RESUMO
O presente estudo teve como objetivo descrever possíveis correlações entre estresse, transtornos físicos e/ou mentais e diferentes formas de vitimização em pacientes com fibromialgia (FM). Foram examinados 16 prontuários de pacientes que recebiam tratamento por fisioterapeuta e psicólogo. Os prontuários incluíam os resultados de avaliações em Psicologia e Fisioterapia, indicadores de saúde geral, de nível socioeconômico e registros, em áudio e vídeo, de sessões em psicoterapia. Adicionalmente, foram analisados os escores em inventários de estresse, ansiedade e depressão, obtidos no início do tratamento. As sessões de psicoterapia foram examinadas e os relatos de eventos vitimizadores ao longo da vida foram organizados em cinco categorias: negligência e abuso emocional, abuso físico, assédio e abuso sexual. As pacientes eram 16 mulheres, com idade variando entre 22 e 73 anos. Todas apresentaram indicadores de estresse. Correlações significativas foram estabelecidas entre tender points, estresse e ansiedade. No relato dos pacientes, Negligência e abuso emocional foram as categorias predominantes, tanto na infância, quanto na vida adulta. Categorias de vitimização na infância foram positivamente relacionadas à ansiedade, depressão e tender points. Vitimização na infância e trabalho infantil foram correlacionados a um maior número de doenças na vida adulta, enquanto abuso físico foi positivamente associado a doenças musculoesqueléticas. Uma proposta tenta integrar as diversas correlações observadas de uma perspectiva analítico-comportamental.(AU)
The present study aimed to investigate possible correlations between stress, mental and physical disorders, and different forms of victimization in fibromyalgia patients (FM). The medical records of 16 patients who received treatment from both a physiotherapist and a psychologist were examined. The medical records included the results from psychological and physiotherapeutic assessments, general health information, economic indicators, as well as both transcripts and copies of videotaped and audiotaped therapy sessions. Additionally, the patients' records included stress, anxiety and depression's scores obtained at the beginning of treatment that were taken into consideration. The therapy sessions were analyzed and lifelong victimization events were classified in the following five categories: emotional neglect and abuse, physical abuse, sexual harassment and abuse. The patients were women between 22 and 73 years of age. All of them presented stress indicators. The analysis revealed significant correlations between tender points, stress, and anxiety. Emotional neglect and abuse during childhood and adulthood were the predominant categories in patients reports. Victimization categories in childhood were positively related to anxiety, depression and tender points. Early victimization and child labor were correlated with different medical conditions in adult life, while physical abuse was associated with pathologies of the muscular-skeletal system. A tentative proposal to integrate the observed correlations from the perspective of Behavior Analysis is presented.(AU)
RESUMO
Chronic myelogenous leukaemia (CML) cells show expression of BCL-X(L), an anti-apoptotic oncogene. This expression is induced by BCR-ABL protein kinase through activation of the signal transducer and activator of transcription-5 protein (STAT5). To date, however, the contribution of BCL-X(L) and STAT5 to the transforming phenotype in CML is still unclear. This study was aimed at defining the status of activated STAT5 and BCL-X(L) expression and their relation to BCR-ABL rearrangement in CML cells derived from patients at different clinical stages. Twenty-seven consecutive patients with CML were enrolled in the study. Peripheral blood mononuclear cells were lysed and subjected to immunoprecipitation and Western blotting to analyse phosphorylated STAT5. The p210 BCR-ABL rearrangements were determined by reverse transcriptase-polymerase chain reaction (RT-PCR) and BCL-X(L) expression by semi-quantitative RT-PCR. We found that increased transcription of BCL-X(L) gene was associated with phosphorylated STAT5 in the majority of blast crisis patients and in a few accelerated and chronic phase patients. Moreover, BCL-X(L) expression levels were found to be decreased in chronic phase, contrary to a marked increase in blast crisis. We found no difference in expression of BCL-X(L) and phosphorylated STAT5 when related with b3a2 and b2a2 BCR-ABL rearrangements. These results suggest that STAT5 activity and BCL-X(L) overexpression may reflect a stage of differentiation among CML phases, and this could contribute to BCR-ABL-dependent transformation.
