Limiar e tolerância à dor em mulheres com fibromialgia: correlação com a capacidade funcional, qualidade do sono e força muscular

O estudo tem como objetivo principal comparar o limiar e a tolerância à dor em mulheres com fibromialgia e mulheres sem sintomas de dor, correlacionando com capacidade funcional, qualidade do sono e força de preensão manual. Trata-se de um estudo descritivo de corte transversal realizado na Universidade Potiguar e na Universidade Federal do Rio Grande do Norte, envolvendo uma equipe multidisciplinar com fisioterapeutas, médicos e educadores físicos. Setenta e duas mulheres foram divididas em dois grupos: grupo com fibromialgia (GF, n = 40) e grupo controle (GC, n = 32) sem sintomas de dor, pareadas por idade e índice de massa corporal. Questionários foram usados para medir capacidade funcional (Fibromyalgia Impact Questionnaire FIQ) e qualidade do sono (Pittsburgh Sleep Quality Index - PSQI). Limiar e tolerância à dor foram medidas por um algômetro de pressão e para determinar força foi usado um dinamômetro de preensão manual. Na análise estatística o teste T de Student foi usado para comparar grupos e o coeficiente de correlação de Spearman foi usado no GF para correlacionar limiar e tolerância à dor com as demais medidas. O GF mostrou piores resultados nas medianas comparado ao GC: limiar de dor 2 kg/cm2 versus 5,5 kg/cm2 (p <0,001), tolerância à dor 2,8 kg/cm2 versus 7,2 kg/cm2 (p <0,001) e força de preensão manual 14,5 kgf versus 25,2 kgf (p <0,001). Adicionalmente os dois questionários apresentaram resultados piores também no GF em relação ao GC, respectivamente: FIQ 65 versus 14,3 (p <0,001) e PSQI 13 versus 5 (p <0,001). No GF foi observada correlação negativa tanto entre o limiar de dor quanto a tolerância à dor com os escores do FIQ e do PSQI. No GF foram observadas correlações positivas tanto entre o limiar de dor (p <0,01) quanto a tolerância à dor (p <0,01) com força de preensão manual. É possível concluir que limiar de dor e tolerância à dor estão correlacionados com capacidade funcional, qualidade do sono e força de preensão manual em mulheres com fibromialgia

Interações físicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

Avaliação do cortisol, dehidroepiandrosterona sulfato e dos perfis lipídico e imunológico e suas correlações com a sensibilidade dolorosa, depressão e funcionalidade em mulheres com fibromialgia na pós-menopausa

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome characterized by widespread musculoskeletal pain with palpable tender points, muscle stiffness, fatigue, and sleep disturbances. Patients with FM have hormonal changes that are directly correlated with symptoms of the syndrome. The neuroendocrine regulation may be impaired, with abnormalities in the hypothalamus-pituitary-adrenal (HPA) axis with various hormones showing changes in their levels. In women in fertile period, various gonadal hormones are associated with symptoms of the syndrome, but studies focusing only a population of women in post-menopausal period who do not use hormone replacement are rare. We developed an analytical cross sectional study to assess the plasma levels of cortisol and dehidroepiandrosterona sulfate (DHEA-S) with quimioluminescence method in a group of 17 women with FM and 19 healthy women in post-menopause who do not use hormone replacement and observe the correlation with the symptoms of pain through algometry, depression and physical functional capacity measured from the Beck Depression Index (BDI) and the Fibromyalgia Impact Questionnaire (FIQ). Three blood samples were collected in the morning (between 8:00 9:30) with an interval of 24 hours for the measurements of hormonal levels and biochemical profile. There were no immunological or lipid changes in patients with FM. Comparing the two groups, there is no difference in levels of cortisol and a tangential effect for DHEA-S (p=0,094) with the lowest levels in the FM. DHEA-S also correlated with pain threshold (r=0,7) and tolerance (r=0,65) in group FM. We found the presence of depressive state and low physical functional capacity in FM. It was also evident that women in post-menopausal period, DHEA-S should influence the symptoms of increased sensitivity to pain, but not the presence of depressive status and low physical functional

Utilización de columnas verticales de filtración de manta y arena como pre-tratamiento de un sistema de filtración lenta

Slow sand filtration is an efficient water treatment technique used for treating surface water with relatively low levels of contamination. Despite the slow sand filtration at pathogen, algae and cyanobacteria removal efficiency, it has some restrictions in relation to the required area for slow filters, and the cleaning activities for the filters and the stone pre-filters when used in the treatment. This research evaluated during 120 days the use of non woven & sand pre-filtration columns as part of a slow filtration process for the apparent color, turbidity, algae, cyanobacteria, phytoflagellates and diatomaceous. The columns shown an efficient removal of the monitored parameters and demonstrated as a vantage their faster and easier cleaning process and less awkward than the required to the stone pre-filters. The turbidity removal efficiency increased progressively during the experiment, especially after the first 35 days of the start; the apparent color removal by the pre-filtration columns was of 85%, and working together with the polishing of activated carbon columns was up to 95; the diatomaceous, phytoflagellates, algae and cyanobacteria removal by the columns achieve a weekly average of 95%, its recommended to use filtration rates lower to 1,5m(3)/m(2)/d.

Influencia del tratamiento térmico en la cristalización y rugosidad de películas delgadas de LiNbO3 depositadas por el método Spin Coating

Lithium niobate (LiNbO3) thin films with 1/1 stoichiometry were prepared by a spin-coating from polymeric precursor method. The films deposited on silicon (100) substrates, were thermally treated from 400° to 600°C for 3 hours in order to study the influence of thermal treatment on the crystallinity, microstructure, grain size and roughness. X-ray diffraction (XRD) results showed that LiNbO3 phase crystallizes at low temperature (400°C). It was observed by scanning electron microscopy (SEM) that it is possible to obtain dense thin films at temperatures around 500°C. The atomic force microscopy (AFM) results showed that the grain size and roughness are strongly influenced by the annealing temperature.

Prótesis radífera: Alternativa en el tratamiento de neoplasias de cabeza y cuello

Radipherpus protheses are a means of treatment for malignant tumor-carrying patients. These protheses are used in cases of brachytherapy or external actinotherapy by contact and allow treating them with high radiation doses that are quickly released from the areas next to tumor, so that the radiations be restricted to the affected region, without the emissions damaging or destroying the soft tissues. Based on these considerations, the present paper was aimed at making literature review on the use of radipherous protheses for the treatment of head and neck neoplasias. © 2006 1995, Editorial Ciencias médicas.

Evaluación del conocimiento de los cirujanos dentistas brasileños sobre aspectos bioéticos en el tratamiento odontológico

Professional-patient relationship and its importance for a good performance and success of the dental treatment must be reflected upon by means of their bioethical aspects. Our study aimed at evaluating dentist-surgeons' knowledge (n=163) in conducting specialization courses at São Paulo State University-UNESP, on these aspects. Out of the people surveyed, 88.1% mentioned that a decision for the treatment should be made by mutual agreement between professionals and patients, however, 26.4% report that patients' or their legal representative's participation in decision-making can cause negative interference. Professionals' acting when patients choose a less suitable treatment, 95.6% try to convince patients that it is not the best choice and persuade them for a better one by keeping the paternalistic model. It was noticed that 20.3% did not know how to relate the importance of professional-patient interaction as regards the dental treatment. It was therefore concluded that many dentist-surgeons are not taking these bioethical aspects into account in clinical practice.

El tratamiento fisioterapéutico ¿es efectivo en el mantenimiento físico y en la reducción del declive cognitivo de las demencias?

Introduction. Dementia is a chronic and neurodegenerative disease responsible for a progressive decline of cognition and physical capacity. Objective: To verify the effectiviness of three months of physiotherapy intervention on cognitive functions and balance of institutionilized elderly people with dementia. Patients and methods. This study has comprised thirty subjects, divided in two groups: EG (experimental group) and CG (control group). EG was composed by 15 participants with mean age of 71,6 ± 8,5 years and scholarity of 4,7 ± 4,2 years. CG was formed by 15 subjects with mean age of 78,5 ± 7,6 years and scholarity of 2,2 ± 1,8 years. The sample was evaluated by means of the following instruments: Mini-Mental State Examination, Semantic Verbal Fluency test, Clock Drawing test, Berg Balance Scale and Timed Get Up and Go test. The statistical procedures were done by means of Multivariate Analisis of Variance (MANOVA), with significance of 5 % (p < 0,05). Results. The results has shown a heterogeneity of both groups related to age (F = 0,2, p < 0,05) and scholarity (F = 2,6, p < 0,05). MANOVA pointed beneficts of physiotherapy on balance (F = 7,3, p < 0,01) but not on cognitive functions (F = 0,3, p > 0,05). Conclusions. Three months of physiotherapy were effective to improuve physical capacity of institucionilized elderly people with dementia. Neverthless, it was not able to minimize cognitive decline commonly seen on dementia. The question if a prolonged intervention could propitiate cognitive beneficts remains, specially in a more homogeneous groups.

Percepción del cirujano-dentista respecto del uso del consentimiento informado en el tratamiento odontológico

The objective of this study was to evaluate: the profile of the surgeon-dentist that undergoes a course in specialization at the Odontology Faculty of Aracatuba/UNESP, Brazil; if they requested informed consent from the patient and/or their legal representative before the realization of procedures, and if the treatment was decided upon with the patient. It was elaborated, validated and applied in questionnaire form, and the data obtained was analyzed by the program EPI-INFO 3.3 The conclusion was, given that surgeon-dentists still do not obtain any type of document before beginning treatment, a large percentage of them are totally vulnerable if submitted to ethical or legal prosecution and that it is necessary to be aware of this aspect.

Aplicabilidad del proceso de nitritación/desnitritación en el tratamiento de lixiviado de relleno sanitario

The biological nitritation/denitritation process in the removal of organic matter and nitrogen in a landfill leachate was studied, using an activated sludge sequencing batch reactor. Treatment cycles were formed by an anoxic and an aerobic phases, in which the conditions for oxidation of the influent N load and the prevalence of nitrite concentration at the end of aerobic treatment cycles were determined, as well as the use of organic matter present in the leachate as a carbon source for denitrifying organisms in the anoxic stage. The removal efficiencies of N-NO 2-at the end of the anoxic process (48h) ranged between 14 and 30%, indicating low availability of biodegradable organic matter in the leachate. As for the accumulation of N-NO 2-at the end of the aerobic phase (48h) of treatment cycles, imbalances were not observed, while 100% removal efficiencies of N and specific nitritation rates from 0.095 to 0.158kgN-NH 3/kgSSV per day were recorded, demonstrating the applicability of simplified nitrification in the treatment of effluents with low C/N ratios.

Violencia en la pareja: tratamiento legal: evolución y balance = Violence within couples: legal treatment: review of progress and results

Incluye Bibliografía

El tratamiento del problema de población en la producción de los científicos sociales en Chile, 1958-1972

Incluye Bibliografía

Desafíos y tendencias de la modernización de los sistemas estadísticos nacionales: el tratamiento de la confidencialidad de las informaciones estadísticas en el Instituto Brasileño de Geografía y Estadística

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