883 resultados para Dolor Crónico


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Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The ambivalent image of the sea is recurrent in Bojunga Nunes’s work. It receives a lot of symbolic meanings in her production, being sometimes a positive and sometimes a negative element. Thus, the sea is used in a utopic way, as a place for pleasure and leisure, and in a dystopic way, as scenery of a rite of passage, which includes the pain and suffering, part of the rite of passage that characterizes the bildungsromans. So, if in some texts the sea assumes a utopic character, being a place of snuggle, security, the ideal to reach, in others it is represented as dystopic, a place of distress, asphyxia and death. In this text we will study the hypothesis that, even in its dark symbolic meaning, in the author’s work the sea is an element of reflection and revelation. Thereby, it assumes metaphorically a sense of magnification of the reader’s expectative, being an element of emancipation. The objective of this text is to present a reflection on the sea’s symbolism on the mentioned texts and its importance for the reader’s formation.

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This article is based on the author's clinical practice in the area of public health, and discusses depression as it is known today. Essentially, the author questions the practice of labeling depression as a psychopathological condition. The author also questions today’s trend of seeing a subject’s suffering as a "malaise," or a “disorder.” The possibility is brought up of understanding it as a "demand for analysis." Finally, the article is meant as a contribution to the ethics of psychoanalysis focused on the subject and the possibilities of psychoanalysis in subjectivating this "malaise."

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Underdeveloped nations have the largest absolute number of the world's elderly population. Approximately 10.7% of the Brazilian population comprises aged individuals. Aging populations are associated with a higher incidence of chronic degenerative diseases such as dementia. Demented individuals place a high burden of care on healthcare systems and family members. General practitioners should be able to diagnose the most common elderly diseases such as dementia since they act as gatekeepers to specialized care. In Brazil, many medical students work as general practitioners upon graduating. The present study shows some scenarios of medical schools worldwide, including Brazilian, regarding teaching on dementia.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Dexamethasone is a synthetic glucocorticoid widely used to treat allergic and inflammatory processes. This drug is used in three main situations, are used to contain acute or chronic inflammatory processes, or like immunosuppressive drug's. In these cases the patient will receive high doses for a chronic period and, therefore, has a much greater chance of adverse side effects, such as hypertension, diabetes and dyslipidemia. Dexamethasone promotes deleterious effects on the arachidonic acid pathway, when administered in high doses, because it is a potent anti-inflammatory drug. We recently demonstrated that dexamethasone significantly reduces the protein expression of vascular endothelial growth factor (VEGF) in both skeletal muscle and heart, but the mechanisms involved remain unclear. Meanwhile, exercise has been shown to be effective against high blood pressure, diabetes and dyslipidemia, promoting, among other factors, the increase in VEGF and angiogenesis. One possible explanation for these effects would be the creation of new vessels mediated by inflammation, or by the stimulation of the formation of products of the metabolism of arachidonic acid (AA), such as prostaglandin E2 (PGE2) and VEGF, by increasing the stimulation of the enzymes cyclooxygenase 1 and 2 (COX-1 and COX-2). Little is known about the preventive effects of training on the action of dexamethasone in the arachidonic acid pathway. Therefore, the aim of this study was to determine whether aerobic exercise training, performed before and concomitant treatment with dexamethasone, was able to prevent the effects of the dexamethasone in the protein expression of COX-2 and VEGF. For this, we used young Wistar rats (n = 40) which were randomly divided into 4 groups: sedentary control (SC), sedentary and treated with dexamethasone (SD), trained control (TC) and trained and treated with dexamethasone (TD). These rats performed aerobic exercise training, 60% of maximum capacity, 5

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Dexamethasone (DEXA) is a synthetic glucocorticoid widely used in the handling of several drugs, for its proven benefits in fighting inflammation and allergies. Despite their benefits, their chronic use leads to several side effects that include changes in the body in the metabolism of carbohydrates, lipids and proteins. Moreover, being an anti-inflammatory, acts on the arachidonic acid pathway, reducing the expression of the enzyme cyclooxygenase (COX-2) and growth factor derived from the endothelium of blood vessels (VEGF) in various tissues. However, its effects on the myocardium are still uncertain. The physical training (PT), in turn, promotes effects contrary to those caused by chronic use of DEXA, however, little is known about the preventive effects of TF in the side effects of Dexa in the myocardium. Therefore, the aim of this study was to determine if the TF has the ability to prevent and/or mitigate the effects of Dexa in protein expression of COX-2 and VEGF in the myocardium. Forty animals were divided into 4 groups: sedentary control (SC), sedentary treated with Dexa (SD), trained control (TC) and Trained treated with Dexa (TD) and submitted to a protocol of physical training on the treadmill for 70 days (1 h/day-5 days per week, 60% of physical capacity) or kept sedentary. Over the past 10 days, rats were treated with Dexa (Decadron, 0.5 mg/kg per day, ip) or saline. During training the animals were weighed weekly and during treatment daily. At the end of treatment was made to measure fasting glucose levels of animals. The rats were killed with excess anesthesia and cardiac muscle was removed, weighed, homogenized, centrifuged and stored at -20° C for analysis of protein expression of VEGF and COX-2 by Western blotting technique. Treatment with dexamethasone caused a weight loss of 18% in sedentary animals and 13% in trained as well as elevated levels of fasting glucose in sedentary (88%). The TF was unable to mitigate the loss in...

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Muscle atrophy is always associated with Dexamethasone (Dexa) treatment, however the mechanisms are not completely understood. This study investigated the effects of Dexa on myostatin and p70S6K protein expression and if previous exercise training (T) can attenuate these effects. Eighty rats were distributed into 4 groups: sedentary control (SC), sedentary treated with Dexa (SD; 0,5 mg/kg per day, i.p., 10 days), trained control (TC) and trained treated with Dexa (TD) and underwent a training period where they were either submitted to a running protocol (60% of physical capacity, 5 days/week for 8 weeks) or kept sedentary. After T period, animals underwent Dexa treatment concomitant with training. Western Blot was performed to identify myostatin and p70S6k protein expression in the tibialis anterior (TA) and soleus (SOL) muscle. Ten days of Dexa treatment increased fasting glucose (SD=+62%), however previous T attenuated this increase (TD=+20%, p<0.05). Dexa determined significant decrease in body weight in TD (-22%) and SD (-25%), followed by TA weight reduction in SD (-23%) and TD (-20%). Previous training could not avoid these decreases. Myostatin protein expression was not altered by dexa treatment or training in TA muscle but in SOL muscle it was significantly modified after T, regardless of treatment (TC=+%23 and TD=+25) compared with their respective controls. The protein p70S6K was not modified neither by dexa nor training in any of the analyzed muscle or condition. The results of this study allowed us to conclude that previous training attenuates the hyperglycemia induced by Dexa, however it did not prevent the body or muscle weight reductions. Even in the presence of muscle atrophy, the expression of myostatin and p70S6K do not justify the mechanisms of muscle loss induced by Dexa, which suggests that other catabolic or anabolic proteins could be involved in the process of muscle atrophy after 10 days of treatment with Dexa

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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BACKGROUND AND OBJECTIVES: Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma. METHOD: Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the first 24 hours and after 8 weeks of delivery using a numerical pain scale. RESULTS: We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 ± 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33). CONCLUSIONS: The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Pós-graduação em Patologia - FMB