ABSTRACT
The aim of this controlled randomized double-blinded clinical trial was to evaluate the use of a CO2 laser with or without topical application of acidulated fluorides in the prevention of dental caries in partially erupted first permanent molars. We selected 61 healthy children at high risk of caries, all between 6 and 8 (7.1 ± 0.8) years of age and with 4 partially erupted first permanent molars. A CO2 laser device emitting at 10.6 µm was used (0.5 W, 0.05 mJ per pulse, 10 kHz). Each first molar in an individual was randomly assigned to one treatment: (L) CO2 laser (0.066 J/cm2); (FL) 1.23% acidulated fluoride gel and CO2 laser (0.066 J/cm2); (V) 5% fluoride varnish, or (S) sealant (control). Patients were followed-up at 3, 6, 12, and 18 months after treatment, through direct visual examination and by an operator blinded to the treatments (kappa ≥ 0.70). The International Caries Detection and Assessment System (ICDAS-II) index was used to assess the soundness of tooth structure or the presence of white spot lesions, cavitated enamel, and/or dentin lesions. The Yildiz Visual Index was used to evaluate sealant retention. Results were evaluated using Kaplan-Meier survival analysis, and the hazard ratio of the treatments was estimated using shared frailty models with a gamma distribution, which considered the patient as a cluster. There were no significant differences among treatments compared to sealants. After 18 months, the use of a CO2 laser with or without acidulated fluorides was shown to be effective in preventing caries on the occlusal surface of partially erupted permanent first molars in children at high risk for caries.
Subject(s)
Dental Caries/prevention & control , Lasers, Gas/therapeutic use , Molar/radiation effects , Tooth Eruption/radiation effects , Child , Dental Caries/epidemiology , Dental Caries/pathology , Female , Follow-Up Studies , Humans , Incidence , Male , Molar/pathology , Pit and Fissure Sealants/therapeutic use , Proportional Hazards Models , Treatment OutcomeABSTRACT
Objective: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. Method: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale - PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression - CGI), functionality (Global Assessment of Functioning - GAF), personal and social performance (Personal and Social Performance - PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia - MATRICS battery) were applied at baseline and at the end of the study. Results: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). Conclusions: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Schizophrenic Psychology , Psychological Distance , Social Support , Employment/psychology , Psychiatric Status Rating Scales , Severity of Illness Index , Follow-Up Studies , Symptom Assessment , Work PerformanceABSTRACT
OBJECTIVE: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. METHOD: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale - PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression - CGI), functionality (Global Assessment of Functioning - GAF), personal and social performance (Personal and Social Performance - PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia - MATRICS battery) were applied at baseline and at the end of the study. RESULTS: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). CONCLUSIONS: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.
Subject(s)
Employment/psychology , Psychological Distance , Schizophrenic Psychology , Social Support , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Severity of Illness Index , Symptom Assessment , Work Performance , Young AdultABSTRACT
Objective: Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in MDD is essential for improving therapeutic strategies and predicting response to interventions. This systematic review discusses recent findings regarding cortical alterations in depressed patients during emotional or cognitive tasks, as measured by electroencephalography (EEG). Methods: A search of the MEDLINE/PubMed and Cochrane databases was carried out using the keywords EEG and depression, confined to article title. Results: The studies identified reveal the frontal cortex as an important brain structure involved in the complex neural processes associated with MDD. Findings point to disorganization of right-hemisphere activity and deficient cognitive processing in MDD. Depressed individuals tend to ruminate on negative information and respond with a pattern of relatively higher right frontal activity to emotional stimuli associated with withdrawal and isolation. Conclusion: Patients with MDD may have altered dynamic patterns of activity in several neuroanatomical structures, especially in prefrontal and limbic areas involved in affective regulation. Identification of these alterations might help predict the response of patients to different interventions more effectively and thus maximize the effects both of pharmacotherapeutic and of psychotherapeutic strategies.
Subject(s)
Humans , Brain/physiopathology , Cognition/physiology , Depressive Disorder, Major/physiopathology , Electroencephalography , Emotions/physiology , Brain Mapping , Cerebral Cortex/physiopathology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychologyABSTRACT
OBJECTIVE:: Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in MDD is essential for improving therapeutic strategies and predicting response to interventions. This systematic review discusses recent findings regarding cortical alterations in depressed patients during emotional or cognitive tasks, as measured by electroencephalography (EEG). METHODS:: A search of the MEDLINE/PubMed and Cochrane databases was carried out using the keywords EEG and depression, confined to article title. RESULTS:: The studies identified reveal the frontal cortex as an important brain structure involved in the complex neural processes associated with MDD. Findings point to disorganization of right-hemisphere activity and deficient cognitive processing in MDD. Depressed individuals tend to ruminate on negative information and respond with a pattern of relatively higher right frontal activity to emotional stimuli associated with withdrawal and isolation. CONCLUSION:: Patients with MDD may have altered dynamic patterns of activity in several neuroanatomical structures, especially in prefrontal and limbic areas involved in affective regulation. Identification of these alterations might help predict the response of patients to different interventions more effectively and thus maximize the effects both of pharmacotherapeutic and of psychotherapeutic strategies.
Subject(s)
Brain/physiopathology , Cognition/physiology , Depressive Disorder, Major/physiopathology , Electroencephalography , Emotions/physiology , Brain Mapping , Cerebral Cortex/physiopathology , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychology , HumansABSTRACT
Although the literature reports a higher incidence of anxiety disorders in women, the majority of basic research has focused on male rodents, thus resulting in a lack of knowledge on the neurobiology of anxiety in females. Bridging this gap is crucial for the design of effective translational interventions in women. One of the key brain mechanisms likely to regulate anxious behavior is adult hippocampal neurogenesis (AHN). This review paper aims to discuss the evidence on the differences between male and female rodents with regard to anxiety-related behavior and physiology, with a special focus on AHN. The differences between male and female physiologies are greatly influenced by hormonal differences. Gonadal hormones and their fluctuations during the estrous cycle have often been identified as agents responsible for sexual dimorphism in behavior and AHN. During sexual maturity, hormone levels fluctuate cyclically in females more than in males, increasing the stress response and the susceptibility to anxiety. It is therefore of great importance that future research investigates anxiety and other neurophysiological aspects in the female model, so that results can be more accurately applicable to the female population.
Subject(s)
Anxiety/physiopathology , Hippocampus/physiopathology , Neurogenesis/physiology , Sex Characteristics , Adult , Female , Humans , MaleABSTRACT
O objetivo é verificar os efeitos da Shantala na interação entre mãe e criança com síndrome de Down. Utilizou-se por 60 dias, uma vez por semana, a técnica de massagem Shantala em três crianças com síndrome de Down, da instituição APAE, localizada em Itaquaquecetuba, SP, Brasil. Para a obtenção dos resultados foram aplicados dois questionários, um ao início, para se obter maiores informações sobre as crianças e outro ao final, para se verificar os resultados da técnica utilizada. Foi possível concluir que a Shantala beneficiou as crianças com síndrome de Down, proporcionando uma qualidade de vida melhor. Para as mães, a técnica permitiu uma melhor aceitação da doença e houve melhora no relacionamento entre as mães e as crianças.(AU)
This study aimed to verify the effects of Shantala massage therapy on the interaction between mother and child with Down's syndrome. The methodology consisted in applying the massage technique "Shantala" for 60 days, once a week, on three children from APAE Institution, located at Itaquaquecetuba, SP, Brazil. At the beginning of the treatment we applied a questionnaire to obtain more information about the patient. At the end, it was applied another questionnaire to verify the results of the treatment. It was observed that Shantala benefited the kids with Down's syndrome, providing to them a better quality of life. For the mothers, the technique provided a better acceptability of the disease and an improvement in the relationship between mothers and kids.(AU)
ABSTRACT
O objetivo é verificar os efeitos da Shantala na interação entre mãe e criança com síndrome de Down. Utilizou-se por 60 dias, uma vez por semana, a técnica de massagem Shantala em três crianças com síndrome de Down, da instituição APAE, localizada em Itaquaquecetuba, SP, Brasil. Para a obtenção dos resultados foram aplicados dois questionários, um ao início, para se obter maiores informações sobre as crianças e outro ao final, para se verificar os resultados da técnica utilizada. Foi possível concluir que a Shantala beneficiou as crianças com síndrome de Down, proporcionando uma qualidade de vida melhor. Para as mães, a técnica permitiu uma melhor aceitação da doença e houve melhora no relacionamento entre as mães e as crianças
Subject(s)
Humans , Child , Child Development , Down Syndrome , Massage , Mother-Child Relations , Qualitative ResearchABSTRACT
OBJECTIVE: To evaluate the impact of an exercise program organized into supervised walking groups in subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: Fifty-nine diabetic subjects were randomized to a control group receiving standard lifestyle recommendations or an intervention group assigned to three supervised walking sessions per week and counseling. Changes in metabolic features, weight, 6-min walk test, prescription of antidiabetic medications, and overall physical activity were assessed. RESULTS: Functional capacity and overall physical activity were higher in the intervention group, whereas metabolic changes were not different between groups after 4 months. However, in subjects who attended at least 50% of scheduled walking sessions, changes in A1C and fasting glucose were greater than in control subjects. Discontinuation or reduction of antidiabetic drugs occurred in 33% of these patients versus 5% of control subjects (P<0.05). CONCLUSIONS: Supervised walking may be beneficial in diabetic subjects, but metabolic improvement requires adequate compliance.
Subject(s)
Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/metabolism , Motor Activity/physiology , Walking/physiology , Aged , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/drug therapy , Fasting/blood , Female , Glycated Hemoglobin/metabolism , Humans , Hypoglycemic Agents/administration & dosage , Hypoglycemic Agents/therapeutic use , Male , Middle AgedABSTRACT
Como parecem existir similaridades entre os mecanismos patogenéticos de doenças reumatológicas, como a artrite reumatóide e a artrite idiopática juvenil com a periodontite, alguns estudos têm sido publicados com o objetivo de levantar evidências de uma possível inter-relação entre essas condições. A artrite reumatóide parece modular a resposta imune do hospedeiro, podendo aumentar a suscetibilidade à doença periodontal destrutiva em adultos. Recentemente, evidenciou-se que também pacientes com artrite idiopática juvenil possuíam maior suscetibilidade à doença periodontal destrutiva comparados a indivíduos saudáveis da mesma idade. No entanto, ainda se desconhecem os mecanismos que justificariam uma hipótese de associação entre essas condições crônicas inflamatórias. Sendo assim, o objetivo deste trabalho foi promover uma revisão da literatura sobre uma possível relação entre artrite crônica e periodontite.
As similarities between pathogenetic mechanisms concerning rheumatic diseases, such as rheumatoid arthritis and juvenile idiopathic arthritis, with periodontitis may exhist, some studies have been published with the objective of showing evidences of a possible relationship between these conditions. Rheumatoid arthritis seems to modulate the host's immune mechanisms and may increase the susceptibility of adults to destructive periodontal disease. Recently evidences showed that also patients with juvenile idiopathic arthritis had an increased susceptibility to destructive periodontal disease compared to healthy individuals of the same age. Nevertheless the mechanisms of association of these chronic inflammatory conditions remain unclear. So, this study aims to review literature concerning a possible relationship between chronic arthritis and periodontitis.
Subject(s)
Humans , Arthritis , Arthritis, Juvenile , Arthritis, Rheumatoid , Arthritis, Juvenile/complications , Gingivitis , Periodontitis , Rheumatic DiseasesABSTRACT
A literatura comprova a existência de variação interexaminador na identificação dos pontos anatômicos durante a confecção de um cefalograma. Desta forma, o objetivo desse trabalho foi verificar se essa variação interfere nos resultados cefalométricos de medidas envolvendo os incisivos, dados estes, que influenciam na decisão clínica da necessidade ou não de extrações dentárias. Para tanto, foram selecionadas 40 telerradiografias laterais, que foram todas enviadas, em momentos diferentes, para tanto, foram obtidos 3 cefalogramas de cada radiografia. Neste trabalho foram analisados os itens 1/.NS, 1/.NA, 1/-NA, /1.NB, /1-NB, FMA, IMPA, discrepância de Tweed e de Vigorito. Os resultados quantitativos mostraram diferença estatisticamente significativa para um P maior ou igual 0,05 em 1 dos 7 fatores avaliados e nas 2 discrepâncias cefalométricas. A análise qualitativa apresenta resultados significativos para todos os fatores, exceto para o fator/1-NB, ou seja, os resultados diferem de um examinador para outro. A avaliação descritiva dos resultados mostrou variação de até 14,34 mm para a discrepância de Tweed e de até 16° para o 1.NB, entre os examinadores. A partir dos resultados encontrados podemos concluir que as diferenças existem e podem resultar em diagnósticos diferentes, induzindo a planos de tratamento distintos para o mesmo paciente
