Prevalence of fibromyalgia in a low socioeconomic status population

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil.</p> <p>Methods</p> <p>We cross-sectionally sampled individuals assisted by the public primary health care system (n = 768, 35–60 years old). Participants were interviewed by phone and screened about pain. They were then invited to be clinically assessed (304 accepted). Pain was estimated using a Visual Analogue Scale (VAS). Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ), as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level = 5%).</p> <p>Results</p> <p>From the phone-interview screening, we divided participants (n = 768) in three groups: No Pain (NP) (n = 185); Regional Pain (RP) (n = 388) and Widespread Pain (WP) (n = 106). Among those participating in the clinical assessments, (304 subjects), the prevalence of fibromyalgia was 4.4% (95% confidence interval [2.6%; 6.3%]). Symptoms of pain (VAS and FIQ), feeling well, job ability, fatigue, morning tiredness, stiffness, anxiety and depression were statically different among the groups. In multivariate analyses we found that individuals with FM and WP had significantly higher impairment than those with RP and NP. FM and WP were similarly disabling. Similarly, RP was no significantly different than NP.</p> <p>Conclusion</p> <p>Fibromyalgia is prevalent in the low socioeconomic status population assisted by the public primary health care system. Prevalence was similar to other studies (4.4%) in a more diverse socioeconomic population. Individuals with FM and WP have significant impact in their well being.</p

A list of land plants of Parque Nacional do Caparaó, Brazil, highlights the presence of sampling gaps within this protected area

Brazilian protected areas are essential for plant conservation in the Atlantic Forest domain, one of the 36 global biodiversity hotspots. A major challenge for improving conservation actions is to know the plant richness, protected by these areas. Online databases offer an accessible way to build plant species lists and to provide relevant information about biodiversity. A list of land plants of “Parque Nacional do Caparaó” (PNC) was previously built using online databases and published on the website "Catálogo de Plantas das Unidades de Conservação do Brasil." Here, we provide and discuss additional information about plant species richness, endemism and conservation in the PNC that could not be included in the List. We documented 1,791 species of land plants as occurring in PNC, of which 63 are cited as threatened (CR, EN or VU) by the Brazilian National Red List, seven as data deficient (DD) and five as priorities for conservation. Fifity-one species were possible new ocurrences for ES and MG states

Streptococcus canis Are a Single Population Infecting Multiple Animal Hosts Despite the Diversity of the Universally Present M-Like Protein SCM

Streptococcus canis is an animal pathogen which occasionally causes infections in humans. The S. canis M-like protein (SCM) encoded by the scm gene, is its best characterized virulence factor but previous studies suggested it could be absent in a substantial fraction of isolates. We studied the distribution and variability of the scm gene in 188 S. canis isolates recovered from companion animals (n = 152), wild animal species (n = 20), and humans (n = 14). Multilocus sequence typing, including the first characterization of wildlife isolates, showed that the same lineages are present in all animal hosts, raising the possibility of extensive circulation between species. Whole-genome analysis revealed that emm-like genes found previously in S. canis correspond to divergent scm genes, indicating that what was previously believed to correspond to two genes is in fact the same scm locus. We designed primers allowing for the first time the successful amplification of the scm gene in all isolates. Analysis of the scm sequences identified 12 distinct types, which could be divided into two clusters: group I (76%, n = 142) and group II (24%, n = 46) sharing little sequence similarity. The predicted group I SCM showed extensive similarity with each other outside of the N-terminal hypervariable region and a conserved IgG binding domain. This domain was absent from group II SCM variants found in isolates previously thought to lack the scm gene, which also showed greater amino acid variability. Further studies are necessary to elucidate the possible host interacting partners of the group II SCM variants and their role in virulence

Reeducação Postural Global: uma revisão da literatura Global Postural Re-education: a literature review

CONTEXTUALIZAÇÃO: O método de Reeducação Postural Global (RPG) tem sido utilizado na clínica com relatos de benefícios para a prevenção e recuperação de disfunções musculoesqueléticas. Após duas décadas de aplicação, estudos têm verificado sua eficácia no tratamento de diferentes condições clínicas e ele tem sido comparado com outros recursos fisioterapêuticos. Entretanto, são poucos os estudos voltados à comprovação dos princípios defendidos pelo autor do método, o que torna frágeis as argumentações em favor dele. OBJETIVO: Realizar, com base na literatura científica, uma análise crítica dos efeitos da intervenção fisioterapêutica utilizando o método RPG. MÉTODOS: Pesquisaram-se as bases de dados Medline, SciELO, LILACS e PeDRO, de 2000 a 2010, considerando os unitermos: RPG, alongamento global e alongamento ativo. RESULTADOS: Foram encontrados 25 estudos, sendo 13 relacionados ao método RPG e oito aos alongamentos global e ativo, além de três livros e uma tese. Após análise, 20 referências foram utilizadas. CONCLUSÕES: Parte dos estudos aponta que o método RPG é mais efetivo, enquanto outros mostram resultados similares a outros métodos de intervenção fisioterapêutica. Estudos indicam benefícios do método na melhora da força muscular respiratória, expansibilidade torácica, mobilidade toracoabdominal e da pressão respiratória máxima, além de reduzir a dor, a perda de urina em mulheres incontinentes, melhorar a flexibilidade, a atividade eletromiográfica nas disfunções temporomandibulares e a estabilidade postural em alterações ortopédicas de membros inferiores. Limitações metodológicas observadas sugerem a necessidade de maior rigor em futuras pesquisas.<br>BACKGROUND: The Global Postural Re-education (GPR) method has been widely used in clinical practice, with reported benefits for prevention and rehabilitation of musculoskeletal dysfunctions. In parallel with almost two decades of clinical implementation, research studies have tested and verified the effectiveness of GPR in treating different clinical conditions and have also compared this method with other physical therapy resources. However, few studies focused on the verification of the principles of mechanisms of action defended by the author of the method making the arguments in favor of the method weak. OBJECTIVE: To perform a critical systematic review of the effects of physical therapy intervention that use the GPR method. METHODS: We searched Medline, SciELO, LILACS and PeDRO, from 2000 to 2010, considering the key words: Global Postural Re-education, global and active stretching. RESULTS: We found 25 studies, 13 about GPR and 8 about global and active stretching in addition to three books and a thesis. After analysis, 20 references were included. CONCLUSIONS: Some of the studies indicated that the GPR method was more effective than other physical therapy interventions, while others demonstrated similar results of GPR when compared to other physical therapy interventions. Studies showed benefits of the GPR in improving the respiratory muscle strength, chest expansion, maximal respiratory pressure and in reducing pain, loss of urine in incontinent women, increasing flexibility, the electromyographic activity in temporomandibular disorders and postural stability in lower limb orthopedic alterations. Methodological limitations observed suggest the need for greater rigor in future research

Effectiveness of two physical therapy interventions, relative to dental treatment in individuals with bruxism: study protocol of a randomized clinical trial

Abstract Background Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. Methods/Design Participants will be randomized into one of three groups: Group 1 (n = 24) intervention will consist of massage and stretching exercises; Group 2 (n = 24) will consist of relaxation and imagination therapies; and Group 3 (n = 24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile - 14. Significance level will be determined at the 5% level. Discussion This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. The study will support the practice of evidence-based physical therapy for individuals with bruxism. Data will be published after study is completed. Trial registration ClinicalTrials.gov, NCT0177888