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1.
Int J Dent Hyg ; 2023 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-37122131

RESUMO

OBJECTIVE: This case-control study evaluated the association of sociodemographic profile, mental health disorders and oral health-related quality of life (OHRQoL) with periodontitis. METHODS: Patients with periodontitis (PP, n = 50) and control patients (CP, n = 50) were allocated into 2 groups after a complete periodontal examination. Data collection included age, sex, marital status, education and application of 2 questionnaires: Hospital Anxiety and Depression Scale for the diagnosis of anxiety/depression and Impact Profile on Oral Health (OHIP-14) for classification of well-being. An adjusted multiple binary logistic regression analysis was performed to assess the effect of all studied covariates on periodontitis. RESULTS: The results show that mean clinical attachment loss and periodontal probing depth were 5.92 (SD = 0.42) and 5.46 (SD = 0.78) in PP and 0.00 (SD = 0.00) and 2.85 (SD = 0.23) in CP, respectively (p < 0.001). The regression analysis demonstrated a significant effect on periodontitis for age (OR = 1.13; p < 0.0001; 95% CI: 1.07-1.20), with the PP having more people aged 50 years or older than CP, anxiety (OR = 1.25; p = 0.020; 95% CI: 1.04-1.50) and OHIP-14 (OR = 1.17; p < 0.0001; 95% CI: 1.08-1.226). CONCLUSIONS: The findings showed a positive association between anxiety, OHRQoL and age with periodontitis.

2.
Int. j. high dilution res ; 21(1): 10-10, May 6, 2022.
Artigo em Inglês | LILACS, HomeoIndex - Homeopatia | ID: biblio-1396585

RESUMO

Periodontitis and Diabetes Mellitus type 2 (DMII) are chronic diseases treated by conventional practices and traditional medicine. In many cases, when conventional medicine cannot offer a satisfactory treatment, increases the demand for alternative therapies in chronic conditions. The aim of this study randomized was to compare and evaluate for one year clinical and serologic parameters the effects of homeopathy as an adjunct of conventional periodontal therapy in individual with periodontitis and DMII. Materials and Methods:85 individuals, of both genders, between 35 and 70 years old, participated in this randomized study, which 70 were eligible in Institute of Endocrinology and Diabetes of Rio de Janeiro-Brazil. They were divided into two groups G-1: individuals with periodontitis without systemic conditions and G-2: individuals with periodontitis and DMII. Both groups received homeopathic treatment and were evaluated in clinical and laboratorial examinations. The medication used was chosen based on the similarity principle, following the Berberis 6CH protocol (2 tablets, 2 times a day for 45 days), Mercurius Solubilis / Belladona / Hepar Sulfur-6CH (2 tablets, 3 times a day for 15 days) and a Pyrogenium 200CH biotherapeutic (single weekly dose, 2 weeks). Medications are prescribed in diluted low concentration doses for all signs and symptoms, while biotherapy is used for chronic stimulation Results:Both groups showed significant improvements throughout the study,clinical and laboratorial, at 1 year baseline: reductions in total cholesterol, triglycerides, glucose, glycated hemoglobin, uric acid and CPR. Statistical and descriptive analyzes were performed. The data obtained after laboratory analysis were tabulated and then submitted to the SPSS 17.0 software for Windows (SPSS Inc., Chicago, IL) and significance level with p <0.05. For most of parameters, G-1 performed better than G-2 (p<0.05).Conclusion:After 1 year follow-up this clinical trial suggest that homeopathy therapy, as an adjunct of periondontal treatment, improves local and systemic parameters and can provide better health condition.


Assuntos
Periodontite/terapia , Homeopatia , Diabetes Mellitus
3.
Altern Ther Health Med ; 28(1): 100-106, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34197339

RESUMO

CONTEXT AND OBJECTIVE: Periodontitis and type 2 diabetes (T2D) are chronic diseases generally treated with conventional therapies alone. The aim of this study was to compare the effects of homeopathy as an adjunct to conventional periodontal therapy in individuals with periodontitis and T2D. DESIGN: 85 individuals, age between 35 and 70 years, of both genders, participated in this randomized study; 70 patients were from the Institute of Endocrinology and Diabetes of Rio de Janeiro, Brazil. They were divided into 2 groups: G1, individuals with periodontitis without systemic conditions; and G-2, individuals with periodontitis and T2D. Both groups received homeopathic treatment and were evaluated in clinical and laboratory examinations. The medication used was chosen based on the similarity principle: Berberis 6CH, Mercurius Solubilis/Belladona /Hepar Sulfur and a Pyrogenium 200CH biotherapic. Medications were prescribed in diluted low ultra-diluted concentration doses for all signs and symptoms, while biotherapics were used for chronic stimulation. SETTING: The study was performed in Brazil by university research professors of homeopathy and periodontics. RESULTS: Both groups showed significant clinical and laboratory improvements during the study from baseline to 1 year with reductions in total cholesterol (total-C), triglycerides, glucose, glycated hemoglobin (A1cHb), uric acid and C-reactive protein (CRP). Statistical and descriptive analyses were performed. For most parameters, G1 performed better than G2 (P < .05). CONCLUSION: Homeopathy as an adjunct to periodontal treatment improves local and systemic clinics and can provide better health conditions for patients with or without T2D.


Assuntos
Periodontite Crônica , Diabetes Mellitus Tipo 2 , Homeopatia , Adulto , Idoso , Brasil , Periodontite Crônica/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Masculino , Compostos de Mercúrio , Pessoa de Meia-Idade
4.
Complement Ther Clin Pract ; 45: 101482, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34530182

RESUMO

INTRODUCTION: According to the World Health Organization, the coronavirus disease 2019 (COVID-19) has 48.896.564 reported cases and 1.236.995 deaths worldwide on November 5, 2020. Despite great efforts, there is no treatment of COVID-19 up to nowadays. Therefore, it is essential to search for therapeutic alternatives to COVID-19, such as Integrative Medicine, especially Homeopathy, which was used with excellent results in the great epidemics. AIM: This study aims to describe the coronavirus Pandemic from the perspective of Classical Systemic Homeopathy and to identify the homeopathic medicine (medicines genius) that has its sphere of action in most of the symptoms involved in this pandemic. METHODS: Articles published in indexed journals and websites of medical institutions, books of homeopathic materia medica, scientific journals, and government publications were reviewed. RESULTS: A total of 39 references were selected and enclosed 20 articles indexed on COVID-19, 08 references of systemic conditions, 11 articles indexed of homeopathy, 06 classic homeopathy books. After the study, the homeopathic medicine Cinchona officinalis (China officinalis) was proposed, according to pathogenesis (experimental pathophysiological study in humans) described in the materia medica books consulted, for the relief of symptoms. Its sphere of action in most of the symptoms involved in this pandemic. Moreover, acute homeopathic medicines were determined to act in the relief of symptoms of the various phases of the manifestations of the disease. CONCLUSION: Data contributes to use in homeopathic interventions during the COVID-19 epidemic as a health promotion and treatment strategy that can be used as an adjunct to all sanitary and therapeutic measures recommended by health authorities.


Assuntos
COVID-19 , Homeopatia , Materia Medica , Humanos , Materia Medica/uso terapêutico , Pandemias , SARS-CoV-2
6.
Altern Ther Health Med ; 26(S2): 112-116, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33245703

RESUMO

CONTEXT: SARS-CoV-2 is a new virus responsible for the outbreak of COVID-19. Studies have shown that the expression of ACE2 was found in the smaller salivary glands was higher than that in the lungs, suggesting that salivary glands may be a potential target of the virus. This may indicate that one of the main gateways to coronavirus infection is the oral cavity. OBJECTIVE: This review intended to evaluate the comorbidities of the oral cavity and their relationships to COVID-19 and to show the benefits of homeopathic therapies as adjuvant treatments to increase oral and general health and mitigate the devastating effects of the coronavirus. DESIGN: The authors conducted a narrative review of articles published in indexed journals and websites of dental institutions and the WHO. They were selected oral pathological manifestations, sleep disorders, mood, orofacial pain and bruxism, associated with the oral-facial manifestations of Covid-19 and articles of evidence of homeopathy in dentistry. SETTING: Study done in Brazil with research professors in Homeopathy and Periodontics in universities. RESULTS: Some studies report that patients who are more susceptible to anxiety and stress during the pandemic, due to social confinement, may have disorders in the stomatognathic system such as: neuralgic pain in the face and teeth, fractures of teeth and dental prostheses, nibbled mucosa, stomatitis, ulcers, pain in the Temporal Mandibular Joint, otalgias, dental tightening, bruxism, xerostomia, peeling of the mucous membranes and skin, facial paralysis. CONCLUSIONS: The researchers concluded that homeopathy is a safe and viable therapy for the control of COVID-19 symptoms, as scientific evidence has proven its benefits through clinical trials and use in previous epidemics. In dentistry, this therapy allows the dentist to act fully in the promotion of oral health and in the prevention of oral and systemic diseases.


Assuntos
Infecções por Coronavirus , Homeopatia , Saúde Bucal , Pandemias , Pneumonia Viral , Betacoronavirus , Brasil , COVID-19 , Humanos , SARS-CoV-2 , Sistema Estomatognático
7.
Braz Dent J ; 30(2): 139-145, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970056

RESUMO

Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.


Assuntos
Periodontite Crônica , Diabetes Mellitus Tipo 2 , Homeopatia , Adulto , Idoso , Raspagem Dentária , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal
8.
Braz. dent. j ; 30(2): 139-145, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1001440

RESUMO

Abstract Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.


Resumo Periodontite crônica (CP) e Diabetes mellitus tipo 2 (DMII) são doenças crônicas normalmente tratadas por práticas convencionais. Por outro lado, a homeopatia pode colaborar no tratamento de diferentes doenças. O objetivo do presente estudo foi avaliar os efeito da homeopatia como adjunto a terapia periodontal não cirúrgica (NSPT) em indivíduos com CP e DMII. Oitenta indivíduos com CP e DMII de ambos os sexos com idade entre 32 e 70 anos, participaram desse estudo clínico randomizado, placebo controlado, duplo cego. Os pacientes foram divididos em 2 grupos: grupo controle (CG) e grupo teste (TG), e ambos receberam NSPT. TG também recebeu terapia homeopática, incluindo Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, enquanto o CG recebeu placebo. Exames clínicos e laboratoriais foram avaliados no baseline e 1, 6 e 12 meses após o tratamento. Ambos grupos mostraram melhoras significantes através do estudo para a maioria dos parâmetros avaliados. TG apresentou um ganho significativo nos níveis clínicos de inserção aos 1 e 12 meses, quando comparado ao grupo controle. Valores médios de glicemia e hemoglobina glicada reduziram significativamente em ambos grupos aos 6 e 12 meses. Entretanto, houve uma redução adicional desses parâmetros no TG, quando comparado ao CG. Concluindo, homeopatia como suplemento a NSPT pode promover as condições de saúde, incluindo o controle glicêmico, em pacientes com DMII e CP.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus Tipo 2 , Periodontite Crônica , Homeopatia , Índice Periodontal , Método Duplo-Cego , Raspagem Dentária
9.
Full dent. sci ; 11(41): 135-143, 2019. tab, ilus
Artigo em Português | BBO - Odontologia | ID: biblio-1052067

RESUMO

O bruxismo é descrito como uma parafunção orofacial que afeta crianças e adultos caracterizado pelo hábito de ranger ou apertar os dentes, com etiologia complexa, multifatorial, assim como seu diagnóstico e controle. Pode ser considerado cêntrico, quando o hábito de apertar os dentes ocorre de ação semi-inconsciente, denominado diurno ou vigília (BV) e, excêntrico, quando ocorre ranger dos dentes de ação inconsciente, denominado noturno ou do sono (BS). A homeopatia (H) visa restabelecer o equilíbrio da energia vital do paciente permitindo o movimento de cura do organismo. O objetivo desta pesquisa foi avaliar a eficácia dos medicamentos homeopáticos (Matricaria chamomilla e Cimex lectularius), concomitante com a terapêutica convencional para que se tenha uma alternativa no controle do bruxismo. A amostra abordou 60 pacientes com diferentes antecedentes sociais, de ambos os gêneros, com idade de 18 a 60 anos, os quais responderam a questionários específicos e passaram por exames clínicos orais com resposta positiva para o bruxismo. Foram divididos aleatoriamente em Grupo Teste (GT) com 30 indivíduos tratados com placas interoclusais de acrílico associadas com medicamentos homeopáticos e Grupo Controle (GC) com 30 indivíduos utilizando placas interoclusais mais placebo (medicamentos homeopáticos sem o princípio ativo) por um período total de 6 meses, avaliados mensalmente para a verificação da diminuição dos sinais e sintomas do bruxismo. O resultado final concluiu a eficácia da terapêutica homeopática como coadjuvante ao tratamento convencional com as placas interoclusais, amenizando os transtornos de dor e desgastes dentários provocados pelo bruxismo (AU).


Bruxism is described as an orofacial parafunction that affects children and adults characterized by the habit of grinding or clench the teeth, with complex and multifactorial etiology, as well as its diagnosis and control. Can be considered centric when the habit of squeezing the teeth occurs semi-conscious and action is called day or vigil (BV) and, eccentric, when there is the gnashing of teeth and unconscious action is called nightcrawler night or sleep (BS). The homeopathy (H) aims to restore the balance of the vital energy of the patient allowing the motion of the body's healing. The objective of this research was to evaluate the efficacy of homeopathic medicines (Cimex lectularius and Matricaria chamomilla), concomitant with the conventional therapy for an alternative in the control of bruxism. The sample was constituted of 60 patients with different social backgrounds, both genders aged from 18 to 60 years old, who answered to questionnaires and passed through oral clinical examination with positive response to bruxism. They were divided into Test Group (GT) with 30 subjects treated with interoclusais acrylic plates associated with homeopathic medicines and the Control Group (GC) with 30 individuals using interoclusais plates more placebo (homeopathic medicines without the active) for a total period of 6 months, evaluated monthly for checking the reduction of signs and symptoms of bruxism. The final result was concluded the effectiveness of homeopathic therapy as an adjunct to conventional treatment with interoclusais board, easing pain disorders and dental damage caused by bruxism (AU).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Estresse Psicológico , Bruxismo , Desgaste dos Dentes , Homeopatia , Dor , Qualidade de Vida , Brasil , Inquéritos e Questionários
10.
J Indian Soc Periodontol ; 20(6): 623-626, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-29238143

RESUMO

BACKGROUND: The purpose of the study is to examine the quality of life (QoL) in chronic periodontitis (CP) patients associated with or not with well-controlled type 2 diabetes mellitus (DM2). MATERIALS AND METHODS: Five hundred CP patients, 250 with DM2 (GDM2 group) and 250 age- and gender-matched controls without DM2 (GND), were enrolled in this cross-sectional case-controlled study from January to September 2015. They were interviewed by a QoL questionnaire (Functional Assessment of Chronic Illness Therapy-Fatigue) validated to Portuguese. Periodontal examinations were also performed to confirm CP: probing pocket depth and clinical attachment level must be >3 mm. RESULTS: An association between the presence of DM2 and a high negative impact on QoL was observed. All domains in GDM2 patients presented mean values above 19. On the other hand, three functional domains in GND (physical, social/family, and emotional) showed values below 19 (medium negative impact). Comparisons between GND and GDM2 revealed the statistical difference between them for all domains (P < 0.05). CONCLUSIONS: This study shows that DM2 associated with CP negatively affect QoL, even considering well-controlled diabetic patients.

11.
J Indian Soc Periodontol ; 19(2): 155-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26015664

RESUMO

CONTEXT: Despite the recognition that systemic factors can alter the risk to the chronic periodontitis (CP), only recently has evidence begun to emerge, still under investigation, that infections of the oral cavity are related with low quality-of-life (QoL) and are able to influence the occurrence and severity of certain conditions and systemic diseases. AIMS: The aim of this study was to evaluate the impact of CP on the QoL and on the metabolic systemic condition of CP patients. SETTINGS AND DESIGNS: Cross-sectional, case-controlled, age- and gender-matched study. SUBJECTS AND METHODS: Quality-of-life assessment (Functional Assessment of Chronic Illness Therapy-Fatigue), periodontal examinations and blood tests were obtained from 20 CP patients and 20 age- and gender-matched healthy controls (HC). STATISTICAL ANALYSIS USED: parametric paired t-test for numerical data (metabolic parameters) and nonparametric paired Wilcoxon signed rank test to compare the QoL ordinal data of both groups. Statistical significance was determined at the 0.05 level. RESULTS: Healthy controls had fewer negative impacts in all QoL areas studied. CP patients showed higher levels of low-density lipoprotein cholesterol, glucose, and uric acid compared with the HC. CONCLUSIONS: Chronic periodontitis negatively affected the overall well-being and systemic condition of a group of Brazilian individuals.

12.
Rio de janeiro; s.n; 2015. 60 p. ilus.
Tese em Português | LILACS, BBO - Odontologia | ID: biblio-1009980

RESUMO

Introdução e objetivo: a periodontite crônica (PC) é uma doença inflamatória crônica resultante do rompimento da homeostase entre microbiota subgengival e as defesas do hospedeiro. Como a homeopatia (H) visa restabelecer o equilíbrio da energia vital do paciente permitindo o movimento de cura do organismo. O objetivo do presente estudo foi avaliar os efeitos longitudinais (um ano) da terapia homeopática como coadjuvante no tratamento da periodontite crônica generalizada (PC) em pacientes diabéticos tipo II, sobre os parâmetros clínicos e laboratoriais, e seu impacto na qualidade de vida do paciente. Materiais e métodos: Oitenta pacientes com PC e DM II, de ambos os sexos e com idades entre 32 e 70 anos de idade, participaram desse ensaio clínico randomizado, duplo-cego, placebo-controlado. Os pacientes foram divididos em dois grupos: grupo controle (GC) e o Grupo teste (GT). Ambos os grupos receberam a Terapia periodontal básica (TPB). G-T recebeu adicionalmente a Terapia homeopática (TH): Berberis, Mercurius solubilis/ Belladona/ Hepar sulphur e Pyrogenium, enquanto GC recebeu placebo. As avaliações foram feitas no baseline e após 30 dias, 6 e 12 meses de tratamento. As respostas locais e sistêmicas foram avaliadas por parâmetros clínicos e laboratoriais respectivamente. Também, foi utilizado um questionário de qualidade de vida, Oral Health Impact Profile-14 (OHIP-14). Os dados foram analisados pelos testes paramétricos e não paramétricos. O nível de significância foi de 5%. Resultados: A avaliação intragrupos mostrou melhoras significativas em ambos os grupos, ao longo do estudo, para os parâmetros clínicos periodontais estudados. Na análise laboratorial, G-T mostrou níveis estatisticamente menores de LDL, Colesterol Total, Glicemia, Hemoglobina glicada e ácido úrico após 1ano de acompanhamento. Em relação ao impacto na qualidade de vida, G-T apresentou valores significativamente menores nos domínios limitação funcional, aos seis meses e dor física, aos seis meses. Conclusão: ambos os grupos apresentaram melhoras clínicas periodontais significativas durante o acompanhamento de um ano, No entanto, os resultados sugerem que os medicamentos homeopáticos, como coadjuvante para TPB, podem proporcionar melhoras em parâmetros laboratoriais e qualidade de vida para o tratamento convencional da PC.


Introduction and objective: the chronic periodontitis (CP) is a chronic inflammatory disease that results from the disruption of homeostasis between Subgingival microbiota and host defenses. As Homeopathy (H) aims to restore the balance of the vital energy of the patient allowing the healing movement of the body, the aim of this study was to evaluate the effects of H as a supporting role for basic periodontal therapy (BTP) in individuals with Diabetes mellitus type 2 (DMII).Materials and methods: After the calculation of sample size, 80 individuals with CP and DM II, of both sexes and aged between 32 and 70 years of age, participated in this randomized, double-blind, placebo-controlled. The patients were divided into two groups: control group (GC) and the test group (GT) both groups received the TPB. G-T received Additionally the homeopathic Therapy (TH): Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while GC received placebo. The evaluations were made at baseline and after 30 days, six and 12 months of treatment. The local and systemic responses were evaluated by clinical and laboratory parameters respectively. Also, it was used a questionnaire of quality of life, Oral Health Impact Profile-14 (OHIP-14). Data were analyzed by parametric and nonparametric tests. The significance level was 5%. Results: Intra-group evaluation showed significant improvement in both groups, throughout the study, for most of the parameters studied. G-T and G-C, in three evaluation periods (1, 6 and 12 months), most biofilm (BTI) and lower values of PBS were verified in G-C above the G-T, although similar levels of bleeding have been observed in the same periods; It was observed a value significantly lower NIC in G-T only to 30 days; in laboratory testing, G-T showed statistically lower levels of various parameters, namely: LDL, Total cholesterol and Glucose, glycated Hemoglobin and uric acid after 12 months. In relation to the impact on quality of life, G-T presented significantly lower values in functional domains and physical pain, to six months after BPT Conclusion: both groups showed significant improvement during the follow-up of one year However, the results of the present study suggest that homeopathy as supplement of BTP may improve some laboratory parameters and the quality of life of PC.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Farmacodinâmica do Medicamento Homeopático , Periodontite Crônica/terapia , Tratamento Conservador , Ensaio Clínico Controlado Aleatório , Perfil de Impacto da Doença
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