Estudio comparativo del dolor abdominal en las culturas maya Tzeltal, maya Tzotzil y maya Q ́eqchi ́y el uso de Ageratina ligustrina para su tratamiento / Comparative study of abdominal pain in the Mayan cultures Tzeltal, Maya Tzotzil and Maya Q ́eqchi´ and use of Ageratina ligustrina for the treatment

El presente estudio es una comparación del dolor abdominal producido por trastornos gastrointestinales, aliviado por Ageratina ligustrina , entre los grupos maya Tzeltal, Tzotzil y Q ́eqchi ́, el cual integró un enfoque etnomédico, etnobotánico y transcultural, comparando estudios previos con el presente trabajo de campo. Para evaluar la eficacia de Ageratina para aliviar el dolor abdominal, se realizó un inventario de las moléculas reportadas en esta especie, así como de su actividad farmacológica, a través de una revisión bibliográfica. Los resultados mostraron que la epidemiología del dolor producido por TGI, su etnobotánica y el modelo explicativo del dolor abdominal fueron similares entre grupos étnicos. Asimismo, se identificaron 27 moléculas con efectos antiinflamatorios y antinociceptivos, lo que podría explicar por qué esta especie es culturalmente importante para los pobladores maya Tzeltal, Tzotzil y Q ́eqch i ́ para el alivio del dolor abdominal, mientras que, desde el punto de vista biomédico, es una especie con potencial para inhibir el dolor visceral.

The current study is a comparison of the abdominal pain conception produced by gastrointestinal disorders, relieved by Ageratina ligustrina , among inhabitants of the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups ethnomedical, ethnobotanical, and cross -cultural approaches were used to compare previous studies with the present field work. To evaluate the efficacy of A. ligustrina to relieve pain, also through a bibliographic review an inventory of the molecules present in this species was performed, as well as their pharmacological activity. The results showed that the epidemiology of pain produced by GID, its ethnobotany, and the explanatory model of abdominal pain are similar among ethnic groups. Likewise, 27 molecules with anti-inflammatory and anti-nociceptive effects were identified, which could explain why this species is culturally important for the Mayan Tzeltal, Tzotzil, and Q'eqchi' groups for the relief of abdominal pain, while, from a biomedical point of view, it is a species with potential to inhibit visceral pain.

Divertículo de Meckel complicado. Experiencia de 15 años en un hospital interzonal / Complicated Meckel's diverticulum. Fifteen years of experiencein an interzonal hospital in the Province of Buenos Aires

Introducción: el divertículo de Meckel es la anomalía congénita más frecuente del tracto gastrointestinal. Puede presentarse con hemorragia, obstrucción intestinal o diverticulitis, complicaciones que disminuyen con la edad, por lo que en el adulto el diagnóstico suele ser incidental. El tratamiento de las complicaciones es quirúrgico, mediante diverticulectomía o resección segmentaria del intestino delgado, dependiendo de sus características morfológicas. Objetivo: analizar nuestra experiencia en el manejo del divertículo de Meckel complicado en un período de 15 años. Diseño: estudio descriptivo, observacional, transversal, retrospectivo. Material y métodos: se revisaron las historias clínicas de los pacientes operados por divertículo de Meckel complicado en el Servicio de Cirugía General del Hospital San Roque durante el periodo 2007-2022. Se registraron datos demográficos, presentación clínica, diagnóstico preoperatorio, tratamiento quirúrgico, complicaciones postoperatorias y hallazgos histopatológicos. Resultados: se incluyeron 25 pacientes, 21 (84%) hombres, 3 menores de 18 años. La presentación clínica fue un síndrome de fosa iliaca derecha en el 80% de los casos, obstrucción intestinal en el 16% y hemorragia en el 4%. En solo 2 casos se realizó el diagnóstico preoperatorio, confirmado mediante tomografía computada. Se realizó diverticulectomía en el 68% de los pacientes y resección segmentaria el 32%. El abordaje fue laparotómico en el 64%, principalmente en el periodo inicial y laparoscópico en el 36%. Hubo una complicación IIIb de Clavien-Dindo en un paciente pediátrico tratado con drenaje percutáneo. En un solo paciente (4%), que se presentó con hemorragia digestiva masiva, se encontró epitelio de tipo gástrico y páncreas ectópico en el divertículo. Conclusiones: En nuestra experiencia el divertículo de Meckel complicado se presentó predominantemente en hombres. La complicación más frecuente en el adulto fue la diverticulitis. El diagnóstico preoperatorio fue infrecuente y realizado por tomografía computada. La diverticulectomía es suficiente en la mayoría de los casos. Actualmente, la laparoscopia es una herramienta segura, rentable y eficiente que permite el diagnóstico y tratamiento oportunos de esta entidad. (AU)

Introduction: Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract. It can present with bleeding, intesti-nal obstruction or diverticulitis, complications that decrease with age, so in adults the diagnosis is usually incidental. Treatment of complications is surgical, through diverticulectomy or segmental resection of the small intestine, depending on its morphological characteristics. Objective: to analyze our experience in the management of complicated Meckel's diverticulum over a period of 15 years. Design: descriptive, observational, cross-sectional, retrospective study. Materials and methods: the medical records of patients operated on for complicated Meckel's diverticulum in the General Surgery Service of the San Roque Hospital during the period 2007-2022 were reviewed. Demo-graphic data, clinical presentation, preoperative diagnosis, surgical treatment, postoperative complications, and histopathological findings were recorded. Results: twenty-five patients were included, 21 (84%) men, 3 under 18 years of age. The clinical presentation was a right iliac fossa syndrome in 80% of cases, intestinal obstruction in 16% and hemorrhage in 4%. In only 2 cases was the preoperative diagnosis made, confirmed by computed tomography. Diverticulectomy was performed in 68% of patients and segmental resection in 32%. The approach was by laparotomy in 64%, mainly in the initial period, and by laparoscopy in 36%. There was a Clavien-Dindo IIIb complication in a pediatric patient treated with percutaneous drain-age. In only one patient (4%), who presented with massive gastrointestinal bleeding, gastric-type epithelium and ectopic pancreas were found in the diverticulum. Conclusions: In our experience, complicated Meckel's diverticulum occurred predominantly in men. The most frequent complication in adults was diverticulitis. Preoperative diagnosis was infrequent and was made by computed tomography. Diverticulectomy is sufficient in most cases. Currently, laparoscopy is a safe, profitable and efficient tool that allows for the timely diagnosis and treatment of this entity. (AU)

Falta de conhecimento sobre os fatores de risco não ocupacionais da dor lombar entre profissionais de saúde ocupacional brasileiros: um estudo observacional transversal / Lack of knowledge about non-occupational low back pain risk factors among brazilian occupational health professionals: a cross-sectional observational study

INTRODUÇÃO: A dor lombar possui alta prevalência, sendo uma das principais causas de incapacidade no Brasil e no mundo. A dor lombar apresenta etiologia multifatorial, sendo extremamente comum em trabalhadores. OBJETIVOS: Verificar o conhecimento sobre os fatores de risco para dor lombar, crenças e atitudes sobre o manejo da dor lombar entre profissionais de saúde (fisioterapeutas e ergonomistas) atuantes na área ocupacional. MATERIAIS E MÉTODOS: Foi realizado um estudo observacional transversal com 81 profissionais de saúde ocupacional brasileiros. Os participantes preencheram um questionário eletrônico composto por dados profissionais, sociodemográficos, itens sobre fatores de risco para dor lombar e a Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Conhecimentos, crenças e atitudes foram analisados por meio do teste do qui-quadrado para fatores de risco para dor lombar e um modelo de regressão linear para crenças e atitudes dos profissionais de saúde. RESULTADOS: Obesidade (7,4%), ficar sentado mais de 2 horas (8,6%), atividade física (9,9%), falta de apoio psicossocial no trabalho (11,1%) e consumo de álcool (37,0%), apresentaram os menores índices de conhecimento sobre fatores de risco da dor lombar pelos profissionais. Itens sobre saúde geral apresentaram o menor conhecimento. Uma orientação biomédica e psicossocial equilibrada de crenças e atitudes sobre o manejo da dor lombar foi observada. CONCLUSÃO: Profissionais de saúde ocupacional brasileiros carecem de conhecimento sobre os fatores de risco não ocupacionais da dor lombar, especialmente o estado geral de saúde. Esses profissionais também possuem conceitos biomédicos e psicossociais equilibrados no manejo da dor lombar.

INTRODUCTION: Low back pain (LBP) is highly prevalent and is one of the main causes of disability in Brazil and around the world. LBP presents a multifactorial etiology, being extremely common in workers. OBJECTIVE: This study aimed to verify the knowledge about the LBP risk factors, beliefs and attitudes about the management of LBP among health professionals (physiotherapists and ergonomists) working in the occupational area. MATERIALS AND METHODS: A cross-sectional observational study was conducted with 81 Brazilian occupational health professionals. Participants completed an electronic questionnaire comprising professional data, sociodemographics, items about LBP risk factors, and the Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Knowledge, beliefs and attitudes were analyzed using the chi-square test for LBP risk factors and the linear regression model for health professionals' beliefs and attitudes. RESULTS: Obesity (7.4%), sitting for more than 2 hours (8.6%), physical activity (9.9%), lack of psychosocial support at work (11.1%) and consuming alcohol (37.0%) presented the lowest rate of knowledge about LBP risk factors by professionals. Items about general health showed the lowest knowledge. A balanced biomedical and psychosocial orientation of beliefs and attitudes about managing LBP was observed. CONCLUSION: Brazilian occupational health professionals lack knowledge about non-occupational LBP risk factors, especially general health status. These professionals also have balanced biomedical and psychosocial concepts in managing LBP.

"Penumbra sign" in knee pain: a case of distal femur osteomyelitis

"Penumbra sign" is a characteristic finding in magnetic resonance imaging (MRI) of Brodie's abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago. There were no additional findings in the patient's vital parameters, physical examination, and medical history. X-ray imaging revealed two screws in the distal femur and a well-defined sclerotic rim surrounding a radiolucent lesion anterior to the screws. MRI revealed a lesion in the distal femoral metaphysis with low-density fluid and hyperintense granulation tissue surrounding it. After surgical abscess drainage and local debridement, bone cement was placed in the resulting cavity. Teicoplanin treatment was started. The patient was discharged and complete recovery was achieved in the second month. The diagnosis of osteomyelitis is often missed or confused with bone tumors in non-traumatic cases presenting with persistent bone pain. MRI imaging is frequently used in differential diagnosis, and detection of characteristic imaging signs such as the penumbra sign accelerates the diagnosis. In this context, emergency department clinicians, in particular, should be cautious and not forget that early treatment can be started by recognizing these signs.

Analysis of the metabolic profile and comorbidities in women with endometriosis before and after surgical treatment / Análise do perfil metabólico e comorbidades em mulheres com endometriose antes e depois do tratamento cirúrgico

Aim: this study aimed to evaluate the effects of surgical treatment for endometriosis on the metabolic profile of women diagnosed with deep endometriosis. Methods: we conducted a prospective observational study with a sample of 30 women in the menacme diagnosed with deep endometriosis who underwent videolaparoscopic surgery in a reference center in Brazil between October 2020 and December 2021. A total of 30 women performed clinical and laboratory tests regarding their metabolic profile on two occasions, during preoperative tests and six months after video-laparoscopy. Results: patients had lower average levels of Total Cholesterol (TC), Low-Density Cholesterol (LDL-c), Triglycerides (TGC), and Fasting Glycemia (FG) after the surgical procedure. The average TC level was 8.2% lower after surgery, LDL-c was 12.8% lower, TGC was 10.9% lower, and FG was 7.3% lower. The results showed a statistically significant difference for all these parameters (p < 0.001). Conclusions: video-laparoscopy was associated with a favorable lipid profile compared to the preoperative lipid profile, with a significant improvement in the average levels of LDL-c, HDL-c, TC, TGC, and FG. Long-term follow-up studies are needed to determine whether surgical treatment for endometriosis can improve the metabolic parameters of women with endometriosis and favor a lower predisposition to atherogenesis.

Objetivo: Aeste estudo teve como objetivo avaliar os efeitos do tratamento cirúrgico da endometriose no perfil metabólico de mulheres com diagnóstico de endometriose profunda. Métodos: foi realizado um estudo observacional prospectivo com uma amostra de 30 mulheres na menacme, com diagnóstico de endometriose profunda, que foram submetidas à videolaparoscopia em um centro de referência no Brasil, entre outubro de 2020 e dezembro de 2021. As mulheres realizaram exames clínicos e laboratoriais quanto ao seu perfil metabólico em duas ocasiões, durante exames pré-operatórios e seis meses após a videolaparoscopia. Resultados: as pacientes apresentaram níveis médios mais baixos de Colesterol Total (CT), Colesterol de Baixa Densidade (LDL-c), Triglicerídeos (TGC) e Glicemia de Jejum (GJ) após o procedimento cirúrgico. O nível médio de CT foi 8,2% menor após a cirurgia, o LDL-c foi 12,8% menor, o TGC foi 10,9% menor e a GJ foi 7,3% menor. Os resultados mostraram diferença estatisticamente significativa para todos esses parâmetros (p < 0,001). Conclusões: a videolaparoscopia foi associada a um perfil lipídico favorável em comparação ao perfil lipídico pré-operatório, com melhora significativa nos níveis médios de LDL-c, HDL-c, CT, TGC e GJ. Estudos de acompanhamento a longo prazo são necessários para determinar se o tratamento cirúrgico da endometriose pode melhorar os parâmetros metabólicos de mulheres com endometriose e favorecer uma menor predisposição à aterogênese.

Pain Patterns of the Temporomandibular Joint Dysfunction and Implications of Stress-Related Behaviors: A Pilot Study / Patrones de Dolor de la Disfunción de la Articulación Temporomandibular e Implicaciones de los Comportamientos Relacionados con el Estrés: Un Estudio Piloto

SUMMARY: Temporomandibular joint dysfunction interferes with the quality of life and activities of daily living among patients. The symptoms of temporomandibular dysfunction, including pain and clicking and popping sounds, are worsened during stressful events, and patients report increased pain around the temporomandibular joint. Stress-related behaviors, such as teeth clenching and teeth grinding, are commonly reported as increasing during stress. The prevalence of temporomandibular dysfunction and stress-related behaviors is reported differently in the literature. Stress in higher education is common. The purpose of this pilot study was to investigate the prevalence of temporomandibular joint dysfunction and stress-related behaviors among staff members at a local University. The study also sought to explore pain patterns described by people experiencing temporomandibular joint dysfunction and the relationship between stress-related behaviors and pain symptoms experienced. Further, the impact of stress on symptoms experienced by people with temporomandibular dysfunction was investigated in this pilot study.

La disfunción de la articulación temporomandibular interfiere con la calidad de vida y las actividades de la vida diaria entre los pacientes. Los síntomas de la disfunción temporomandibular, incluidos el dolor y los chasquidos, empeoran durante los eventos estresantes, y los pacientes informan un aumento del dolor alrededor de la articulación temporomandibular. Los comportamientos relacionados con el estrés, como apretar y rechinar los dientes, suelen aumentar durante el estrés. La prevalencia de la disfunción temporomandibular y los comportamientos relacionados con el estrés se informa de manera diferente en la literatura. El estrés en la educación superior es común. El propósito de este estudio piloto fue investigar la prevalencia de la disfunción de la articulación temporomandibular y los comportamientos relacionados con el estrés entre los miembros del personal de una universidad local. El objetivo del estudio además fue explorar los patrones de dolor descritos por personas que experimentan disfunción de la articulación temporomandibular y la relación entre los comportamientos relacionados con el estrés y los síntomas de dolor experimentados. Además, en este estudio piloto se investigó el impacto del estrés en los síntomas que experimentan las personas con disfunción temporomandibular.

Evolución clínica en pacientes con síndrome del túnel carpiano tratados con ultrasonido o infiltración con corticoesteroides / Clinical Evolution in Patients with Carpal Tunnel Syndrome Treated with Ultrasound or Corticosteroid Infiltration

Introducción. El Síndrome del túnel carpiano es la neuropatía periférica compresiva más común de la extremidad superior, que se produce por la compresión del nervio mediano. Los casos leves y moderados pueden tratarse con métodos conservadores como ultrasonido terapéutico o infiltración con corticoesteroides. Objetivo. Describir la evolución clínica de pacientes con síndrome de túnel carpiano tratados con terapia por ultrasonido e infiltración de corticoesteroides. Metodología. Ensayo clínico abierto, en pacientes con síndrome del túnel carpiano leve y moderado, que consultaron del 1 de octubre 2021 al 30 de mayo 2022. Se formaron dos grupos; el que recibió tratamiento con ultrasonido con 12 casos y el grupo tratado con infiltración con corticoesteroides con seis casos. Ambos grupos fueron intervenidos en la consulta inicial, y luego, en las cuatro y ocho semanas posteriores al inicio del tratamiento. Resultados. Se muestran los resultados descriptivos relacionados con la intensidad de dolor, valorada con la Escala Visual Numérica, la infiltración obtuvo dos casos sin dolor y cuatro con dolor moderado, contrario a ultrasonido que se mantuvo con cuatro casos leves, tres moderados y cinco intensos. En los síntomas, la infiltración redujo el número de casos en cuatro de los síntomas estudiados, en cambio el ultrasonido únicamente en dos. En severidad, valorada con el cuestionario de Boston para túnel carpal, con infiltración se obtuvieron dos casos asintomáticos y ninguno con ultrasonido. Respecto a los signos clínicos, el signo de Tinel desapareció en cuatro casos en ambos grupos, mientras que signo de Phalen desapareció en cuatro casos en ultrasonido y dos en infiltración. Conclusión. En intensidad de dolor y grado de severidad, la infiltración generó casos asintomáticos y redujo mayor cantidad de síntomas que el ultrasonido. Ambos tratamientos disminuyeron la presencia de signos clínicos

Introduction. Carpal tunnel syndrome is the most common compressive peripheral neuropathy of the upper extremity, which is caused by compression of the median nerve. Mild and moderate cases can be treated with conservative methods such as therapeutic ultrasound or corticosteroid infiltration. Objective. To describe the clinical evolution of patients with carpal tunnel syndrome treated with ultrasound therapy and corticosteroid infiltration. Methodology. A prospective open clinical trial was conducted in patients with mild and moderate carpal tunnel syndrome who consulted from October 1, 2021 to May 30, 2022. Two groups were formed: the group that received ultrasound treatment with 12 cases and the group treated with corticosteroid infiltration with six cases. Both groups were treated at the initial consultation and then at four and eight weeks after the start of treatment. Results. The descriptive results related to the intensity of pain, evaluated with the Visual Numeric Scale, are shown. Infiltration obtained two cases without pain and four with moderate pain, contrary to ultrasound which was maintained with four mild, three moderate and five intense cases. In symptoms, infiltration reduced the number of cases in four of the symptoms studied, while ultrasound reduced the number of cases in only two. In severity, assessed with the Boston carpal tunnel questionnaire, with infiltration, there were two asymptomatic cases and none with ultrasound. Regarding clinical signs, Tinel's sign disappeared in four cases in both groups, while Phalen's sign disappeared in four cases in ultrasound and two in infiltration. Conclusion. Infiltration produced asymptomatic patients and reduced more symptoms than ultrasonography in terms of pain intensity and severity. Clinical symptoms were less common with both treatments.

Trastornos somatomorfos y rasgos de personalidad en pacientes hospitalizados por lumbalgia crónica en El Salvador / Somatoform Disorders and Personality Traits in Hospitalized Patients with Chronic Back Pain in El Salvador

Introducción. El trastorno somatomorfo se caracteriza por la presentación de múltiples síntomas físicos que no pueden ser atribuidos a otra enfermedad física, mental o al uso de sustancias, teniendo como comorbilidad más prevalente a los trastornos de personalidad. Objetivo. Determinar la frecuencia de trastorno somatomorfo, sus características principales y diferentes rasgos de personalidad entre pacientes con lumbalgia crónica. Metodología. Estudio descriptivo transversal realizado con pacientes ingresados en el servicio de neurocirugía del Hospital General del Instituto Salvadoreño del Seguro Social. La recolección de datos se realizó a través de la escala Screening for Somatoform Symptoms 2 y la escala InternationalPersonality Disorder Examination. Las variables cualitativas fueron analizadas a través de frecuencias absolutas. Las variables cuantitativas fueron analizadas a través de medidas de tendencia central y de dispersión. Los análisis estadísticos fueron realizados en el programa Statistical Package for the Social Sicience, versión 26. Resultados. Se incluyeron 60 pacientes, 40 de ellos mujeres, 31 entre los 41 y 60 años. Veintiocho pacientes presentaron ocho o más síntomas, excluyéndose dolor lumbar. Cuarenta y cinco pacientes reportaron sintomatología por más de un año. Cincuenta y tres pacientes presentaron trastorno somatomorfo. Los trastornos de personalidad más frecuentes fueron obsesivo-compulsivos (31), límites (21) y paranoides (21). Conclusión. Los pacientes con dolor lumbar crónico que requieren ingreso hospitalario presentan una alta frecuencia de trastornos somatomorfos, con dolor en piernas o brazos como síntoma principal; además, estos pacientes se caracterizan por presentar en su mayoría rasgos de personalidad obsesivo-compulsivos.

Introduction. The somatoform symptoms disorder is characterized by multiple psychical symptoms that can't be attributed to another physical or mental health diagnosis or drug abuse, having personality disorders as the most common comorbidity. Objective. To determine the frequency of somatoform disorders, it's most important characteristics and different personality traits among patients with chronic back pain. Methodology. Cross-sectional descriptive study carried out with patients admitted to the neurosurgery department of the General Hospital of the Salvadoran Social Security Institute. Data collection was carried out using the Screening for Somatoform Symptoms 2 scale and the International Personality Disorder Examination scale. The qualitative variables were analyzed through absolute frequencies. The quantitative variables were analyzed through measures of central tendency and dispersion. The statistical analyzes were carried out using the Statistical Package for the Social Sciences version 26. Results. The study included 60 patients, 40 of them women, 31 between 41 and 60 years old. Twenty-eight patients presented eight or more symptoms, excluding low back pain. Forty-five patients reported symptoms for more than one year. Fifty-three patients presented somatoform disorder. The most frequent personality disorders were obsessive-compulsive (31), borderline (21) and paranoid (21). Conclusion. Patients with chronic lower back pain who require hospital admission have a high frequency of somatoform disorders, with the main symptom being pain in the legs or arms; furthermore, these patients are characterized by mostly presenting obsessive-compulsive personality traits

Systemic and local antiinflammatory effect of magnesium chloride in experimental arthritis

Abstract Objective Despite some knowledge gaps in scientific evidence, MgCl2 is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl2 in an acute arthritis model. Methods Mice received 0.1 mg/25μL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h. Synovia were excised for histopathology and analysis of immunoexpression of nuclear factor kappa B (NFκB) and tumor necrosis factor (TNF)-α. Groups (n = 6/group) received either 90 mg/kg MgCl2/100 μL or saline per os (systemic) or 500 μg/25 μL MgCl2 or saline intra-articularly (i.a.) 30 min prior to Zy. Results MgCl2 given either systemically or locally significantly reduced cell influx (p = 0.0012 and p = 0.0269, respectively), pain (p = 0.0005 and p = 0.0038, respectively), and intra-articular IL-1 level (p = 0.0391), as compared to saline. Systemic MgCl2 significantly decreased NFκB (p < 0.05) immmunoexpression, as compared to saline. Conclusion MgCl2 given systemically or locally displayed anti-inflammatory activity in a severe acute arthritis model reducing cell influx, pain, and cytokine release. MgCl2 operates at least partially via inhibiting NFκB activation. This is the first in vivo demonstration that MgCl2 decreases cytokine release in arthritis, prompting reduction of inflammation and pain relief.

Having chronic back pain did not impact COVID-19 outcome in a low-income population - a retrospective observational study

Abstract Introduction Chronic back pain (CBP) is a major cause of years lived with disability. Social inequalities increase the prevalence and burden of CBP. Management of CBP was affected by restricted access to non-pharmacological treatments and outdoor activities during COVID-19 pandemic. Objectives To determine the prevalence of CBP among patients with COVID-19 as well as the impact of having CBP in COVID-19 outcome in our low-income population. Methods Retrospective cohort of individuals with confirmed COVID diagnosis from May 2020 - March 2021, at Hospital Regional UNIMED (HRU) in Fortaleza, Ceará, Brazil. Data included comorbidities and household income. Results Among 1,487 patients, 600 (40.3%) were classified as having CBP. Mean age as well as income were similar in CBP and non-CBP groups, with more women in the CBP group. Hypertension and asthma, but not diabetes, were more prevalent in those with CBP. Need for emergency care, hospitalization, and admission to intensive care unit were similar regardless of having CBP. Dyspnea was more common in CBP vs. non-CBP groups, with 48.8% vs. 39.4% percentages, respectively (p = 0.0004). Conclusion Having CBP prior to COVID did not impact the acute clinical outcome of COVID individuals of a low- income population.

Transcranial magnetic stimulation in the treatment of phantom limb pain: a systematic review / Estimulação magnética transcraniana no tratamento da dor do membro fantasma: uma revisão sistemática

Abstract Background Phantom limb pain (PLP) occurs after amputations and can persist in a chronic and debilitating way. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation method capable of influencing brain function and modulating cortical excitability. Its effectiveness in treating chronic pain is promising. Objective To evaluate the evidence on the efficacy and safety of using rTMS in the treatment of PLP, observing the stimulation parameters used, side effects, and benefits of the therapy. Methods This is a systematic review of scientific articles published in national and international literature using electronic platforms. Results Two hundred and fifty two articles were identified. Two hundred and forty six publications were removed because they were duplicated or met the exclusion criteria. After selection, six studies were reviewed, those being two randomized clinical trials and four case reports. All evaluated studies indicated some degree of benefit of rTMS to relieve painful symptoms, even temporarily. Pain perception was lower at the end of treatment when compared to the period prior to the sessions and remained during patient follow-up. There was no standardization of the stimulation parameters used. There were no reports of serious adverse events. The effects of long-term therapy have not been evaluated. Conclusion There are some benefits, even if temporary, in the use of rTMS to relieve painful symptoms in PLP. High-frequency stimulation at M1 demonstrated a significant analgesic effect. Given the potential that has been demonstrated, but limited by the paucity of high-quality studies, further controlled studies are needed to establish and standardize the clinical use of the method.

Resumo Antecedentes A dor do membro fantasma (DMF) ocorre após amputações e pode persistir de forma crônica e debilitante. A estimulação magnética transcraniana repetitiva (EMTr) é um método de neuromodulação não invasivo capaz de influenciar a função cerebral e modular a excitabilidade cortical. Sua eficácia no tratamento da dor crônica é promissora. Objetivo Avaliar as evidências sobre a eficácia e segurança do uso da EMTr no tratamento da DMF, observando os parâmetros de estimulação utilizados, efeitos colaterais e benefícios da terapia. Métodos Trata-se de uma revisão sistemática de artigos científicos publicados na literatura nacional e internacional utilizando plataformas eletrônicas. Resultados Foram identificados 252 artigos. Duzentas e quarenta e seis publicações foram removidas por estarem duplicadas ou atenderem aos critérios de exclusão. Após a seleção, foram revisados seis estudos, sendo dois ensaios clínicos randomizados e quatro relatos de caso. Todos os estudos avaliados indicaram algum grau de benefício da EMTr no alívio dos sintomas dolorosos, mesmo que temporariamente. A percepção da dor foi menor ao final do tratamento quando comparada ao período anterior às sessões e permaneceu durante o acompanhamento do paciente. Não houve padronização dos parâmetros de estimulação utilizados. Não houve relatos de eventos adversos graves. Os efeitos da terapia a longo prazo não foram avaliados. Conclusão Existem alguns benefícios, mesmo que temporários, no uso da EMTr para alívio dos sintomas dolorosos na DMF. A estimulação de alta frequência em M1 demonstrou um efeito analgésico significativo. Dado o potencial demonstrado, mas limitado pela escassez de estudos de alta qualidade, são necessários mais estudos controlados para estabelecer e padronizar o uso clínico do método.

Impact of the COVID-19 pandemic on the perception of treatment and chronic musculoskeletal pain in users of a family health unit: qualitative study / Impacto da pandemia da COVID-19 na percepção do tratamento e da dor musculoesquelética crônica em usuários de uma unidade de saúde da família: estudo qualitativo

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain has a high demand for health care due to its multifactorial cause. The COVID-19 pandemic represented a scenario of social stress, in which there was a reduction in care for chronic non-communicable diseases, including cases of chronic pain. The aim of this study was to understand the impacts of the pandemic on this population, considering the perception of pain, experience with care and mental health. METHODS: This is an exploratory case study using a qualitative methodology. An intentional sample of six patients diagnosed with chronic musculoskeletal pain, of both genders and aged between 30 and 70 was used. The individuals underwent a semi-structured interview, in which the data was analyzed by thematic analysis and coding. RESULTS: After the analysis, three themes emerged: 1) Multidimensional impact of pain and coping strategies; 2) Characteristics of the health service and individual-centered care; 3) Influence of pain on quality of life and perspective of future life. The impact of health care was a factor of anxiety and uncertainty about pain. It had repercussions on new coping strategies, such as telehealth. In this context, Primary Health Care was a scenario capable of managing the short- and long-term quality of life of individuals with chronic pain. CONCLUSION: This study contributed to understanding the impact of the COVID-19 pandemic on individuals with chronic pain, which represents a challenge to current care.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica apresenta alta demanda de assistência à saúde, devido a sua causa multifatorial. A pandemia da COVID-19 representou um cenário de estresse social, em que houve redução de atendimentos às doenças crônicas não transmissíveis, incluindo os casos de dores crônicas. O objetivo deste estudo foi compreender os impactos da pandemia para este público, considerando a percepção da dor, experiência com assistência e saúde mental. MÉTODOS: Trata-se de um estudo de caso exploratório de metodologia qualitativa. Foi utilizada uma amostra intencional de seis pacientes com diagnóstico de dor musculoesquelética crônica, de ambos os sexos e com idade entre 30 e 70 anos. Os indivíduos passaram por uma entrevista semiestruturada, na qual os dados foram analisados por análise temática e codificação. RESULTADOS: Após a análise, emergiram três temas: 1) Impacto multidimensional da dor e estratégias de enfrentamento; 2) Características do serviço de saúde e atenção centrada no indivíduo; 3) Influência da dor na qualidade de vida e na perspectiva de vida futura. O impacto na assistência à saúde foi um fator de ansiedade e incertezas sobre a dor. Isso repercutiu em novas estratégias de enfrentamento, como os teleatendimentos. Nesse contexto, a Atenção Primária à Saúde foi o cenário capaz de gerenciar a qualidade de vida a curto e a longo prazo dos indivíduos com dor crônica. CONCLUSÃO: Este estudo contribuiu para a compreensão do impacto da pandemia da COVID-19 em indivíduos com dor crônica, o qual representa desafios à assistência atual.

Multidisciplinary treatment program for improvement in pain and disability associated with nonspecific chronic low back pain / Programa de tratamento multidisciplinar para melhora da dor e incapacidade associada a dor crônica lombar inespecífica

ABSTRACT BACKGROUND AND OBJECTIVES: Lumbar disorders, which contribute to significant workplace absenteeism and chronic disability, are associated with a considerable financial and social burden. Although a conservative approach provides satisfactory pain relief, biomechanical improvement and is associated with a low risk of adverse effects, there is lack of consensus in the literature regarding the best therapeutic strategy in such cases. METHODS: This retrospective longitudinal study used secondary data from the institutional medical records of patients who completed a multidisciplinary program for the treatment of low back pain between 2019 and 2021. Data regarding pain levels and motor skills were obtained from patients who completed the care program at a private hospital in Bento Gonçalves, RS. The following step-wise treatment algorithm was used: evaluation by a specialist physician for the etiological diagnosis of pain, pharmacological management and dry needling, followed by standard rehabilitation intervention performed by the physiotherapy team and exercises by the physical education team. The visual analogue scale (VAS) was used to measure pain at the start and at the completion of the intervention, and the Oswestry Disability Index (ODI) was used to measure motor skills at the start and at 6 and 12 months following the multiprofessional intervention for rehabilitation. RESULTS: A reduction in pain and motor disability in patients who completed all stages of the treatment program was observed. Pain by the VAS presented the following scores: baseline 7 [5-8] and after treatment 2 [0-4]; and the scores of the ODI were: at baseline 0.34 [0.26 - 0.40], at 6 months 0.16 [0.08 - 0.26] and after treatment 0.12 [0.04 - 0.21]. CONCLUSION: The treatment program reduced the pain and disability associated with low back pain and can serve as the basis for further studies carried out to confirm the effectiveness of this intervention.

RESUMO JUSTIFICATIVA E OBJETIVOS: As doenças lombares, que contribuem para um absenteísmo significativo no local de trabalho e para a incapacidade crônica, estão associadas a um encargo financeiro e social considerável. Embora a abordagem conservadora proporcione alívio satisfatório da dor, melhore a biomecânica e esteja associada a baixo risco de efeitos adversos, não há consenso na literatura sobre a melhor estratégia terapêutica nesses casos. MÉTODOS: Neste estudo longitudinal retrospectivo, foram utilizados dados secundários dos prontuários médicos institucionais de pacientes que completaram um programa multidisciplinar para tratamento de dor lombar entre 2019 e 2021. Dados sobre níveis de dor e habilidades motoras foram obtidos de pacientes que completaram o programa assistencial de um hospital privado de Bento Gonçalves, RS. Foi utilizado o seguinte tratamento passo a passo: avaliação por médico especialista para diagnóstico etiológico da dor, manejo farmacológico e agulhamento a seco, seguido de intervenção de reabilitação padrão realizada pela equipe de fisioterapia e exercícios pela equipe de educação física. A escala analógica visual (EAV) foi utilizada para medir a dor no início e após a conclusão da intervenção, e o Índice de Incapacidade de Oswestry (ODI) foi usado para medir as habilidades motoras no início e aos 6 e 12 meses após a intervenção multiprofissional para reabilitação. RESULTADOS: Observou-se redução na dor e na incapacidade motora em pacientes que completaram todas as etapas do programa de tratamento. A intensidade da dor medida pela EAV apresentou as seguintes pontuações: basal 7 [5-8] e após tratamento 2 [0-4]; enquanto o ODI apresentou as pontuações: basal 0,34 [0,26 - 0,40], até 6 meses 0,16 [0,08 - 0,26] e após o tratamento 0,12 [0,04 - 0,21]. CONCLUSÃO: O programa de tratamento reduziu a dor e a incapacidade associadas à dor lombar e pode servir de base para novos estudos realizados para confirmar a eficácia desta intervenção.

Type of pain locus of control related to the level of dependence and depression in the elderly / Tipo de lócus de controle da dor relacionado ao nível de dependência e depressão em idosos

ABSTRACT BACKGROUND AND OBJECTIVES: The locus of control (LC) of pain is the perception of the individual about pain control. The investigation of the relationship between LC, dependence and depression in elderly patients is of great importance given the high prevalence of chronic diseases among this population. The objective of this study was to analyze the association between LC of pain in elderly patients and the level of dependence and prevalence of depression. METHODS: Ninety-one elderly individuals, aged over 60 years, were selected from the Association of Retirees, Pensioners, and Elderly of Lavras and Region (AAPIL) and all participants underwent a comprehensive anamnesis to effectively describe and characterize the sample. The Health Locus of Control Multidimensional Scale was used to assess perception of pain, the Yesavage Geriatric Depression Scale was used to determine the prevalence of depression, and Katz Index to evaluate functional capacity. Chi-square test was used to analyze nominal variables with a 95% level of significance. RESULTS: The majority of the elderly participants (83.5%) reported experiencing chronic pain, while 85.7% had no suspected depression. Internal control was the most prevalent type of LC among participants, and there was no significant relationship between LC of pain and depression. CONCLUSION: Findings suggest that the type of LC of pain reported by the elderly participants in this study does not significantly interfere with the likelihood of depression. These results contribute to the understanding of the relationship between LC, dependence, and depression among senior patients and may inform interventions to improve their quality of life.

RESUMO JUSTIFICATIVA E OBJETIVOS: O lócus de controle (LC) da dor é a percepção do indivíduo sobre o controle da dor. A investigação da relação entre LC, dependência e depressão em idosos é de grande importância dada a alta prevalência de doenças crônicas nessa população. O objetivo deste estudo foi analisar a associação entre LC de dor em idosos, o grau de dependência e a prevalência de depressão. MÉTODOS: Noventa e um indivíduos idosos com idade superior a 60 anos foram selecionados na Associação de Aposentados, Pensionistas e Idosos de Lavras e Região (AAPIL), e todos os participantes passaram por uma anamnese abrangente para descrever e caracterizar efetivamente a amostra. A Escala Multidimensional de Lócus de Controle da Saúde foi usada para avaliar a percepção de dor, a Escala de Depressão Geriátrica Yesavage para determinar a prevalência de depressão e o Índice de Katz para avaliar a capacidade funcional. O teste Qui-quadrado foi utilizado para analisar variáveis nominais com nível de significância de 95%. RESULTADOS: A maioria dos idosos participantes (83,5%) relatou sentir dor crônica, enquanto 85,7% não tinham suspeita de depressão. O controle interno foi o tipo de LC mais prevalente entre os participantes, não havendo relação significativa entre LC de dor e depressão. CONCLUSÃO: Os achados sugerem que o tipo de LC da dor relatado pelos idosos participantes deste estudo não interferiu significativamente a probabilidade de depressão. Esses resultados contribuem para a compreensão da relação entre LC, dependência e depressão entre pacientes idosos e podem auxiliar em intervenções para melhorar sua qualidade de vida.

Skin abscess after the use of transdermal buprenorphine. Case report / Abscesso cutâneo após o uso de buprenorfina transdérmica. Relato de caso

ABSTRACT BACKGROUND AND OBJECTIVES: Buprenorphine is a partial agonist semi-synthetic opioid used as an option in the treatment of patients with moderate to severe pain. The only presentation of buprenorphine available in Brazil is for transdermal use. This is an important route of drug administration, especially for the treatment of chronic pain, as it has several advantages, however it is not free from complications. The objective of this study was to present a serious adverse skin reaction after the use of transdermal buprenorphine, requiring surgical intervention. CASE REPORT: Female patient, 63 years old, hypertensive and diabetic, diagnosed with rheumatoid arthritis, fibromyalgia syndrome and lumbar disc herniation, with severe chronic pain, advised to use transdermal buprenorphine 10 mg to help control algic. After 24 hours of use, the patient developed erythema and local itching, requiring removal of the adhesive, but the lesion progressively worsened with the formation of an abscess and the need for surgical drainage. CONCLUSION: Transdermal buprenorphine has a favorable safety and tolerability profile, as it reduces the risk of unwanted effects such as respiratory depression, constipation and suicidal ideation. However, its use in senior patients with comorbidities, such as the immunosuppression described in this case, requires greater vigilance, due to the possibility of developing more serious adverse reactions.

RESUMO JUSTIFICATIVA E OBJETIVOS: A buprenorfina é um opioide agonista parcial semissintético utilizado como opção no tratamento de pacientes com dor de moderada a intensa. A única apresentação disponível da buprenorfina no Brasil é para uso por via transdérmica. Esta é uma via importante de administração de fármacos, principalmente para o tratamento de dor crônica, já que apresenta diversas vantagens, no entanto não é isenta de complicações. O objetivo deste estudo foi apresentar uma reação cutânea adversa grave após o uso de buprenorfina transdérmica, com necessidade de intervenção cirúrgica. RELATO DO CASO: Paciente do sexo feminino, 63 anos, hipertensa e diabética, com diagnósticos de artrite reumatoide, síndrome fibromiálgica e hérnia de disco lombar, portadora de dor crônica intensa, com orientação de utilizar buprenorfina transdérmica 10 mg para auxiliar o controle álgico. Após 24 h de uso, a paciente evoluiu com eritema e prurido local, sendo indicada a remoção do adesivo, porém a lesão piorou progressivamente com formação de abscesso e necessidade de drenagem cirúrgica. CONCLUSÃO: A buprenorfina transdérmica apresenta um perfil favorável de segurança e tolerabilidade, pois reduz o risco de efeitos indesejados, como depressão respiratória, constipação e ideação suicida. No entanto, seu uso em pacientes idosos portadores de comorbidades, como a imunossupressão descrita no caso, exige maior vigilância, devido à possibilidade de desenvolvimento de reações adversas mais graves.

Prevalence of musculoskeletal pain in body segments in Judo and Jiu-jitsu athletes / Prevalência de dor musculoesquelética nos segmentos corporais em atletas de Judô e Jiu-jitsu

ABSTRACT BACKGROUND AND OBJECTIVES: A notable gap persists in understanding the prevalence of pain and musculoskeletal injuries in combat sports. This study offers a comprehensive exploration of the most affected anatomical regions. Such an investigation is pivotal for refining clinical strategies involving preventive measures and physiotherapeutic interventions. METHODS: This is a cross-sectional observational study. Individuals aged 18 years or over, combat sport modalities practitioners, of both genders, and capable of answering the questionnaire were included. Data were analyzed using descriptive statistics and the Chi-square test. RESULTS: The final sample consisted of 71 athletes. Female athletes practiced 12.65% Judo and 21.51% practiced Jiu-jitsu, while 26.58% of male athletes practiced Judo and 39.24% Jiu-jitsu. The mean age was 31.14±11.75 years, and body mass index of 27.69 kg/m2 (±5.31). The average time of practice was 8±10.59 years. The regions most affected by pain in the last 12 months were the lumbar spine (90%), knees (90%) and wrists/ hands (60%). Female Judo presented a significant index of pain in the last 12 months in the upper limbs, and the neck was the region identified as most responsible for limiting activities. In the last 7 days, the thoracic and lumbar spine regions were more significant. In female Jiu-jitsu, in the 12-month and 7-day analyses, the ankle/foot were the most affected regions when compared to the male gender, and the knees were identified as most responsible for limiting activities. CONCLUSION: A comprehensive description of the main regions affected by musculoskeletal disorders and pain is of fundamental importance for the development of prevention and physiotherapeutic treatment strategies.

RESUMO JUSTIFICATIVA E OBJETIVOS: Persiste uma lacuna notável na compreensão da prevalência da dor e das lesões musculoesqueléticas nos esportes de combate. Este estudo oferece uma exploração abrangente das regiões anatômicas mais afetadas. Tal investigação é fundamental para refinar estratégias clínicas envolvendo medidas preventivas e intervenções fisioterapêuticas. MÉTODOS: Estudo observacional transversal. Foram incluídos indivíduos com idade igual ou superior a 18 anos, praticantes de modalidades esportivas de combate, de ambos os sexos e capazes de responder ao questionário. Os dados foram analisados por estatística descritiva e o teste Qui-quadrado. RESULTADOS: A amostra final foi composta por 71 atletas. Das atletas do sexo feminino, 12,65% praticavam Judô e 21,51% praticavam Jiu-jitsu, enquanto 26,58% do sexo masculino praticavam Judô e 39,24% Jiu-jitsu. A média de idade foi de 31,14±11,75 anos, e índice de massa corporal de 27,69 kg/ m2 (±5,31). O tempo médio de prática foi de 8±10,59 anos. As regiões mais afetadas pela dor nos últimos 12 meses foram coluna lombar (90%), joelhos (90%) e punhos/mãos (60%). O Judô feminino apresentou índice significativo de dor nos últimos 12 meses em membros superiores, sendo o pescoço identificado como o maior responsável pela limitação das atividades. Nos últimos 7 dias, colunas torácica e lombar foram mais significativas. No Jiu-jitsu feminino, em 12 meses e 7 dias, tornozelo/pé foram mais afetados quando comparado ao masculino, e os joelhos foram os maiores responsáveis pela limitação das atividades. CONCLUSÃO: Uma descrição abrangente das principais regiões afetadas por dor e lesões musculoesqueléticas é de fundamental importância no desenvolvimento de estratégias de prevenção e tratamento fisioterapêutico.

Contextual and individual aspects related to musculoskeletal pain in adults in southern Brazil / Aspectos contextuais e individuais relacionados à dor osteomuscular em adultos do sul do Brasil

ABSTRACT BACKGROUND AND OBJECTIVES: Pain generates negative consequences in the personal and social life of individuals. The objective of this study was to investigate the association between musculoskeletal pain and individual and contextual aspects in adults in the south of Brazil. METHODS: Cross-sectional analysis of a population-based cohort study (n=571). Musculoskeletal pain was assessed using the adapted and translated version for Brazil of the Nordic Musculoskeletal Questionnaire (NMQ). In the multivariable analysis, the variables were adjusted for each other taking into account the two levels: contextual and individual. RESULTS: The prevalence of musculoskeletal pain was 71.1% (95% CI: 66.4-75.4). In the adjusted analysis, the following were associated with greater musculoskeletal pain at the contextual level: lower income, lower social support from the neighborhood and lower social action. At the individual level, sex (female), older age, lower education, lower social support and morbidities (≥ 3) were associated. CONCLUSION: The present research findings showed a high prevalence of musculoskeletal pain. Social action at the contextual level remained in the model after adjustment, this association suggests the contribution of socio-environmental factors to health outcomes.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor gera consequências negativas na vida pessoal e social dos indivíduos. O objetivo deste estudo foi investigar a associação entre dor osteomuscular e aspectos individuais e contextuais em adultos do sul do Brasil. MÉTODOS: Análise transversal de um estudo de coorte de base populacional (n=571). A dor osteomuscular foi avaliada através da versão adaptada e traduzida para o Brasil do Questionário Nórdico de Sintomas Osteomusculares (QNSO). Na análise multivariável, as variáveis foram ajustadas entre si levando em consideração os dois níveis: contextual e individual. RESULTADOS: A prevalência de dor osteomuscular foi de 71,1% (IC 95%:66,4-75,4). Na análise ajustada estiveram associados a maior dor osteomuscular em nível contextual: menor renda, menor apoio social da vizinhança e menor ação social. Em nível individual estiveram associados o sexo (feminino), maior idade, menor escolaridade, menor apoio social e morbidades (≥3). CONCLUSÃO: Os achados desta pesquisa evidenciaram alta prevalência de dor osteomuscular. A ação social no nível contextual permaneceu no modelo após ajustamento, essa associação sugere a contribuição dos fatores socioambientais em desfechos de saúde.

Effect of butorphanol-soaked nasal packing after endoscopic nasal surgery: a double-blind, randomized, placebo-controlled trial

Abstract Objective This study was designed to investigate the effect of butorphanol-soaked nasal packing on analgesia and sleep quality in patients undergoing bilateral endoscopic nasal surgery. Methods Sixty-six patients were enrolled and randomly allocated into three groups: group B1 (butorphanol 0.03 mg/kg), group B2 (butorphanol 0.04 mg/kg) and group N (control group). The primary outcome was postoperative pain scores evaluated by a Visual Analogue Scale (VAS) at 2 h (T1), 8 h (T2), 24 h (T3) and 48 h (T4) after surgery. Secondary outcome was postoperative sleep quality measured using Subjective Sleep Quality Value (SSQV). Results Postoperative VAS scores of butorphanol groups were significantly lower than the control group at T2, T3 and T4. VAS scores at each time point did not differ between groups B1 and B2. On the first and second nights after surgery, SSQV was higher in butorphanol groups than in the control group. There were no significant differences in SSQV1 and SSQV2 between group B1 and group B2. The incidence of respiratory depression, dizziness, agitation and rescue analgesic use did not show difference among three groups. Conclusions Butorphanol-soaked nasal packing can reduce pain and improve sleep quality after bilateral endoscopic nasal surgery without increasing adverse effects. A concentration of 0.03 mg/kg may be appropriate for clinical application. Level of Evidence Level 1B.

Low back pain, pelvic pain, and associated factors in type 1 diabetic pregnant women

Abstract Introduction Pregnancy and diabetes mellitus promote several musculoskeletal changes predisposing this population to complaints of Lower Back (LB) and Pelvic Pain (PP). Objective To assess the frequency of LB and PP and associated factors in type 1 Diabetic (DM1) pregnant women. Method: An observational analytical cross-sectional study. Thirty-six pregnant women with DM1 were evaluated through a postural assessment with a focus on pelvic positioning and what patients reported. The associated factors were assessed using the State-Trait Anxiety Inventory (STAI), the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI). Results The frequency of LB and PP was 55.6 % and 30.6 %, respectively. The presence of anxiety was not associated with a higher prevalence of pain. The incidence of sexual dysfunctions was higher in the GD. DM1 duration had a mean of 14.9 years (± 8.2 SD) in the GD and 9.0 years (± 6.9 SD) in the GSD, which was statistically significant (p ≤ 0.050). In the multiple binary regression analysis for the occurrence of pain, the independent factor was DM1 duration ≥ 17 years (OR = 11.2; 95 % CI = 1.02‒124.75). The association between DM1 duration ≥ 17 years and being overweight showed a probability of 95 % for the studied population in the analysis of the probabilities of occurrence of the pain event. Conclusion There was a high frequency of LB and PP related to pregnancy in DM1 pregnant women in the second trimester of pregnancy. The incidence of sexual dysfunction and DM1 duration ≥ 17 years increases the chance that DM1 pregnant women will experience pain. There was no association between anxiety. urinary incontinence and pain in DM1 pregnant women.

Practice of immersion in hot water to relieve pain in neonatology: an integrative review / Práctica de inmersión en agua caliente para aliviar el dolor en neonatología: una revisión integradora / Prática da imersão em água quente no alívio da dor em neonatologia: revisão integrativa

ABSTRACT Objectives: to identify immersion use in hot water to relieve pain in newborns. Methods: an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns? Results: nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters. Conclusions: hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.

RESUMEN Objetivos: identificar el uso de la inmersión en agua caliente para aliviar el dolor en recién nacidos. Métodos: revisión integrativa de la literatura, realizada en las bases de datos PubMed, BVS, EMBASE, Scopus, CINAHL, Cochrane y SciELO, con investigaciones en inglés, español, francés o portugués, publicadas entre 2002 y 2022. Se utilizaron los Descriptores de Ciencias de la Salud (DeCS) y los Medical Subject Headings (MeSH) para responder la siguiente pregunta: ¿cuáles son los usos de la inmersión en agua caliente para aliviar el dolor en los recién nacidos? Resultados: fueron incluidos nueve estudios, principalmente brasileños, experimentales, con predominio de niveles de evidencia fuerte y moderado. Se observó el uso de hidroterapia y baños (inmersión y vendaje), intervenciones prometedoras en la reducción de las puntuaciones de dolor, evaluadas mediante escalas y parámetros fisiológicos y endocrinos. Conclusiones: el agua caliente demostró ser una intervención no farmacológica prometedora para aliviar el dolor en neonatos en diferentes contextos.

RESUMO Objetivos: identificar o emprego da imersão em água quente no alívio da dor em neonatos. Métodos: revisão integrativa da literatura, realizada nas bases de dados PubMed, BVS, EMBASE, Scopus, CINAHL, Cochrane e SciELO, com investigações em inglês, espanhol, francês ou português, publicadas entre 2002 e 2022. Foram utilizados os Descritores em Ciências da Saúde (DeCS) e Medical Subject Headings (MeSH) para responder à seguinte inquietação: quais são os empregos da imersão em água quente no alívio da dor em neonatos? Resultados: foram incluídos nove estudos, principalmente brasileiros, experimentais, predominando o nível de evidência forte e moderada. Foram observados o emprego da hidroterapia e banhos (imersão e enfaixado), intervenções promissoras na redução do escore álgico, avaliados por meio de escalas, parâmetros fisiológicos e endócrinos. Conclusões: a água quente se mostrou uma intervenção não farmacológica promissora no alívio da dor de neonatos em diferentes contextos.