SUMMARY OBJECTIVE: The aim of this study was to identify the frequency of Cochrane systematic reviews and Cochrane systematic reviews protocols using (or planning to use) the risk of bias 2.0 tool to assess the risk of bias of the included randomized clinical trials. STUDY DESIGN: This is a meta-research study. METHODS: We included Cochrane systematic reviews or Cochrane systematic reviews protocols that planned to include randomized clinical trials. We assessed the Cochrane Database of Systematic Reviews and screened for issues published after the launch of risk of bias 2.0 tool (2019–2022). Two independent investigators performed the study selection and data extraction. RESULTS: We analyzed 440 Cochrane systematic reviews and 536 Cochrane systematic reviews protocols. Overall, 4.8% of the Cochrane systematic reviews and 28.5% of the Cochrane systematic reviews protocols used or planned to use risk of bias 2.0 tool. Although low, adherence is increasing over time. In 2019, 0% of Cochrane systematic reviews used risk of bias 2.0 tool, compared to 24.1% in 2022. In Cochrane systematic reviews protocols, adherence increased from 6.9% in 2019 to 41.5% in 2022. A total of 274 (62.1%) Cochrane systematic reviews had their protocols published before 2018; only one used risk of bias 2.0 tool and reported the change of versions in the “Differences between protocol and revision” section. CONCLUSION: The Cochrane's risk of bias 2.0 tool has low adherence among Cochrane protocols and systematic reviews. Further efforts are necessary to facilitate the implementation of this new tool.

RESUMO. Déficit de atenção e hiperatividade (TDAH) é uma das mais frequentes condições psiquiátricas da infância. Objetivo: O objetivo deste artigo foi identificar, sintetizar os resultados e avaliar criticamente todas as revisões sistemáticas (RS) da Cochrane sobre as intervenções farmacológicas para crianças e adolescentes (até 18 anos de idade) diagnosticados com transtorno do déficit de atenção com hiperatividade. Métodos: A pesquisa foi realizada na base de dados Cochrane de Revisões Sistemáticas — CDSR (via Wiley) em julho de 2020. Resultados: A estratégia de busca resultou em quatro RS de alta qualidade metodológica, que analisavam 51 ensaios clínicos randomizados (9.013 participantes). Comparado ao placebo, o tratamento com antidepressivos tricíclicos (desipramina), anfetamina e metilfenidato apresentou melhora nos sintomas, como dificuldade de concentração, impulsividade e hiperatividade no curto prazo (até seis meses). Houve aumento na ocorr≖ncia de eventos adversos, como redução do apetite, dificuldade para dormir e dor abdominal. Foram encontradas evid≖ncias insuficientes para apoiar os efeitos da suplementação com ácidos graxos poli-insaturados. Conclusões: Com base nos resultados de revisões sistemáticas Cochrane, o uso de antidepressivos tricíclicos, anfetamina e metilfenidato em crianças e adolescentes com TDAH parece apresentar efeitos positivos e taxas mais elevadas de eventos adversos menores quando comparado ao placebo. Dado o alto risco de viés nos estudos primários incluídos nessas RS, ainda são necessários novos ensaios clínicos randomizados com rigor metodológico para apoiar esses achados.

ABSTRACT. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent childhood psychiatric problems. Objective: The objective of this study was to identify, synthesize the results, and critically evaluate all Cochrane systematic reviews (SRs) on the pharmacological interventions for children and adolescents (up to age 18) diagnosed with ADHD. Methods: The search was performed in the Cochrane Database of Systematic Reviews (via Wiley) in July 2020. Results: The search strategy resulted in four SRs of high methodological quality, analyzing 51 randomized clinical trials (9,013 participants). Compared to placebo, treatment with tricyclic antidepressants (TCAs) (desipramine), amphetamine, and methylphenidate showed improvement in symptoms such as difficulty concentrating, impulsivity, and hyperactivity in the short term (up to 6 months). There was an increase in the occurrence of adverse events, such as reduced appetite, difficulty sleeping, and abdominal pain. Insufficient evidence was found to support the effects of supplementation with polyunsaturated fatty acids. Conclusions: The use of TCAs, amphetamine, and methylphenidate in children and adolescents with ADHD seems to present positive effects and higher rates of minor adverse events when compared to placebo.

ABSTRACT Objective: To provide an overview of the most relevant studies on non-pharmacological behaviour management techniques for contemporary children, the so-called alpha generation, who undergo dental treatment. Material and Methods: A systematic search was performed on the Medline/PubMed and Google Scholar (grey literature) databases. The articles were read and data collected by two reviewers on an independent basis. Two reviewers collected data from the studies selected in tables structured by using the Rayyan QCRI software. The following data were extracted: year of study, child's age, child's gender, technique used. Results: A total of 322 articles were found, remaining only 17 after duplicates were removed and inclusion and exclusion criteria applied. The studies were conducted between 2010 and 2019 in Saudi Arabia, Greece, India, Brazil, USA, Italy, and Switzerland. The samples ranged from 15 to 306 children aged between 3 and 10 years old. The children attended the dental office for different reasons, ranging from simple prevention to endodontic treatment under local anaesthesia. Several behaviour modification methods are known to be used before and during a dental consultation. Conclusion: After reading the articles, we concluded that alpha generation children are inserted in a daily environment of modernization and that conventional non-pharmacological techniques using technology, such as audio-visual glasses, are more interesting and make children distracted and relaxed during dental treatment, thus minimizing their stress, anxiety and fear.

OBJETIVO: verificar a ocorrência de mordida aberta anterior e de hábitos orais deletérios em crianças de quatro a seis anos de idade. MÉTODOS: foram avaliadas 266 crianças de quatro a seis anos incompletos, de ambos os gêneros, na cidade de Suzano - São Paulo. As avaliações constaram de aplicação de ficha de avaliação para detecção de ocorrência de hábitos bucais deletérios aos responsáveis e da realização de exame clínico constituído por avaliação da oclusão das crianças. RESULTADOS: verificou-se que 221 crianças (83,1%) apresentaram pelo menos um hábito bucal deletério, sendo o mais frequente o uso de mamadeira 167 (75,6%). A ocorrência simultânea de hábitos deletérios e alterações de oclusão dentária foi observada em 119 crianças (44,1% da amostra) e nestas, a maior prevalência foi a presença da mordida aberta anterior, presente em 89 (79,8%). CONCLUSÃO: a mordida aberta anterior (MAA) foi a alteração oclusal mais prevalente nas crianças, havendo associação estatisticamente significante entre hábitos orais deletérios, como uso de mamadeira, chupeta e ocorrência de bruxismo e presença de mordida aberta anterior.

PURPOSE: to determine the occurrence of anterior open bite and harmful oral habits in children from four to six-year old. METHODS: a total of 266 four-to-six-year-old male and female children in the city of Suzano (São Paulo, Brazil) were evaluated. An assessment chart for detecting the occurrence of harmful oral habits was administered to the guardians and clinical exams were performed for assessing occlusion in the children. RESULTS: a total of 221 children (83.1%) had at least one harmful oral habit, the most frequent of which was the use of a feeding bottle (n=167; 75.6%). The occurrence of simultaneous harmful habits and dental occlusion abnormalities was observed in 119 children (44.1% of the sample); among these children, the greatest prevalence was of anterior open bite (n=89; 79.8%). CONCLUSION: anterior open bite was the most prevalent occlusion alteration in the children and had a statistically significant association with harmful oral habits, such as the use of a bottle and/or pacifier and teeth grinding.

Uno de los principales objetivos en el manejo del paciente pediátrico con caries es la utilización de técnicas no invasivas, que permitan el tratamiento de la patología dentaria sin afectar el comportamiento del niño. El propósito de este estudio fue evaluar la reacción de niños y registrar su sensación mientras recibían tratamiento de caries dentinal utilizando elementos rotatorios de baja velocidad, en comparación al tratamiento químico mecánico de caries dentinal en dentición decidua. Participaron en el estudio 36 niños, entre 4 y 8 años de edad. Se utilizó un diseño de estudio al azar de sección cruzada de manera tal que cada niño sirviera como su propio control, recibiendo cada tratamiento en cada lado de la misma arcada. Cada paciente era asignado al azar para recibir el tratamiento con elementos rotatorios o tratamiento químico mecánico en la primera visita, administrándosele el restante en la segunda visita. Luego de su tratamiento, todos los dientes fueron obturados con ionómero de vidrio fotopolimerizable. Para la evaluación objetiva de la reacción de los niños se aplicó la Escala de Comportamiento ante el Dolor Modificada. Inmediatamente después de realizado el tratamiento, se solicitaba a los niños que llenaran el formulario que contenía la Escala Facial para Registro del Dolor de Wong-Baker (Facial Pain Scale) para la evaluación subjetiva. El tratamiento químico mecánico demostró ser un procedimiento mejor aceptado por los pacientes pediátricos que el tratamiento con elementos rotatorios de baja velocidad

One of the main objectives during the pedodontics assistance is the use of noninvasive techniques, that allow the treatment of the dental caries without affecting the behavior of the child. The aim of this study was to evaluate the reaction of children and to register its sensations during the treatment of dental caries in deciduous teeth, using low speed cutting rotatory instruments in comparison to the chemical and mechanical caries removal treatment. 36 children participated in the study, between 4 and 8 years of age. A cross section study design was used and each child served like his own control, receiving the two treatment in teeth of the same arches. Each patient one was selected randomly to receive the treatment with rotatory instruments or the chemical and mechanical treatment in the first visit, administered him to it the rest treatment in the second visit. After their treatment, all the teeth were restorated with light-curing glass ionomer. For the objective evaluation of the reaction of the children the Behavior Scale in the Modified Pain was applied. Immediately after the treatment, one asked for the children who filled the form that contained the Wong-Baker’s Face Scale for Registry of the Pain (Face Pain Scale) for the subjective evaluation. The chemical-mechanical treatment demostrated to be more accepted for the children in comparasion to the treatment with cutting rotatory istruments

El PapacárieÒ es un nuevo método de remoción química y mecánica del tejido cariado básicamente constituido por papaína, cloramina, azul de toluidina, sales y espesante. El presente estudio tiene como objetivo presentar la utilización del sistema PapacárieÒ en lesiones de caries, demostrando su efectividad, así como el modus operandi del mismo

PapacárieÒ is a new method for chemical and mechanical removal of the decay tissue; basically it’s constitution is papain, clhoramine, toluidine blue, salts and thickens agents. Thisd study had an objective shows the PapacárieÒ system in decay lesions, showing the effectiveness and it’s modus operandi

O PapacárieÒ is um método novo da remoção química e mecânica da caries; constituído bàsicamente pelo papaína, cloramina, azul do toluidina, sais e espessantes.  O estudo atual deve como objetivo mostrar o uso do Papacárie em ferimentos da caries, demonstrando sua eficácia, assim modus operandi do mesmo.

This work verified the changes caused by ethanol ingestion on the myenteric neurons of the ileum of rats subjected to chronic alcoholism. Twenty rats (Rattus norvegicus) were divided in control (GC) and alcoholic (GA) groups during 210 days. The animals from group GA received sugar-cane brandy diluted to 30 GL and those from group GC received water. Both groups were fed with rodent chow ad libitum. The ileum was prepared as whole-mounts for neuronal staining according to Barbosa (1978) and Gabella (1979). The neurons were counted and the cell bodies were measured. The statistical analysis revealed a significant decrease in the number of large neurons in GA compared with GC, while there was a significant increase in the number of small neurons in GA. There was a smaller body growth in GA, thus causing a smaller spread of the nerve cells and a larger number of neurons evidenced by the techniques of Giemsa and NADH-diaphorase in the alcoholic animals than in the controls, and a decrease in the size of the cell bodies, evidenced by the increase in the proportion of small neurons and decrease in the proportion of large nerve cells

Verificamos los cambios causados por la ingestión de etanol en las neuronas mioentéricas del íleon en ratas sometidas a alcoholismo crónico. 20 ratas (Ratus novergicus) fueran divididas en grupo control (GC) y grupo alcohólico (GA). Durante 210 días los animales del GA recibieron aguardiente de caña diluida a 30° y los animales del GC recibieron agua. El íleon fue sometido a la elaboración de preparados totales para marcación neuronal de acuerdo con Barbosa (1978) y Gabella (1969). Las neuronas fueran contadas y medidos los cuerpos celulares. En ambas técnicas, las ratas alcoholizadas presentaron una mayor densidad neuronal. El análisis estadístico, reveló una redución significativa del número de neuronas grandes en el GA cuando fue comparado con el GC; en el GA hubo un aumento significativo en el número de neuronas pequeñas. Ocurrió un menor crecimiento en las ratas GA, causando una menor dispersión de las células nerviosas y un amplio número de neuronas evidenciado a través de las técnicas de Giemsa y NADH-diaforase tanto en los animales del GA como del GC y reducción en el tamaño de los cuerpos celulares, comprobado por el aumento de la proporción de neuronas pequeñas