UNDENATURED COLLAGEN TYPE II FOR THE TREATMENT OF OSTEOARTHRITIS OF THE KNEE.

Objective: To test the hypothesis that undenatured type II collagen (UC-II) relieves pain, quality of life, and joint function in women aged from 60 to 80 years with knee osteoarthritis. Methods: 53 patients in the UC-II treatment group (for 90 days) and 52 in the control group (without UC-II) were evaluated at 1, 30, and 90 days regarding health-related quality of life, pain, and function with questionnaires, anthropometric data, alignment, range of motion, and radiographic analysis. Results: Quality of life increased significantly in the Physical domain in the treatment vs control group. Also, there was a difference between the first and the last evaluation on the pain visual analog scale (-3.8 ± 1.8 versus -1.3 ± 2.0) and on the WOMAC score (-9.5 ± 11.9 versus -1.3 ± 11.1). No variation in the temporal evolution of the Mental domain was found. Conclusion: Pain, joint stiffness, and quality of life (Physical domain) improved with the inclusion of UC-II for 90 days to the therapeutic toolbox for knee osteoarthritis in individuals aged 60 to 80 years. Level of evidence II, Comparative Prospective Study.

Objetivo: Testar a hipótese de que o colágeno não hidrolisado tipo II (UC-II) melhora a dor, qualidade de vida e função articular de indivíduos entre 60 e 80 anos com osteoartrite (OA) de joelho. Métodos: Cinquenta e três pacientes do grupo tratamento com UC-II (por 90 dias) e 52 do grupo controle (GC - sem UC-II) foram avaliados no tempo 0, 30 e 90 dias quanto à qualidade de vida em saúde, dor e função com os questionários, além de dados antropométricos, alinhamento, amplitude de movimento e análise radiográfica. Resultados: A qualidade de vida aumentou significantemente no domínio PCS no grupo tratamento versus controle. Houve ainda diferença entre a primeira e última avaliação na dor pela escala visual analógica (−3.8 ± 1.8 versus −1.3 ± 2.0) e no escore WOMAC (−9.5 ± 11.9 versus −1.3 ± 11.1). Não houve variação na evolução temporal do domínio MCS. Conclusão: Dor, rigidez articular e qualidade de vida (domínio físico) melhoram com a inclusão do UC-II por 90 dias ao arsenal terapêutico na OA do joelho em indivíduos de 60 a 80 anos. Nível de Evidência II, Estudo Prospectivo Comparativo.

Association and Risk Factors of Osteonecrosis of Femoral Head in Sickle Cell Disease: A Systematic Review.

OBJECTIVE: The objective was to evaluate the level of evidence about the associated factors and the risk factors of osteonecrosis of femoral head (ONFH) in sickle cell individuals. METHODS: The review was based on the search and selection of studies available in the electronic databases PubMed, SCIELO, LILACS, BVS. As descriptors, the terms of Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) corresponding to "Osteonecrosis", "Necrosis avascular" and "Aseptic necrosis" and "Femoral head" and "sickle cell disease" and "risk factor" and "predictor". RESULTS: Among clinical and laboratorial factors the most promising risk factors were the severity of sickle cell disease and acute chest syndrome. As a result, from studies of a moderate level of quality, blood pressure, body weight, previous trauma, haemoglobin to haematocrit ratio (Hb/HCT), and number of hospitalizations can be highlighted. Others, such as genetic markers and male gender, have also been positively associated in lower quality studies. CONCLUSION: For a better clarification of what the risk factors are for the ONFH, it is necessary to study with populations of different origins, different ages, different profiles of Hb, which present greater methodological rigor and perform a multivariate analysis to control confounding factors. Further study is also needed to understand the genetic determinants of ONFH.

Undenatured collagen type ii for the treatment of osteoarthritis of the knee / Colágeno não hidrolisado tipo ii para tratamento da osteoartrite do joelho

ABSTRACT Objective: To test the hypothesis that undenatured type II collagen (UC-II) relieves pain, quality of life, and joint function in women aged from 60 to 80 years with knee osteoarthritis. Methods: 53 patients in the UC-II treatment group (for 90 days) and 52 in the control group (without UC-II) were evaluated at 1, 30, and 90 days regarding health-related quality of life, pain, and function with questionnaires, anthropometric data, alignment, range of motion, and radiographic analysis. Results: Quality of life increased significantly in the Physical domain in the treatment vs control group. Also, there was a difference between the first and the last evaluation on the pain visual analog scale (−3.8 ± 1.8 versus −1.3 ± 2.0) and on the WOMAC score (−9.5 ± 11.9 versus −1.3 ± 11.1). No variation in the temporal evolution of the Mental domain was found. Conclusion: Pain, joint stiffness, and quality of life (Physical domain) improved with the inclusion of UC-II for 90 days to the therapeutic toolbox for knee osteoarthritis in individuals aged 60 to 80 years. Level of evidence II, Comparative Prospective Study.

RESUMO Objetivo: Testar a hipótese de que o colágeno não hidrolisado tipo II (UC-II) melhora a dor, qualidade de vida e função articular de indivíduos entre 60 e 80 anos com osteoartrite (OA) de joelho. Métodos: Cinquenta e três pacientes do grupo tratamento com UC-II (por 90 dias) e 52 do grupo controle (GC - sem UC-II) foram avaliados no tempo 0, 30 e 90 dias quanto à qualidade de vida em saúde, dor e função com os questionários, além de dados antropométricos, alinhamento, amplitude de movimento e análise radiográfica. Resultados: A qualidade de vida aumentou significantemente no domínio PCS no grupo tratamento versus controle. Houve ainda diferença entre a primeira e última avaliação na dor pela escala visual analógica (−3.8 ± 1.8 versus −1.3 ± 2.0) e no escore WOMAC (−9.5 ± 11.9 versus −1.3 ± 11.1). Não houve variação na evolução temporal do domínio MCS. Conclusão: Dor, rigidez articular e qualidade de vida (domínio físico) melhoram com a inclusão do UC-II por 90 dias ao arsenal terapêutico na OA do joelho em indivíduos de 60 a 80 anos. Nível de Evidência II, Estudo Prospectivo Comparativo.

Desenvolvimento de instrumento em doenças raras: acesso à saúde e ao suporte social / Development of instrument in rare diseases: access to health and social support / Desarrollo de instrumento en enfermedad raras: acceso a la salud y al apoyo social

INTRODUÇÃO: A condição crônica degenerativa relacionada às Doenças Raras (DR) é permeada por processos sociais e de acesso à saúde complexos, cuja compreensão exige avaliação na perspectiva dos acometidos. OBJETICO: Construir um instrumento que possibilite avaliar a percepção do acesso à saúde e ao suporte social destinado aos acometidos por DR. MÉTODOS: Estudo de desenvolvimento de um instrumento embasado no modelo proposto por Luiz Pasquali. RESULTADOS: Após análise fatorial, o resultado final que mostrou evidências preliminares de validação foi um instrumento com quatro domínios: Recursos de Saúde, Recursos Financeiros, Aspectos Sociais e Aspectos Individuais, com 10 itens. CONSIDERAÇÕES FINAIS: O instrumento final desenvolvido reuniu evidências de validade, revelando qualidade dos itens em representar os conceitos subjacentes a cada domínio. Por meio de suas propriedades psicométricas, o instrumento mostrou que tem representatividade no que concerne à percepção do acometido por DR quanto ao seu acesso à saúde e ao suporte social.

INTRODUCTION: The chronic degenerative condition related to Rare Diseases (DR) is permeated by complex social processes and access to health, whose understanding requires evaluation from the perspective of affected patients. OBJECTIVE: To build up an instrument that allows those affected by these pathologies to evaluate their perception regarding access to healthcare and social support. METHODS: Study on the development of an instrument based on the model proposed by Luiz Pasquali. RESULTS: After a factorial analysis, the final result that showed preliminary evidence of validation was an instrument with four domains: Health Resources, Financial Resources, Social Aspects, and Individual Aspects, with 10 items. FINAL CONSIDERATIONS: The final instrument developed gathered evidence of validity, revealing item quality in representing the concepts underlying each domain. Through its psychometric properties, the instrument showed that it has representativeness regarding the perception of the affected by DR regarding their access to health and social support..

INTRODUCCIÒN: La condición crónica degenerativa relacionada a las Enfermedades Raras (ER) está impregnada por procesos sociales y de acceso a la salud complejos, cuya comprensión exige evaluación en la perspectiva de los acometidos. OBJETIVO: Construir un instrumento que posibilite evaluar la percepción del acceso a la salud y al apoyo social destinado a los acometidos por ER. MÈTODOS: Estudio sobre el desarrollo de un instrumento en el modelo propuesto por Luiz Pasquali. RESULTADOS: Después del análisis factorial, el resultado final que mostró evidencias preliminares de validación fue un instrumento con cuatro dominios: Recursos de Salud, Recursos Financieros, Aspectos Sociales y Aspectos Individuales, con 10 ítems. CONSIDERACIONES FINALES: El instrumento final desarrollado reunió evidencia de validez, revelando la calidad del elemento al representar los conceptos subyacentes a cada dominio. A través de sus propiedades psicométricas, el instrumento demostró que tiene representatividad acerca de la percepción de los afectados por RD con respecto a su acceso a la salud y al apoyo social.

FUNCTIONAL INDEPENDENCE OF PEDIATRIC PATIENTS WITH MUCOPOLYSACCHARIDOSES.

OBJECTIVE: To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses. METHODS: A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale. RESULTS: Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5). CONCLUSION: Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision. Level of Evidence IV, Case Series.

OBJETIVO: Medir a independência funcional para realização de Atividades de Vida Diária de pacientes pediátricos diagnosticados com mucopolissacaridoses (MPS). MÉTODOS: Estudo transversal, descritivo, realizado com a população de pacientes pediátricos com diagnóstico enzimático confirmado de mucopolissacaridoses, cadastrados no ambulatório de ortopedia de um hospital no Estado da Bahia. Os dados foram coletados entre outubro de 2016 e março de 2017, a partir da análise documental das fichas de avaliação utilizadas no serviço. As variáveis deste estudo compreenderam sexo, idade, tipo de MPS e nível de independência funcional, mensurado pela escala de Medida de Independência Funcional. RESULTADOS: Participaram do estudo 26 pacientes, que eram predominantemente do sexo masculino (61,5%), com média de idade de 10 ± 4,5 anos, acometidos por mucopolissacaridoses VI (73,1%). No domínio motor, a pontuação média foi 65 (± 19,9 pontos); o domínio cognitivo obteve escore médio igual a 28 (± 8,2 pontos); e o escore total da MIF foi 93 (±26,5). CONCLUSÃO: Foi observado comprometimento da independência funcional de crianças e adolescentes com mucopolissacaridoses. Tarefas relacionadas ao vestuário, utilização do vaso sanitário, banho, resolução de problemas e interação social foram as que demandaram maior assistência e/ou supervisão. Nível de Evidência IV, Série de Casos.

Functional independence of pediatric patients with mucopolysaccharidoses / Independência funcional de pacientes pediátricos com mucopolissacaridoses

ABSTRACT Objective: To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses. Methods: A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale. Results: Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5). Conclusion: Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision. Level of Evidence IV, Case Series.

RESUMO Objetivo: Medir a independência funcional para realização de Atividades de Vida Diária de pacientes pediátricos diagnosticados com mucopolissacaridoses (MPS). Métodos: Estudo transversal, descritivo, realizado com a população de pacientes pediátricos com diagnóstico enzimático confirmado de mucopolissacaridoses, cadastrados no ambulatório de ortopedia de um hospital no Estado da Bahia. Os dados foram coletados entre outubro de 2016 e março de 2017, a partir da análise documental das fichas de avaliação utilizadas no serviço. As variáveis deste estudo compreenderam sexo, idade, tipo de MPS e nível de independência funcional, mensurado pela escala de Medida de Independência Funcional. Resultados: Participaram do estudo 26 pacientes, que eram predominantemente do sexo masculino (61,5%), com média de idade de 10 ± 4,5 anos, acometidos por mucopolissacaridoses VI (73,1%). No domínio motor, a pontuação média foi 65 (± 19,9 pontos); o domínio cognitivo obteve escore médio igual a 28 (± 8,2 pontos); e o escore total da MIF foi 93 (±26,5). Conclusão: Foi observado comprometimento da independência funcional de crianças e adolescentes com mucopolissacaridoses. Tarefas relacionadas ao vestuário, utilização do vaso sanitário, banho, resolução de problemas e interação social foram as que demandaram maior assistência e/ou supervisão. Nível de Evidência IV, Série de Casos.

Qualidade de vida e funcionalidade nos pacientes com desordens do manguito rotador / Quality of life and functionality in patients with rotator cuff disorders

OBJETIVO: Verificar se existe correlação entre os domínios da qualidade de vida e a funcionalidade nos pacientes com desordens do manguito rotador. MÉTODO: Estudo do tipo transversal com 109 pacientes avaliados entre outubro 2013 e fevereiro 2014. Para avaliar a qualidade de vida foi utilizado o questionário WORC, e as escalas UCLA e ASES para avaliação da funcionalidade. RESULTADO: Amostra de 73 mulheres e 36 homens (média de idade: 52,3 anos+12,8). O ombro avaliado foi o direito em 63 pacientes (57,8%). O WORC apresentou correlação positiva alta com as escalas UCLA (r= 0,73) e ASES (r= 0,77). Ao analisar o WORC verificou-se correlação mais forte com a UCLA no domínio "Trabalho" (r=0,74), e menor no domínio "Esporte/Recreação" (r= 0,67). Quando comparado o WORC com a ASES identificou-se a maior correlação com o domínio "Trabalho" (r= 0,79) e menor correlação com o domínio "Emoções" (r= 0,64). CONCLUSÃO: Alterações na funcionalidade, frequentes nestas desordens, impactam na qualidade de vida em especial no domínio "Trabalho".

OBJECTIVE: To evaluate the correlation between different domains of quality of life and functionality in patients with rotator cuff disorders. METHODS: Cross sectional study with 109 patients evaluated between October 2013 and February 2014. The WORC questionnaire was used to evaluate quality of life, and the UCLA and ASES scales to evaluate functionality. RESULTS: The sample included 73 female and 36 males (mean age 52,3+12,8 years). The right shoulder was evaluated in 63 patients (57,8%). There was a high positive correlation between the WORC results and the UCLA (r= 0,73) and ASES (r= 0,77) scales. There was a stronger correlation between the WORC and the UCLA in the "Work" domain (r= 0,74), and a weaker correlation in the "Sport/Recreation" domain (r= 0,67). When comparing the WORC with the ASES scale, a higher correlation was identified with the "Work" domain (r=0,79) and a lower correlation with the "Emotions" domain (r= 0,64). CONCLUSION: Alterations in functionality, frequent in RCD, have a considerable impact in the quality of life in special to the "Work" domain.

Quality of life among women with epilepsy during their reproductive years.

PURPOSE: The purpose of this study was to assess the health-related quality of life (HRQoL) of women with epilepsy during their reproductive years. METHOD: A cross-sectional study comparing two groups, one with and another without epilepsy, was conducted. Semistructure questionnaires regarding socioeconomic, demographic, and clinical profiles were used. The HRQoL was measured using the Quality of Life in Epilepsy Inventory (QOLIE-31), for comparison within the group with epilepsy, and World Health Organization of Quality of Life (WHOQOL)-bref, for comparison between the groups with and without epilepsy. Statistical analysis was performed using Fisher's exact test, Mann-Whitney test, and multivariate linear regression. A measure of significance was considered as p < 0.05. RESULTS: Eighty women were included (40 with epilepsy and 40 without epilepsy) with mean age of 28.2 ±â€¯6.51 years. Women of childbearing age with epilepsy tend to have lower quality of life than those without epilepsy (with epilepsy: 85.15 ±â€¯13.50 vs. without epilepsy: 90.75 ±â€¯12.17, p = 0.051). The groups were similar in relation to most sociodemographic characteristics, with the exception of the percentage of women with epilepsy outside the labor market (with epilepsy: 57.5% vs. without epilepsy: 30%, p = 0.012) and with clinical (with epilepsy: 27.5% vs. without epilepsy: 7.5%, p = 0.018) and psychiatric comorbidities (with epilepsy: 20% vs. without epilepsy: 0%, p = 0.003). However, logistic regression showed no influence of these variables on the HRQoL of women with epilepsy. The clinical variables associated with the worsening of HRQoL were seizure control and antiepileptic drugs (AEDs) adverse effects. CONCLUSION: Epilepsy has a negative impact on the HRQoL of women of childbearing age, and the clinical variables controlling seizures and adverse effects of AEDs influenced HRQoL in this population.

Ultrasound Findings on Hands and Wrists of Patients with Systemic Lupus Erythematosus: Relationship with Physical Examination.

Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US.

Acute Poisoning in Children in Bahia, Brazil.

Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7%) and male sex (53.4%), were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%), venomous animals (19.3%), nonvenomous animals (10%), household cleaning products (9.0%), and raticide agents (8.7%) predominated. The majority of cases were characterized as light (73.5%) and around 18% required hospitalization, and there was low lethality (0.5%).

Indicators of depression in elderly and different screening methods.

OBJECTIVE: To determine the prevalence of depressive symptoms among elderly and correlate the agreement between the screening methods used. METHODS: A cross-section study of 137 elderly attending the Programa Vivendo a Terceira Idade [Living for the Elderly Program]. Depressive symptoms were screened by the Patient Health Questionnaire-9 and the 15-item Geriatric Depression Scale, by Yesavage. Cohen´s kappa analyzed the degree of agreement of these scales. RESULTS: The prevalence of depressive symptoms screened by the Patient Health Questionnaire-9 was 62.8% and, by the Geriatric Depression Scale, 52.6%. The Spearman correlation between the results of scales obtained rho=0.387, p<0.000. The Kappa reliability coefficient was 0.41 and significance level of p<0.001. The screening methods showed sensitivity of 80% and specificity of 44%. CONCLUSION: Both scales showed moderate agreement and were useful for detecting a relevant prevalence of the target outcome of depression among the elderly.

Indicators of depression in elderly and different screening methods / Indicadores de depressão em idosos e os diferentes métodos de rastreamento

ABSTRACT Objective To determine the prevalence of depressive symptoms among elderly and correlate the agreement between the screening methods used. Methods A cross-section study of 137 elderly attending the Programa Vivendo a Terceira Idade [Living for the Elderly Program]. Depressive symptoms were screened by the Patient Health Questionnaire-9 and the 15-item Geriatric Depression Scale, by Yesavage. Cohen´s kappa analyzed the degree of agreement of these scales. Results The prevalence of depressive symptoms screened by the Patient Health Questionnaire-9 was 62.8% and, by the Geriatric Depression Scale, 52.6%. The Spearman correlation between the results of scales obtained rho=0.387, p<0.000. The Kappa reliability coefficient was 0.41 and significance level of p<0.001. The screening methods showed sensitivity of 80% and specificity of 44%. Conclusion Both scales showed moderate agreement and were useful for detecting a relevant prevalence of the target outcome of depression among the elderly.

RESUMO Objetivo Determinar a prevalência dos sintomas depressivos entre idosos e correlacionar a concordância entre os métodos de rastreamentos utilizados. Métodos Estudo de corte transversal com 137 idosos vinculados ao Programa Vivendo a Terceira Idade. Os sintomas depressivos foram rastreados peloPatient Health Questionnaire-9 e pela Escala de Depressão Geriátrica de Yesavage-15. O teste Kappa de Cohen analisou o grau de concordância dessas escalas. Resultados A prevalência dos sintomas depressivos rastreados pelo Patient Health Questionnaire-9 foi 62,8% e, pela Escala de Depressão Geriátrica, foi 52,6%. A correlação de Spearman entre os resultados das escalas obteve rho=0,387, p<0,000. O coeficiente de confiabilidade de Kappa foi 0,41 e significância de p<0,001. Os métodos de rastreamento apresentaram sensibilidade de 80% e especificidade de 44%. Conclusão Ambas as escalas apresentaram moderada concordância e foram úteis para detectar uma relevante prevalência do desfecho indicativo de depressão entre os idosos.

Intensidade da dor em pacientes com síndrome do ombro doloroso / Pain severity in patients with painful shoulder syndrome

O objetivo do estudo é avaliar intensidade da dor e associações com características clínicas em grupo de pacientes com Síndrome do Ombro Doloroso (SOD). Realizou-se estudo descritivo utilizando dados retrospectivos de 77 prontuários. Como instrumento de avaliação utilizamos Escala Visual Numérica (EVN). Foram consideradas variáveis de interesse: EVN (77), diagnóstico (57), ombro acometido (77), sexo (77), idade (76), localização da dor (77), uso de medicamentos (59) e problema cervical associado (77). Destes 53,2 por cento eram do sexo feminino com média de idade 50,4±15,7 anos. O ombro direito foi o mais afetado (57,1 por cento). Dor intensa foi referida por 41,6 por cento dos pacientes sendo mais freqüente no sexo feminino (56,1 por cento vs 25,0 por cento; p=0,006). Os pacientes queixaram-se de dor intensa com mais freqüência em ombro esquerdo (57,7 por cento vs 31,8 por cento, p=0,034). Dos pacientes estudados, 59 (81,3 por cento) usavam medicamentos, sendo mais freqüente o antinflamatório. A síndrome do manguito rotador estava presente em 80,7 por cento (57) e dor cervical associada em 15,6 por cento (77). Localização da dor exclusivamente no ombro correspondeu a 76,6 por cento. Evidenciamos que a síndrome do manguito rotador foi causa mais freqüente da SOD, sendo mais comum e intensa em mulheres com idade próxima de 51 anos. A EVN mostrou-se instrumento relevante para mensurar a dor na SOD.

The aim of this study was to assess the severity of pain and its correlations to clinical characteristics in Painful Shoulder Syndrome (PSS) patients. A descriptive study was conducted using retrospective data from 77 medical record files. The Visual Numerical Scale (VNS) was used as an assessment instrument. The following variables of interest were considered: VNS (77), diagnosis (57), affected shoulder (77), sex (77), age (76), pain site (77), use of medications (59) and associated cervical pain (77). 53.2 percent of the patients were females and the mean age was 50.4±15.7 years. The right shoulder was the most affected side (57.1 percent). Severe pain was reported by 41.6 percent of patients, more frequently in women (56.1 percent vs 25.0 percent; p=0.006), and on left shoulder (57.7 percent vs 31.8 percent, p=0.034). Of the studied patients, 59 (81.3 percent) used medications, most frequently anti-inflammatory drugs. The rotator cuff syndrome was present in 80.7 percent (57) and associated cervical pain in 15.6 percent (77). Pain exclusively on the shoulder accounted for 76.5 percent. The rotator cuff syndrome was shown to be the most frequent cause of PSS, more commonly and severely affecting women close to 51 years old. EVN was shown to be a relevant instrument for measuring pain in PSS.

Identificaçäo da isoenzima de fosfatase alcalina por termoinativaçäo. Relevância clínica e ensaio laboratorial / Identification of bone alkaline phosphatase by thermoinactivation. Clinical aspects and laboratorial assay

Aplica-se técnica alternativa, rápida, simples e de baixo custo operacional para a dosagem da isoenzima óssea de fosfatase alcalina baseada na termoinativaçao como método qualitativo e na relaçao de Roy como método quantitativo. Essa técnica foi usada em busca de valores preliminares de normalidade. Foi encontrada média de 39,96 por cento (DP=16,50), como valor normal em indivíduos entre um e 20 anos de idade. A importância da fosfatase alcalina óssea em certas condiçoes ortopédicas patológicas como marcador da atividade osteoblástica é discutida, especialmente em tumores ósseos malignos (osteossarcoma). Conclui-se que, por se tratar de técnica de fácil execuçao, acabará por difundir o uso da isoenzima óssea de fosfatase alcalina na pesquisa da atividade osteoblástica.