Analgesic efficacy of a portable, disposable, and self-applied transcutaneous electrical nerve stimulation device during migraine attacks: A real-life randomized controlled trial.

OBJECTIVE: The objective of this study was to evaluate the analgesic efficacy of a portable, disposable, and home self-applied transcutaneous electrical nerve stimulation (TENS) device during migraine attacks. BACKGROUND: TENS has been used as a noninvasive treatment for migraine, but there are no reports on the outcomes following use of this treatment option for use at home during migraine attacks. DESIGN AND METHODS: A double-blind, randomized controlled trial was conducted over 3 months, with monthly assessments. Active placebos (sham group) were in place and were allocated at a 1:1 ratio. Adult patients who had been diagnosed with migraine by a specialist were included. Pain intensity levels and functional disability were measured before and after the 20-min self-applied TENS intervention during the migraine attacks. RESULTS: Seventy-four participants were randomly allocated to the sham and intervention groups. Although both groups of subjects reported lower pain scores, the intervention group showed a statistically significant reduction in pain scores compared to the sham group. CONCLUSION: In our controlled trial, the use of a self-applied, TENS device is safe and effective in relieving pain associated with migraine attacks. Participants in the intervention group showed a statistically significant improvement in pain and functional disability scores. TENS has been used as a noninvasive treatment for migraine, but there are no reports on the outcomes following use of this treatment option for use at home during migraine attacks. This double-blind, randomized controlled trial had 2 groups: active-placebo and intervention. Seventy-four participants were randomly allocated. Participants in the intervention group showed a statistically significant improvement in pain and functional disability scores.

Intercostal nerve mononeuropathy: study of 14 cases.

This retrospective study describes 14 cases of intercostal nerve mononeuropathy (INM) found in 5,560 electromyography (EMG) exams performed between January 1991 and June 2004 in our University Hospital. Medical charts of all patients with history of thoracic pain and EMG diagnosis of intercostal mononeuropathy were reviewed. INM was detected in 14 patients; etiology was thoracic surgery in 6 (43%), post-herpetic neuropathy in 4 (28%), probable intercostal neuritis in 2 (14%), lung neoplasia in 1 (7%), and radiculopathy in 1 (7%). From this study, trauma and infection were the main etiologies in intercostal neuropathic pain development. Tricyclic antidepressants and anticonvulsants were the most common therapeutic drugs used.

A Experiência da Comissão de Apoio Pedagógico na Faculdade de Medicina de Botucatu UNESP / The Experience of the Teaching Support Committee at Botucatu Medical School (UNESP)

Resumo: A Faculdade de Medicina de Botucatu, dentro de um processo de reforma curricular, organizou a partir de 1989 uma ampla avaliação através de seus docentes, alunos e ex-alunos. Como resultado, integrar disciplinas, introduzir metodologias inovadoras e estender o ensino para outros níveis de atenção médica do município foram as propostas mais contundentes. No início dos anos 90, a parceria da escola com o Programa UNI contribuiu para que a proposta se concretizasse. Em 1995, foi criada a Comissão de Apoio Pedagógica (CAP) para prestar apoio pedagógico aos órgãos colegiados na implementação do novo currículo, referente às inovações metodológicas em ensino, integração de disciplinas e produção de material didático. Para somar às avaliações Já desenvolvidas, a CAP coordenou o Projeto Cinaem. Como estratégia para integração das disciplinas, membros da CAP e docentes do ciclo básico organizaram dois módulos do atual primeiro ano de Medicina, introduzindo o método de ensino baseado em problemas (PBL). A filosofia do ensino ativo, centrado no aluno, norteou a proposta.

Abstract: Since 1989, as part of a process of curricular reform, Botucatu Medical School has been conducting extensive evaluation by way of faculty members, students and alumni: The most conspicuous outcomes are decisions to integrate subjects, introduce new and innovative methodologies and extend teaching to other levels of medical care in the municipality. This program was made possible partly by a partnership set up in the early nineties between the Medical School and the UNI Program. In 1995 the Teaching Support Committee (CAP) was set up to provide teaching support to the groups involved in implementing this new curriculum, as regards innovation in teaching methodology, integration among disciplines and production of teaching materials. To complement the existing evaluations, the CAP coordinated the Cinaem Project. As a strategy for integrating displines, members of the committee and professors of the foundation course, organized two modules of the present first year of Medicine, introducing Problem Basie Learning. The proposal was informed by the notion of active student-centered learning.