps in the knowledge of dental students and dentists in the identification of potentially malignant disorders. Therefore, this deficit reinforces the needed of more training and investments in education, as well as more training and investments in education and periodic follow-up of patients with such disorders are needed in order to prevent potential malignant transformations.

Professional practice of pharmacists in private community pharmacies of Minas Gerais, Brazil

Abstract Considering the wide accessibility of population to private community pharmacies, Pharmaceutical Services must be provided comprehensively in such establishments. This research aims to understand how pharmaceutical practice is developed by pharmacists in private community pharmacies of Minas Gerais, Brazil. Qualitative descriptive research was performed. Data were collected through online questionnaires (n=113) and interviews (n=12) with pharmacists working in such institutions and they were analyzed according to Bardin's Content Analysis, with the contribution of software IRAMUTEQ. Two main categories of analysis were formed: "Professional training of pharmacists and the working conditions in private community pharmacies" and "Pharmaceutical Services in private community pharmacies of Minas Gerais". Pharmacists understood the population's healthcare as the main purpose of their professional practice. However, the routine focused on the technical management of medicines and the lack of private rooms hindered the provision of qualified assistance. Furthermore, commercial strategies were identified as motivators for ethical dilemmas and conflicts among the work team. It is suggested that the growth of the pharmaceutical retail market in Minas Gerais should be accompanied by favorable conditions for the production of care, so that pharmaceutical practice in these institutions can be developed in an ethical and responsible way.

Effectiveness of ozone therapy in the treatment of periodontal diseases: a systematic review / Eficácia da ozonioterapia no tratamento de doenças periodontais: uma revisão sistemática

ABSTRACT The aim of this study was to evaluate the effectiveness of ozone as an adjuvant factor in the treatment of periodontal diseases. A systematic review was carried out using the PubMed, LILACS/BIREME, CoChrane, and Scielo databases and manual searches. Clinical studies published in English, Spanish, Portuguese, and French, between 1950 and 2020 that evaluated the effects of ozone in the treatment of periodontal diseases were included. The search resulted in 178 articles, of which 24 met the proposed eligibility criteria and were selected for this review. The risk of bias was assessed for each selected study in accordance with the Cochrane risk-of-bias tool - version 5.1.0. The selected studies evaluated the effect of ozone therapy on periodontitis, gingivitis, and peri-implant diseases. It was observed that the ozone in its oily form presented the best clinical results. In cases of periodontitis, it was concluded that ozone therapy in the gaseous form did not bring any additional benefit. With respect to gingivitis, ozone provided faster remission compared to the control group. And in peri-implant disease cases, ozone had the capacity to reduce the development of mucositis. Regarding microbiology, it was observed that ozone can continuously and significantly reduce periodontal microorganisms; however, with no difference from control groups. Further studies with adequate control of biases are suggested, using ozone in the oily or aqueous form, which are the most promising forms, also evaluating the possible effectiveness of ozone by-products.

RESUMO O objetivo deste estudo foi avaliar a eficácia do uso do ozônio como fator adjuvante no tratamento das doenças periodontais. Foi realizada uma revisão sistemática utilizando as bases de dados PubMed, LILACS/BIREME, CoChrane, Scielo e pesquisa manual. Foram incluídos estudos clínicos publicados em inglês, espanhol, português e francês entre 1950 e 2020, que avaliaram os efeitos do ozônio no tratamento de doenças periodontais. A busca resultou em 178 artigos, destes 24 estudos atenderam aos critérios de elegibilidade propostos e foram selecionados para esta revisão. Foi realizada a avaliação do risco de viés em cada estudo selecionado de acordo com a ferramenta de avaliação de risco de viés Cochrane Risk of Bias Tool - versão 5.1.0. Os estudos selecionados avaliaram o efeito da ozonioterapia na periodontite, gengivite e em doenças peri-implantares. Observou-se que a utilização do ozônio na forma oleosa foi a que apresentou os melhores resultados clínicos. Nos casos de periodontite, concluiu-se que a ozonioterapia não trouxe nenhum benefício adicional sob a forma gasosa. Em relação à gengivite, o ozônio proporcionou uma remissão mais rápida do que do grupo controle. E nas doenças peri-implantares, o ozônio foi capaz de reduzir o desenvolvimento da mucosite. Com relação a microbiologia, foi observado que o ozônio pode reduzir contínua e significativamente os microorganismos periodontais, contudo, sem diferença para grupos controle. Sugerem-se mais estudos com controle adequado de vieses, utilizando o ozônio de forma oleosa ou aquosa, formas mais promissoras, além da avaliação de possível eficácia de subprodutos do ozônio.

Position of lingual foramina in cone beam computed tomography and its implications for choosing the dimensions of dental implants for mandibular symphysis / Posição das foraminas linguais na tomografia computadorizada de feixe cônico e suas implicações na escolha das dimensões dos implantes dentários para sínfise mandibular

ABSTRACT Objective: To identify the lingual foramina in a Brazilian population of 210 individuals through Cone-Beam Computed Tomography images, in order to guide the installation of dental implants in the region of the mental symphysis. Methods: After identifying the lingual foramina on a parasagittal section, four measurements were taken: distance to the alveolar ridge, distance to the mandibular lower border, distance to the limit of the vestibular cortical, and alveolar ridge inclination angle. The measurements were compared in relation to gender by the Mann-Whitney test. The association between gender and the number of foramina was done by the chi-square test. Pearson's correlation analyzed the linear relationship between age and number of foramina. Results: Lingual foramina are present in 99.6% of the research participants. In the upper-inferior direction, a mean distance to the alveolar ridge of 21.4 mm was noted, while the mean distance to the lower mandibular border was 13.1 mm. In the bucco-lingual direction, a mean distance from the lingual foramina to the vestibular cortical of 15.2 mm is noted. The inclination angle of the alveolar ridge had a mean of 25.4º. Regarding gender, the test was not significant only for the distance to the vestibular cortical. Conclusion: The lingual foramina had a descending way in 100% of cases, being positioned mainly in the middle thirds (66.5%) and lower thirds (32.7%) of the mandibular ridge height. The use of dental implants up to 13 mm in length and up to 4 mm in diameter in the region of the symphysis mentualis is recommended.

RESUMO Objetivos: Identificar as foraminas linguais em uma população brasileira de 210 indivíduos, por meio de imagens de tomografia computadorizada de feixe cônico, a fim de orientar a instalação de implantes dentários em região de sínfise mentual. Métodos: Após identificação das foraminas linguais em corte parasagital, foram realizadas quatro medidas: distância até à crista alveolar, distância até à borda inferior da mandíbula, distância até o limite da cortical vestibular e ângulo de inclinação do rebordo alveolar. As medidas foram comparadas em relação ao sexo pelo teste Mann-Whitney. A comparação entre os sexos e o número de foraminas foi feito pelo teste qui-quadrado. A correlação de Pearson analisou a relação linear entre idade e número de foraminas. Resultados: As foraminas linguais estão presentes em 99,6% dos indivíduos. No sentido súpero-inferior, nota-se uma distância média até à crista alveolar de 21,4 mm, enquanto a distância média até à borda inferior da mandíbula foi de 13,1 mm. No sentido vestíbulo-lingual, nota-se uma distância média da foramina lingual até a cortical vestibular de 15,2 mm. O ângulo de inclinação do rebordo alveolar apresentou uma média de 25,4º. Em relação ao sexo, o teste só não foi significativo para a distância até a cortical vestibular. Conclusão: As foraminas linguais apresentam um trajeto descendente em 100% dos casos, posicionando-se, principalmente, nos terços médios (66,5%) e terços inferiores (32,7%) da altura do rebordo mandibular. Recomenda-se o uso de implantes dentários de até 13 mm de comprimento e de até 4mm de diâmetro em região de sínfise mentual.

Infodemia de COVID-19 e estresse percebido em idosos que utilizam as mídias sociais / COVID-19 infodemic and perceived stress in elderly people who use social media

Objetivo: Analisar a relação entre infodemia de COVID-19 e estresse percebido em idosos que utilizam as mídias sociais. Métodos: Estudo transversal por web-based survey, 470 idosos respondentes a questões sociodemográficas, de exposição a informações sobre COVID-19, e sinais e sintomas associados ao sofrimento psíquico. Variável de desfecho avaliada pela Escala de Estresse Percebido e pontuação média segundo variáveis independentes comparada por teste t, análise de variância ou correlação de Pearson e construído modelo final por regressão linear múltipla. Resultados: As variáveis significativas no modelo final (p < 0,05) foram: exposição pela TV (β = -0,144; IC95 porcent= -11,195 - -1,609); exposição pelas redes sociais (β = -0,175; IC95 porcent= -8,117 - -0,837); rastreio positivo para sofrimento psíquico devido à exposição a informações sobre COVID-19 (β = -0,380; IC95 porcent= -16,033 - -8,975). Conclusão: A infodemia pode potencializar o estresse em idosos, demandando cuidados específicos para essa população e o fortalecimento de sua rede social(AU)

Objective: To analyze the relationship between COVID-19 infodemic and perceived stress in elderly people who use social media. Methods: Cross-sectional study using a web-based survey, 470 aged respondents to sociodemographic questions, exposure to information about COVID-19, and signs and symptoms associated with psychological distress. Outcome variable evaluated by the Perceived Stress Scale and mean score according to independent variables compared by t-test, analysis of variance or Pearson's correlation and final model constructed by multiple linear regression. Results: The significant variables in the final model (p < 0.05) were: TV exposure (β = -0.144; 95percentCI= -11.195 - -1.609); exposure through social networks (β = -0.175; CI95percent = -8.117 - -0.837); positive screening for psychological distress due to exposure to information about COVID-19 (β = -0.380; 95percentCI= -16.033 - -8.975). Conclusion: infodemic can increase stress in the elderly, demanding specific care for this population and the strengthening of their social network(AU)

Objetivo: Analizar la relación entre la infodemia de COVID-19 y el estrés percibido en ancianos usuarios de redes sociales. Métodos: Estudio transversal mediante una encuesta basada en la web; 470 ancianos que respondieron preguntas sociodemográficas, exposición a la información sobre la COVID-19 y los signos y síntomas asociados con la angustia psicológica. La variable se evaluó por la escala de estrés percibido y la puntuación media según las variables independientes, comparadas por t-test, análisis de variación o correlación de Pearson y el modelo final construido por regresión lineal múltiple. Resultados: Las variables significativas en el modelo final (p < 0,05) fueron: exposición a la televisión (β = -0,144; IC95 por ciento = -11,195 - -1,609); exposición a través de redes sociales (β = -0,175; IC95 por ciento = -8,117 - -0,837); cribado positivo de malestar psicológico por exposición a información sobre la COVID-19 (β = -0,380; IC95 por ciento= -16,033 - -8,975). Conclusiones: La infodemia puede aumentar el estrés en los ancianos, lo que exige cuidados específicos para esa población y el fortalecimiento de su red social(AU)

Factors associated with recent and regular non-use of dental services by students from a university in southeastern Brazil: a cross-sectional study.

BACKGROUND: Lack of use of dental services can be a risk factor for oral health. In addition to recent visits to dental services, it is important to assess the regularity of use of these services, as well as the motivations for visiting the dentist. There is a gap in literature studies on the patterns of use of oral health services by the young university students. The goal of this study was to assess the factors associated with recent and regular non-use of dental services by young university students, using the Andersen model as a reference. METHODS: This was a cross-sectional study with 477 university students between 18 and 24 years old, carried out as a web survey, through which predisposing, enabling and need variables were collected, according to the model proposed by Andersen, to test the factors associated with recent and regular non-use of dental services. Bivariate analyses and robust Poisson regression were performed, with estimation of crude and adjusted prevalence ratios, using confidence intervals of 95%. The variables with p < 0.05 remained in the final model. RESULTS: The prevalence of recent non-use was of 19.5% (95% CI 16.0-23.3%), and of regular non-use, of 53.5% (95% CI 48.9-58.0%). After the adjusted analysis, the following were found to be associated with the outcome of recent non-use: type of service used (PR = 0.91; 95% CI 0.85-0.98) and perceived need for dental treatment (PR = 0.98; 95% CI 0.97-0.99); and the following variables were associated with regular non-use: father's level of education (PR = 0.86; 95% CI 0.78-0.96), area of study (PR = 1.08; 95% CI 1.02-1.15), reason for last dental appointment (PR = 0.81; 95% CI 0.75-0.88), use of dental services throughout childhood (PR = 0.92; 95% CI 0.86-0.97), self-perceived oral health (PR = 0.86; 95% CI 0.76-0.88), and toothaches over the last 2 years (PR = 0.93; 95% CI 0.87-0.99). CONCLUSION: The motivation for young university students to use dental services are curative treatment needs, not prevention. The results point to the need to implement health prevention and promotion policies in higher education institutions and to expand access to dental services for this young population.