Evaluation of Microstrain in the Regions Surrounding Morse Taper and External Hexagon Implants.

OBJECTIVE: The aim of this study was to compare the Morse taper (MT) + titanium base (Ti-Base) abutment with the external hexagon (EH) + Ti-Base abutment by using the strain gauge method in the mesial, distal, and apical-buccal areas around these types of implants. MATERIALS AND METHODS: This study investigated two groups, MT and EH, each comprising five polyurethane samples with a dental implant in the area of artificial tooth 15 (3.75 × 11.5 mm) of a dental manikin. The strain gauges were glued to the mesial, distal, and apical-buccal polyurethane areas of all samples in relation to the implant. Ti-Base nonangled abutments measuring 5.0 × 4.7 × 1.0 mm (DSP, Brazil) were installed on the implants in each group. Ten identical zirconia crowns were constructed by scanning and milling and were subsequently cemented onto the Ti-base abutments with calcium hydroxide cement. Then, an axial load of 100 N was applied to the occlusal region of the zirconia crowns, and strain gauge measurements were taken. STATISTICAL ANALYSIS: Strain gauge data were assessed by a two-way analysis of variance (ANOVA) with "implant connection" and "strain gauge position" factors, followed by the Bonferroni test (p < 0.05). RESULTS: The MT group exhibited a statistically significant reduction in microstrain in the mesial and apical strain gauge measurements compared to the EH group. CONCLUSION: The MT group exhibited less microstrain in the mesial and apical areas of the polyurethane samples near the implant. Consequently, the MT connection was considered more biomechanically advantageous.

Effect of Chlorhexidine and Tea Tree Oil on Reducing the Number of Oral Microorganisms.

OBJECTIVES: Thus, the aim of this study was to compare the effect of using two preoperative mouthwashes (0.12% chlorhexidine and 0.2% tea tree oil) on the number of colonies of oral microorganisms. MATERIALS AND METHODS: Forty participants who needed to be rehabilitated with dental implants were included in this study. They were randomly divided into two groups (chlorhexidine group and tea tree group; n = 20, each). For each group, saliva samples were collected at four different times: T0 (initially)-before using the mouthwash, T1-after 1 minute of using the mouthwash, T10-after 10 minutes of using the mouthwash, and T60-after 60 minutes of using the mouthwash. At T0 and T1, saliva samples were collected before implant placement surgery, and at T10 and T60, saliva samples were collected during surgery. In each group, one saliva sample was collected at each evaluated time point for each patient, totaling 4 saliva collections per patient. MSB agar (Mitis-Salivarius-Bacitracin) and BHI agar (Brain Heart Infusion) culture media were used in each group. Microbial colony counts were performed using a magnifying glass and recorded in CFU (colony forming units)/mL. Statistical analyses were performed using the Friedman, Mann-Whitney U and Wilcoxon tests (p < 0.05). RESULTS: Based on MSB agar culture medium, at T0, the number of Streptococcus mutans colonies in the chlorhexidine group was significantly higher compared with the tea tree group (p <0.05; MSB agar). The chlorhexidine group showed significantly lower CFU/mL values for Streptococcus mutans at T1, T10, and T60 compared with the tea tree group (p <0.05; MSB agar). Based on BHI agar culture medium, at T0, the chlorhexidine group showed a significantly lower value of CFU/mL compared with the tea tree group (p < 0.05; BHI agar). At T1, T10, and T60, the chlorhexidine group showed significantly lower CFU/mL values compared with the tea tree group (p <0.05; BHI agar). CONCLUSION: Chlorhexidine is more indicated as a preoperative mouthwash than tea tree oil, due to its significantly more effective antimicrobial action.

Abutment on Titanium-Base Hybrid Implant: A Literature Review.

An increase in the use of Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) technologies challenges the conventional prosthetic fabrication procedures that are practical and centered on a digital workflow for the patient, especially for dental implants. Increasing workflow of digital restoration work, considering computer-used CAM for restoration technology systems and also fast/CAM for building restoration technology; fast/CAD, also known as abut-Base, has increased interest. Studies on adaptation of different restorative materials, on titanium (Ti)-base abutments, traction, and transformed cycling have become relevant. The objective of this work was to research, through literature studies, on restoration-type abutments. A total of 24 articles were found after searching the following terms in PubMed/Medline, Scopus, and Embase databases: "ti-base AND abutment." Twenty-one manuscripts selected from the inclusion and exclusion criteria. After an analysis of these articles, it was concluded that the Ti-base abutment and components from the same manufacturer as the Implant should be used preferably; milled monolithic crowns designed to adapt to the Ti-base the hybrid abutment-crown assembly does not affect torque maintenance after thermal aging; the saliva and cleaning protocol of the Ti-base bonding surfaces can influence the operations of the Ti-base crowns; Ti-base and Crown surface treatment is recommended for better applicability and stability results, and the superiority of resin-based cements compared with other types of cements.

Comparison of Techniques for Obtaining Centric Relation Based on the Reproducibility of the Condylar Positions in Centric Relation-A Systematic Review.

The objective of this systematic review was to compare centric relation (CR) techniques that belong to the same method of obtaining CR (guided, graphical, or physiological method), to verify which CR technique within each method of obtaining CR generates the greatest reproducibility of the condylar positions (or mandibular position) in CR. The PubMed, Cochrane Library, SciELO, Scopus, and Web of Science databases were searched for articles published up to May 5, 2021. The search terms were combinations of "dental centric relation" (MeSH), with each of the following terms (individually): "reproducibility of findings" (MeSH); "jaw relation record" (MeSH); "chin point"; "gothic arch"; "bimanual manipulation"; "swallowing" (MeSH); and "jig." Inclusion criteria: clinical studies in English; individuals without temporomandibular dysfunction and with complete or almost complete dentition or complete edentulous; and comparison between CR techniques belonging to the same method of obtaining CR based on the reproducibility of condylar positions in CR. For each method of obtaining the CR, the following CR techniques were considered: guided method (chin point guidance and bimanual manipulation); graphic method (intraoral and extraoral gothic arch tracing); and physiologic method (swallowing and tongue retrusion along the palate). A total of 1692 articles were screened. After the inclusion and exclusion criteria were applied, six articles were included in this review. None of the included studies evaluated edentulous individuals. All included articles compared CR techniques of the guided method. Three articles concluded that the bimanual technique showed greater reproducibility of the condylar positions in CR than the chin point guidance technique, two articles showed equivalence between these techniques, and 1 article concluded that the chin point guidance technique showed greater reproducibility of the condylar positions in CR than the bimanual technique. Thus, in this systematic review, the bimanual technique was often superior (generated greater reproducibility of the CR) or at least equivalent to the chin point guidance technique. Therefore, for individuals with complete dentition and without temporomandibular disorders, the bimanual technique is more recommended.

Influence of Different Pigment Incorporation Methods on the Sorption and Solubility of Medical Silicones.

OBJECTIVE: The aim of this study is to verify the influence of three pigment incorporation methods (conventional, mechanical, and industrial) on the sorption and solubility of the MDX4-4210 and A-2186 silicones. MATERIALS AND METHODS: The groups formed were based on the silicones used (A-2186 and MDX4-4210), intrinsic pigments (pink, bronze, and black), and pigment incorporation methods (conventional, mechanical, and industrial). The dimensions of all samples were 45-mm diameter (ø) × 1-mm thickness. Readings were taken initially and after 1,008 hours of aging. STATISTICAL ANALYSIS: Three-way analysis of variance and the Tukey's test were performed (α = 0.05). RESULTS: For sorption and solubility, there was no difference between the incorporation methods for the A-2186 silicone, regardless of the pigment used (p > 0.05). For pink MDX4-4210, the industrial and mechanical methods showed higher values of sorption compared with the conventional method (p < 0.05). For bronze MDX4-4210, the industrial method showed a higher sorption value compared with the conventional and mechanical methods (p < 0.05). For black MDX4-4210, there was no difference between incorporation methods based on sorption (p > 0.05). For pink MDX4-4210, the mechanical method showed a higher solubility value compared with the industrial and conventional methods (p < 0.05). For black MDX4-4210 and bronze MDX4-4210, there was no statistically significant difference between incorporation methods based on solubility (p > 0.05). CONCLUSION: Based on sorption and solubility, for the A-2186 silicone, the conventional, mechanical, and industrial methods of pigment incorporation were equivalent. For the MDX4-4210 silicone, its results of sorption and solubility were varied, and further studies are recommended.

Dentistry and Intensive Care Unit: A Brief Report.

OBJECTIVE: The aim of this study is to verify whether removable dentures of patients admitted to an intensive care unit (ICU) are niches of microorganisms that can cause pathologies (Staphylococcus aureus, Candida spp., and enterobacteria). MATERIALS AND METHODS: Fifteen patients who were denture wearers (removable partial denture and complete denture) were included in this study. Patients must wear their dentures daily, and these dentures must have acrylic parts. Microbial biofilm was collected from the acrylic part of one denture of each patient. Then, the biofilm was seeded on different culture media: Sabouraud agar, blood agar, MacConkey agar, and mannitol salt agar. In this study, biochemical evaluations of microorganisms were performed. STATISTICAL ANALYSIS: The percentage of dentures with the microorganism identified by each culture medium was calculated. RESULTS: In total, 100% of the dentures were positive for Staphylococcus spp. (blood agar) and Candida spp. (Sabouraud agar); 33.3% of the dentures were positive for S. aureus (Mannitol salt agar); and 13.3% of the dentures were positive for Shigella spp. (MacConkey agar). CONCLUSION: Removable dentures of patients (removable partial dentures and complete dentures) admitted to an ICU are niches of microorganisms that can cause pathologies.

Quality of Life, Satisfaction, Occlusal Force, and Halitosis after Direct and Indirect Relining of Inferior Complete Dentures.

OBJECTIVE: The aim of this study was to compare the direct relining technique with the indirect relining technique in relation to quality of life, satisfaction with the relining, occlusal force, and halitosis of users of acrylic complete dentures. MATERIALS AND METHODS: Twenty bimaxillary edentulous individuals were selected. They had to use the same pair of complete dentures for a minimum of 1 year and a maximum of 5 years. The subjects were randomly divided in groups of direct relining and indirect relining of the inferior denture (n = 10). Both groups received the same silicone-based relining. The clinical tests verified the quality of life (Oral Health Impact Profile in edentulous individuals), the satisfaction with the relining, the occlusal force, and halitosis. The tests (halitosis and occlusal force) were performed initially (before the relining), immediately after the relining, and 30, 60, 90, and 180 days after the relining. The questionnaires (quality of life and satisfaction with the relining) were performed initially (before the relining), and 30, 60, 90, and 180 days after the relining. STATISTICAL ANALYSIS: Analysis of variance and the Tukey test were used (p < 0.05). RESULTS: There was no statistical difference comparing the two techniques in all the evaluations (p < 0.05). There was a significant statistical difference for the factor of time in all clinical tests for each relining technique (p < 0.05). The quality of life and satisfaction with the relining increased significantly 30 days after the relining when compared with the initial time point, for both techniques (p < 0.05). The occlusal force increased significantly after 90 and 180 days when compared with the initial time point, for both techniques (p < 0.05). Halitosis decreased significantly immediately after the relining when compared with the initial time point, for both techniques (p < 0.05). CONCLUSION: Independent of the relining technique used, there was an increase in the quality of life, satisfaction with the relining, and occlusal force, as well as a reduction in the level of halitosis. Both techniques generated similar results and therefore can be options in clinical practice.

Pregnant patient with prune belly syndrome: case report.

Prune belly syndrome is a rare congenital disease of unknown etiology that is present in one in every 40 thousand live births, and predominantly affects males, at a ratio of 4:1. In males, it presents with anomalies in the urinary system, absence of abdominal muscles, bilateral cryptorchidism, and infertility. In women, the syndrome has variable presentations, but fertility is preserved. Searching the medical literature, we found only one case of prune belly syndrome in pregnant women. Therefore, the patient in this report is the second case. She was primiparous, 25-years-old, with no abdominal muscles, severe congenital kyphoscoliosis, and pulmonary restriction. Elective cesarean section was performed at 37 weeks of gestation due to maternal risk of uterine rupture by transverse presentation and fetal risk of intrauterine growth restriction. The pre-anesthetic approach defined that general anesthesia might have more risks for the patient due to severe maternal lung disease compared to ultrasound-guided locoregional anesthesia. During prenatal care, there were some maternal complications, such as asthma exacerbations, abdominal pain, and constipation. The newborn was born small for gestational age and this can possibly be explained by maternal restrictive lung capacity. The newborn presented with Apgar score 8/9 and tachypnea, but improved after two hours of life.

Parental burnout: a scoping review.

OBJECTIVE: to map available evidence on parental burnout theme. METHOD: scoping review as according to the Joanna Briggs Institute. Search in January 2021, in six databases of publications in English, Portuguese or Spanish, without time limits. Data extracted and descriptively analyzed by three independent researchers. RESULTS: 374 articles were identified and 20 were included in the final sample, all published in English, from 2017 onwards. Parental burnout is a complex, multifactorial problem, distinct from burnout cases, depressive symptoms and other mental health alterations. It affects 0.2 to 20% of parents, has validated and suitable instruments for measurement; if not treated, can have consequences on marital life, work relationships, child neglect and violence. CONCLUSIONS: this is a recent theme that needs to be explored, due to the possible impact on children's and families' health and on parents' work processes. Protocol registered in the Open Science Framework (https://osf.io/jd7vk).

Relation Between Insertion Torque and Implant Stability Quotient: A Clinical Study.

OBJECTIVES: This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). MATERIALS AND METHODS: Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, resonance frequency analysis was used to assess the secondary stability of each implant. STATISTICAL ANALYSIS: The insertion torque data were correlated with ISQ measurements by using Pearson's correlation. The significance level was 5%. RESULTS: There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). CONCLUSION: The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (and vice versa).

SARS-CoV-2 and Dentistry-Review.

SARS-CoV-2 (or 2019-nCoV) is the novel Coronavirus that affects humans. It originated in China at the end of 2019 due to the consumption of animals contaminated with this pathogen. SARS-CoV-2 causes the disease known as COVID-19 (coronavirus disease - 2019), and until May 21, 2020, approximately 213 countries and territories had been affected by SARS-CoV-2. The objective of this study was to review the origin and characteristics of this virus (SARS-CoV-2), symptoms and diagnosis of COVID-19, treatment of people with COVID-19, forms of transmission of the SARS-CoV-2, and precautions in dentistry. A literature search on PubMed/Medline was performed on the May 21, 2020, using the keywords (Mesh terms) "COVID-19" or "SARS-CoV-2" or "Coronavirus" associated with "dentistry" or "dental care" or "oral medicine." SARS-CoV-2 articles about the origin and characteristics of this virus (SARS-CoV-2), symptoms and diagnosis of COVID-19, treatment of people with COVID-19, forms of transmission of the SARS-CoV-2, and precautions in dentistry were included. The search was expanded according to necessity. Articles related to precautions in dentistry and SARS-CoV-1 or MERS-CoV were also selected, since precautions used in the dental clinic to avoid these viruses also apply to SARS-CoV-2. In addition, the references cited in the publications of articles included were also considered when appropriate. There was no limit in relation to the year of publication, and only articles written in English were included. In this study, suggestions for the safety of dental professionals were also included. Forty-seven articles and nine websites were included in this review.

In vitro evaluation of the effect of different disinfectants on the biofilm of Staphylococcus epidermidis and Staphylococcus aureus formed on acrylic ocular prostheses.

The aim of this study was to evaluate the effect of disinfectants on the biofilm of Staphylococcus aureus and Staphylococcus epidermidis formed on the acrylic surface of ocular prostheses. In this study, 396 acrylic specimens were manufactured (50% for Staphylococcus epidermidis, and 50% for Staphylococcus aureus). For each bacterium, 66 specimens were subjected to biofilm formation on their surfaces for 24 hours, 66 specimens were subjected to biofilm formation on their surfaces for 48 hours, and 66 specimens were subjected to biofilm formation on their surfaces for 72 hours. Then, they were divided into groups according to disinfection method (n = 6): sterile distilled water for 10, 15, 30 min, and 6 hours (control); soap for 30 min (NES30); Opti-Free for 30 min (OPF30) and 6 h (OPF6); Efferdent for 15 min (EFF15); and 0.5%, 2%, and 4% chlorhexidine for 10 min (0.5% CHX10, 2% CHX10, and 4% CHX10). After the treatments, the specimens were vortexed to release the biofilm and the counting of bacterial colonies was performed (CFU/mL). Three-way ANOVA and the Tukey-Kramer HSD test were used (α = 0.05). For Staphylococcus epidermidis, there was no significant difference between NES30, OPF30, and OPF6 with their respective control groups; nor between NES30, OPF30, and OPF6 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, there was no significant difference between NES30 and OPF30 with their control group; nor between NES30 and OPF30 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, OPF6 showed a significant reduction in the number of CFU/mL when compared with its control group, NES30, and OPF30, regardless of the biofilm development period (P <0.05). For both bacteria, 0.5% CHX10, 2% CHX10,4% CHX10, and EFF15 showed a significant reduction in the number of CFU/mL when compared with their control groups, NES30, OPF30, and OPF6, regardless of the biofilm development period (P <0.05). Therefore, EFF15 and CHX (0.5%, 2% and 4%) were effective in reducing Staphylococcus epidermidis and Staphylococcus aureus on acrylic surfaces. NES30 and OPF (30 and 6) are not recommended.

Influence of Different Pigmentations and Accelerated Aging on the Hardness and Tear Strength of the A-2186 and MDX4-4210 Silicones.

OBJECTIVE: To evaluate the influence of different pigmentations and accelerated aging on the hardness and tear strength of the A-2186 and MDX4-4210 silicones. MATERIALS AND METHODS: The samples A-2186 and MDX4-4210 were manufactured without and with pigmentations (black, bronze, and pink). For the Shore A hardness test, 80 samples of each silicone were fabricated, and for the tear strength test, 320 samples of each silicone were fabricated. Eight groups were created for each test (n = 10). These tests were performed before and after 252, 504, and 1008 hours of aging. Three-way repeated-measures analysis of variance and the Tukey test were performed (α = 0.05). RESULTS: The A-2186 silicone showed higher hardness and tear strength when compared with the MDX4-4210 silicone (p < 0.05), except in the hardness of the A-2186 and MDX4-4210 groups without pigmentation after 1008 hours (p > 0.05). All hardness values were between 25 and 35 units, regardless of the silicone type, period, and pigmentation (or no pigmentation). In most situations, the hardness of silicones used increased after 252 hours (p < 0.05). The nonpigmented MDX4-4210 group and all A-2186 groups showed an increase in tear strength after 252 hours (p < 0.05). For the nonpigmented MDX4-4210 group, from 252 to 1008 hours, there was no change in tear strength (p > 0.05). All pigmented MDX4-4210 groups showed no change in tear strength from 0 (initial) to 1008 hours of aging (p > 0.05). In all A-2186 groups, from 252 to 504 hours, there was a reduction in tear strength (p < 0.05), and from 504 to 1008 hours, there was an increase in tear strength (p < 0.05), except in the bronze A-2186 group (p > 0.05). CONCLUSION: In most situations, the A-2186 silicone showed significantly higher values of hardness and tear strength than the MDX4-4210 silicone. All hardness values were considered clinically acceptable. Accelerated aging could increase, decrease, or not significantly change the hardness and tear strength of the silicones used. The results of hardness and tear strength suggest that MDX4-4210 was more influenced by the presence of pigmentation after aging.

The signaling effects of ATP on melanoma-like skin cancer.

Melanoma is a type of skin cancer originated by the malignant transformation of melanocytes. Increasing incidence and mortality require efforts focused on studies and research about this cancer. Its microenvironment is rich in extracellular ATP, but there are no studies evaluating the ectonucleotidases and ATP effects on tumor-derived melanoma cells with known amounts of ATP. This way, the objective of this work was to evaluate the purinergic signaling in the pathophysiology of in vivo melanoma and the in vitro effects of ATP signaling. We found increased and effective extracellular ATP hydrolysis in platelets and a significant decrease of extracellular ATP levels and adenosine hydrolysis. In addition, we cultured PBMCs of melanoma patients and used ATP salt with specific concentrations to evaluate its signaling effects. The enzymatic activity analysis revealed that even with higher ATP doses cells metabolize adenine nucleotides less efficiently, and present low ATP, ADP and AMP hydrolytic activity in CM compared to CT cells. In summary, we showed for the first time important data about the purinergic signaling in the pathophysiology of melanoma and ATP signaling exercising immunosuppressive effects. Therefore, as already shown for other tumors, the purinergic signaling should be considered a potential target for melanoma management and treatment and could offer novel therapeutic prospects.

Personality Inventory for DSM-5 (PID-5): cross-cultural adaptation and content validity in the Brazilian context.

OBJECTIVE: To describe the process of cross-cultural adaptation of the Personality Inventory for DSM-5 (PID-5) to the Brazilian context. METHODS: Cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, and back-translation. Analysis of content validity was conducted by a multidisciplinary expert committee and consisted of quantitative assessment of agreement indicators. The test was then applied to a target population. RESULTS: All the steps required for a cross-cultural adaptation were followed and satisfactory agreement values (≥ 4.75) were reached for most of the structures assessed. Most of the changes suggested by the experts were followed; these changes consisted primarily of adjustments to verb tense and agreement and the inclusion of letters and words to allow gender inflection. In the pre-test, no suggestions were made and the instrument was considered comprehensible. CONCLUSION: The Brazilian version of the PID-5 was found to be adequate to the Brazilian context from semantic, idiomatic, cultural, and conceptual perspectives. The Brazilian version assessed here can be freely used, was approved by the publishers who hold the copyright on the instrument, and is considered the official version of the instrument. New studies are underway to determine the validity and reliability of the PID-5.

Sentinel lymph node biopsy in adenocarcinoma of minor salivary gland.

Adenocarcinoma of the minor salivary gland (MSG) is a rare neoplasm. It represents about 2% of all MSG malignant tumours. It is more common in the palate and in females. This tumour occurs in a mean age of sixty and its mean size at presentation is 1.5cm. Microscopically, the neoplasms classified as adenocarcinoma not otherwise specified (NOS) are a histologically heterogeneous group: they vary from highly anaplastic adenocarcinoma to moderate and well-differentiated lesions. This report describes a case of adenocarcinoma of MSG occurring in the buccal mucosa of a 24-year-old male. The patient underwent a sentinel node biopsy as a staging tool in association with the primary surgical treatment. In the histological examination of sentinel lymph node (SLN) there was no evidence of metastatic disease. The patient presents no evidence of recurrent disease after 4years of follow-up. We believe that the use of SLN biopsy can be indicated in similar cases considering the tumoural biology (well-differentiated) because prospective randomized studies would be very difficult to be performed due to the rarity of this neoplasm.

The effect of the "K" technique on levels of anxiety and salivar cortisol in adolescents / O efeito da técnica "K" nos níveis de ansiedade e cortisol salivar em adolescentes / El efecto de la técnica "K" sobre la ansiedad y los niveles de cortisol salivales en adolescentes

This research presents theoretical arguments of a new approach called Technique "K," which aims to reduce student's anxiety before a cognitive challenge. Through a randomized, controlled clinical trial, we evaluate the Beck Anxiety Inventory and salivary cortisol. We compared the results in the last year of high school, who were facing school tests, before and after the application of the "K" technique (intervention group) and placebo (control group). Statistical analyses consisted of using the Chisquare, Spearman and the Wilcoxon test. The principal component analysis observed in the case group, - 10.50 (-18.25; -4.75), was statistically higher than the control group, -6.00 (-8.75; -1.25). It is not possible to identify statistical significance (p = 0.462) in the variation of salivary cortisol concentration. The results suggest the effectiveness of the "K" technique in managing anxiety in high school students. Although, future research is needed to extend the preliminary data obtained in this study

Esta pesquisa apresenta argumentos teóricos de uma nova abordagem denominada Técnica "K", visando reduzir a ansiedade do aluno diante de um desafio cognitivo. Por meio de um ensaio clínico randomizado e controlado, avaliamos o Inventário de Ansiedade de Beck e o cortisol salivar. Comparamos os resultados dos alunos, que estavam enfrentando provas escolares, antes e após a aplicação da técnica "K" (grupo intervenção) e placebo (grupo controle). As análises estatísticas consistiram na utilização do Qui-quadrado, Spearman e teste de Wilcoxon. A análise de componentes principais observada no grupo caso, -10,50 (-18,25; -4,75), foi estatisticamente superior ao grupo controle, -6,00 (-8,75; -1,25). Não é possível identificar significância estatística (p = 0,462) na variação da concentração de cortisol salivar. Os resultados sugerem a eficácia da técnica "K" no manejo da ansiedade em estudantes do ensino médio. No entanto, pesquisas futuras são necessárias para estender os dados preliminares obtidos neste estudo

Esta investigación presenta argumentos teóricos para un nuevo enfoque denominado Técnica "K", con el objetivo de reducir la ansiedad de los estudiantes frente a un desafío cognitivo. A través de un ensayo clínico aleatorizado y controlado, evaluamos el Inventario de Ansiedad de Beck y el cortisol salival. Comparamos los resultados de los estudiantes, que se enfrentaban a pruebas escolares, antes y después de la aplicación de la técnica "K" (grupo de intervención) y placebo (grupo control). Los análisis estadísticos consistieron en utilizar la prueba de Chicuadrado, Spearman y Wilcoxon. El análisis de componentes principales observado en el grupo de casos, -10,50 (-18,25; -4,75), fue estadísticamente superior al grupo control, -6,00 (-8,75; -1,25). No es posible identificar significación estadística (p = 0,462) en la variación de la concentración de cortisol salival. Los resultados sugieren la efectividad de la técnica "K" en el manejo de la ansiedad en estudiantes de secundaria. Sin embargo, se necesitan futuras investigaciones para ampliar los datos preliminares obtenidos en este estudio

Psychometric properties of the dimensional anxiety scales for DSM-5 in a Brazilian community sample.

The DSM-5 highlights the use of dimensional assessments of mental health as a supplement to categorical diagnoses. This study investigated the psychometric properties of the DSM-5 Dimensional Anxiety Scales in a Brazilian community sample. Dimensional scales for generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and specific phobia were administered to 930 adults aged 18 to 70, 64.2% female. Psychometric properties investigated were: unidimensionality; measurement invariance; internal consistency; composite reliability; test-retest reliability; convergent and divergent validity; category thresholds and item performance analyses. Analyses revealed unidimensionality for all scales except for specific phobia. Measurement invariance, high internal consistency and composite reliability, and convergent and divergent validity were demonstrated. Test-retest reliability was high for all scales but generalized anxiety disorder. Item-based analyses evidenced that none of the items were very easy to endorse and that the scales offered more information about subjects with high severity estimates of anxiety. The DSM-5 Dimensional Anxiety Scales are a valid and reliable alternative to assess anxiety symptomatology in community settings, although further evaluation is needed, especially for specific phobia. The scales seem to be more useful for characterizing dimensionality of symptoms for subclinical or clinical cases than for slight or mildly anxious subjects.

Parental burnout: a scoping review / Parental burnout: revisión del alcance / Burnout parental: revisão de escopo

ABSTRACT Objective: to map available evidence on parental burnout theme. Method: scoping review as according to the Joanna Briggs Institute. Search in January 2021, in six databases of publications in English, Portuguese or Spanish, without time limits. Data extracted and descriptively analyzed by three independent researchers. Results: 374 articles were identified and 20 were included in the final sample, all published in English, from 2017 onwards. Parental burnout is a complex, multifactorial problem, distinct from burnout cases, depressive symptoms and other mental health alterations. It affects 0.2 to 20% of parents, has validated and suitable instruments for measurement; if not treated, can have consequences on marital life, work relationships, child neglect and violence. Conclusions: this is a recent theme that needs to be explored, due to the possible impact on children's and families' health and on parents' work processes. Protocol registered in the Open Science Framework (https://osf.io/jd7vk).

RESUMEN Objetivo: mapear la evidencia disponible sobre el tema del agotamiento de los padres. Método: revisión del alcance, según el Instituto Joanna Briggs. Búsqueda en enero de 2021, en seis bases de datos de publicaciones en inglés, portugués o español, sin límite de tiempo. Datos extraídos y analizados descriptivamente por tres investigadores independientes. Resultados: se capturaron 374 artículos y se incluyeron 20 en la muestra final, todos publicados en inglés, a partir de 2017. El burnout parental es un problema complejo y multifactorial, distinto de los casos de burnout, síntomas depresivos y otras alteraciones de la salud mental. Afecta entre el 0,2 y el 20% de los padres, cuenta con instrumentos de medición validados y adecuados y, si no se trata, puede tener consecuencias en la vida conyugal, las relaciones laborales, el abandono y la violencia contra el niño. Conclusiones: este es un tema reciente que necesita ser explorado, por el posible impacto en la salud de los niños y las familias y en los procesos laborales de los padres. Protocolo registrado en el Open Science Framework (https://osf.io/jd7vk).

RESUMO Objetivo: mapear evidências disponíveis sobre a temática burnout parental Método: revisão de escopo, conforme o Joanna Briggs Institute. Busca em janeiro de 2021, em seis bases de dados de publicações em inglês, português ou espanhol, sem delimitação de tempo. Dados extraídos e analisados descritivamente por três pesquisadores independentes. Resultados: capturados 374 artigos e incluídos 20 na amostra final, todos publicados em inglês, a partir de 2017. Burnout parental consiste em problema complexo, multifatorial, distinto dos casos de burnout, sintomas depressivos e outras alterações de saúde mental. Acomete 0,2 a 20% dos pais, possui instrumentos validados e adequados para mensuração e, se não tratado, pode acarretar consequências na vida conjugal, relações de trabalho, negligência e violência contra a criança. Conclusões: trata-se de temática recente que necessita ser explorada, pelo possível impacto na saúde de crianças e famílias e nos processos de trabalho dos pais. Protocolo registrado no Open Science Framework (https://osf.io/jd7vk).

Pregnant patient with prune belly syndrome: case report

ABSTRACT Prune belly syndrome is a rare congenital disease of unknown etiology that is present in one in every 40 thousand live births, and predominantly affects males, at a ratio of 4:1. In males, it presents with anomalies in the urinary system, absence of abdominal muscles, bilateral cryptorchidism, and infertility. In women, the syndrome has variable presentations, but fertility is preserved. Searching the medical literature, we found only one case of prune belly syndrome in pregnant women. Therefore, the patient in this report is the second case. She was primiparous, 25-years-old, with no abdominal muscles, severe congenital kyphoscoliosis, and pulmonary restriction. Elective cesarean section was performed at 37 weeks of gestation due to maternal risk of uterine rupture by transverse presentation and fetal risk of intrauterine growth restriction. The pre-anesthetic approach defined that general anesthesia might have more risks for the patient due to severe maternal lung disease compared to ultrasound-guided locoregional anesthesia. During prenatal care, there were some maternal complications, such as asthma exacerbations, abdominal pain, and constipation. The newborn was born small for gestational age and this can possibly be explained by maternal restrictive lung capacity. The newborn presented with Apgar score 8/9 and tachypnea, but improved after two hours of life.