Chronic pain associated with the Chikungunya Fever: long lasting burden of an acute illness

Abstract Background Chikungunya virus (CHIKV) is responsible for major epidemics worldwide. Autochthonous cases were recently reported in several European countries. Acute infection is thought to be monophasic. However reports on chronic pain related to CHIKV infection have been made. In particular, the fact that many of these patients do not respond well to usual analgesics suggests that the nature of chronic pain may be not only nociceptive but also neuropathic. Neuropathic pain syndromes require specific treatment and the identification of neuropathic characteristics (NC) in a pain syndrome is a major step towards pain control. Methods We carried out a cross-sectional study at the end of the major two-wave outbreak lasting 17 months in Réunion Island. We assessed pain in 106 patients seeking general practitioners with confirmed infection with the CHIK virus, and evaluated its impact on quality of life (QoL). Results The mean intensity of pain on the visual-analogical scale (VAS) was 5.8 ± 2.1, and its mean duration was 89 ± 2 days. Fifty-six patients fulfilled the definition of chronic pain. Pain had NC in 18.9% according to the DN4 questionnaire. Conversely, about two thirds (65%) of patients with NC had chronic pain. The average pain intensity was similar between patients with or without NC (6.0 ± 1.7 vs 6.1 ± 2.0). However, the total score of the Short Form-McGill Pain Questionnaire (SF-MPQ)(15.5 ± 5.2 vs 11.6 ± 5.2; p < 0.01) and both the affective (18.8 ± 6.2 vs 13.4 ± 6.7; p < 0.01) and sensory subscores (34.3 ± 10.7 vs 25.0 ± 9.9; p < 0.01) were significantly higher in patients with NC. The mean pain interference in life activities calculated from the Brief Pain Inventory (BPI) was significantly higher in patients with chronic pain than in patients without it (6.8 ± 1.9 vs 5.9 ± 1.9, p < 0.05). This score was also significantly higher in patients with NC than in those without such a feature (7.2 ± 1.5 vs 6.1 ± 1.9, p < 0.05). Conclusions There exists a specific chronic pain condition associated to CHIKV. Pain with NC seems to be associated with more aggressive clinical picture, more intense impact in QoL and more challenging pharmacological treatment.

Rousseau preceptor: orientações pedagógicas para a instrução de crianças verdadeiras

Este trabalho tem por objetivo interpretar o tema da educação em alguns escritos de Rousseau. À luz da bibliografia sobre o tema, a análise centra-se no modo pelo qual Rousseau compreende a educação especialmente no Projeto para a educação do Senhor de Sainte-Marie, escrito no início dos anos 40 do século XVIII, a propósito do ofício de preceptor desempenhado pelo filósofo em 1740. Nesse sentido, compreende-se que, no referido escrito, Rousseau estabelece comentários e apreciações críticas acerca das práticas de ensino vigentes, fazendo recomendações e traçando sugestões pedagógicas para a educação das crianças. Tratava-se, no caso, de uma prática de ensino doméstico. Procurou-se confrontar essa perspectiva com as propostas expostas por Rousseau relativamente ao ensino público. Para tanto, interpretaram-se preliminarmente os aspectos educacionais contidos no verbete que, em 1755, Rousseau escreve para a Enciclopédia francesa sob o título Economia (moral e política). Buscou-se também identificar o tema da educação em Considerações sobre o governo da Polônia, texto escrito em 1771.

Animadversiones in regulas et usum critices, spectantos ad historiam ecclesiae ... : accedunt notationes historicae, cronologicae, et criticae /

Mode of access: Internet.

Traité des effets de la musique sur le corps humain /

Mode of access: Internet.

Animadversiones in regulas et usum critices, spectantes ad historiam ecclesiae ... : accedunt notationes historicae, cronologicae, et criticae /

Mode of access: Internet.

Animadversiones in regulas et usum critices ... : accedunt notationes historicae, cronologicae et criticae /

Mode of access: Internet.

Animadversiones in regulas et usum critices ... : accessit Dissertatio de inscriptione S. Faciei Monstroliensis : adde his notationes historicas, cronologicas, et criticas /

Mode of access: Internet.

Animadversiones in regulas et usum critices ... : accedunt notationes historicae, cronologicae et criticae /

Mode of access: Internet.

Nouveau formulaire medical et pharmaceutique /

Mode of access: Internet.

Animadversiones in regulas et usum critices ... : accedunt notationes historicae, cronologicae, et criticae /

Mode of access: Internet.

Dans l'Orient byzantin.

"Plusieurs de[s] ... articles [qui composent ce volume] ont été publiés dans le Gaulois, d'autres au Journal des savants on à la Revue de Paris. L'un est une lecture faite à la séance publique annuelle des cinq académies; d'autres ... ont été des conférences."--Préf.

Les mains pleines;

At head of title: Mrs. Wilfred Ward.

Conciones aduentuales super missus est. : in quibus honor deiparae propugnatur contra impios & blasphemos haereticos /

Mode of access: Internet.

Dissertation sur les médecins-poètes ...

Mode of access: Internet.

Shooting Rapids at Sault-St-Maria [sic]

Sault Sainte Marie, Mich.