Temporomandibular Disorders Treatments and Its Effects on Headaches: Systematic Review and Meta-analysis of Randomized Controlled Trials / Tratamentos das Disfunções Temporomandibulares e seus Efeitos nas Cefaleias: Revisão Sistemática e Metanálise de Ensaios Controlados Randomizados

Objective: temporomandibular Disorders (TMD) are the most common causes of chronic orofacial pain and, along with primary headaches, are considered Chronic Overlapping Pain Conditions (COPCs). The aim of this study is to evaluate TMD treatment effects in individuals with comorbid headaches. Methods: a systematic review was conducted over a search in the database up to October 2020. Selected studies were randomized clinical trials with individuals diagnosed with TMD and comorbid headaches compared to a control group after treatments for TMD. All included studies were evaluated for their methodological quality through the Cochrane Collaboration tool for assessing the risk of bias. Results: seven studies fulfilled the inclusion criteria and were applied in the review, with a total of 432 participants. Four studies were included in a meta-analysis. There was no significative mean difference in the frequency of headache after TMD treatment, nor for a reduction in pain, after TMD intervention for less than 12 weeks. Although for an individual with a TMD intervention period higher than 12 weeks, there was a significant reduction in pain. Conclusion: there is moderate evidence that painful TMD therapies for 12 weeks or higher reduce headache intensity in individuals with painful TMD and headaches. Simultaneous management of TMD and headache must be prioritized for more effective results on both conditions.

Objetivo: as Disfunções Temporomandibulares (DTM) são as causas mais comuns de dor orofacial crônica e, junto com as cefaleias primárias, são consideradas Condições de Dor Sobrepostas Crônicas (CPOCs). O objetivo deste estudo é avaliar os efeitos do tratamento das DTMs em indivíduos com cefaleia comórbida. Métodos: foi realizada uma revisão sistemática por meio de uma busca em banco de dados até outubro de 2020. Os estudos selecionados foram ensaios clínicos randomizados com indivíduos diagnosticados com DTM e cefaleia comórbida em comparação com um grupo controle após tratamentos para DTM. Todos os estudos incluídos foram avaliados quanto à sua qualidade metodológica por meio da ferramenta Cochrane Collaboration para avaliar o risco de viés. Resultados: sete estudos preencheram os critérios de inclusão e foram incluídos na revisão, totalizando 432 participantes. Quatro estudos foram incluídos em uma meta-análise. Não houve diferença média significativa na frequência de cefaleia após tratamento para DTM, nem para redução da dor, após intervenção para DTM por menos de 12 semanas. Para indivíduos com DTM, o tempo de intervenção maior que 12 semanas resultou em uma redução significativa da dor. Conclusão: há evidências moderadas de que terapias para DTM dolorosa por períodos de 12 semanas ou mais reduzem a intensidade da cefaleia em indivíduos com DTM dolorosa e cefaleia. O manejo simultâneo de DTM e cefaleia deve ser priorizado para resultados mais efetivos em ambas as condições.

LEVELS OF SALIVARY CORTISOL IN ADULTS AND CHILDREN WITH BRUXISM DIAGNOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: To evaluate the levels of salivary cortisol in adults and children diagnosed with bruxism. METHODS: A search strategy was developed using the following terms: "cortisol", "bruxism" and "sleep bruxism". These were searched in databases: Medline, Embase, Scopus, Cochrane, Web of Science, LILACS and gray literature, for studies published until May 2020. RESULTS: We obtained a total of six primary studies, involving 854 participants, who met the criteria and were included in the present study. The analysis cortisol levels shows a significant difference favourable to the control group 1.10 (95% CI: 0.68-1.53), showing that patients with bruxism have higher values of salivary cortisol. Heterogeneity of I²â€¯= 4% (P = .31). CONCLUSIONS: It was concluded that despite the different methodologies adopted for the collection and analysis of salivary content, this review found significant results of higher levels of salivary cortisol in adult patients with bruxism.

Corticosteroids in Pregnancy for Preventing RDS: Overview of Systematic Reviews.

The objective of this study was to analyze the available evidence of systematic reviews that evaluated the efficacy of antenatal corticosteroids in order to contribute to a reduction in magnitude and transcendence of respiratory distress syndrome of the newborn (RDS). Thus, an overview was conducted including all systematic reviews of randomized controlled trials (RCTs) that evaluated women who received corticosteroid treatment during pregnancy to prevent RDS. Therefore, a search strategy was developed using the terms "respiratory distress syndrome, newborn," "corticosteroids," "perinatal death," "neonatal death," "neonate," and "pregnancy." The electronic databases searched were MEDLINE, EMBASE, Cochrane Library, LILACS, and Google Scholar, for studies published until June 2020. We identified 354 references, 38 of which were relevant after the initial screening. Ten systematic reviews met the inclusion criteria. For RDS, 1522 cases occurred in the control group composed of 8716 participants, while in the intervention group was 1088 in 8740 participants (RR = 0.67, 95% CI 0.60-0.75). For neonatal death, 343 cases occurred in 5248 participants of the control group, while in the intervention group, there were 227 cases in 5246 participants (RR = 0.66, 95% CI 0.56-0.78). For perinatal death, there were 344 cases in 3345 participants in the control group, while in the intervention group, the number of cases was 264 in 3384 participants (RR = 0.72, 95% CI 0.58-0.89). Thus, the use of corticosteroids during pregnancy in women at risk of preterm birth is effective for the prevention of RDS in neonates and reducing the number of neonatal and perinatal deaths in preterm. PROSPERO protocol no: CRD42017074604.

Perception of body self-image in adolescents with psychiatric disorders: Systematic Review / Percepção da autoimagem corporal em adolescentes com transtornos psiquiátricos: Revisão Sistemática

Objective: To map the evidence on the presence of dissatisfaction with body perception among adolescents with psychiatric disorders. Databases: systematic review using the databases MEDLINE, EMBASE, Cochrane Library, Web of Science, IBECS, LILACS and gray literature (Google Scholar) using the following keywords: "Mental Disorders", "BodyImage", "BodyDysmorphicDisorders" , and "Adolescent" and its synonyms consulted in Medical SubjectHeadings (MeSH). Data synthesis: Ten studies published between 1995 and 2015 were included in this review, including the countries: Spain, Portugal, Italy, Canada, United States and Germany. All studies had a cross-sectional design and the psychiatric disorders evaluated were Attention Deficit Hyperactivity Disorder, Depressive Disorder and Eating Disorders. The ten studies included in this review show significant results for the presence of Image Disorder, greater body dissatisfaction and changes in the perception of body self-image associated with the presence of psychiatric disorders in adolescents. Conclusion: The results of this study indicate that adolescents with psychiatric disorders have a higher frequency of Image Disorder, body dissatisfaction and changes in the perception of body self-image

Objetivo: Mapear as evidências sobre a presença de insatisfação com a percepção corporal entre adolescentes com transtornos psiquiátricos. Bases de dados: revisão sistemática utilizando as bases de dados MEDLINE, EMBASE, Cochrane Library, Web of Science, IBECS, LILACS e literatura cinza (Google Acadêmico) utilizando as seguintes palavras chaves: "Mental Disorders", "BodyImage", "BodyDysmorphicDisorders", e "Adolescent" e seus sinônimos consultadas no Medical SubjectHeadings (MeSH). Síntese de dados: Foram incluídos nesta revisão dez estudos publicados entre os anos de 1995 a 2015, incluindo os países: Espanha, Portugal, Itália, Canadá, Estados Unidos e Alemanha. Todos os estudos tiveram delineamento do tipo transversal e os transtornos psiquiátricos avaliados foram Transtorno de Déficit de Atenção e Hiperatividade, Transtorno Depressivo e Transtornos Alimentares. Os dez estudos incluídos nesta revisão apresentam resultados significativos para presença de Distúrbio de Imagem, maior insatisfação corporal e alterações na percepção da autoimagem corporal associados à presença de transtornos psiquiátricos em adolescentes. Conclusão: Os resultados deste trabalho indicam que adolescentes com transtornos psiquiátricos apresentam maior frequência de Distúrbio de Imagem, insatisfação corporal e alterações na percepção da autoimagem corporal.