Acupuntura em adolescentes com fibromialgia juvenil

OBJETIVO: Descrever a utilização da acupuntura em adolescentes com fibromialgia juvenil. MÉTODOS: Estudo retrospectivo realizado em pacientes com fibromialgia juvenil (critérios do Colégio Americano de Reumatologia) submetidos a, pelo menos, 11 sessões semanais de acupuntura. As avaliações antes e após acupuntura incluíram dados demográficos, características da dor musculoesquelética, número de pontos dolorosos (NPD), escala visual analógica (EVA) de dor, algiometria e índice miálgico (IM). Durante o estudo, os pacientes puderam usar analgésicos, amitriptilina e foram orientados a praticar atividade física aeróbica. Os resultados antes e após acupuntura foram comparados pelo teste não paramétrico de Wilcoxon. RESULTADOS: Dos 38 pacientes com fibromialgia juvenil acompanhados em oito anos consecutivos, 13 tinham todas as informações nos prontuários e nas fichas de acupuntura e foram avaliados. Destes 13, sete obtiveram melhora nos três parâmetros analisados (número de pontos dolorosos, EVA de dor e IM). As medianas do número de pontos dolorosos e da EVA de dor foram significativamente maiores antes do tratamento quando comparados ao final do tratamento com as sessões de acupuntura [14 (11-18) versus 10 (0-15), p=0,005; 6 (2-10) versus 3 (0-10), p=0,045; respectivamente]. Em contraste, a mediana do IM foi significativamente menor antes do tratamento [3,4 (2,49-4,39) versus 4,2 (2,71-5,99), p=0,02]. Nenhum dos pacientes com fibromialgia juvenil apresentou eventos adversos associados à acupuntura. CONCLUSÕES: Acupuntura é uma modalidade de Medicina Tradicional Chinesa que pode ser utilizada nos pacientes pediátricos com fibromialgia. Futuros estudos controlados serão necessários.

Palynostratigraphy and sedimentary facies of Middle Miocene fluvial deposits of the Amazonas Basin, Brazil

Palynostratigraphic and sedimentary fades analyses were made on sedimentary deposits from the left bank of the Solimoes River, southwest of Manaus. State of Amazonas, Brazil. These provided the age-elating and subdivision of a post-Cietaceous stratigraphic succession in the Amazonas Basin. The Novo Remanso Formation is subdivided into upper and lower units, and delineated by discontinuous surfaces at its top and bottom. The formation consists primarily of sandstones and minor mudstones and conglomerates, reflecting fluvial channel, point bar and floodplain facies of a fluvial meandering paleosystem. Fairly well-preserved palynoflora was recovered from four palynologically productive samples collected in a local irregular concentration of gray clay deposits, rich in organic material and fossilized wood, at the top of the Nova Remanso Formation upper unit. The palynoflora is dominated by terrestrial spores and pollen grains, an d is characterized by abundant angiosperm pollen grains (Tricolpites, Grimsdalea, Perisyncolporites, Tricolporites and Malvacearumpollis). Trilete spores are almost as abundant as the angiosperm pollen, and are represented mainly by the genera Deltoidospora. Verrutriletes, and Hamulatisporis. Gymnosperm pollen is scarce. The presence of the index species Grimsdalea magnaclavata Germeraad et al. (1968) indicates that these deposits belong to the Middle Miocene homonymous palynozone (Lorente, 1986; Hoorn, 1993; Jaramillo et al., 2011). Sedimentological characteristics (poorly sorted, angular to sub-angular, fine to very-coarse quartz sands facies) are typical of the NOW Remanso Formation upper part. These are associated with a paleoflow to the NE-E and SE-E, and with a a entirely lowland-derived palinofloristic content with no Andean ferns and gymnosperms representatives. All together, this suggests a cratonic origin for this Middle Miocene fluvial paleosystem, which was probably born in the Purus Arch eastern flank and areas surrounding the crystalline. The palynological analysis results presented herein are the first direct and unequivocal evidence of the occurrence of Middle Miocene deposits in the central part of the Amazonas Basin. They also provide new perspectives for intra- and interbasin correlations, as well as paleogeographic and paleoenvironmental interpretations for the later deposition stages in the northern Brazilian sedimentary basins. (C) 2011 Elsevier Ltd. All rights reserved.

Simultaneous circulation of all four dengue serotypes in Manaus, State of Amazonas, Brazil in 2011

Introduction: Manaus, the capital city of the state of Amazon with nearly 2 million inhabitants, is located in the middle of the Amazon rain forest and has suffered dengue outbreaks since 1998. Methods: In this study, blood samples were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), aimed at identifying dengue virus serotypes. Results: Acute phase sera from 432 patients were tested for the presence of dengue virus. Out of the 432 patients, 137 (31.3%) were found to be positive. All the four dengue virus serotypes were observed. Conclusions: The simultaneous circulation of the four dengue serotypes is described for the first time in Manaus and in Brazil.