Physiotherapeutic treatment associated with the pain neuroscience education for patients with chronic non-specific low back pain-single-blind randomized pilot clinical trial.

OBJECTIVES: Pain Neuroscience Education (PNE) shows improvement in pain and functional capacity in patients with chronic low back pain (CLBP). Therefore, the study aimed to verify if the physiotherapeutic treatment associated with PNE decreases the functional disability of patients with nonspecific CLBP. METHODS: Forty patients were clinically evaluated and answered the following questionnaires: Brief pain inventory, Central Sensitization Inventory (CSI), Roland-Morris disability questionnaire, pain catastrophizing scale, Tampa scale of kinesiophobia, hospital anxiety, and depression scale, SF6D quality of life questionnaire and performed quantitative sensory tests (QSTs). Afterward, they were randomly divided into the intervention group (IG, n=20) and the control group (CG, n=20). Both performed kinesiotherapy exercises twice a week for 6 weeks. The IG received 3 individual PNE sessions and answered the pain neurophysiology questionnaire. RESULTS: IG showed significant improvement for all variables analyzed (p<0.001). The association decreased the kinesiophobia (estimated difference between CG-IG means: 7.6-95% CI: 2.3-12.9) (p=0.006). In the lumbar paravertebral region (CG and IG), there was a statistical difference in the intensity of CLBP in the QSTs (p<0.05). CONCLUSION: The association showed better results compared to only therapeutic exercises to reduce kinesiophobia and change the perception of pain intensity in the lumbar region.

Regulation of N-type calcium channels by nociceptin receptors and its possible role in neurological disorders.

Activation of nociceptin opioid peptide receptors (NOP, a.k.a. opioid-like receptor-1, ORL-1) by the ligand nociceptin/orphanin FQ, leads to G protein-dependent regulation of Cav2.2 (N-type) voltage-gated calcium channels (VGCCs). This typically causes a reduction in calcium currents, triggering changes in presynaptic calcium levels and thus neurotransmission. Because of the widespread expression patterns of NOP and VGCCs across multiple brain regions, the dorsal horn of the spinal cord, and the dorsal root ganglia, this results in the alteration of numerous neurophysiological features. Here we review the regulation of N-type calcium channels by the NOP-nociceptin system in the context of neurological conditions such as anxiety, addiction, and pain.

Benefits of electroacupuncture and a swimming association when compared with isolated protocols in an osteoarthritis model.

Background and aim: Osteoarthritis (OA) is characterized by pain and inflammation. Electroacupuncture (EA) and swimming (SW) are non-pharmacological interventions recommended for treating OA. The study evaluated the benefits of electroacupuncture (EA) and swimming (SW) association when compared with isolated protocols in an OA rodent model. Experimental. Procedures: An ankle monoarthritis model was induced in rats by applying Complete Freund's Adjuvant (CFA). After seven days of induced OA, the groups were submitted to EA (ST36 and the GB 30 Acupoint), SW, or the EA + SW protocol. The nociceptive behavior was measured by the Von Frey test, the Cold Stimulation test, and the Paw Flick Immersion test. Inflammatory activity was evaluated by measuring TNF levels, myeloperoxidase, NAGase, immunological parameters and the histology from the subcutaneous tissue. Results: Compared to CFA group, EA decreased the nociceptive scores in the cold stimulation test (p < 0.05), and it also increased the latency time in thermal cold (p < 0.01) and heat hyperalgesia (p < 0.001). Also, EA reduced NAGase (p < 0.01). SW reduced the edema (p < 0.05) and did not increase the inflammatory infiltrates or congestion, neither in the histological measurements nor by analyzing the levels of TNF. The association of EA + SW decreased the neutrophils and the monocytes, MPO (p < 0.05), and the glutamate levels in the cerebrospinal fluid (CSF, p < 0.001). Conclusion: There were statistical differences between combination therapy and monotherapy as seen by the inflammatory parameters, which could be associate to the delay of the chronification osteoarthritis retardation. However, EA + SW did not show benefits when compared to isolated protocols in nociceptive behavior.

Curcumin for attention-deficit-hyperactivity disorder: a systematic review and preliminary behavioral investigation.

Curcumin has protective actions in neuropsychiatric disorders, acting as a neuroprotective agent. As a first approach, the study aimed at a systematic review of the potential effects of curcumin on cognitive performance for attention-deficit-hyperactivity disorder (ADHD). This research was carried out in the databases of PubMed, Embase, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and the Grey literature. Upon discovering the scarcity of relevant studies, and knowing that curcumin might have an ADHD hyperactive and anxious behavior, the study proposed to evaluate the effects of curcumin in an ADHD phenotype of spontaneously hypertensive Wistar rats (SHR). No studies were found that related to curcumin and ADHD. Fifteen SHRs were then divided into separate groups that received water (1 mg/kg/day), curcumin (50 mg/kg/day), or methylphenidate (1 mg/kg/day) for 42 days. Behavioral tests to assess activity (Open Field Test), anxiety and impulsivity (Elevated Plus-Maze, and Social Interaction), and memory (Y-Maze, and the Object Recognition Test) were all performed. The animals that were treated with curcumin showed less anxious and hyperactive behavior, as seen in the Open Field Test and the Social Interaction Test. Anxious behavior was measured by the EPM and was not modulated by any treatment. The results of the Y-Maze Test demonstrated that curcumin improved spatial memory. In the Object Recognition Test, neither the short nor the long-term memory was improved. The treatments that were used in this study beneficially modulated the anxious and hyperactive behavior of the SHR.

Anti-obesity, slimming, biochemical and genotoxic effects of Cordia ecalyculata in diet-induced obese rats.

BACKGROUND: Overweight and obesity are associated with deaths and diseases worldwide. Cordia ecalyculata is a plant marketed as a slimmer. METHODS: The study evaluated the anti-obesity effects of the dry extract from C. ecalyculata in rats fed with a standard diet (STD) or cafeteria diet (CD) receiving the dry extract from C. ecalyculata at 500, 1000, and 2000 mg/kg for 40 days. Furthermore, it evaluated the slimming effect on diet-induced obese rats by the treatment with the same doses for 30 days. The bodyweight of the rats, as well as the intake of food, was measured. Blood samples were collected to determine the liver function (albumin, alanine transaminase (ALT), alkaline phosphatase (ALP), glucose), renal function (urea and creatinine), and lipid profile (cholesterol, triglycerides). RESULTS: The genotoxic effect in peripheral blood was assessed through the comet assay. A lower C. ecalyculata dose significantly prevented the weight gain in rats fed with STD and CD and decreased body weight and intake food of obese rats. The biochemical parameters were not altered, except to increase the serum albumin. Only the higher dose induced DNA damage when evaluated in rats fed with CD in the slimming evaluation model used. CONCLUSIONS: These results reinforce the extract as an anti-obesity and slimming supplement.

Evaluation of lipolysis and toxicological parameters of low-level laser therapy at different wavelengths and doses in the abdominal subcutaneous tissue.

Investigate the effects of low-level lasers therapy (LLLT) aiming abdominal lipolysis. Female Wistar rats received applications of LLLT directly in the abdominal skin twice a week (5 weeks). Except the control group (n = 5), animals received treatments with red wavelength 660 nm being (I) R3.3 group (n = 5): 3.3 J/cm2, and (II) R5 group (n = 5): 5 J/cm2, or infrared wavelength 808 nm being (III) IR3.3 group (n = 5): 3.3 J/cm2, and (IV) IR5 group (n = 5): 5 J/cm2. Abdominal subcutaneous and liver tissues were evaluated histologically. Levels of thiobarbituric acid reactive substances (TBARS) and catalase (CAT) activity were analyzed in liver tissue. In the peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and total cholesterol were investigated. Micronucleus assay was performed in the bone marrow. Except for the IR3.3 group, all treated groups reduced the body weight (p < 0.001). The R5 group reduced the abdominal subcutaneous tissue weight and thickness (p < 0.05), even though all treated groups reduced the number of adipocytes and its size (p < 0.001). No histological changes in the liver. There were no alterations in the triglycerides and LDL levels. The IR5 group increased the total cholesterol levels and decreased the HDL, ALT (both p < 0.05), and AST levels (p < 0.001). The group IR3.3 showed higher levels of ALP (p < 0.01). The R3.3 group increased the TBARS and CAT activity (p < 0.05). No mutagenic effects were found. The red laser treatment at 5 J/cm2 led to lipolysis and did not alter the liver's parameters.

The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain.

BACKGROUND: The Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene is a potential biomarker of vulnerability to pain. Thus, the present study aimed to investigate the association of this polymorphism with clinical and biopsychosocial factors in patients with chronic low back pain (CLBP). METHODS: A total of 107 individuals with CLBP answered questionnaires that were validated and adapted for the Brazilian population, including the Brief Inventory of Pain, the Central Sensitization Inventory, the Roland Morris Disability Questionnaire, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, the Survey of Pain Attitude-Brief, and the Hospital Anxiety and Depression Scale. All of the subjects were genotyped for the BDNF Val66Met polymorphism. RESULTS: The sample showed moderate scores of disability, central sensitization, and kinesiophobia, in addition to mild anxiety, hopelessness, and ruminant thoughts. No significant association was observed between the Val66Met polymorphism and the variables analyzed. Besides, there was no relationship between the BDNF Val66Met polymorphism with CSI, catastrophization, or disabilities that were generated by CLBP. CONCLUSION: The results showed that the Val66Met polymorphism of the BDNF gene was not associated with clinical and biopsychosocial characteristics of CLBP in the sample studied.

The effects of Brazilian chitosan-based biomaterials on wound healing in rats.

The use of natural supplies is a resource to mimic an original extracellular matrix that allows for migration, proliferation, and cellular organization. Chitosan from Brazilian Atlantic Ocean had low protein, minerals percentage and excellent antibacterial activity. The aim of this study was to evaluate and to compare the effectiveness of different types of acids as solvents with Brazilian chitosan-membrane in the healing process of skin lesions. Experimental full-thickness 2 × 2 cm wounds were created on the dorsum skin of Wistar rats. The applied different treatments were saline, collagenase®, microcrystalline chitosan salt membrane (MCSM), microcrystalline chitosan acetic acid membrane (MCAAM), and microcrystalline chitosan hydrochloric acid membrane (MCHAM). The wound repairs were measured morphologically and histologically on days 0, 3, 7, 10, and 14. The exudate formation and the final wound contractions were similar in all of the groups. There were mild exudations in the groups with chitosan-membranes, despite the formation of crust under the membrane. This configured a serum hematic aspect, but there was no impact on the healing process. The MCHAM group had more favorable aspects that histologically showed the healing phases. A significant migration of neutrophils and macrophages seen by myeloperoxidade and Beta-N-Acetylglucosaminidase activities was evident in the chitosan groups, MCHAM and MCSM, respectively. Furthermore, the MCHAM group created its histological arrangement in a dense and more consistent manner.

Phoneutria nigriventer Tx3-3 peptide toxin reduces fibromyalgia symptoms in mice.

Fibromyalgia is characterized by the amplification of central nervous system pain with concomitant fatigue, sleep, mood disorders, depression, and anxiety. It needs extensive pharmacological therapy. In the present study, Swiss mice were treated with reserpine (0.25 mg/kg, s.c.) over three consecutive days, in order to reproduce the pathogenic process of fibromyalgia. On day 4, the administrations of the Tx3-3 toxin produced significant antinociception in the mechanical allodynia (87.16% ±12.7%) and thermal hyperalgesia (49.46% ± 10.6%) tests when compared with the PBS group. The effects produced by the classical analgesics (duloxetine 30 mg/kg, pramipexole 1 mg/kg, and pregabalin 30 mg/kg, p.o., respectively) in both of the tests also demonstrated antinociception. The administrations were able to increase the levels of the biogenic amines (5-HTP and DE) in the brain. The treatments with pramipexole and pregabalin, but not duloxetine, decreased the immobility time in the FM-induced animals that were submitted to the forced swimming test; however, the Tx3-3 toxin (87.45% ± 4.3%) showed better results. Taken together, the data has provided novel evidence of the ability of the Tx3-3 toxin to reduce painful and depressive symptoms, indicating that it may have significant potential in the treatment of FM.

Behavioral, Oxidative, and Biochemical Effects of Omega-3 on an Ovariectomized Rat Model of Menopause.

OBJECTIVES: Menopause induces changes in neuronal transmission, leading to anxiety and depression. Changes in the brain's glutamate levels cause psychological behavior in postmenopausal women. Omega-3 has been studied to improve some of these behaviors. METHODS: Twenty-four female Wistar rats were divided into four groups: sham-operated treated with water (SO-W), sham-operated treated with omega-3 (SO-O), ovariectomized (OVX) treated with water (OVX-W), and bilateral OVX treated with omega-3 (OVX-O). These treatments were performed for 20 days via gavage, before and after surgery, totaling 40 days. RESULTS: In the forced swimming, elevated plus-maze, and open field tests to assess behaviors, such as depression and anxiety, omega-3 improved these behaviors in both treated groups. The levels of thiobarbituric acid reactive substances (TBARS) in the brain were not different between the groups; however, there was a significant decrease in the catalase activity in the SO-O group compared with the SO-W group (P < 0.05). The glutamate level in the cerebrospinal fluid (CSF) was elevated in the SO-O group (P < 0.001) but not in the OVX-W or OVX-O groups. CONCLUSIONS: These results bring novel data when related to the glutamatergic system in the SO-O group. This has suggested that the action mechanism of omega-3 was not dependent on glutamate levels in the CSF of the OVX group, but it played a regulatory role in the sham-operated animals. To confirm this, more studies are needed to explore this field when relating to the estrogen and glutamate receptor changes in specific brain regions.

Adaptogenic effects of curcumin on depression induced by moderate and unpredictable chronic stress in mice.

Curcumin has been investigated for the prevention and treatment of diseases due to its anti-oxidant, anti-inflammatory, immunomodulatory, and neuroprotective actions. This current study evaluated the adaptogenic effects of a subchronic oral administration of curcumin to Swiss mice that were submitted to a chronic unpredictable mild stress (CUMS) model of depression. Four groups of mice (vehicle control, CO; curcumin control, COC; CUMS + vehicle, CUMS; CUMS + curcumin, CUMSC) were evaluated for the biochemical parameters. The CUMS model caused depressive-like and anxiety-like behavior in the animals when they were viewed in the Forced Swimming Test and in the Elevated Plus Maze Test. The treatments with curcumin prevented the depressive-like behavior in the Forced Swimming Test and they had anxiolytic effects on the non-stressed animals. This was confirmed by the Elevated Plus Maze Test. Curcumin showed antioxidant effects (IC50 of 38.86 ± 1.78 µg/mL) in the in vitro DPPH (2,2-diphenyl-1-picryl-hydrozole) test. The compound also showed antioxidant effects in vivo, increasing the catalase (CAT) levels in the brains of the stressed animals. The biochemical analyses did not reveal potential renal and hepatic damage. Together, these results have demonstrated the antidepressant and antioxidant effects of curcumin, highlighting in this mice model, the compound's novel adaptogenic potential.

The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain

Abstract Background: The Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene is a potential biomarker of vulnerability to pain. Thus, the present study aimed to investigate the association of this polymorphism with clinical and biopsychosocial factors in patients with chronic low back pain (CLBP). Methods: A total of 107 individuals with CLBP answered questionnaires that were validated and adapted for the Brazilian population, including the Brief Inventory of Pain, the Central Sensitization Inventory, the Roland Morris Disability Questionnaire, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, the Survey of Pain Attitude-Brief, and the Hospital Anxiety and Depression Scale. All of the subjects were genotyped for the BDNF Val66Met polymorphism. Results: The sample showed moderate scores of disability, central sensitization, and kinesiophobia, in addition to mild anxiety, hopelessness, and ruminant thoughts. No significant association was observed between the Val66Met polymorphism and the variables analyzed. Besides, there was no relationship between the BDNF Val66Met polymorphism with CSI, catastrophization, or disabilities that were generated by CLBP. Conclusions: The results showed that the Val66Met polymorphism of the BDNF gene was not associated with clinical and biopsychosocial characteristics of CLBP in the sample studied.

Analgesic effects of the CTK 01512-2 toxin in different models of orofacial pain in rats.

BACKGROUND: Orofacial pain is clinically challenging, having therapeutic failures and side effects. This study evaluated the antinociceptive activities of the CTK 01512-2 toxin, the TRPA1 channel antagonist, and the selective inhibitor of the N-type voltage-gated calcium channels (N-type VGCC), in different pain models. MATERIALS AND METHODS: The trigeminal ganglia were stimulated in vitro with capsaicin. The in vivo models received subcutaneous (sc) injections of formalin into the upper lip of the rats, Freund's Complete Adjuvant (FCA) into the temporomandibular joint (TMJ), and infraorbital nerve constrictions (IONC). CTK 01512-2 at concentrations of 30, 100, and 300 pmol/site, intrathecally (ith), and MVIIA at 10, 30, and 100 pmol/site in the formalin test, guided the doses for the models. The glutamate levels in the CSF of the rats that were submitted to IONC were analyzed. RESULTS: CTK 01512-2 decreased the nociceptive behavior in the inflammatory phase of the formalin test (65.94 ± 7.35%) and MVIIA in the neurogenic phase (81.23 ± 3.36%). CTK 01512-2 reduced facial grooming with FCA in the TMJ (96.7 ± 1.6%), and in the IONC neuropathy model, it decreased heat hyperalgesia (100%) and cold hyperalgesia (81.61 ± 9.02%). The levels of glutamate in the trigeminal ganglia in vitro (81.40 ± 8.59%) and in the CSF in vivo (70.0 ± 9.2%) were reduced. CONCLUSIONS: The roles of TRPA1 in pain transduction and the performance of CTK 01512-2 in the inhibition of the N-type VGCCs were reinforced. This dual activity may represent an advantage in clinical treatments.

Recombinant peptide derived from the venom the Phoneutria nigriventer spider relieves nociception by nerve deafferentation.

The avulsion of nerve roots of the brachial plexus that is commonly seen in motorcycle accidents is a type of neuropathy due to deafferentation. This type of pain is clinically challenging since therapeutical protocols fail or have severe side effects. Thus, it is proposed to evaluate the antinociceptive activity of the recombinant CTK 01512-2 peptide that is derived from the venom of the Phoneutria nigriventer spider, as a future new therapeutical option. The neuropathic pain was surgically induced by avulsion of the upper brachial plexus trunk in groups of male Wistar rats and after 17 days, they were treated intrathecally with morphine, ziconotide, and CTK 01512-2. Behavioral tests were performed to evaluate mechanical and thermal hyperalgesia, cold allodynia, the functional activity of the front paw, and exploratory locomotion after the treatments. The peripheral blood samples were collected 6 h after the treatments and a comet assay was performed. The spinal cord was removed for the lipoperoxidation dosing of the membranes. The cerebrospinal fluid was analyzed for the dosage of glutamate. The recombinant peptide showed an antinociceptive effect when compared to the other drugs, without affecting the locomotor activity of the animals. Mechanical and thermal hyperalgesia, as well as cold allodynia, were reduced in the first hours of treatment. The levels of glutamate and the damage by membrane lipoperoxidation were shown to be improved, and genotoxicity was not demonstrated. In a scenario of therapeutical failures in the treatment of this type of pain, CTK 01512-2 was shown as a new effective alternative protocol. However, further testing is required to determine pharmacokinetics.

Padrões mínimos para assistência de enfermagem segura a usuários de bebidas alcoólicas / Normas mínimas para cuidado de enfermería segura a los usuarios de las bebidas alcohólicas / Minimum standards for safe nursing care for users of alcoholic beverages

To develop minimum standards for nursing care for people intoxicated by alcohol and treated in the emergency units. Method: documental research, built upon the experience of the authors as members of the nursing care team of a center of toxicological assistance, based on literature review. Results: we presented the results in two units. Firstly, through a brief literature review on patient safety and alcohol users attended in emergency department, and secondly through a description of minimum standards for initial nursing care necessary for the safety of users of alcohol in three aspects: clinical/biological, psycho-emotional and social. Conclusion: The presented standardization, besides regulating nursing practice, improves the execution of assistance programs in the toxicology centers...

Elaborar padrões mínimos para assistência de enfermagem às pessoas intoxicadas por álcool e atendidas em unidades de atenção às urgências. Método: investigação documental, construída a partir da experiência dos autores como integrantes da equipe assistencial de enfermagem de um centro de assistência toxicológica, alicerçada em revisão de literatura. Resultados: foram apresentados em duas unidades. Breve revisão bibliográfica sobre segurança do paciente e de usuários de bebidas alcoólicas atendidos em serviços de urgência, e descrição de padrões mínimos de assistência inicial de enfermagem, necessários à segurança de usuários de bebida alcoólica, em três aspectos; clínico/biológico, psicoemocional e social. Conclusão: A padronização apresentada, além de normatizar a prática de enfermagem, melhora a execução de programas assistenciais em centros de assistência toxicológica...

Desarrollar normas mínimas para la atención de enfermería para las personas intoxicadas por alcohol y tratadas en las unidades de atención de emergencia. Método: la investigación documental, construida a partir de la experiencia de los autores como miembros del equipo de atención de enfermería en un centro de asistencia toxicológica, basado en revisión de la literatura. Resultados: fueron presentados en dos unidades. Primeramente, una breve revisión de la literatura sobre la seguridad de los usuarios y de los pacientes vistos en un departamento de emergencias, y la descripción de las normas mínimas para la atención inicial de enfermería necesaria para la seguridad de los usuarios de alcohol en tres aspectos: clínico/biológico, psico-emocional y social. Conclusión: La normalización presenta, además de regular la práctica de la enfermería, la mejora de la ejecución de los programas de asistencia en los centros de toxicología...

Cotidiano de cuidadores familiares de usuários de álcool que necessitaram de internação em Terapia Intensiva / The quotidian of family caregivers of alcohol users who required Intensive Care Hospitalization

The aim of this study was to describe the daily life of home care rendered by familycaregivers to alcohol users. This is a descriptive and exploratory study, with data from a case series of 10 patients enrolled in a Poison Control and Information Center of Paraná State, in 2011. It was made an analysis of records of toxicological occurrence and interviews with the family caregivers. Data were analyzed using the technique of content analysis on Thematic Analysis mode. Among the alcohol users who required ICU admission, seven were discharged, with five of them having physical and psychosocial squeals, and three died. The care provided to users of alcohol immediately after ICU became more complex. Caring and co-inhabiting with alcohol dependent was a difficult situation because their caregivers were often exposed to violence. The participation of other family members in the caregiving process was an important facilitating factor for the caregiver. Families of alcohol users have undergone a process of destruction not only because of alcohol dependence in the family, but also by the hospitalization of the alcohol user in intensive care units.

O objetivo foi descrever o cotidiano do cuidado domiciliar a usuários de álcool, antes e após a internação destes em UTI, praticado por seus cuidadores familiares. Estudo descritivo e exploratório, com dados de uma série de casos de dez pacientes registrados em um Centro de Informação e Assistência Toxicológica do Paraná, no ano de 2011. Realizou-se análise de fichas de ocorrência toxicológica e dos prontuários hospitalares dos pacientes, e entrevistas com seus cuidadores familiares. Os dados foram analisados, utilizando-se a técnica de análise de conteúdo na modalidade Análise Temática. Sete receberam alta hospitalar, com cinco deles apresentando sequelas físicas e psicossociais, e três evoluíram a óbito. Os cuidados prestados aos usuários de álcool imediatamente após a internação em UTI tornaram-se de maior complexidade. Cuidar e co-habitar com usuários dependentes de álcool, era uma situação difícil, pois seus cuidadores muitas vezes estiveram expostos às violências. As famílias dos usuários de álcool sofreram o processo de desestruturação não só pela dependência do álcool no âmbito familiar, mas também pela internação do parente usuário de álcool em terapia intensiva.

Perfil de usuários intoxicados por drogas de abuso e associação com o óbito / Profile of users intoxicated by drugs of abuse and association with death

Caracterizar o perfil de usuários intoxicados por drogas de abuso notificados em um centro deinformação e assistência toxicológica relacionando com a ocorrência de óbitos. Métodos: estudo de sériede casos notificados no biênio 2010-2011, após busca ativa de casos. Os dados foram obtidos das fichasepidemiológicas arquivadas no centro, e submetidos à análise estatística univariada, com teste qui quadrado ede Fischer. Resultados: encontrou-se 339 casos, a maioria homens (87,3%), escolaridade fundamental (61,0%),e idosos (37,2%). Uso de álcool (83,8%) e intoxicações crônicas (89,9%) foram predominantes. Intercorrênciasclínicas estavam presentes na maioria dos diagnósticos médicos (63,4%), no entanto, a letalidade foi maiorna ocorrência de ferimento por armas branca e de fogo. Conclusão: O consumo de drogas de abuso influenciaa morbimortalidade, principalmente em homens, na faixa etária de 60 anos ou mais e com menor nível deescolaridade...

Characteristics of patients hospitalized at an intensive care unit due to drug abuse / Características de los pacientes internados en una unidad de terapia intensiva por abuso de drogas / Características dos pacientes internados numa unidade de terapia intensiva por abuso de drogas

Objective. To characterize the clinical and demographic profile of patients hospitalized due to drug intoxication at an intensive care unit (ICU) of a teaching hospital between 2004 and 2010. Methodology. In this descriptive study, information was collected from the hospitalized patients, as informed by a Toxicology Care Center (CAT) in Paraná (Brazil). The clinical files were checked and information was collected about age, gender, toxic agents and intoxication circumstances, comorbidities and clinical outcomes. Results. Sixty-two patients were included in the study, with a mean age of 58 years and 77% male. Alcohol was the substance related to most hospitalizations (77%), followed by psychoactive drugs (14%) and marihuana and crack (5% each). The main comorbidities were bronchopneumonia due to aspiration (37%), alcohol-related liver cirrhosis (24%) and traumatic brain injury (19%). The most frequent intoxication circumstances were chronic abuse (79%), attemptive suicide (19%) and acute abuse (4.9%). Thirty-nine percent of the patients died during hospitalization. Conclusion. The results show a concerning reality, as most of the patients are men of economically active age, who were intoxicated by a legal substance like alcohol, with a relevant number of deaths. Nurses need to pay particular attention to this health problem, in the context of which they play a fundamental role as educators with a view to the encouragement of healthy lifestyles.

Objetivo. Caracterizar el perfil clínico y demográfico de los pacientes hospitalizados por intoxicación por sustancias de abuso en unidad de cuidados intensivos (UCI) de un hospital universitario en los años de 2004 a 2010. Metodología. Estudio descriptivo en el que se recolectó información de los pacientes hospitalizados quienes fueron informados por un Centro de Asistencia Toxicológica (CAT) de Paraná (Brasil). Las historias clínicas fueron revisadas y se tomó información sobre edad y sexo, agentes tóxicos y circunstancias de la intoxicación, comorbilidades y resultados clínicos. Resultados. Se incluyeron en el estudio 62 pacientes, que tuvieron un promedio de edad de 58 años y de los cuales el 77% era de sexo masculino. El alcohol fue la sustancia relacionada con el mayor número de internaciones (77%), seguida por los medicamentos sicoativos (14%) y la marihuana y el crack (5%, cada uno). Las principales comorbilidades fueron la bronconeumonía por aspiración (37%), la cirrosis hepática de origen alcohólica (24%) y el traumatismo cráneo-encefálico (19%). Las circunstancias más frecuentes de la intoxicación fue el abuso crónico (79%), la tentativa de suicidio (19%) y el abuso agudo (4.9%). Un 39% de los pacientes falleció durante la internación. Conclusión. Los resultados muestran una preocupante realidad pues los pacientes en su mayoría son hombres en edad económicamente activa, quienes se intoxicaron con una sustancia lícita como es el alcohol, con un número relevante de muertes. El enfermero debe prestar especial atención a este problema de salud, dentro del cual tiene un papel fundamental como educador en el fomento de estilos de vida saludables.

Objetivo. Caracterizar o perfil clínico e demográfico dos pacientes hospitalizados por intoxicação por substâncias de abuso em Unidade de Terapia Intensiva (UTI) de um hospital universitário entre os anos de 2004 a 2010. Metodologia. Estudo descritivo no que se coletou informação dos pacientes hospitalizados que foram informados por um Centro de Assistência Toxicológica (CAT) do Paraná (Brasil). As histórias clínicas foram revisadas e se tomou informação sobre idade e sexo, agentes tóxicos e circunstâncias da intoxicação, comorbilidades e resultados clínicos. Resultados. Incluíram-se no estudo 62 pacientes, que tiveram uma média de idade de 58 anos e um 77% foram homens. O álcool foi a substância relacionada com o maior número de internações (77%), seguida pelos medicamentos psicoativos (14%) e a maconha e o craque (5%, cada um). As principais comorbilidades foram a broncopneumonia por aspiração (37%), a cirrose hepática de origem alcoólica (24%) e o traumatismo crânio-encefálico (19%). As circunstâncias mais frequentes da intoxicação foi o abuso crônico (79%), a tentativa de suicídio (19%) e o abuso agudo (4.9%). Um 39% dos pacientes faleceram durante a internação. Conclusão. Os resultados mostram uma preocupante realidade pois os pacientes em sua maioria são homens em idade economicamente ativa e que se intoxicaram com uma substância lícita como é o álcool, com um número relevante de mortes. O enfermeiro deve prestar especial atendimento a este problema de saúde onde tem um papel fundamental como educador no fomento de estilos de vida saudáveis.

Sentimentos dos cuidadores de usuários de bebidas alcoólicas frente à internação / Feelings of caregivers of alcohol abusers at hospital admission

OBJETIVO: Descrever os sentimentos dos cuidadores de usuários de bebidas alcoólicas frente à internação em unidade de terapia intensiva. MÉTODOS: Pesquisa qualitativa que incluiu dez cuidadores familiares de pacientes internados em unidade de terapia intensiva com diagnóstico médico associado ao uso crônico de bebidas alcoólicas. Os dados foram coletados através de entrevista semiestruturada nos domicílios e submetidos a Análise de Conteúdo. RESULTADOS: os sentimentos relatados foram: sofrimento, tristeza, desespero e culpa. A religiosidade apareceu como forma de enfrentamento ao sofrimento e o afeto pelo familiar foi mais importante do que a sobrecarga do processo de cuidar. CONCLUSÃO: A internação dos usuários de bebidas alcoólicas em unidade de terapia intensiva mostrou-se como um evento difícil de ser vivenciado pela família e pelos cuidadores familiares pois desperta sentimentos de sofrimento, tristeza, desespero e culpa. Observou-se a fé e religiosidade dos cuidadores como importante fator de apoio ao enfrentamento do sofrimento causado ao vivenciar essa experiência.

OBJECTIVE: To describe caregivers' feelings about alcohol abusers at hospital admission to the intensive care unit. METHODS: This qualitative study included ten family caregivers of patients admitted to an intensive care unit with a diagnosis of chronic alcohol use. Data were collected by semi-structured interviews at the respondents' homes, and data were subsequently submitted to content analysis. RESULTS: The caregivers reported suffering, sadness, desperation, and guilt. Religion appeared as a way to confront suffering, and affection by the family member was more important than the workload associated with care delivery. CONCLUSION: Admission of alcohol users to the intensive care unit is a difficult event for the patient's family and caregiver because it causes feelings of suffering, sadness, and guilt. The faith and religiosity of caregivers is an important supporting factor in response to the suffering caused by this experience.

Síndrome de Menkes: relato de caso em irmãos / Menkes disease: report of two cases in siblings

A Síndrome de Menkes ou tricopoliodistrofia é umadesordem neurodegenerativa de caráter recessivo, ligadaao cromossomo X, caracterizada por um distúrbiono transporte e metabolismo do cobre. O diagnósticoé sugerido pela tríade clássica dos fatores clínicos(atraso no desenvolvimento, degeneração neurológicae má formação dos cabelos) e com a demonstração daredução dos níveis séricos de cobre e ceruloplasmina.Relata-se o caso de dois irmãos, diagnosticados comSíndrome de Menkes, enfatizando-se ainda, a raridadedesse acontecimento e os tratamentos atuais de eficácialimitada.

Menkes syndrome or Twisted Hair Syndromeand trichopolyodistrophy is a rare, X-linked recessiveneurodegenerative disorder, characterized by adisturbance in copper metabolism. The diagnosis isclinically suggested by the classic triad of features(developmental delay, neurological degenerationand malformation of the hair) and with the demonstrationof reduction of serum copper and ceruloplasmin.We report on the case of two brothers, diagnosedwith Menkes syndrome, emphasizing also therarity of this event and the current treatments of limitedeffectiveness.