Kinesiophobia in migraine

Pain aggravation by movement and avoidance of movement (kinesiophobia) is often reported by patients during migraine attacks. Yet its specific contribution to migraine diagnosis is undetermined. To characterize the frequency and severity of kinesiophobia during migraine and its role in the diagnosis of primary headaches, we questioned 150 patients (126 women and 24 men, average age 38.5 yrs) with migraine (n = 111) or tension-type headache (TTH) (n = 39) about aggravation of pain by bending forward, brisk head movements (jolt), and avoidance of movement during the attacks. The degree of pain worsening by each stimulus was measured through a visual analog scale and compared to worsening produced by other sensory stimuli such as light, sound, and smell. The discrimination power of kinesiophobia between migraine and TTH was calculated, using the International Classification of Headache Disorders criteria as gold standard. Sensitivity/specificity of studied symptoms was high in differentiating the 2 headache types: bending forward: 98%/85.7%; jolt: 96.3%/81.6%; and immobility during the attacks: 100%/70%. The degree of kinesiophobia was identical to photo- and phonophobia in migraine patients. We conclude that kinesiophobia discriminates between migraine and TTH. Bending forward and jolt may be useful additional questions to ask patients for the differentiation of headache attacks. PERSPECTIVE: This article evaluates the specific role of movement (movement-induced pain aggravation and avoidance of movement) in primary headaches. Kinesophobia is an easy symptom to screen, explained by migraine pathophysiology, and proved to be a sensitive and specific measure to identify migraine attacks when compared to tension-type headache

Pullback attractors for a singularly nonautonomous plate equation

We consider the family of singularly nonautonomous plate equation with structural damping $$u_{tt} + a(t,x)u_{t} + (- \Delta) u_{t} + (-\Delta)^{2} u + \lambda u = f(u),$$ in a bounded domain $\Omega \subset \R^n$, with Navier boundary conditions. When the nonlinearity $f$ is dissipative we show that this problem is globally well posed in $H^2_0(\Omega) \times L^2(\Omega)$ and has a family of pullback attractors which is upper-semicontinuous under small perturbations of the damping $a$

Critical phenomena and quantum phase transition in long range Heisenberg antiferromagnetic chains

Antiferromagnetic Hamiltonians with short-range, non-frustrating interactions are well-known to exhibit long range magnetic order in dimensions, $d\geq 2$ but exhibit only quasi long range order, with power law decay of correlations, in d=1 (for half-integer spin). On the other hand, non-frustrating long range interactions can induce long range order in d=1. We study Hamiltonians in which the long range interactions have an adjustable amplitude lambda, as well as an adjustable power-law $1/|x|^\alpha$, using a combination of quantum Monte Carlo and analytic methods: spin-wave, large-N non-linear sigma model, and renormalization group methods. We map out the phase diagram in the lambda-alpha plane and study the nature of the critical line separating the phases with long range and quasi long range order. We find that this corresponds to a novel line of critical points with continuously varying critical exponents and a dynamical exponent, z<1.Comment: 27 pages, 12 figures. RG flow added. Final version to appear in JSTA

Cerebral venous thrombosis: retrospective analysis of 49 cases

Introduction: Cerebral Venous Thrombosis (CVT) is a rare and potentially life-threatening disease, accounting for about 0.5% of stroke cases. However, it is believed to be an underdiagnosed condition. Early diagnosis requires a high degree of suspicion and appropriate use of imaging modalities. Objectives: Imagiological and clinical characterization of CVT cases diagnosed at our hospital from 2004 to 2007. Methods: This study was a retrospective, cross-sectional analysis from 2004 to 2007, using our institution database. We reviewed hospital discharge data to assess the incidence of CVT. The study population consisted of 49 patients. Retrospective review of the clinical data and imaging studies of these patients was then performed. Results: Of the 49 patients with confirmed CVT, 38 were female. Patient age varied between 16 and 75 years, with an average of 42.6 years. Thrombotic risk factors were found in 43 patients; the most frequent was dyslipidemia (n = 22) followed by oral contraceptive use (n = 18). Initial head Computerized Tomography (CT) was normal in six cases. Diagnosis was made by Magnetic Resonance (MR) in 38 cases, Cerebral CT-Venography in 10 cases and Digital Subtraction Angiography in one case. Average time from onset of symptoms to diagnosis was nine days; this was not significantly different when comparing the group diagnosed by MR with the group diagnosed by CT-Venography. Right transverse sinus was the most frequent location of thrombosis (n = 36). Only in four cases thrombosis did not involve the lateral sinuses. Conclusions: Lateral sinus thrombosis is a frequent variety of CVT, accounting for 91.8% of our cases. A negative Head CT scan does not exclude the presence of cerebral venous thrombosis; therefore appropriate imaging study should be performed whenever there's a high degree of clinical suspicion. Cerebral CT-Venography seems to be a good alternative to MR for the diagnosis of CVT

Phase III Clinical Trials in First-Line Follicular Lymphoma: A Review of Their Design and Interpretation

Follicular lymphoma (FL) is one of the most common subtypes of non-Hodgkin lymphoma worldwide. Improved survival outcomes with rituximab-based therapy in clinical trials led to the establishment of rituximab-based immunochemotherapy as standard of care for first-line (1L) treatment of FL. In the GALLIUM trial, obinutuzumab-based immunochemotherapy demonstrated improved progression-free survival (PFS), prolonged time-to-next antilymphoma treatment (TTNT) and comparable overall survival (OS) compared with rituximab-based immunochemotherapy as 1L treatment for FL. Using GALLIUM as an example, this article aims to explain how improved outcomes in 1L treatment of FL have changed the landscape for the design and interpretation of future trials. As approved therapies for 1L FL already achieve good responses, it is becoming more difficult to design trials that demonstrate further treatment benefits with the currently accepted primary endpoints. New endpoints are needed to reflect the long remission times, low relapse rates, and impact of subsequent therapies in FL. PFS is used as a primary efficacy endpoint in registrational clinical trials for indolent malignancies like FL, where improvement in OS is not always observed due to the large number of patients and long study duration required to demonstrate a clear survival benefit. However, there are limitations to using PFS as the primary endpoint. Other potential endpoints, including TTNT, progression of disease within 2 years, response rate, and minimal residual disease status are explored

Natural polymorphisms of HIV type 2 pol sequences from drug-naive individuals

Until today, the susceptibility of human immunodeficiency virus type 2 (HIV-2) to protease and nucleosidic reverse-transcriptase inhibitors (PI and NRTI, respectively) has not been clearly documented. In this report we studied HIV-2 proviral sequences (n = 30) from drug-naive patients. Our results revealed that several amino acid positions in the protease and reverse transcriptase coding sequence harbored residues that have been associated with drug resistance in HIV-1-infected patients. In particular, the M46I substitution in the protease was detected in 90% of the sequences analyzed, which, together with the other substitutions identified, may indicate a reduced susceptibility of HIV-2-infected drug-naive patients to PI. Furthermore, interpretation of genotypic data with four available algorithms, developed for interpretation of HIV-1 sequence data, suggested nonoverlapping profiles of drug resistance

Biofilmes polimicrobianos em águas ornamentais, potenciais riscos para a saúde pública e estratégias de prevenção

As águas ornamentais podem funcionar como reservatórios de microrganismos patogénicos, constituindo um risco para a saúde pública. Este trabalho tem, como principal objetivo, avaliar a capacidade de produção de biofilmes in vitro, por bactérias potencialmente patogénicas para o Homem, isoladas de águas ornamentais. As bactérias do estudo pertencem aos géneros Escherichia, Pseudomonas, Aeromonas e Klebsiella e foram caraterizadas segundo o crescimento a diferentes temperaturas, o tempo de geração, a temperatura ótima de crescimento e a capacidade de produção de biofilmes. A última foi determinada pelo método de cristal violeta, para bactérias isoladas ou em consórcios binários, de isolados do mesmo mês de colheita (co-existentes no ambiente) ou de meses distintos. Adicionalmente, foram comparados, qualitativa e estatisticamente, os resultados do método de cristal violeta (método convencional) e de impedância elétrica (método inovador), na determinação do efeito de Aeromonas spp., ou do seu sobrenadante, em biofilmes de Klebsiella pneumoniae. A maioria dos isolados demonstrou crescimento a todas as temperaturas (5, 25, 37 e 45 ºC) e todos cresceram preferencialmente a 25 e 37 ºC, tendo apresentado tempos de geração inferiores a 88,8 minutos. Quanto à capacidade de formação de biofilme, 25 % dos isolados foram classificados como não produtores ou produtores fracos, 40 % como produtores moderados e 10 % como fortes produtores de biofilme. Em biofilmes binários, 90 % das interações entre bactérias co-existentes no ambiente foram competitivas, contudo, existiu uma maior competição em co-culturas de isolados de meses distintos de colheita. Na comparação entre os dois métodos, a análise qualitativa e a análise estatística apresentaram relações distintas (direta e inversa, respetivamente). Em suma, estes resultados sugeriram que 75 % dos isolados apresentaram capacidade para produzir biofilmes in vitro, o que amplia o risco de infeções no Homem. É, assim, crucial, a tomada de medidas de controlo dos biofilmes no ambiente

Instrumentos inovadores de aprendizagem: uma experiência com o WhatsApp

Parte-se do reconhecimento de que as dinâmicas atuais da comunicação do conhecimento sofrem o impacto de diferentes inovações tecnológicas; estas usam variados suportes que transformam os modos de expressão: novos tipos de linguagem, recursos disponibilizados num único aparelho ou programa. Isso impeliu a Universidade a promover mudanças no modo de ensinar, aprender e conviver, para se aproximar das demandas do tempo presente. Esta pesquisa foi realizada na UFF (RJ-Brasil) com alunos de Pedagogia e outras licenciaturas. Desenvolve-se como pesquisa-ação, com foco na avaliação do uso do aplicativo WhathApp, como ferramenta de ensino-aprendizagem. Questões:em que medida o WhathApp torna o ensino mais motivador? Que fatores aumentam essa motivação? Este procedimento fomenta hábitos de estudo profundo, ou induz apenas hábitos de estudo estratégico ou superficial? Foram criados grupos no WhatsApp, por escolha dos próprios alunos. Todo o material didático é colocado à disposição dos grupos no aplicativo; o contacto extra-aula entre aluno e professor, pelo WhatsApp, é livre. O professor e o aluno monitor participam ativamente no grupo de aprendizagem; os questionários aplicados foram construídos para coletar dados que permitam responder às questões da pesquisa; as sessões de grupo focal visaram aprofundar os fenómenos observados. O tratamento dos dados é quantitativo e qualitativo; as respostas já analisadas respondem positivamente às questões que nortearam a pesquisa. Palavras chave: WhatsApp; aprendizagem; novas tecnologías; universitários