Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome

In addition to the debilitating fatigue, the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. These pain complaints show the greatest overlap between CFS and fibromyalgia (FM). Although the literature provides evidence for central sensitization as cause for the musculoskeletal pain in FM, in CFS this evidence is currently lacking, despite the observed similarities in both diseases. The knowledge concerning the physiological mechanism of central sensitization, the pathophysiology and the pain processing in FM, and the knowledge on the pathophysiology of CFS lead to the hypothesis that central sensitization is also responsible for the sustaining pain complaints in CFS. This hypothesis is based on the hyperalgesia and allodynia reported in CFS, on the elevated concentrations of nitric oxide presented in the blood of CFS patients, on the typical personality styles seen in CFS and on the brain abnormalities shown on brain images. To examine the present hypothesis more research is required. Further investigations could use similar protocols to those already used in studies on pain in FM like, for example, studies on temporal summation, spatial summation, the role of psychosocial aspects in chronic pain, etc

Imagem corporal e comportamentos de risco para transtornos alimentares em bailarinos profissionais Body image and risk behavior for eating disorders in professional ballet dancers

INTRODUÇÃO E OBJETIVO: A grande preocupação com a aparência e a forma física e a constante pressão para manterem baixo peso corporal são fatores que levam a distorções da imagem corporal e tornam os bailarinos um grupo de risco para o desenvolvimento de transtornos alimentares (TA). O objetivo deste estudo foi avaliar a percepção da imagem corporal e sua associação com comportamentos de risco para TA em bailarinos profissionais. MÉTODOS: Foram estudados 61 bailarinos (39 mulheres e 22 homens) de uma instituição representante da elite do balé clássico brasileiro. A avaliação dos comportamentos de risco para TA foi feita com base nas versões em português dos questionários Eating Attitudes Test (EAT-26) e Bulimic Investigatory Test Edinburgh (BITE). A Escala de Silhuetas de Stunkard foi utilizada para avaliação da percepção da imagem corporal. A associação entre as variáveis foi avaliada com base na razão de prevalência (RP) e seus respectivos intervalos de confiança (IC) de 95%. RESULTADOS: Trinta e um bailarinos (50,8%) gostariam de ter a silhueta menor que a autopercebida como usual. A presença de comportamentos de risco para TA foi 2,71 vezes maior (IC 95% = 1,02 - 7,18) entre os que desejavam ter silhueta menor que a usual e 2,64 vezes maior (IC 95% = 1,20 - 5,80) entre aqueles que desejavam ter silhueta menor que a considerada mais saudável, quando comparados com os que estavam satisfeitos com a sua silhueta. CONCLUSÃO: A alta frequência de insatisfação com o corpo encontrada pode estar colaborando para ocorrência de comportamentos de risco para TA nos bailarinos investigados.<br>INTRODUCTION AND OBJECTIVE: Great concern with physical appearance and fitness as well as constant pressure in maintaining low body weight make ballet dancers a risk group for the development of eating disorders (ED). The objective of the present study was to evaluate the body image perception and its association with risk behavior for ED in professional ballet dancers. METHOD: Sixty-one dancers (39 women and 22 men) who represent the Brazilian classical ballet elite were assessed. The Portuguese versions of Eating Attitudes Test (EAT-26) and Bulimic Investigatory Test Edinburgh (BITE) questionnaires were used to evaluate de risk behavior for ED. Stunkard´s standard silhouettes were used to assess body image perception. Association between variables was evaluated through the prevalence ratio (PR) and respective 95% confidence interval (CI). RESULTS: Thirty-one dancers (50.8%) would like to have smaller silhouette than the usual. The presence of risk behavior for ED was 2.71 times higher (CI 95%=1.02-7.18) among those who would like to have smaller silhouette than the usual and 2.64 times higher (CI 95% = 1.20 - 5.80) among those who would like to have smaller silhouette than the ones considered healthier. CONCLUSION: The high frequency of body dissatisfaction found can be collaborating for the onset of risk behavior for ED in professional ballet dancers

Thermal Sensitivity To Warmth During Rest and Exercise: A Sex Comparison.

Purpose The study aimed to compare thermal sensation in response to a fixed warm stimulus across 31 body locations in resting and active males and females. Methods Twelve males (20.6 ± 1.0 yrs, 78.1 ± 15.6 kg, 180 ± 8.9 cm, 34.4 ± 5.2 ml•kg-1•min-1) and 12 females (20.6 ± 1.4 yrs, 62.9 ± 5.5 kg, 167 ± 5.7 cm, 36.5 ± 6.6 ml•kg-1•min-1) rested in a thermoneutral (22.2 ± 2.2°C, 35.1 ± 5.8% RH) room whilst a thermal probe (25 cm2), set at 40°C was applied in a balanced order to 31 locations across the body. Participants reported their thermal sensation 10 seconds after initial application. Following this, participants began cycling at 50% 〖"V" ̇"O" 〗_"2max" for 20 minutes, which was then lowered to 30% 〖"V" ̇"O" 〗_"2max" and the sensitivity test repeated. Results Females had significantly warmer magnitude sensations than males at all locations (4.7 ± 1.8 vs 3.6 ± 2.2, p0.05). Conclusion The data provides evidence that the thermal sensation response to warmth varies between genders and between body regions and reduces during exercise. These findings have important implications for clothing design and thermophysiological modellin