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Background: In Brazil, treatment of panic disorder is most frequently initiated with pharmacotherapy, but only half of the patients can be expected to be panic free after medication. Studies have suggested that individual or group cognitive-behavior therapy (CBT) is an effective treatment strategy for panic patients who have failed to respond to pharmacotherapy. Methods: Thirty-two patients diagnosed with panic disorder with agoraphobia having residual symptoms despite being on an adequate dose of medication were treated with 12 weeks of group CBT. The outcome was evaluated for panic frequency and severity, generalized anxiety, and global severity. Comorbid conditions, a childhood history of anxiety, and defense mechanism styles were assessed as potential predictors of treatment response. Results: Twenty-nine patients completed the 12-week protocol. Treatment was associated with significant reductions in symptom severity on all outcome measures (p < 0.001). Patients with depression had a poorer outcome of the treatment (p = 0.01) as did patients using more neurotic (p = 0.002) and immature defenses (p = 0.05). Conclusion: Consistent with previous reports, we found that CBT was effective for our sample of treatment-resistant patients. Among these patients, depression as well as neurotic defense style was associated with a poorer outcome. The use of CBT in Brazil for treatment-resistant and other panic patients is encouraged.

Background: Improvements in quality of life (QoL) as well as symptomatic relief are important outcomes for the treatment of panic disorder (PD). The aim of this study is to assess the impact of brief cognitive behavior group therapy (CBGT) for panic disorder on QoL and to identify the clinical features associated with these changes. Methods: Thirty-six patients with PD refractory to pharmacological treatment took part in a treatment protocol consisting of 12 sessions of CBGT. To evaluate the changes in QoL, the WHOQOL-bref was administered before and after treatment. Results: Thirty-two patients completed the treatment. Significant improvement in all domains of QoL was observed (p< 0.001), which was associated with reductions in general and anticipatory anxiety (p = 0.018) and agoraphobic avoidance (p = 0.046). Consistent with previous findings, associations between QoL and panic-free status did not reach significance in this small study (p = 0.094). Conclusions: CBGT was efficacious in the treatment of PD; the symptoms of anticipatory anxiety and avoidance appear to be more important than episodic panic episodes in affecting QoL.

The Fusion Evaluated Nuclear Data Library (FENDL) is a comprehensive and validated collection of nuclear cross section data coordinated by the International Atomic Energy Agency (IAEA) Nuclear Data Section (NDS). FENDL assembles the best nuclear data for fusion applications selected from available nuclear data libraries and has been under development for decades. FENDL contains sub-libraries for incident neutron, proton, and deuteron cross sections including general purpose and activation files used for particle transport and nuclide inventory calculations. We describe the history, selection of evaluations for the various sub-libraries (neutron, proton, deuteron) with the focus on transport and reactor dosimetry applications, the processing of the nuclear data for application codes, and the development of the TENDL-2017 library which is the currently recommended activation library for FENDL. We briefly describe the IAEA IRDFF library as the recommended library for dosimetry fusion applications. We also present work on validation of the neutron sub-library using a variety of fusion relevant computational and experimental benchmarks. A variety of cross section libraries are used for the validation work including FENDL-2.1, FENDL-3.1d, FENDL-3.2, ENDF/B-VIII.0, and JEFF-3.2 with the emphasis on the FENDL libraries. The results of the experimental validation showed that the performance of FENDL-3.2b is at least as good and in most cases better than FENDL-2.1. Future work will consider improved evaluations developed by the International Nuclear Data Evaluation Network (INDEN). Additional work will be needed to investigate differences in gas production in structural materials. Covariance matrices need to be updated to support the development of fusion technology. Additional validation work for high-energy neutrons, protons and deuterons, and the activation library will be needed.

Resin cement and preheated restorative resin composite may be used for luting laminate veneers. The main advantage of resin composite is increased wear resistance, which could lead to better marginal performance in long term. This article reports a clinical treatment with feldspar laminate veneers luted to the maxillary teeth with preheated resin composite in a private practice. Case was finalized in May 2009 and followed by 10 years. Excellent clinical service and remarkable long-lasting marginal integrity were observed after 123 months. Scanning electron microscopy analysis showed no wear, gaps, or ditching at the margins. Restorative margins showed a smooth transition between ceramic and tooth with no signs of degradation. Preheated resin composite for luting ceramic laminate veneers may be considered an excellent clinical option.

The aim of this study was to compare the bonding ability of a universal dental adhesive (Scotchbond Universal/SBU, 3 M ESPE) and other contemporary dental bonding agents applied to different substrates: enamel, dentin, resin composite, and porcelain. SBU was tested using both the etch-and-rinse/ER and self-etch/SE bonding approaches. The other adhesives tested were Scotchbond Multipurpose/SBMP (3 M ESPE), Single Bond 2/SB (3 M ESPE), and Clearfil SE Bond/CLSE (Kuraray). Specimens of each substrate were prepared for microtensile bond strength test/μTBS (dentin and composite) or shear/SBS test (enamel and porcelain). In composite and porcelain, negative (no treatment) and positive (silane + SB) control groups were tested. Data were analyzed using One-Way ANOVA and Tukey’s test (α = 0.05). In enamel, SBU resulted in similar SBS (p ≥ 0.458) compared to all other adhesives (SBMP = 19.0 ± 10.2 B ; SB = 26.6 ± 9.3 A ; CLSE = 26.0 ± 8.5 A ; SBU-SE = 23.5 ± 8.4 AB ; SBU-ER = 22.6 ± 9.9 AB ). In dentin, SBU showed similar results to all other materials (p ≥ 0.123), except SB (p ≤ 0.045), which showed the highest μTBS (SBMP = 35.4 ± 10.5 AB ; SB = 39.4 ± 11.2 A ; CLSE = 36.6 ± 10.9 AB ; SB-SE = 28.1 ± 13.7 B ; SBU-ER = 26.9 ± 7.4 B ). In resin composite, SBU and the positive control presented similar μTBS (p = 0.963), and were higher than the negative control (p ≤ 0.001) (SBU = 28.4 ± 9.9 A ; positive control = 29.5 ± 11.7 A ; negative control = 12.1 ± 8.7 B ). In porcelain, SBU had higher SBS than the positive control (p = 0.001), which showed higher SBS (p < 0.001) than the negative control (SBU = 29.0 ± 6.9 A ; positive control = 21.0 ± 7.0 B ; negative control = 5.3 ± 2.7 C ). Equilibrium of adhesive and mixed failures occurred in dentin and resin composite, whereas a predominance of adhesive failures was observed in enamel and porcelain. In conclusion, the bonding ability of the universal adhesive was comparable to the other contemporary bonding agents tested, although it was dependent on the substrate evaluated. Universal adhesives seem to have potential applicability in adhesive dentistry.

Wernicke-Korsakoff syndrome (WKS) is caused by severe thiamine (vitamin B1) deficiency and can lead to chronic deficits. In this case, a 22-year-old pregnant patient at 10 1/7 weeks of gestation presented to the emergency department with malaise, asthenia, headache, weakness, vomiting, and weight loss of 12 kg. Pancreatitis and hepatic steatosis were considered but ruled out, and cholecystolithiasis was confirmed by ultrasound. After significant neurological deterioration, the patient underwent a cranial MRI that revealed suggestive findings in the thalamus consistent with WKS. WKS is a rare complication of hyperemesis gravidarum and should be included in the differential diagnosis of persistent vomiting in order to initiate early and appropriate treatment.

Herein, the effect of different post-pressing times and pressure in two cycles of polymerization on the degree of conversion (DC) of thermally activated acrylic resin (TRRA) is analyzed to optimize the polymerization of this material. After post-pressing for 0, 6, or 12 h, polymerization was performed with or without a pressure of 60 psi (0.41 MPa) in a short (4 h) or a long (11 h) cycle, totaling 12 groups. To determine the DC, PMMA specimens were analyzed by Fourier transform infrared spectroscopy. The influence of each factor alone on the DC was studied by experimental planning. The statistical tests used were three-way ANOVA, t-test, Tukey’s test, and Levene’s test, with a margin of error of 5%. Two groups prepared with post-pressing times of 12 h had the lowest DC (p<0.001). Post-pressing times of 0 and 6 h did not yield statistically different results. Pressure increased the DC in only one group (long cycle +12 h, p=0.001). The short cycle resulted in a higher DC than the long cycle in 2 groups (with pressure +0 h, p=0.002; without pressure +6 h, p=0.015), while the long cycle yielded a statistically higher DC in only one group (with pressure +12 h, p<0.001). The polymerization showed satisfactory DC in all 12 groups. Small differences found among the specimens indicate that the pressure, post-pressing time, and polymerization cycles herein were not influential factors for the DC of PMMA.

Background: Behçet's disease (BD) is an inflammatory multisystem disease with unknown etiology, and consists of a TRIAD comprising recurrent oral ulcers, genital ulcers, and uveitis. In some cases, the disease affects the central nervous system, called Neuro-Behçet Disease (NBD). Few cases of NBD simulating a brain tumor have been previously reported. Case Description: Here, we describe the case of a 46-year-old male patient with a previous diagnosis of brain tumor who was later diagnosed for BD. Conclusion: This case highlights the importance of differential diagnosis of lesions with tumoral features. Checking for the possibility of NBD may help avoiding biopsy in these types of cases.

Objectives This study was designed to adapt a previously developed in vitro microcosm biofilm model to create carries-affected dentin (CAD) and establish conditions for using the model in bonding studies. Materials and methods Biofilms were originated from human saliva and grown on dentin discs for 0 (sound dentin), 3, 5, 7, 14, or 21 days under intermittent cariogenic condition ( n  = 10). At each time point, composite cylinders were bonded to the dentin using self-etch adhesive (Clearfil SE Bond). The response variables were integrated mineral loss (Δ S ), lesion depth (LD), shear bond strength (SBS), and failure mode. Data were statistically analyzed ( α  = 0.05). Bonded interfaces were analyzed by scanning electron microscopy (SEM), and dentin surfaces characterized by infrared spectroscopy (Fourier transform infrared spectroscopy, FTIR). Results Lower Δ S was found for sound dentin than for CAD in all experimental groups, except for the group under cariogenic challenge for 3 days. The SBS to CAD was significantly lower than control for all cariogenic challenge times. Adhesive failures were predominant in all groups. Δ S and LD had a significant negative correlation with SBS. A significant exponential decay in SBS was associated with increased Δ S values. CAD had lower mineral and amide I content and an irregular hybridization interface compared to sound dentin. Conclusions The microcosm biofilm model was able to artificially induce CAD, which imposed challenge to the bonding of the polymeric adhesive material. Clinical relevance Presence of CAD might interfere with the bonding of polymeric materials. The microcosm biofilm model proposed could be useful for preclinical dentin bonding studies.

Resin cement and preheated restorative resin composite may be used for luting laminate veneers. The main advantage of resin composite is increased wear resistance, which could lead to better marginal performance in long term. This article reports a clinical treatment with feldspar laminate veneers luted to the maxillary teeth with preheated resin composite in a private practice. Case was finalized in May 2009 and followed by 10 years. Excellent clinical service and remarkable long-lasting marginal integrity were observed after 123 months. Scanning electron microscopy analysis showed no wear, gaps, or ditching at the margins. Restorative margins showed a smooth transition between ceramic and tooth with no signs of degradation. Preheated resin composite for luting ceramic laminate veneers may be considered an excellent clinical option.