RESUMO
This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8%). Another 20 patients (18.3%) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.
Assuntos
Neuralgia/epidemiologia , Traumatismos da Medula Espinal/complicações , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Neuralgia/etiologia , Dor/epidemiologia , Dor/etiologia , Medição da Dor , Prevalência , Inquéritos e Questionários , Tradução , Adulto JovemRESUMO
This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2 percent (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8 percent). Another 20 patients (18.3 percent) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.
Estudo transversal descritivo em pacientes com lesão medular que residem em Curitiba, Paraná, Brasil. O objetivo foi avaliar as características da dor em pacientes com lesão medular acompanhados em Centros de Reabilitação de referência na cidade. Os sujeitos envolvidos na pesquisa foram 109 pacientes adultos com lesão medular. Foi avaliada a presença de dor, principalmente dor neuropática, mediante aplicação do Questionário DN4, um instrumento universal traduzido e validado para o português. A Escala Visual Analógica (EVA) também foi usada para avaliar a intensidade da dor. A prevalência de dor nos 109 pacientes avaliados foi de 31,2 por cento, ou seja, 34 pacientes. Destes, nove apresentaram dor nociceptiva classificada como músculo-esquelética, quatro dor visceral e um paciente apresentou dor mista, totalizando 14 pacientes (12,8 por cento). Além disso, 20 pacientes (18,3 por cento) apresentaram dor neuropática, cumprindo os critérios para este tipo de dor com uma contagem superior a 4/10 para o DN4. Sobre as características dos pacientes com dor neuropática, a maioria era do sexo masculino, abaixo de 40 anos, paraplégico com lesão incompleta e tempo de evolução entre um e cinco anos de lesão. A etiologia predominante foi perfuração por arma de fogo e a intensidade da dor era severa, com EVA superior a cinco. Este estudo confirma parcialmente outros estudos publicados sobre o tema. Pesquisas deste tipo são importantes para entender o perfil destes pacientes com a finalidade de estabelecer estratégias para uma reabilitação com foco no tratamento e manejo adequado da dor.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Neuralgia/epidemiologia , Traumatismos da Medula Espinal/complicações , Brasil/epidemiologia , Estudos Transversais , Idioma , Neuralgia/diagnóstico , Neuralgia/etiologia , Medição da Dor , Prevalência , Dor/epidemiologia , Dor/etiologia , Inquéritos e Questionários , TraduçãoRESUMO
BACKGROUND AND OBJECTIVES: Stimulations with formalin in the orofacial region can be related to transient or subacute nociceptive activity and behavioral changes. The evaluation of behavioral changes induced by persistent or chronic irritating nociceptive substance has not yet been described.METHOD: Complete Freund's Adjuvant (CFA) was injected in the temporomandibular joint (TMJ) region of rats and analyzed comparing it to the groups treated with saline and 2.5% formalin. In addition, behaviors such as grooming, freezing, rest/sleeping and chewing-like were electronically observed and quantified.RESULTS: It was shown that the chewing-like behavior was significantly increased and that it was inhibited by indometacin (5 mg/kg) and morphine (4 mg/kg). CONCLUSION: These results suggest that chewing-like may be a possible behavior of persistent or chronic orofacial pain, and may be a tool for clinical-pharmacological studies.
JUSTIFICATIVA E OBJETIVOS: Estímulos com formalina na região orofacial podem estar relacionados com a atividade nociceptiva e as alterações comportamentais transitórias ou subagudas. A avaliação de comportamentos sob ação de substância irritante nociceptiva persistente e crônica ainda não foi descrita.MÉTODO: Foi feita injeção de adjuvante completo de Freund (ACF) na região da articulação temporomandibular (ATM) de ratos e foi analisada comparando-a com os grupos tratados com salina e formalina a 2,5%. Além disso, foram observados e quantificados eletronicamente os comportamentos grooming, freezing, rest/sleeping e chewing-like (mastigação). RESULTADOS: Observou-se que o comportamento mastigação (chewing-like) estava significativamente aumentado e que ele foi inibido pela indometacina (5 mg/kg) e morfina (4 mg/kg).CONCLUSÃO: Esses resultados sugerem ser o chewing-like um possível comportamento de dor orofacial persistente, oferecendo-se como instrumento para análise clínico-farmacológica
Assuntos
Animais , Masculino , Ratos , Analgésicos/farmacologia , Dor Facial/fisiopatologia , Mastigação/efeitos dos fármacos , Transtornos da Articulação Temporomandibular/fisiopatologia , Analgésicos Opioides/uso terapêutico , Anestésicos Locais/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Comportamento Animal , Modelos Animais de Doenças , Adjuvante de Freund , Indometacina/uso terapêutico , Lidocaína/uso terapêutico , Morfina/uso terapêutico , Ratos Wistar , Transtornos da Articulação Temporomandibular/induzido quimicamenteRESUMO
How to handle Western blot (WB) seroindeterminate individuals for Human T-lymphotropic Virus 1/2 (HTLV-1/2) constitutes a challenge for blood banks and families. We made a cross-sectional study of 191 enzyme linked immunoassay (EIA) reactive individuals from the hematological center (HEMOCE) of Fortaleza (Brazil), examining their serological (WB) and molecular (PCR) diagnosis, and demographic profiles, as well as a possible association of their condition with other infectious pathologies and risk factors. Ethical institutional approval and personal consent were obtained. Out of 191 EIA reactive individuals, 118 were WB seroindeterminate and 73 were seropositive for HTLV-1/2. In the PCR analysis of 41 WB seroindeterminate individuals, 9 (22%) were positive and 32 (78%) were negative for HTLV-1/2. The demographic analysis indicated a trend towards a predominance of males among the seroindeterminate individuals and females in the seropositive ones. The seroindeterminate individuals were younger than the seropositive ones. We did not find any association of these conditions with syphilis, Chagas disease or HIV or hepatitis, and with risk factors such as breast-feeding, blood transfusion, STD (syphilis) and IDU.
Assuntos
Primers do DNA/genética , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-II/diagnóstico , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 2 Humano/genética , Western Blotting , Brasil/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-II/epidemiologia , Humanos , Masculino , Reação em Cadeia da Polimerase , Fatores de RiscoRESUMO
A paraparesia espástica tropical (PET/MAH) é uma mielopatia associada em grande parte ao retrovírus HTLV-I, que pertence à família Retroviridade e subfamília Oncovirinae. Esse vírus é prevalente no Japão, Caribe, América do Sul, África e Melanésia , e no mundo existem cerca de 20 milhões de indivíduos infectados e mais de 2000 casos descritos de PET/MAH. O diagnóstico da infecção é feito por testes sorológicos ( Elisa, descritos de PET/MAH. O diagnóstico da infecção é feito por testes sorológicos ( (Elisa Western blot e mais recentemente INNO-LIA) e moleculares (PCR). Clinicamente , a PET/MAH se caracteriza por uma paraparesia espástica insidiosamente progressiva associada a variáveis distúrbios esfincterianos e sensitivos. Os critérios diagnósticos foram propostos pela OMS e têm sido usado como guia na definição clínica e laboratorial . tais como LCR, estudo de potenciais evocados somatossentivos e ressonância nuclear magnética, têm sido utilizados para confirmação e diagnóstico diferencial da PET/MAH. Do ponto de vista neuropatológico, a PET/MAH apresenta lesões inflamatórias e desmielinizantes centradas principalmente na medula torácica baixa.As hipóteses fisiopagênicas atuais apontam para mecanismos imunológicos, de onde tentativas terapêuticas pertinentes advêm.
Assuntos
Humanos , Anticorpos Anti-HTLV-I , Paraparesia Espástica Tropical/diagnóstico , Paraparesia Espástica Tropical/epidemiologia , Paraparesia Espástica Tropical/fisiopatologia , Paraparesia Espástica Tropical/terapiaRESUMO
How to handle Western blot (WB) seroindeterminate individuals for Human T-lymphotropic Virus 1/2 (HTLV-1/2) constitutes a challenge for blood banks and fam ilies. We made a cross-sectional study of 191 enzyme linked immunoassay (EIA) reactive individuals from the hematological center (HEMOCE) of Fortaleza (Brazil), examining their serological (WB) and molecular (PCR) diagnosis, and demographic profiles, as well as a possible association of their condition with other infectious pathologies and risk factors. Ethical institutional approval and personal consent were obtained. Out of 191 EIA reactive individuals, 118 were WB seroindeterminate and 73 were seropositive for HTLV-1/2. In the PCR analysis of 41 WB seroindeterminate individuals, 9 (22 percent) were positive and 32 (78 percent) were negative for HTLV-1/2. The demographic analysis indicated a trend towards a predominance of males among the seroindeterminate individuals and females in the seropositive ones. The seroindeterminate individuals were younger than the seropositive ones. We did not find any association of these conditions with syphilis, Chagas disease or HIV or hepatitis, and with risk factors such as breast-feeding, blood transfusion, STD (syphilis) and IDU