Apendicitis aguda sin dolor o El paraíso de los tontos: caso clínico / Painless acule appendicitis: The fools´ paradise: report of two cases

The diagnosis of acute appendicitis has been based on the presence of ríght lower quadrant pain and guarding. Occasionally, the pain disappears, even in the presence of a continuing appendicular process. This phenomenon is called "the fools' paradise". We report two male patients aged 19 and 17 years with an acute appendicitis confirmed by an abdominal ultrasound in one and an abdominal CAT sean in the other, in whom the abdominal pain disappeared during the evolution. Despite of the absence of pain, both were operated, based on imaging and laboratory studies, confirming the presence of an inflamed appendix.

Prevalência e fatores associados a dor em bailarinos profissionais / Prevalence and associated factors with pain in professional dancers

PURPOSE: To investigate factors associated to pain in ballet dancers as well its prevalence. METHODS: We conducted an analytical cross-sectional study among 141 professional ballet dancers from the main capitals of Northeastern Brazil. In order to evaluate the symptoms of pain we used Portuguese official versions of the McGill Protocol and the Pain Inventory of Wisconsin. For statistical analysis of the results we performed a descriptive assessment, followed by T-Student and Pearson's Correlation tests (taking a value of p < 0.05). RESULTS: We observed high levels of pain tolerance in 70.2% of the subjects, in which the intensity varied from moderate to severe. The lumbar region was the most affected (85.8%). We observed positive correlations concerning the intensity degree of pain with activities such as dancing (60.3%), sleeping (28.4%), marching (20.6%), general activities (32.6%), mood (27.7%), and personal relations (16.3%). CONCLUSION: We observed a high prevalence of pain in professional ballet dancers from the main Northeastern capitals, attacking mostly the lumbar region, followed by knees, neck, hip and feet, with substantial interference of pain symptoms in several activities of the personal and professional lives of these people.