Relação entre ansiedade odontológica e cortisol salivar em pacientes submetidos à exodontia de terceiros molares inferiores
12 Dec 2012-Vol. 15, Iss: 3, pp 49-50
About: The article was published on 2012-12-12 and is currently open access. It has received None citation(s) till now.
TL;DR: As an adjunct to pharmaceutical therapy, social and behavioral interventions such as regular physical activity and social support reduce the chronic stress burden and benefit brain and body health and resilience.
Abstract: The brain is the key organ of the response to stress because it determines what is threatening and, therefore, potentially stressful, as well as the physiological and behavioral responses which can be either adaptive or damaging. Stress involves two-way communication between the brain and the cardiovascular, immune, and other systems via neural and endocrine mechanisms. Beyond the "flight-or-fight" response to acute stress, there are events in daily life that produce a type of chronic stress and lead over time to wear and tear on the body ("allostatic load"). Yet, hormones associated with stress protect the body in the short-run and promote adaptation ("allostasis"). The brain is a target of stress, and the hippocampus was the first brain region, besides the hypothalamus, to be recognized as a target of glucocorticoids. Stress and stress hormones produce both adaptive and maladaptive effects on this brain region throughout the life course. Early life events influence life-long patterns of emotionality and stress responsiveness and alter the rate of brain and body aging. The hippocampus, amygdala, and prefrontal cortex undergo stress-induced structural remodeling, which alters behavioral and physiological responses. As an adjunct to pharmaceutical therapy, social and behavioral interventions such as regular physical activity and social support reduce the chronic stress burden and benefit brain and body health and resilience.
TL;DR: The functional and neuroanatomical data obtained suggest that disease processes involving inappropriate stress control involve dysfunction of processive stress pathways.
Abstract: Integration of the hypothalamo–pituitary–adrenal stress response occurs by way of interactions between stress-sensitive brain circuitry and neuroendocrine neurons of the hypothalamic paraventricular nucleus (PVN). Stressors involving an immediate physiologic threat (`systemic' stressors) are relayed directly to the PVN, probably via brainstem catecholaminergic projections. By contrast, stressors requiring interpretation by higher brain structures (`processive' stressors) appear to be channeled through limbic forebrain circuits. Forebrain limbic sites connect with the PVN via interactions with GABA-containing neurons in the bed nucleus of the stria terminalis, preoptic area and hypothalamus. Thus, final elaboration of processive stress responses is likely to involve modulation of PVN GABAergic tone. The functional and neuroanatomical data obtained suggest that disease processes involving inappropriate stress control involve dysfunction of processive stress pathways.
TL;DR: A review explores reasons for discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence that suggest the awakening cortisol response is under a distinct regulatory influence different from the rest of the diurnal cortisol secretory cycle.
Abstract: The awakening cortisol response (ACR) is a discrete and distinctive part of the cortisol circadian cycle. In healthy adults salivary free cortisol concentrations increase by between 50 and 160% in the first 30 min immediately post-awakening (approximate average increase of 9 nmol/l, range 4-15 nmol/l, estimated to be equivalent to about three secretory episodes). However there are no agreed norms for the absolute concentrations of free cortisol in saliva either immediately post-awakening (range of 4.7-18.5 nmol/l) or 30 min post-awakening (range of 8.6-21.9 nmol/l). This review explores reasons for these discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence. Although the physiological role of the ACR has not been clearly defined evidence is discussed that suggests it is under a distinct regulatory influence, different from the rest of the diurnal cortisol secretory cycle. Despite the difficulties associated with its measurement a range of studies have demonstrated an association between the ACR and psychosocial variables, stress and health. However it remains unclear whether positive affect and good health are consistently associated with larger or smaller awakening responses. It is early days in the search for the role and significance of the ACR. Its putative role in the regulation of physiological function across the day (e.g. the immune system) and its sensitivity to psychosocial variables make it a prime candidate as an intermediary linking mind and health.
TL;DR: The present data demonstrate that the psychometric properties of the Portuguese versions of the BDI and STAI are comparable to the original English language versions of these questionnaires, thereby indicating their use in clinical situations.
Abstract: We have validated a Portuguese version of the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) tests by obtaining profiles for three Brazilian samples: 270 university students, 117 panic patients and 30 depressed patients. The mean BDI scores were higher for depressed patients (25.2 +/- 12.6), intermediate for anxious patients (15.8 +/- 10.3) and lower for students (8.5 +/- 7.0). Mean STAI scores for anxious (52.8 +/- 11.4) and depressed patients (56.4 +/- 10.5) were higher than for the student sample (40.7 +/- 8.6). BDI and STAI scores were correlated significantly in all samples. The internal consistency of the Portuguese version of BDI is in agreement with the literature (0.81 for students and 0.88 for depressed patients). The present data demonstrate that the psychometric properties of the Portuguese versions of the BDI and STAI are comparable to the original English language versions of these questionnaires, thereby indicating their use in clinical situations.
TL;DR: The data indicate that the scale is a reliable, valid, and useful measure of dental anxiety that can be successfully used in the dental office or in research projects.
Abstract: The Corah dental anxiety scale is shown to be a reliable tool for use in dental offices or research projects for measuring anxiety of dental procedures. Old and new data were considered in an evaluation of the Corah Dental Anxiety Scale. The data indicate that the scale can be used in the dental office or in research projects and is a reliable, valid, and useful measure of anxiety of dental treatment.