Navegando por Palavras-chave "dor"

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    Alterações posturais e dores musculoesqueléticas
    (Universidade Federal de São Paulo (UNIFESP), 2005-11-30) Faria, Ivan Barreira Cheida [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Good posture is the one that best fits our musculoskeletal system, balancing and distributing all the effort of our daily activities, encouraging the lowest overhead and helping to prevent pain. Objective: The purpose of this study was to verify the presence of musculoskeletal pain and postural deviations according to age and gender of visitors from the beaches of Santos and Guaruja cities. Methods: We evaluated 2394 subjects from 5 years of age being 43.27% males and 56.73% female. To determine the postural deviations and musculoskeletal pain were carried out data collection and assessment posture. Results: The total prevalence of pain and postural deviations were 64.66% and 63.28% respectively. The most affected area by pain was the backbone with 43.98% of the complaints, in which 17.04% of subjects evaluated cited as the lumbar region most affected. As for postural changes, the misalignment with scoliosis was the largest representation with 64.66%, followed by lumbar hyperlordosis with 38.18% and 30.03% with hyperkyphosis. Conclusion: It was concluded that the postural deviations and musculoskeletal pain have high prevalence among evaluated, especially in women and aged between 41 and 60 years, necessitating the implementation of programs aimed at prevention and correction of such findings.
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    Analgesia com laser terapêutico após tonsilectomia
    (Sociedade de Pediatria de São Paulo, 2010-09-01) Neiva, Felipe Costa [UNIFESP]; Vieira, Fernando Mirage Jardim [UNIFESP]; Figueiredo, Claudia Regina [UNIFESP]; Stamm, Aldo Eden Cassol [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The postoperative period of a tonsillectomy is usually very painful, requiring the use of pain-relieving drugs. The aim of this study was to evaluate the efficacy of low-level laser therapy in post-tonsillectomy pain control. METHODS: 18 children aged 5 to 15 years undergoing adenotonsillectomy between June 2005 and October 2006 were randomized to receive either local application of therapeutic laser immediately after surgery and 24 hours postoperatively (n=9) or routine analgesic drug therapy, if necessary. Pain was assessed by visual analog scale scores, need for analgesics, and acceptance of diet during the postoperative period. RESULTS: Patients undergoing laser applications had lower median pain scores and required less analgesic medication postoperatively than the control group. Acceptance of diet was similar in both groups. CONCLUSIONS: Preliminary results showed that low-level laser therapy is effective in the reduction of post-tonsillectomy pain, minimizing the need of analgesic medication in children and adolescents.
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    Avaliação da efetividade da estimulação elétrica nervosa transcutânea no controle da dor de pacientes com lombalgia aguda
    (Universidade Federal de São Paulo (UNIFESP), 2015-07-05) Cruz, Ganeska da Graca [UNIFESP]; Natour, Jamil Natour [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A lombalgia é uma das queixas mais comuns nos consultórios médicos, sendo a lombalgia aguda caracterizada por episódios de dor com duração inferior a 3 semanas. A estimulação elétrica nervosa transcutânea (TENS), baseada na Teoria das Comportas de controle da dor proposta por Melzack e Wall em 1965, tem sido utilizada como uma terapêutica adjuvante no controle das dores lombares, por ser uma técnica não invasiva, de baixo custo, segura e fácil de aplicar. Nenhum estudo foi encontrado quanto à efetividade da TENS na lombalgia aguda. Objetivo: Avaliar a efetividade da TENS no controle da dor de pacientes com lombalgia aguda. Material e Método: Ensaio clínico, placebo-controlado, randomizado, duplo cego e com análise por intenção de tratar. Foram incluídos 71 pacientes, selecionados nos ambulatórios da UNIFESP, seguindo os critérios: lombalgia aguda, ambos os gêneros, idade entre 18 e 65 anos, dor entre 4 e 8cm na END (escala numérica de dor) e que aceitassem participar do estudo. Foram excluídos pacientes com dor de origem inflamatória, neoplásica ou infecciosa, com marcapasso cardíaco, cirurgia prévia na coluna, sinais de irritação de raízes nervosas, fratura vertebral, que mudaram a atividade física nos últimos 3 meses, gestantes e litígios. Após assinatura do Termo de Consentimento Livre e Esclarecido os pacientes foram randomizados e alocados em um dos grupos: Grupo TENS (GT) ou Grupo Placebo (GP). No GT foi aplicada TENS convencional, com efeito VIF, frequência de 100Hz, largura de pulso de 60?s e intensidade ajustada de acordo com o limiar individual de cada paciente sem provocar contração muscular e/ou dor. Os eletrodos foram dispostos de forma cruzada na região paravertebral (nivéis T12-L1 e L5 - S1). No GP foram adotados os mesmos procedimentos, mas não ocorria passagem de estímulo elétrico. Os pacientes foram informados que poderiam ou não sentir choques elétricos. O tratamento foi composto de 10 sessões (2x/semana/5 semanas), tendo cada sessão duração de 30?. As avaliações ocorreram nos seguintes tempos: T0 (avaliação inicial), T1 a T10 (ao início e final de cada sessão), T11 (após a última sessão), T30 (após 30 dias da última sessão) e T60 (após 60 dias da última sessão). Instrumentos de avaliação: END para dor, SF-36, Roland-Morris, autoavaliação de melhora (escala ?likert?) e consumo de medicamentos (diário). Resultados: Dos 71 pacientes incluídos no estudo, 28 (39,4%) foram do gênero masculino e 43 (60,6%) do gênero feminino. A idade dos participantes variou entre 19 e 62 anos. Os grupos foram homogêneos para todos os parâmetros avaliados no baseline, exceto para o domínio dor do questionário SF-36, onde verificou-se que os pacientes do GT apresentaram maior nível de dor (p=0,011). Não houve diferença entre os grupos quanto ao nível de dor medido pela END (p=0,607) e aos escores obtidos pelos questionários de Roland-Morris (p=0,619) e SF-36. Também não houve diferença quanto ao consumo de medicamento entre os grupos (p=0,368). Conclusão: A TENS não é efetiva para o controle da dor, melhora da função e qualidade de vida, auto avaliação e diminuição do consumo de analgésicos em pacientes com lombalgia aguda.
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    Avaliação da efetividade do método pilates no tratamento de indivíduos com cervicalgia mecânico-postural crônica
    (Universidade Federal de São Paulo (UNIFESP), 2014-04-12) Cazotti, Luciana de Araujo [UNIFESP]; Natour, Jamil Natour [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A dor cervical é uma ocorrência comum e afeta cerca de 70% dos indivíduos em algum momento de suas vidas, sendo considerado um problema frequente de incapacidade e uma razão fundamental para a busca de atenção médica. O método Pilates é um programa de atividade física que propõe a consciência corporal em busca da harmonia entre o corpo e a mente tem sido amplamente utilizada para melhorar o condicionamento físico e reabilitação em geral. Embora os sintomas de dor cervical sejam frequentes na população, faltam evidências na literatura referentes à efetividade do método Pilates, no tratamento de pacientes com cervicalgia mecânico-postural. Objetivo: O objetivo deste estudo foi avaliar a efetividade do método Pilates na melhora da dor, função, qualidade de vida e do consumo de analgésicos em indivíduos com dor cervical mecânico-postural crônica. Material e métodos: Foram selecionados sessenta e quatro pacientes com diagnóstico de dor cervical mecânico-postural crônica. Os critérios de inclusão foram os seguintes: portadores de dor cervical por mais de três meses, ambos os gêneros, idade entre 18 e 65 anos. Foram excluídos pacientes com diagnóstico de fibromialgia, grávidas, lesões traumáticas da coluna vertebral, infecções e inflamações na coluna cervical, dor cervical irradiada para os membros superiores, aqueles que iniciaram ou alteraram a prática de atividade física nos últimos três meses, deficiência visual não corrigida por óculos e doenças do sistema nervoso central (SNC). Os pacientes foram randomizados em dois grupos: Pilates e controle. O primeiro (GP) realizou duas sessões de Pilates por semana, durante 12 semanas. O grupo-controle (GC) permaneceu em lista de espera para o Pilates. Ambos foram instruídos a utilizar paracetamol 750 mg a cada seis horas, em caso de dor, e o consumo do medicamento foi controlado. Os dois grupos foram avaliados para a dor (Escala numérica de dor - END), função (Neck Disability Index - NDI) e qualidade de vida (SF-36). As avaliações foram realizadas por um avaliador cego no baseline (T0), 45 dias (T45), 90 dias (T90) e 180 (T180) dias após o inicio do estudo. Resultados: Trinta e dois pacientes foram randomizados para cada grupo. Eles foram inicialmente homogêneos em relação às características clínicas e demográficas. Somente o índice de massa corpórea (IMC) não foi homogêneo entre eles, com o GP apresentando maior IMC que o GC. Em relação à avaliação entre os grupos ao longo do tempo (ANOVA), encontramos diferença estatística para dor (p<0,001), função (p<0,001) e para os domínios do SF-36 capacidade funcional (p=0,019), dor (p<0,001), estado geral de saúde (p=0,022), vitalidade (p<0,001), saúde mental (p=0,012), sempre com melhores resultados para o GP. Em relação à medicação, o GP consumiu menos analgésicos que o GC (p=0,037). Conclusão: Podemos concluir que o método Pilates é efetivo no tratamento da cervicalgia mecânico-postural crônica, apresentando melhora dos aspectos relacionados à dor, função, qualidade de vida (capacidade funcional, dor, estado geral de saúde, vitalidade e saúde mental) e redução do consumo de analgésicos.
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    Avaliação da imagem corporal, qualidade de vida, sensibilidade tátil e dor em mulheres com câncer de mama submetidas a intervenção cirúrgica
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-27) Bueno, Juliana Nishimura [UNIFESP]; Nazario, Afonso Celso Pinto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Make a comparison between the preoperative and the 30th, 60th and 90th day postoperatively the surgical treatment of breast cancer, the image changes body, quality of life, sensitivity and presence and level of women's pain pesquisadas.A body image of the evaluated patients changed after surgery treatment of breast cancer. There was a worsening of the results of postoperative 30, 60 and 90 days before the preoperative evaluation. The quality of life had changes in some aspects assessed by questionnaire EORTC QLQ C30, physical function in postoperative evaluation 60 days significantly improved compared to the preoperative period and the evaluation of the emotional function in the postoperative 30, 60 and 90 days compared the preoperative. The assessment of cognitive function also showed improvement in 30 days after surgery compared to preoperatively. There was a significant deterioration in social function and loss of appetite in the postoperative period of 30 days in relation to pre operative, and also the symptoms of nausea and vomiting and constipation in the postoperative period 90 days. Body image when assessed by questionnaire EORTC QLQ BR23, was significantly worse in the evaluation of postoperative 30 days, as well as breast symptoms in the postoperative 30 and 60 days, and symptoms arm in all evaluated postoperatively. As for the function and satisfaction sexual significant improvement in postoperative 30 days, as well as prospects have improved in all investigated postoperative. The sensitivity and pain was noticeable worsening on all postoperative when compared to the preoperative evaluation.
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    Avaliação do efeito analgésico da associação de magnésio com morfina na dor de pacientes com câncer: estudo clínico randomizado duplo-cego
    (Universidade Federal de São Paulo (UNIFESP), 2015-07-31) Baaklini, Luis Gustavo [UNIFESP]; Sakata, Rioko Kimiko Sakata [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: The aim of this study was to evaluate if the association of Mg enhances the analgesic effect of morphine in cancer pain. Methods: The study was prospective, randomized, double-blinded, and comparative with placebo. There were studied 40 patients, with more than 18 years, of both genders, with cancer pain, using morphine (third analgesic step recommended by WHO). There were excluded patients with hypersensitivity to drugs, and pregnant. Group 1 patients received oral 656,6mg magnesium sulfate twice daily; group 2 patients received placebo twice a day, in identical capsules. All patients received morphine as needed. Acetaminophen was associated at doses of 2 to 3 g / day (every 4 to 6 h). Adjuvant drugs could be used when indicated. Pain intensity was evaluated by numerical scale from zero to 10 in the first consultation and after 1, 2, 3, and 4 wk. The patient noted the intensity of pain and side effects in a file. The functional performance of Karnofsky (KPS) and the quality of life by QLQ-C30 were evaluated in the 1st consultation and after 4 wk. Results: There was no difference between groups in pain intensity, doses of morphine, functional performance, quality of life and side effects. There was a significant reduction in pain intensity in both groups. There was a increased dose of morphine in G2. Conclusions: The association of magnesium sulfate (656,6mg) to morphine in cancer patients did not improve the analgesic effect, functional performance and quality of life; and did not reduce the side effects; but promoted less need to increase the dose of morphine.
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    Cafeína para o tratamento de dor
    (Sociedade Brasileira de Anestesiologia, 2012-06-01) Tavares, Cristiane [UNIFESP]; Sakata, Rioko Kimiko [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND AND OBJECTIVES: Caffeine is a widely used substance with effects on several systems, presenting characteristic of pharmacokinetic and pharmacodynamic which cause interactions with several drugs. This study's objective is to review the effects caused by caffeine. CONTENT: This review assesses the caffeine pharmacology, its action mechanisms, indications, contraindications, doses, interactions and adverse effects. CONCLUSIONS: There are insufficient double-blind randomized controlled studies that assess the analgesic effect of caffeine on several painful syndromes. Patients presenting chronic pain need caution when it comes to tolerance development, abstinence and drug interaction from chronic caffeine use.
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    Correlação entre o limiar de dor à pressão e a intensidade de dor em individuos com disfunção temporomandibular submetidos a tratamento conservador
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-18) Lalue, Monique [UNIFESP]; Alonso, Luis Garcia Alonso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Pain is a sensation or unpleasant emotional experience associated with actual or potential tissue damage, which features the most prevalent clinical symptoms in individuals with temporomandibular disorders (TMD). However, its quantification is still precarious regarding existing methods, because although they are well established are not very reliable to assess the clinical course of patients. Objective: To measure at different times, with a digital pressure algometer accuracy, the threshold of pain on pressure in masseter and temporalis muscles of TMD patients, who underwent conservative treatment. Methodology: To date were evaluated 27 individuals who had possessed DTM and tenderness in the masseter and temporalis muscles. After diagnostic measurements were performed pain threshold to pressure of these muscles on both sides of the head and the lateral pole of the temporomandibular joint, by placing the pressure algometer in the region being evaluated. For each individual, was established as a conservative treatment that included therapeutic and thermal therapy exercises. These individuals were reevaluated after 15 days and new measurements were obtained. Also will be evaluated after 45 and 75 days of starting treatment. Results: A total of 21 (77.8%) patients adhere to treatment. The Wilcoxon test to evaluate the improvement of the pain threshold to pressure in the first 15 days of treatment in each measured region, both on the right as on the left side of these patients showed statistically significant differences in the measurements. Right masseter Z = 2.24 (p = 0.0250), right temporal Z = 2.13 (p = 0.0325), for the right side Z = 2.55 (p = 0.0106), left masseter Z = 2.74 (p = 0.0060), left temporal Z = 2.27 (p = 0.0228) and left lateral pole Z = 3.43 (p = 0.0006). Conclusion: Based on these results we can infer that the imposition of a conservative treatment in patients with TMD shows positive results in increasing the pressure pain threshold.
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    Cuidados paliativos para pacientes com câncer de cabeça e pescoço: impacto no controle da dor e qualidade de vida
    (Universidade Federal de São Paulo (UNIFESP), 2014-09-24) Eugenio, Cecilia [UNIFESP]; Paiva, Marcos Bandiera Paiva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: Evaluate whether there was a change in the quality of life and pain management in patients with malignant head and neck tumors referred to the Palliative Care Outpatient Clinic in the Department of Head and Neck Surgery, Federal University of São Paulo (UNIFESP) in a period of three months. Method: 44 patients with one of the following criteria were refered to the clinic: presence of distant metastasis, unresectable tumor, or inoperable patients due to lack of clinical conditions. 42 patients participated in the survey. In all 4 stages of the follow up (first office visit, 30, 60, and 90 days) the following survey was applied: the questionnaires on quality of life of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 (version 3.0) and EORTC QLQ-C15-PAL, hospital anxiety and depression scale (HADS), and verbal rating scale (VRS) to assess pain. Results: All patients were classified as stage IV and 78.6 % reported pain. There was improvement on pain management from the first return with p = 0.01, which was maintained in other queries. There was improvement in emotional function on the questionnaires on quality of life and reduction of anxiety on HADS after 60 days follow up. Conclusion: The intervention by a palliative care specialist team is able to better manage pain and emotional symptoms of patients with malignant head and neck tumors with advanced disease and no chance of cure.
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    Diferenças na expressão de dor entre recém-nascidos a termo do sexo feminino e masculino diante de estímulo nociceptivo agudo
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-16) Arias, Maria Carmenza Cuenca [UNIFESP]; Guinsburg, Ruth Guinsburg [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Neonatal exposure to noxious stimuli during their stay in intensive care unit has the potential to alter neurodevelopment and cause permanent changes in somatosensory processing of pain. The consequences of nociception in both the short and long term are known to be affected by variables such as gestational age and newborn morbidity. Furthermore, sex-related differences in the structure and functionality of the brain can also affect its susceptibility to nociceptive stimulus during the neonatal period. However, the impact of sex in the response to an acute nociceptive stimulus in newborn infants remains to be elucidated. In this context the objective of this study was to analyze the differences in the expression of pain in newborns (NB) females and males in response to acute noxious stimulation in the first hours of life. For this purpose, we performed a cross-sectional and blinded study with prospective data collection of 400 infants (200 / sex) healthy, full-term, in the first 6 hours of life, who underwent intramuscular injection of Vitamin K. Heart rate (HR), oxygen saturation (SpO2) and three validated scales for assessing neonatal pain (neonatal Facial Coding System (NFCS), Behavioral Indicators of Infant Pain (BIPP) and Premature Infant pain Profile (PIPP)) were assessed before the procedure, during antisepsis, during injection and two minutes afterwards. The results for both sexes were compared with repeated measures (RM) ANOVA adjusted for gestational age (GA), hours of age, 5-minute Apgar. p <0.05 was considered significant. The studied population had an average or mean GA 39 ± 1 week, birth weight 3169 ± 316g, postnatal age 67 ± 45 minutes, 65% were born by cesarean section and the median Apgar score at 5 minutes was 10. RM-ANOVA adjusted HR, SpO2, BIPP and PIPP were significant for time effect, but not for sex or for the interaction of time and sex. NFCS as to the time effects (p <0.001), gender (p <0.05) and time and sex interaction (p <.03) were significant. Further, construction of contrasts analysis showed that this difference occurred during injection. Therefore, our findings indicate that the newborn full-term healthy females express more facial movements related to pain during an acute nociceptive stimulus in the first 6 hours of life, compared to males.
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    Distúrbios de sono causam impacto na qualidade de vida de mulheres com lúpus eritematoso sistêmico (les)
    (Universidade Federal de São Paulo (UNIFESP), 2015-08-31) Reis, Lilian Karla Cunha dos [UNIFESP]; Trevisani, Virginia Fernandes Moca Trevisani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Despite the small number of studies regarding sleep disorders, they are a frequent complaint of patients with SLE (62 to 80%) and are related to fatigue, pain, and decreased quality of life (Qol). Objective: To assess the impact of sleep disorders in Qol, pain, and fatigue in women with SLE. Methods: We used the following questionnaires, scales and indices: actigraphy to assess sleeping habits of women with SLE, the Pittsburgh Sleep Quality lndex (PSQI) questionnaire, Medical Outcomes short form 36 (SF-36), the Fatigue Severity Scale (FSS), the Visual Analogue Scale (VAS), the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaboration Clinics (SLICC). The software used for data analysis was Minitab version 16.1, with a significance level of 5%. Results: We studied 46 women with SLE, who had subjective complaints of bad sleep (PSQI). When we related the PSQI data with the questionnaires, we observed associations with (FSS) (p=0.048), pain (VAS) (p=0.028), the role-physical (RP) (p = 0.017), the role emotional (RE) (p=0.006), and mental health (MH) scales (SF-36) (p = 0.034). In terms of correlation of the actigraphy variables with the scores of the questionnaires, we observed statistical significance correlation with the SF-36 data in the RE scale, as follows: with sleep latency (SL) (p=0.005), number of wake ups after sleep onset (p=0.038) and sleep efficiency (p=0.046). In the use of drugs: yes or no, the only association that we observed was the use of antimalarial drugs and greater SL (p=0.032). The association of the use of prednisone (PDN) and less total sleep time (TST) almost reached significant value (p=0.056). Conclusion: Our study indicates that patients with SLE and sleep disorders experience a negative impact in terms of fatigue, pain, and some scales of Qol (in the RP, RE and MH scales), particularly role emotional, with increased latency and wake ups after sleep onset, reducing sleep efficiency; in addition to the influence of corticoids and antimalarial drugs over these alterations. We also observed consistency in both evaluation methods (actigraphy and PSQI) in sleep latency. We have no conflict of interest in this study.
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    Dor musculoesquelética idiopática difusa na infância e na adolescência
    (Sociedade de Pediatria de São Paulo, 2011-06-01) Molina, Juliana [UNIFESP]; Silva, Simone Guerra Lopes da [UNIFESP]; Teles, Fernanda Moreira [UNIFESP]; Fraga, Melissa Mariti [UNIFESP]; Paulo, Luciana Tudech Salgueiro Pedro [UNIFESP]; Bugni, Vanessa [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Persistent or intermittent diffuse idiopathic musculoskeletal pain is defined by the presence of pain over three months with no apparent etiology. The diagnosis of this condition in children and adolescents is increasing. The objective of this study was to report the cases of two patients with disabling pain that received multidiscipli-nary treatment and to review the current literature about this subject. CASE DESCRIPTION: The first patient is a nine-year old girl with history of headache, musculoskeletal pain and abdominal pain for two years. During this period she had four episodes of absence of gait with no apparent organic cause. The second patient is a 14-year girl with severe daily low back pain for 14 months, followed by headache and fatigue. Both patients presented a normal physical examina-tion, except for allodynia (case 1) and fibromyalgia tender points (case 2). All tests resulted negative regarding the search for organic reasons for pain complaints. Significant clinical improvement was observed with a multidisciplinary approach offered by pediatricians, psychologists, physical therapists, and nutritionists. Both patients resumed their daily regular activities. COMMENTS: Team integrated performance in a short-term period can provide the attenuation of pain symptoms since emotional, physical and nutritional factors are related to the pain expressed by the patients.
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    Dor pós-operatória em craniotomia
    (Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2005-08-01) Peón, Andréa Ungaro; Diccini, Solange [UNIFESP]; Hospital Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP)
    In the postoperative period, 47% to 75% of the patients report some degree of pain. This study aimed to evaluate pain in the pre and postoperative period of patients submitted to craniotomy. This prospective research was carried out at the neurosurgery unit of a large Brazilian hospital. For a quantitative evaluation of pain, the verbal numeric 0 - 10 rating scale was used. Forty patients with a mean age of 36 years were evaluated. In the preoperative period, 34 (85%) patients indicated headache as the main cause of pain. In the postoperative period, 37 (93%) patients complained of pain while three (7%) reported absence of pain. Pain peaks were observed on the 2nd postoperative day, when 12 (32%) of the patients reported severe pain and 10 (27%) moderate pain. Absence of severe pain occurred after the 8th postoperative day. It was concluded that protocols of analgesia in craniotomy are needed, such as training nurses to better evaluate and handle pain.
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    A dor, o indivíduo e a cultura
    (Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2001-07-01) Sarti, Cynthia Andersen [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    In the pain, the relation between the individual and society appears clearly. The way in which pain is felt and expressed is ruled by cultural codes and pain itself is constituted, as a human fact, by the meanings given to it by society, that sanctions the ways to demonstrate feelings. Although pain is a singular experience for the one who feels it, it happens within a symbolic system, making it a cultural fact.
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    Dores recorrentes na infância e adolescência
    (Sociedade Brasileira de Pediatria, 2003-06-01) Puccini, Rosana Fiorini [UNIFESP]; Bresolin, Ana Maria B.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Secretaria Municipal de Saúde de São Paulo
    OBJECTIVE: to perform a bibliographic review of recurrent pain in children and adolescents, focusing on differential diagnosis and management of such patients. SOURCES OF DATA: search of Medline and Lilacs databases, covering the last four and ten years, respectively. Classical studies and texts related to the matter were also included. SUMMARY OF THE FINDINGS: studies carried out in different parts of the world demonstrate that the most frequent kinds of recurrent pain in children and adolescents are abdominal pain, headache, and limb pain. The occurrence of organic etiology is low, observed in 5% to 10% of the cases. Among the well defined organic etiology, no predominance is observed. The main advances regarding the pathophysiology of recurrent pain in its main localizations were analyzed. Guidelines for the diagnostic and therapeutic approach of the most common infantile diseases related to recurrent pain are presented. CONCLUSIONS: recurrent pain in children and adolescents is very common and determines significant demand on healthcare services. Defined etiology is only presented by 5% to 10% of patients. Anamnesis, physical examination and follow-up are extremely important instruments for dealing with such patients.
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    Efeitos da cinesioterapia associada ou não à acupuntura na reabilitação de pacientes submetidas ao tratamento cirúrgico do câncer de mama
    (Universidade Federal de São Paulo (UNIFESP), 2016-09-27) Santolia, Patricia [UNIFESP]; Facina, Gil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: Study the efficacy of kinesiotherapy with or without acupuncture in patients undergoing surgery for the treatment of breast cancer in the following parameters: pain, range of motion, upper limb function and depressive symptoms. Methods: Women who had pain in the shoulder girdle and upper limb region after three months of surgery , aged 18 years and pain level ? 3 in Visual Analog Scale were included. The patients were randomly divided into two treatment groups received weekly for 10 weeks. Kinesiotherapy group (G1): kinesiotherapy treated with standard pre-defined, lasting 30 minutes. Acupuncture Group + kinesiotherapy (G2): treated with the same protocol kinesiotherapy group followed by another 30 minutes of acupuncture used in pre-defined points. Both groups underwent a physical examination and completed questionnaires of upper limb function and depressive symptoms. Results: 48 patients completed the treatment, and 24 in each group. Regarding pain, the two groups had statistically significant improvement with p < 0,01 at all time points assessed. In the analysis of depression improved significantly only in G1 compared the 1st versus 10th session. The upper limb function had improved only when comparing G1 1st versus 10th session, and G2 showed improvement in all three evaluation times. The range of motion showed improvement in all evaluated movements, movements flexion, extension and internal rotation was improved in G1 and G2 in the comparison of the 1 st session versus 5 th and 1st versus 10th session. In adduction, there was significant improvement only in G2 compared the 1st versus 10th session. Already abduction was no difference in G1 compared to the 1st versus 10th session and G2 in the 1 st session versus 5 th and 1st versus 10th session. Regarding external rotation was improved only in G1 at the 1 st session versus 5 th and 1st versus 10th session. Conclusion: The kinesiotherapy with or without acupuncture was effective for pain relief and function of the upper limb. Depressive symptoms showed significant improvement in the group that did only kinesiotherapy.
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    Efetividade do treinamento sensório-motor em pacientes com osteoartrite de joelho: um ensaio clínico controlado randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2013-05-29) Gomiero, Aline Basolli [UNIFESP]; Trevisani, Virginia Fernandes Moca Trevisani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the effectiveness of sensorimotor training (SMT) and resistance training (RT) on pain and function of a group of individuals with knee osteoarthritis. Methods: Single blind randomized controlled trial. The study included 96 subjects aged between 50 and 75 years with clinical and radiological diagnosis of osteoarthritis of the knee according to the criteria of the American College of Rheumatology. After randomization, participants were divided into three groups: Group 1 - SMT (n = 32), Group 2 - RT (n = 32) and Group 3 - CG (n = 32) for a training program lasting 16 weeks and frequency of twice a week. Interventions for the RT group consisted of guidelines, heating on a bicycle ergometer, exercises for the quadriceps and hamstring muscles and stretching of the lower limbs. The SMT group also received the guidelines, heating and stretching exercises performed by the group RT, associated with interventions consisting of agility drills, balance disorder, coordination and balance of the lower limbs. The CG held just warming up and stretching, also attending the sector twice a week, but without the interventions. Evaluations were performed before (T0) and after the intervention period (T16) and included evaluation of pain by visual analog scale (VAS), the timed up go test (TUG), surface electromyography of the quadriceps muscle (EMG), test of strength of the quadriceps muscle with a dynamometer, Tinetti and Berg functional tests, and the quality of life questionnaires SF-36 and WOMAC knee function, Lequesne and ADLS. The data were analyzed using analysis of variance (ANOVA) with repeated measures analysis by intention to treat (ITT) with a significance level of 5%. Results: 92 patients completed the protocol. There was no difference between groups regarding age, gender distribution, weight and height (p> 0.005). In the RT group, we found statistically significant differences among the evaluated variables for the strength of the quadriceps muscle (p = 0.006), self-assessed physical function questionnaire WOMAC (p = 0.004), and sub-scales of the SF-36 physical functioning (p <0.001), vitality (p = 0.001) and emotional role (p <0.001); and a trend towards improvement, but without statistical significance, on outcomes pain (VAS), TUG test, Tinetti test, the questionnaires Lequesne and ADLS and on the subscales physical role and mental health of SF-36. Regarding the group that underwent sensorimotor training (SMT), our results indicate a significant improvement between the times assessed in the outcomes quadriceps muscle strength (p <0.001) and subscale of SF-36 emotional role (p = 0.004). There was no statistical significance in other variables, however, the group that performed SMT also showed trend towards improvement in pain (VAS), the TUG test, Tinetti test, and the Lequesne questionnaires ADLS and sub-scales physical role and mental health of SF-36. Conclusion: Despite not finding significant differences between groups, both intervention groups showed improvement or a trend towards improvement in most variables measured. Both forms of exercise caused a reduction of perceived pain and functional improvement in the population studied; reducing the negative impact on quality of life of these individuals.
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    Effects of the use of MIG3 bioceramics fabrics use - long infrared emitter - in pain, intolerance to cold and periodic limb movements in post-polio syndrome
    (Academia Brasileira de Neurologia - ABNEURO, 2009-12-01) Silva, Tatiana Mesquita e [UNIFESP]; Moreira, Gustavo Antonio [UNIFESP]; Quadros, Abrahão Augusto Juviniano [UNIFESP]; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Tufik, Sergio [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The main post-polio syndrome (PPS) symptoms are new-onset weakness, new-onset atrophy, fatigue, cold intolerance, and pain associated with sleep disturbances. The polysomnographic study is the gold pattern to analyze sleep disorders. OBJECTIVE: To assess pain, intolerance to cold and periodic limb movements (PLM) index before and after the use of MIG3 bioceramic fabrics over 4 weeks. METHOD: 12 patients with PPS from UNIFESP/EPM. All patients were submitted to polysomnography and infra-red examinations with answered scales of pain and intolerance to cold before and after the use of MIG3 bioceramics fabrics. RESULTS: There were significant decreases in pain and PLM index. CONCLUSION: MIG3 bioceramic fabrics can help in the treatment of pain and PLM in PPS patients.
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    Estimulação elétrica nervosa transcutânea de curta duração no pós-operatório de cirurgia cardíaca
    (Sociedade Brasileira de Cardiologia - SBC, 2010-03-01) Gregorini, Cristie [UNIFESP]; Cipriano Junior, Gerson [UNIFESP]; Aquino, Leticia Moraes de [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Bernardelli, Graziella França [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Respiratory muscle strength has been related to the postoperative outcome of cardiac surgeries. The main documented therapeutic purpose of transcutaneous electrical nerve stimulation (TENS) is the reduction of pain, which could bring secondary benefits to the respiratory muscles and, consequently, to lung capacities and volumes. OBJECTIVES: The objective of the present study was to evaluate the effectiveness of short-duration transcutaneous electrical nerve stimulation (TENS) in the reduction of pain and its possible influence on respiratory muscle strength and lung capacity and volumes of patients in the postoperative period of cardiac surgery. METHODS: Twenty five patients with mean age of 59.9 ± 10.3 years, of whom 72% were men, and homogeneous as regards weight and height, were randomly assigned to two groups. One group received therapeutic TENS (n = 13) and the other, placebo TENS (n = 12), for four hours on the third postoperative day of cardiac surgery. Pain was analyzed by means of a visual analogue scale, and of respiratory muscle strength as measured by maximum respiratory pressures and lung capacity and volumes before and after application of TENS. RESULTS: Short-duration TENS significantly reduced pain of patients in the postoperative period (p < 0.001). Respiratory muscle strength (p < 0.001), tidal volume (p < 0.001) and vital capacity (p < 0.05) significantly improved after therapeutic TENS, unlike in the placebo group. CONCLUSION: Short-duration TENS proved effective for the reduction of pain and improvement of respiratory muscle strength, as well as of lung volumes and capacity. (Arq Bras Cardiol 2010; 94(3):325-331)
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    Estimulação subtalâmica e modulação serotoninérgica em modelo de doença de Parkinson em ratos.
    (Universidade Federal de São Paulo, 2023-11-29) Mauricio, Gustavo Pires [UNIFESP]; Pagano, Rosana de Lima; Caperuto, Luciana Chagas [UNIFESP]; http://lattes.cnpq.br/0144465590218939; http://lattes.cnpq.br/1488843212395172; http://lattes.cnpq.br/2996823655801042
    A doença de Parkinson (DP) é uma doença neurodegenerativa complexa que causa disfunção progressiva com consequente morte de neurônios dopaminérgicos e não dopaminérgicos. A DP apresenta sintomas motores e não motores, sendo a dor um dos sintomas não motores mais prevalentes, debilitantes e ainda pouco compreendidos. O tratamento da DP é eminentemente sintomático, iniciando com uma abordagem farmacológica efetiva que perde sua eficácia ao longo do tempo gerando diversas complicações. Nessa fase, o padrão ouro de tratamento é a estimulação cerebral profunda (Deep Brain Stimulation, DBS) do núcleo subtalâmico (NST), que traz benefícios bastante evidentes frente aos sintomas motores e não motores da DP. Foi observado pelo nosso grupo que a DBS-NST melhora os sintomas motores e nociceptivos em ratos hemiparkinsonianos, resposta essa acompanhada por reversão tanto da neuroinflamação da via motora dopaminérgica como da hiperativação neuronal e glial na medula espinal. Considerando a importância da serotonina no controle da dor, neste projeto investigamos o efeito da DBS-NST na modulação do sistema serotoninérgico de ratos hemiparkinsonianos. Para tanto, avaliamos a marcação de serotonina em áreas envolvidas no controle da dor persistente. O tratamento com DBS-NST foi capaz de reverter o déficit serotoninérgico induzido pela neurotoxina estriatal nos núcleos magno e dorsal da rafe. Adicionalmente, a estimulação subtalâmica aumentou a expressão do receptor serotoninérgico inibitório 5HT1A e inibiu a expressão do 5HT3 excitatório na medula espinal dos ratos hemiparkinsonianos. O efeito ablativo do implante no NST per se modulou parcialmente o sistema serotonérgico; no entanto, não foi capaz de inibir a hipernocicepção dos animais lesionados. Esses dados nos levam a sugerir que o tratamento com DBS-NST inibe a hiperalgesia induzida pela lesão nigroestriatal devido, pelo menos em parte, a restauração do sistema serotoninérgico nos núcleos da rafe e medula espinal, reorganizando a via analgésica descendente com consequente inibição do sintoma de dor persistente. Esta investigação pretende esclarecer o mecanismo de ação da DBS na abordagem do sintoma não motor de dor na DP, com o intuito de nortear o aprimoramento de intervenções terapêuticas mais efetivas e menos invasivas aos pacientes acometidos por essa doença neurodegenerativa cada vez mais incidente.