Heat waves in the Colombian Caribbean: A public health problem?

A popular belief states that if frog is submerged in a container and gradually heats it up, it will try to adapt until it dies; this is probably the situation faced by more and more human populations. As stated by thousands of scientists, academics, and researchers worldwide, the planet's warming is directly related to climate change.

Construction of theoretical framework, item pool and rating scale words of / 中国针灸

Literature investigation and expert consultation were adopted to construct the theoretical framework and item pool of

Superficial thermal response to CrossFit® workout

Abstract Aims: Recently, high-intensity training methods have become popular, integrating the cardiovascular and neuromuscular training in a single training session, among these methods is CrossFit®. The objective of this study was to analyze the superficial thermal response to CrossFit® exercise in men and women, in order to use this knowledge to prevent overuse injuries. Methods: Nineteen volunteers involved in CrossFit® exercise for more than 6-month (12 males and 7 females) were recruited. The acquisition of the thermal images was performed in a climatized room in two moments, at rest (before exercise), and after one CrossFit® training session. The training session lasted 45min, comprising warm-up (10-min), accessory work (15-20min), and workout of the day (15-20-min). Before the first image acquisition, volunteers were acclimated for 15 min. The Wilcoxon signed-rank test was used to compare the skin temperature between pre- and post-exercise. Results: Temperatures rose significantly pre- to post-exercise in the forearm and anterior thigh regions, while it decreased in the anterior thorax and dorsal lower back regions. These results were found both, in the overall sample, and the male volunteers, but not when the female results were isolated. Conclusion: It can be concluded that superficial thermal response to one CrossFit® training session was characterized and was different for men and women. The superficial thermal responses were aligned with the physiological alterations promoted by other modalities, such as resistance training, cycling, and running.

Development and initial evaluation of sensation scale of heat-sensitive moxibustion / 中国针灸

Based on heat-sensitive moxibustion (HSM) theory, a widely applicable scale was developed to reflect the (arrival of ) sensation of HSM. By documentary method and interviewing method, the items of describing sensation of HSM were collected to establish the pool of candidate items. With expert questionnaire, patient questionnaire and core expert discussion, the items were screened and quantified by method of subjective evaluation to develop the initial draft of the scale. A total of 121 patients were pre-surveyed with the initial draft, and the structural validity of the scale was examined by exploratory factor analysis (principal component) and its internal consistency was assessed by Cronbach's coefficient. As a result, the items in the scale was reduced from 36 to 9; 110 effective questionnaires were reclaimed for statistical analysis. Finally, the scale (Version 1.0) contained 9 items and 4 dimensions, of which, 3 items highlighted the comfort emotional experience, 3 items highlighted autonomic response, 2 items highlighted heat sensation, and 1 item highlighted non-heat sensation. In conclusion, the sensation scale of HSM containes 9 items, which has fair content and structure validity. It is in line with the current clinical understanding of sensation of HSM and has strong clinical operability and wide adaptability.

Critical thermal limits of Poecilia caucana (Steindachner, 1880) (Cyprinodontiformes: Poeciliidae)

Aunque la temperatura tiene grandes repercusiones en la biología de los peces, se desconocen los rangos de tolerancia térmica de la mayoría de los peces dulceacuícolas. Esta falta de información impide pronosticar respuestas al cambio climático y limita los análisis comparativos que podrían enriquecer estudios evolutivos y biogeográficos. Utilizamos la metodología del crítico térmico para cuantificar la capacidad de aclimatación y la tolerancia térmica en la especie neotropical dulceacuícola Poecilia caucana. Para peces aclimatados a 20C, 25ºC y 28ºC, los críticos térmicos mínimos (CTmin) fueron 12,52 ± 0,62ºC, 13,41 ± 0,56ºC y 14,24 ± 0,43ºC, respectivamente, y los críticos térmicos máximos (CTmax) fueron 38,43 ± 0,64ºC, 40,28 ± 0,92ºC y 41,57 ± 0,27ºC, respectivamente. Tanto el CTmin como el CTmax cambiaron significativamente con las temperaturas de aclimatación, indicando que P. caucana es efectivamente aclimatable. Comparada con otras especies de peces dulceacuícolas, la capacidad de aclimatación de P. cuacana fue baja para CTmin y promedio para CTmax. Estos resultados, en conjunto con los datos de otras especies, pueden ser utilizados para responder preguntas ecológicas y evolutivas más generales.

Although temperature has far-reaching effects on fish biology, the thermal tolerance ranges of most freshwater fish species are unknown. This lack of information precludes forecasting responses to climatic change and does not allow for comparative analyses that may inform evolutionary and biogeographic studies. We used the critical thermal methodology to quantify acclimation capacity and thermal tolerance in the Neotropical freshwater species Poecilia caucana . For fish acclimated to 20C, 25ºC, and 28ºC, critical thermal minima (CTmin) were 12.52 ± 0.62ºC, 13.41 ± 0.56ºC and 14.24 ± 0.43ºC respectively, and critical thermal maxima (CTmax) were 38.43 ± 0.64ºC, 40.28 ± 0.92ºC and 41.57 ± 0.27ºC, respectively. Both CTmin and CTmax changed with acclimation temperatures, indicating that P. caucana was effectively acclimatable. Relative to values reported for other freshwater fish species, the acclimation capacity of P. caucana for CTmin was low, but it was average for CTmax. The data, together with similar work in other species, can be used in analyses focusing on broad ecological and evolutionary questions.

Extraction of items identifying hiesho (cold disorder) and their utility in young males and females / 中西医结合学报

<p><b>OBJECTIVE</b>Hie (cold sensation) is one of the most common health complaints in Japan. Those who suffer from severe hie are considered as having hiesho (cold disorder). However, exact hiesho symptoms have not been defined clearly and the decision as to whether a person suffers from hiesho is subjective and based on self-awareness. The study was conducted in attempt to develop a standardized hiesho diagnostic scale.</p><p><b>METHODS</b>Subjects comprised 1 146 students. From the self-awareness of hiesho symptoms, males and females were divided into hiesho and non-hiesho groups. Physical, behavioral and adaptive characteristics were compared using the 24-item questionnaire (four-grade survey) and indicators for hiesho symptoms were extracted. Based on the scores, a receiver operating characteristic curve was drawn for the total ordinal scale score of the extracted items in relation to the presence and absence of hiesho symptoms, and an optimal cutoff value was determined.</p><p><b>RESULTS</b>The self-awareness of having hiesho was found in 23.2% males and in 55.6% females. The sensitivity was 84.5% for males and 83.3% for females in the hiesho groups, and the specificity was 86.0% for males and 85.2% for females in the non-hiesho groups.</p><p><b>CONCLUSION</b>A questionnaire consisting of the extracted items may be useful to identify hiesho in young males and females with a high level of accuracy.</p>

Spontaneous Anterior Thoracic Spinal Cord Herniation through Dura Defect: A Case Report

Thoracic spinal cord herniation is a rare disease cause of progressive myelopathy. Magnetic resonance image is a useful tool to diagnose preoperatively. Operation is a treatment of option. Sixty-six-year-old female visited Dong-A University Medical Center for progressive gait disturbance with falling tendency to right side. She had radiating pain and tingling sense on both leg. Sense of touch and temperature was decreased below T6 level. Both hip and knee motor power were grade IV. Magnetic resonance imaging scan showed anterior displacement of the spinal cord at T4-T5 vertebral level. Under the diagnosis of thoracic spinal cord herniation with dura defect, operation was performed for the patient with intraoperative neuromonitoring. Laminectomy at T4 and T5 level was done, and intradural exploration of the spinal cord revealed dura defect about 25mm×8mm in size. Spinal cord was released under microscope and dura defect was repaired with Lyoplant. The patient's symptom improved after the surgical procedure, but touch and temperature sense under T6 level had unchanged.

Association between NOx exposure and deaths caused by respiratory diseases in a medium-sized Brazilian city

Exposure to nitrogen oxides (NOx) emitted by burning fossil fuels has been associated with respiratory diseases. We aimed to estimate the effects of NOx exposure on mortality owing to respiratory diseases in residents of Taubaté, São Paulo, Brazil, of all ages and both sexes. This time-series ecological study from August 1, 2011 to July 31, 2012 used information on deaths caused by respiratory diseases obtained from the Health Department of Taubaté. Estimated daily levels of pollutants (NOx, particulate matter, ozone, carbon monoxide) were obtained from the Centro de Previsão de Tempo e Estudos Climáticos Coupled Aerosol and Tracer Transport model to the Brazilian developments on the Regional Atmospheric Modeling System. These environmental variables were used to adjust the multipollutant model for apparent temperature. To estimate association between hospitalizations owing to asthma and air pollutants, generalized additive Poisson regression models were developed, with lags as much as 5 days. There were 385 deaths with a daily mean (±SD) of 1.05±1.03 (range: 0-5). Exposure to NOx was significantly associated with mortality owing to respiratory diseases: relative risk (RR)=1.035 (95% confidence interval [CI]: 1.008-1.063) for lag 2, RR=1.064 (95%CI: 1.017-1.112) lag 3, RR=1.055 (95%CI: 1.025-1.085) lag 4, and RR=1.042 (95%CI: 1.010-1.076) lag 5. A 3 µg/m3 reduction in NOx concentration resulted in a decrease of 10-18 percentage points in risk of death caused by respiratory diseases. Even at NOx concentrations below the acceptable standard, there is association with deaths caused by respiratory diseases.

The significance of quantitative temperature sense thresholds in diagnosis of small fibrous sensory neuropathy in patients with type 2 diabetes / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To evaluate the small fiber function in patients with type 2 diabetes mellitus of the early stage by measuring the sensory threshold with the quantitative temperature testing technology.</p><p><b>METHODS</b>Twenty cases of patients with type 2 diabetes with no neurological deficit (DM group) and twenty age and sex-matched healthy controls underwent the detecting of cold sensory threshold (CST), warm sensory threshold (WST), cold pain threshold (CPT), heat pain threshold (HPT) in both inside of their hands.</p><p><b>RESULTS</b>There was no significant difference in CST, WST, CPT and HPT between left and right inside of hand of the same sample among all the testers. But the four kinds of threshold showed significant difference in the right inside of hand between patients and healthy people ( P < 0.05). In addition, the CST and WST differed significantly in the left inside of hand between the patients and healthy controls while the CPT and HPT showed no significant difference in the left inside of hand between them. Patients group and control group with CST and WST on the left side of the comparison difference was statistically significant (P < 0.05).</p><p><b>CONCLUSION</b>Quantitative analysis of temperature sense threshold can not only reflect increase of the pain threshold value, also can reflect its decrease, i. e. hyperalgesia, which may help to diagnose small fibrous peripheral neuropathy recognition, especially in early diabetic peripheral neuropathy.</p>

Characteristics and clinical application of the arrival of qi in suspended moxibustion / 中国针灸

The characteristics and clinical application of the arrival of qi in suspended moxibustion was discussed in this paper. Through literature research and clinical practice, three aspects, including characteristics of arrival of qi in suspended moxibustion, the clinical basis regarding arrival of qi in suspended moxibustion improving therapeutic effects and how to acquire arrival of qi in suspended moxibustion, were discussed to clarify the essential role of arrival of qi in suspended moxibustion as well as its importance to the development of moxibustion medicine. The suspended moxibustion at acupoints could produce arrival of qi similar to acupuncture, which was characterized as non-local or non-superficial heat sensation such as penetrating heat, expanding heat, transmitting heat, even non-hot sensation such as aching, numbing, distending, painful, heavy, cold sensation in the applied region. It is heat-sensitive sensation phenomenon that can improve therapeutic effect in suspended moxibustion.

Abdominal skin temperature changes in penetrating moxibustion / 中国针灸

<p><b>OBJECTIVE</b>To explore the technique of temperature control on the abdomen in penetrating moxibustion through observing moxibustion time on the abdomen, abdominal skin temperature and effect after moxibustion so as to provide the safe, effective and easily applicable method for penetrating moxibustion.</p><p><b>METHODS</b>Thirty-two patients were selected in an observation group, 32 healthy persons in a control group. In the observation group, the penetrating moxibustion was applied to the corresponding acupoint locations according to different symptoms. In the control group, moxibustion was used on the abdomen around the umbilicus. The skin temperature was recorded once every minute. The skin temperature of known heat sensation, the time of known heat sensation, the known reduced temperature, the time of temperature reducing, the skin temperature difference, the duration of penetrating moxibustion and the reaction of moxibustion from participants were recorded.</p><p><b>RESULTS</b>The differences in the skin temperature of known heat sensation, the time of known heat sensation and the duration of penetrating moxibustion were significant statistically in comparison between the observation group and the control group (all P<0.01). The differences in the known reduced temperature, the time of temperature reducing and the skin tem- perature difference were not significant (all P>0.05). The differences were significant statistically in skin rashes and moxibustion reaction (gastrointestinal peristalsis, chills, ant climbing feeling and hunger, etc.) between the two groups (P<0.01). The differences were not significant statistically in flushing, sweating and blisters (all P>0.05).</p><p><b>CONCLUSION</b>(1) The level of temperature sensitivity in the observation group is lower than that in the control group. During penetrating moxibustion, the sensations such as gastrointestinal peristalsis, chills, ant climbing feeling and hunger appear easily, suggesting the positive self-adjustment in the body. (2) During penetrating moxibustion, the warm feeling is penetrated not just from the epidermis to the abdominal cavity and lumbar region, but also up to thehead and down to the knee. (3) The flushing, sweating and skin rashes are the important indices for the effectiveness of penetrating moxibustion. (4) The temperature control is the core technique of penetrating moxibustion. The penetrating moxibustion in 28 min to 32 min and the temperature controlled in 43 degrees C to 45 degrees C can solve the moxibustion smoky impact to the environment, but also relieve pains of the patients.</p>

Use of Web-Based Evidence-based Clinical Practice Guidelines for Patients following Gastrectomy: Effects on Body Temperature, Shivering, Perceived Thermal Comfort, and Satisfaction with Temperature Management / 기본간호학회지

PURPOSE: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. METHODS: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. RESULTS: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. CONCLUSION: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders / 国际口腔科学杂志·英文版

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

Cutaneous lesions sensory impairment recovery and nerve regeneration in leprosy patients

It is important to understand the mechanisms that enable peripheral neurons to regenerate after nerve injury in order to identify methods of improving this regeneration. Therefore, we studied nerve regeneration and sensory impairment recovery in the cutaneous lesions of leprosy patients (LPs) before and after treatment with multidrug therapy (MDT). The skin lesion sensory test results were compared to the histopathological and immunohistochemical protein gene product (PGP) 9.5 and the p75 nerve growth factor receptors (NGFr) findings. The cutaneous neural occupation ratio (CNOR) was evaluated for both neural markers. Thermal and pain sensations were the most frequently affected functions at the first visit and the most frequently recovered functions after MDT. The presence of a high cutaneous nerve damage index did not prevent the recovery of any type of sensory function. The CNOR was calculated for each biopsy, according to the presence of PGP and NGFr-immunostained fibres and it was not significantly different before or after the MDT. We observed a variable influence of MDT in the recovery from sensory impairment in the cutaneous lesions of LPs. Nociception and cold thermosensation were the most recovered sensations. The recovery of sensation in the skin lesions appeared to be associated with subsiding inflammation rather than with the regenerative activity of nerve fibres.

Potenciais impactos da variabilidade climática sobre a morbidade respiratória em crianças, lactentes e adultos / Potential impacts of climate variability on respiratory morbidity in children, infants, and adults

OBJETIVO: Estudar a relação existente entre a o número de internações por doenças do aparelho respiratório em lactentes, crianças e adultos e as variações meteorológicas na cidade de Campo Grande (MS). MÉTODOS Foram utilizados dados diários de internações por doenças respiratórias, precipitação, temperatura do ar, umidade e velocidade dos ventos entre 2004 e 2008. Foram calculados os índices de conforto térmico humano, temperatura efetiva e temperatura efetiva com velocidade do vento com base nas variáveis meteorológicas. Foram realizados modelos lineares generalizados utilizando o modelo múltiplo de regressão de Poisson para predizer as internações por doenças respiratórias. RESULTADOS: Foram observados valores relativamente elevados dos coeficientes de correlação entre as variáveis estudadas e internações por pneumonia em crianças (R² = 68,4%), lactentes (R² = 71,8%) e adultos (R² = 81,8%). CONCLUSÕES: Os resultados aqui apresentados indicam em termos quantitativos o risco para um aumento no número de hospitalizações de crianças, lactentes e adultos de acordo com o aumento ou a diminuição das temperaturas, umidade, precipitação, velocidade dos ventos e índice de conforto térmico na cidade de Campo Grande.

OBJECTIVE: To determine whether climate variability influences the number of hospitalizations for respiratory diseases in infants, children, and adults in the city of Campo Grande, Brazil. METHODS: We used daily data on admissions for respiratory diseases, precipitation, air temperature, humidity, and wind speed for the 2004-2008 period. We calculated the thermal comfort index, effective temperature, and effective temperature with wind speed (wind-chill or heat index) using the meteorological data obtained. Generalized linear models, with Poisson multiple regression, were used in order to predict hospitalizations for respiratory disease. RESULTS: The variables studied were (collectively) found to show relatively high correlation coefficients in relation to hospital admission for pneumonia in children (R² = 68.4%), infants (R² = 71.8%), and adults (R² = 81.8%). CONCLUSIONS: Our results indicate a quantitative risk for an increase in the number of hospitalizations of children, infants, and adults, according to the increase or decrease in temperature, humidity, precipitation, wind speed, and thermal comfort index in the city under study.

Actividad espontánea de nociceptores cutáneos en pacientes con neuropatía de fibras delgadas / Spontaneous activity of cutaneous nociceptors in patients with painful polyneuropathy. Report of three patients

Background: Painful polyneuropathy may result from selective impairment of small diameter nerve fibers, while tactile and motor functions are preserved. In these patients clinical and electrophysiological assessment is usually unrevealing. We report three patients with a pure painful polyneuropathy. One of them had neurogenic pruritus additionally. Quantitative sensory analysis disclosed a slight warm hypoesthesia (3/3) and paradoxical hot sensation (2/3) in the feet. Intraneural recordings from the peroneal nerve demonstrated abnormal spontaneous activity in 8 of 17 nociceptive afferents. One of them displayed double firing reflecting impulse multiplication. These results support the notion that patients with pain or pruritus with a distal distribution similar to a polyneuropathy, could have small diameter afferent fiber damage, despite normal function of large diameter fibers.

Diretrizes para avaliação somatossensorial em pacientes portadores de disfunção temporomandibular e dor orofacial / Guidelines for somatosensory evaluation of temporomandibular dysfunction and orofacial pain patients

JUSTIFICATIVA E OBJETIVOS: Diferentes estímulos são necessários para avaliar a integridade das fibras aferentes e compreender melhor os mecanismos envolvidos nas diferentes condições dolorosas que podem afetar a região orofacial. O principal objetivo deste estudofoi realizar uma revisão da literatura, proporcionando diretrizes para a prática clínica.CONTEÚDO: Foram realizadas buscas na literatura de 1990 a 2011, na base de dados PubMed utilizando-se termos MeSH. A estimulação mecânica pôde ser realizada mediante o uso de monofilamentos de Von-Frey, para testar as fibras A-beta e A-delta. O teste de picada é uma maneira simples de se avaliar as fibrasA-delta e C. O limiar de dor à pressão (LDP) testa as fibras A-delta e C. Dentre as modalidades de ensaios térmicos, pode-se utilizar cubos de gelo ou um spray aerosol congelante para medir a nível de sensibilização central envolvido. Os estímulos elétricos, aplicados pelo aparelho Neurometer/Neurotron®, avaliam os três tipos principais de fibras (A-delta, A-beta e C), hiperestesia e hipoestesia. Além disso, as fibras do tipo C também podem ser avaliadas por estímulos químicos com capsaicina e/ou mentol. CONCLUSÃO: Os testes quantitativos sensoriais consistem em uma forma confiável para avaliação da função sensorial das fibras nervosas. O déficit sensorial pode ser quantificado e os dados utilizados como auxílio diagnóstico ou para comparações de eficácia entre diferentes modalidades de tratamento.

BACKGROUND AND OBJECTIVES: Different stimulations are needed to evaluate the integrity of afferent fibers and to better understand the mechanisms involved in different pain conditions which may affec tthe orofacial region. This study aimed primarily at reviewing the literature to provide guidelines to the clinical practice.CONTENTS: PubMed database was searched from 1990 to 2011 using MeSH terms. Mechanical stimulation could be done with Von-Frey monofilaments to testA-beta and A-delta fibers. Pinprick test is a simple way to evaluate A-delta and C fibers. Pressure pain threshold (PPT) tests A-delta and C fibers. Among thermal test modalities one may use ice cubes or a freezing spray to measure the level of central sensitization involved. Electric stimulations applied by the Neurometer/Neurotron® device evaluated three major fibers (A-delta, A-beta and C), hyperesthesia and hypoesthesia. In addition, C fibers can also be evaluated by chemical stimulations with capsain and/or menthol.CONCLUSION: Quantitative sensory tests are a reliable way to evaluate nervous fibers sensory function.Sensory deficit may be quantified and data may be used as diagnostic aid or to compare the effectiveness of differentt reatment modalities.

Thermal record of the test tubes method used for small fibers assessment / Registro térmico do método dos tubos de ensaio aplicado na avaliação de fibras finas

In Brazil, the test that uses test tubes filled with cold water (25ºC) and tubes filled with water heated to a temperature of 45ºC is recommended by the Ministry of Health as a way of evaluate thermal sensitivity on the injured skin of leprosy patients. The purpose of this work was to quantify the thermal stimulation applied to the skin, as well as the temperature variation of the heated water and of the tube's outer surface during stimulation sessions. The experiment had the participation of 14 healthy volunteers (31.2±11.4 years-old), ten of which were male (33.1±13.5 years-old) and four were female (26.5±4.7 years-old). Three consecutive stimulation sessions were carried out, each of them with four stimuli. The maximum skin temperature at the end of the stimuli was measured at 35.8±0.6ºC. Such temperature values may be useful in the assessment of the loss of small fibers, which are responsible for the sensation of warmth.

No Brasil, o teste que utiliza tubos de ensaio preenchidos com água aquecida (45ºC) e resfriada (25ºC) é preconizado pelo Ministério da Saúde como forma de avaliar a sensibilidade térmica nas lesões de pele de pacientes com hanseníase. O objetivo deste trabalho foi quantificar o estímulo térmico na pele e a variação das temperaturas da água aquecida e da superfície externa do tubo, durante as sessões de estimulação. O experimento contou com 14 voluntários saudáveis (31,2±11,4 anos), sendo dez do gênero masculino (33,1±13,5 anos) e quatro do gênero feminino (26,5±4,7 anos). Realizaram-se três sessões seguidas de estimulação com quatro estímulos em cada sessão. A temperatura registrada na pele, ao final dos estímulos, apresentou diferenças entre as sessões, atingindo o máximo de 35,8±0,6ºC. Estes valores de temperatura podem ser úteis na avaliação da perda de fibras finas responsáveis pela sensação de aquecimento.

Validation of a Brazilian quantitative sensory testing (QST) device for the diagnosis of small fiber neuropathies / Validação de um aparelho brasileiro de teste de quantificação sensitiva brasileiro para o diagnóstico de neuropatia de fibras finas

Quantitative sensory testing (QST) is defined as the determination of thresholds for sensory perception under controlled stimulus. Our aim was to validate a new QST device for Brazilian sample. In 20 healthy adults, thermoalgesic thresholds were assessed using a QST prototype (Heat Pain Stimulator-1.1.10; Brazil). A 30 × 30 mm² thermode with a 1°C/s stimulus change rate were applied. Thresholds of three consecutive stimuli were averaged in two different sessions separated by at least two weeks. Additionally long thermal heat pain stimulus was performed. To evaluate the consistency of our method we also analyzed 11 patients with small fiber neuropathy. Results showed good reproducibility of thermal perception thresholds in normal individuals and plausible abnormal thresholds in patients. We conclude that our QST device is reliable when analyzing the nociceptive pathway in controls and patients.

Teste de quantificação sensitiva (TQS) significa determinação de limiares de percepção sensitiva frente a um estímulo de intensidade controlada. Nosso objetivo foi validar um novo equipamento de TQS adaptado à população brasileira. Em 20 adultos saudáveis, limiares termoalgésicos foram avaliados, utilizando um aparelho protótipo do TQS (Heat Pain Stimulator-1.1.10; Brazil). Foi utilizado um termodo de 30 × 30 mm², com estímulo térmico de 1°C/s. A média dos limiares de três estímulos consecutivos foi obtida em duas sessões diferentes, separadas por pelo menos 2 semanas. Adicionalmente, foram aplicados estímulos térmicos dolorosos de longa duração. Para avaliar a consistência do nosso método, foram também analisados 11 pacientes com neuropatia de fibras finas. Os resultados mostraram boa reprodutibilidade dos limiares de percepção nos indivíduos saudáveis, assim como limiares anormais nos pacientes. Em conclusão, nosso aparelho de TQS apresentou boa confiabilidade ao analisar a via nociceptiva de controles e pacientes.