Temporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected. Objective: To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD. Material and Methods: The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events. Results: After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm², while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo. Conclusion: Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol for pain relief in patients with TMD.

O Centro de Atenção Psicossocial (CAPS) é um serviço de saúde mental de base comunitária no Brasil, que visa promover a reabilitação psicossocial dos pacientes. O presente estudo descreve a avaliação do uso de medicamentos em um service de saúde mental primário no Nordeste do Brasil. Ambiente: CAPS «Valter Correia», São Cristovão, Sergipe, Brasil. Métodos: Estudo transversal foi realizado entre agosto de 2009 e maio de 2010. Inicialmente, os registros médicos foram revisados e avaliados. Em seguida, foram realizadas entrevistas com os pacientes (e/ou seus cuidadores) atendidos no CAPS. Informações foram obtidas sobre as características demográficas e clínicas, diagnósticos e medicamentos prescritos. Todos os pacientes cadastrados no CAPS foram incluídos no estudo. Os resultados foram analisados estatisticamente utilizando o programa EpiInfo e foram comparados com os resultados da literatura. Resultados: O CAPS "Valter Correia" é composto por 101 pacientes cadastrados, a maioria do sexo masculino (58,4%), analfabetos (51,5%), sem renda mensal (49,5%) e a média de idade deles era de 42,2 anos (DP = 12,0). A esquizofrenia foi o transtorno mental mais freqüente (31,5%). O número médio de medicamentos por pacientes foi de 3,11 (DP = 1,41), e o grupo de pacientes mais velhos (75-80 anos) apresentou o maior consumo de medicamentos (5,50 medicamentos/paciente). A classe de medicamentos psiquiátricos mais prescrita foi a dos antipsicóticos (44,8%). A classe dos inibidores da enzima conversora da angiotensina foi a mais prevalente classe não-psiquiátrica (15,8%). Foram detectadas 133 interações medicamentosas fármaco-fármaco (3,0% de severidade leve, 54,1% moderada, 29,3% grave e 13,5% contra-indicada). Conclusão: Os resultados demonstram a necessidade de acompanhamento da farmacoterapia de pacientes com transtornos mentais para incentivar o uso racional de medicamentos.

The Psychosocial Care Center (CAPS) is a community-based mental health service in Brazil, which aims to promote the psychosocial rehabilitation of patients. Accordingly, this study describes the drug use evaluation in a primary mental health service in Northeast of Brazil. Setting: CAPS ‘Valter Correia’, São Cristovão, Sergipe, Brazil. Methods: A cross-sectional study was conducted between August 2009 and May 2010. Initially, Medical records were reviewed and evaluated. Then, we applied interviews with the patients (and/or their informal/family caregivers) attended at the CAPS. Informations were obtained regarding to demographic and clinical features, diagnoses and drugs prescribed. All patients registered in the CAPS were included in the study. The results were statistically analyzed using the EpiInfo and were compared with results from literature. Results: The CAPS ‘Valter Correia’ consists of 101 registered patients, the majority were male (58.4%), illiterate (51.5%), without monthly income (49.5%) and the average age of them 42.2 years (SD = 12.0). Schizophrenia was the most frequent mental disorder (31.5%). The average number of medications by patients was 3.11 (SD = 1.41), and the older group of patients (75-80 years) presented the largest consumption of medications (5.50 drugs/patient). The psychiatric drug class most frequently prescribed was antipsychotics (44.8%). Angiotensin-converting enzyme inhibitors were the most prevalent non-psychiatric therapeutic class (15.8%). It was detected 133 drug-drug interactions (3.0% mild, 54.1% moderate, 29.3% severe and 13.5% contraindicated). Conclusion: The results revealed the need for monitoring the pharmacotherapy of patients with mental disorders to encourage the rational use of medications.

No tratamento de desordens mentais, a não-adesão ao tratamento ocorre em cerca de 50% dos casos e é responsável por inúmeros prejuízos, além de ser a principal causa de morbidade psiquiátrica. O presente estudo objetivou avaliar a adesão ao tratamento medicamentoso de pacientes atendidos em um Centro de Atenção Psicossocial (CAPS) no Nordeste do Brasil. A avaliação da adesão ao tratamento foi feita através dos testes de Haynes-Sackett e Morisky-Green-Levine. Todos os pacientes cadastrados no CAPS foram incluídos no estudo (n = 101). Observou-se que apenas 11,88% dos pacientes aderiram ao tratamento medicamentoso. As principais razões para o não uso dos medicamentos foram: esquecimento (68,83%), sentir-se mal após a ingestão de medicamentos (54,22%), não ter dinheiro para comprar medicamentos (43,83%), não encontrar os medicamentos no serviço público de saúde (39,94%) e medo dos danos causados pelos medicamentos (28,90%). Além disso, observou-se que 85,1% dos pacientes não conheciam suas doenças, 88,1% não conheciam seus tratamentos, 86,4% não se sentiam bem quando usavam medicamentos e 88,1% usavam os medicamentos incorretamente. Os resultados demonstram que a falta de informação sobre doenças e medicamentos, os danos decorrentes da terapia medicamentosa e o baixo acesso aos medicamentos comprometem a adesão ao tratamento e, consequentemente, a eficácia do tratamento.

In the treatment of mental disorders, nonadherence to medication, the main cause of psychiatric morbidity, is observed in about 50% of the cases and is responsible for numerous losses. This study evaluated adherence to drug treatment by patients seen in a Psychosocial Care Center (CAPS) in northeastern Brazil. Adherence to treatment was evaluated using the Haynes-Sackett and Morisky-Green-Levine tests. All patients registered in the CAPS were included in the study (n= 101). Only 11.88% of the patients adhered to drug treatment. The main reasons not to use medication were: oblivion (68.83%), feeling unwell after taking the medication (54.22%), not having money to buy the medication (43.83%), not finding the medication in the public health service (39.94%) and fear of harm that might be caused by the drug (28.90%). Furthermore, 85.1% of the patients did not know their diseases, 88.1% did not know their treatment, 86.4% did not feel good when they took their medication, and 88.1% took their medication incorrectly. The results revealed that the lack of information about diseases and drugs used, the nuisance posed by drug therapy and the low access to medications reduce adherence to treatment and, consequently, treatment effectiveness.