Incontinência urinária feminina : comparação da qualidade de vida no menacme e pós-menopausa

Introdução: a incontinência urinária (IU) é qualquer perda involuntária de urina e seus sintomas podem afetar a qualidade de vida (QV) das mulheres. Objetivo: comparar a QV de mulheres incontinentes no menacme e na pós-menopausa. Materiais e métodos: foi realizado um estudo descritivo-retrospectivo envolvendo informações de 86 mulheres com queixas de IU e que foram encaminhadas para tratamento fisioterápico. Foram coletados informações sócio-demográficas, clínicas, antecedentes obstétricos e ginecológicos. A força de contração do assoalho pélvico (AP) foi avaliada pela palpação e a QV avaliada pelo King's Health Questionnaire (KHQ). Foram utilizados o teste de Mann-Whitney e teste t de Student para comparação dos domínios da QV. Resultados: foram selecionadas 36 mulheres no menacme (G1) e 50 na pós-menopausa (G2), com média de idade de 42,9 ( ± 7,4) anos e 61,6 ( ± 9,3) anos respectivamente. O G2 apresentou significativamente mais sintomas de noctúria (p = 0,0057), urge-incontinência (p = 0,0061) e enurese noturna (0,0021), enquanto que no G1 foi mais significativa a presença de dor na bexiga e dificuldade para urinar. Entre os domínios do KHQ, o G2 apresentou mais comprometimento na percepção geral de saúde G1 26,4 ± 16,8 versus G2 38,0 ± 16,2; p = 0,0019) e emoções (G1 15,1 ± 31,3 versus G2 38,9 ± 37,5; p = 0,0051). Conclusão: na amostra estudada, a IU afetou negativamente a QV de mulheres no menacme e na pós-menopausa. As mulheres menopausadas demonstraram maior impacto na QV em domínios relacionados com a percepção geral de saúde e as emoções, além da presença de sintomas irritativos como noctúria, urge-incontinência e enurese noturna.Introduction: urinary incontinence (UI) is defined as any involuntary leakage of urine and their symptoms can affect women's quality of life (QoL). Objectives: to compare incontinent women's QoLin reproductive age (G1) with those in post menopausal period(G2). Material and methods: a descriptive and retrospective study involved 86 women with UI complaints. Clinical, sociodemographic, obstetrical and gynecological antecedents were collected. Pelvic floor evaluation was conducted by digital palpation and QoL was evaluated by King's Health Questionnaire (KHQ). Mann-Whitney and t Student test were used to compare QoL domains. Results: 36 women in reproductive age (G1) 42.9 (± 7,4) years and 50 women in postmenopausal period (G2) 61,6 (± 9,3) years were assessed. The G2 showed significantly more nocturia (p = 0,0057), urge incontinence (p = 0,0061) and enuresis (0,0021) symptoms, whereas in G1 bladder pain and voiding difficulties were more significant. KHQ domains showed statistical differences in: general health perception (G1 26,4 ± 16,8 versus G2 38,0 ± 16.2; p = 0,0019) and emotions (G1 15,1 ± 31,3 versus G2 38,9 ± 37,5; p = 0,0051). Conclusion: UI affects negatively QoLin women. Women on postmenopausal period showed higher impact on the QoLdomains related to general health perception and emotions

Validation of the Brazilian version of Behavioral Pain Scale in adult sedated and mechanically ventilated patients

AbstractBackground and objectivesThe Behavioral Pain Scale is a pain assessment tool for uncommunicative and sedated Intensive Care Unit patients. The lack of a Brazilian scale for pain assessment in adults mechanically ventilated justifies the relevance of this study that aimed to validate the Brazilian version of Behavioral Pain Scale as well as to correlate its scores with the records of physiological parameters, sedation level and severity of disease.MethodsTwenty-five Intensive Care Unit adult patients were included in this study. The Brazilian Behavioral Pain Scale version (previously translated and culturally adapted) and the recording of physiological parameters were performed by two investigators simultaneously during rest, during eye cleaning (non-painful stimulus) and during endotracheal suctioning (painful stimulus).ResultsHigh values of responsiveness coefficient (coefficient=3.22) were observed. The Cronbach's alpha of total Behavioral Pain Scale score at eye cleaning and endotracheal suctioning was 0.8. The intraclass correlation coefficient of total Behavioral Pain Scale score was ≥0.8 at eye cleaning and endotracheal suctioning. There was a significant highest Behavioral Pain Scale score during application of painful procedure when compared with rest period (p≤0.0001). However, no correlations were observed between pain and hemodynamic parameters, sedation level, and severity of disease.ConclusionsThis pioneer validation study of Brazilian Behavioral Pain Scale exhibits satisfactory index of internal consistency, interrater reliability, responsiveness and validity. Therefore, the Brazilian Behavioral Pain Scale version was considered a valid instrument for being used in adult sedated and mechanically ventilated patients in Brazil

Efecto de la radioterapia en la función pulmonar y en la fatiga de mujeres en tratamiento para el cáncer de mama

O presente estudo comparou a função pulmonar e a fadiga de mulheres antes e após a radioterapia (RT) adjuvante para tratamento do câncer de mama, e correlacionou a função pulmonar com a dose de radiação e fadiga. Foi conduzido um estudo observacional longitudinal envolvendo 20 mulheres. A função pulmonar foi avaliada pela espirometria (ClementClarke®) e manovacuometria (GlobalMed®, modelo MVD 300), e a fadiga pelo Functional Assessment of Cancer Therapy Fatigue (FACT-F). Todas as avaliações foram realizadas antes da primeira sessão e uma semana após o término da RT adjuvante. Para a análise estatística foram utilizados os testes Wilcoxon Signed Rank Test e correlação de Spearman, adotando-se nível de significância pEl presente estudio comparó la función pulmonar y la fatiga de mujeres antes y después de la radioterapia (RT) como ayudante para el tratamiento del cáncer de mama, y se correlacionó la función pulmonar con la dosis de radiación y fatiga. Fue realizado un estudio observacional longitudinal involucrando 20 mujeres. La función pulmonar fue evaluada por espirometría (ClementClarke®) y manovacuometría (GlobalMed®, modelo MVD 300) y, la fatiga fue evaluada por la Functional Assessment of Cancer Therapy Fatigue (FACT-F). Todas las evaluaciones fueron realizadas antes de la primera sesión y una semana después del término de la RT. Para el análisis estadístico fueron utilizados los tests Wilcoxon Signed Rank Test y correlación de Spearman, adoptando un nivel de significancia pThis study compared the pulmonary function and fatigue in patients before and after adjuvant radiotherapy (RT) and correlated the pulmonary function with the radiotherapy dose and fatigue. A longitudinal and observational study was conducted involving 20 women. Pulmonary function was evaluated by digital lung spirometry (ClementClarke®) and manometry (GlobalMed®, model MVD 300) and fatigue was analyses by the Functional Assessment of Cancer Therapy Fatigue (FACT-F). All evaluations were conducted before the first RT session and up to one week after this treatment. Statistical analyses were conducted by the Wilcoxon Signed Rank Test and Spearman, considering

Induction of chronic non-inflammatory widespread pain increases cardiac sympathetic modulation in rats

Fibromyalgia (FM) is characterized by chronic non-inflammatory widespread pain (CWP) and changes in sympathetic function. In attempt to elucidate the pathophysiological mechanisms of FM we used a well-established CWP animal model. We aimed to evaluate changes in cardiac autonomic balance and baroreflex function in response to CWP induction in rats. CWP was induced by two injections of acidic saline (pH 4.0, n = 8) five days apart into the left gastrocnemius muscle. Control animals were injected twice with normal saline (pH 7.2, n = 6). One day after the second injection of acidic saline or normal saline, the animals had pulse interval (PI) and systolic arterial pressure (SAP) variability, and spontaneous baroreflex sensitivity (BRS) evaluated. After induction of CWP, there was an increase of power in the low frequency (LF) band of PI spectrum (12.75 +/- 1.04 nu), a decrease in the high frequency (HF) band (87.25 +/- 1.04 nu) and an increase of LF/HF ratio (0.16 +/- 0.01), when compared to control animals (7.83 +/- 1.13 nu LF; 92.16 +/- 1.13 nu HF; 0.08 +/- 0.01 LF/HF). In addition, there was an increase of power in the LF band of SAP spectrum (7.93 +/- 1.39 mmHg(2)) when compared to control animals (2.97 +/- 0.61 mmHg(2)). BRS was lower in acidic saline injected rats (0.59 +/- 0.06 ms/mmHg) when compared to control animals (0.71 +/- 0.03 ms/mmHg). Our results showed that induction of CWP in rats shifts cardiac sympathovagal balance towards sympathetic predominance and decreases BRS. These data corroborate findings in humans with FM. (C) 2011 Elsevier B.V. All rights reserved

Cyclodextrin-complexed Ocimum basilicum leaves essential oil increases fos protein expression in the central nervous system and produce an antihyperalgesic effect in animal models for fibromyalgia

O. basilicum leaves produce essential oils (LEO) rich in monoterpenes. The short half-life and water insolubility are limitations for LEO medical uses. β-Cyclodextrin (β-CD) has been employed to improve the pharmacological properties of LEO. We assessed the antihyperalgesic profile of LEO, isolated or complexed in β-CD (LEO/β-CD), on an animal model for fibromyalgia. Behavioral tests: mice were treated every day with either LEO/β-CD (25, 50 or 100 mg/kg, p.o.), LEO (25 mg/kg, p.o.), tramadol (TRM 4 mg/kg, i.p.) or vehicle (saline), and 60 min after treatment behavioral parameters were assessed. Therefore, mice were evaluated for mechanical hyperalgesia (von Frey), motor coordination (Rota-rod) and muscle strength (Grip Strength Metter) in a mice fibromyalgia model. After 27 days, we evaluated the central nervous system (CNS) pathways involved in the effect induced by experimental drugs through immunofluorescence protocol to Fos protein. The differential scanning analysis (DSC), thermogravimetry/derivate thermogravimetry (TG/DTG) and infrared absorption spectroscopy (FTIR) curves indicated that the products prepared were able to incorporate the LEO efficiently. Oral treatment with LEO or LEO-βCD, at all doses tested, produced a significant reduction of mechanical hyperalgesia and we were able to significantly increase Fos protein expression. Together, our results provide evidence that LEO, isolated or complexed with β-CD, produces analgesic effects on chronic non-inflammatory pain as fibromyalgia

UTILIZAÇÃO DE PLANTAS MEDICINAIS NO TRATAMENTO DA FIBROMIALGIA: UMA PROSPECÇÃO TECNOLÓGICA

A fibromialgia é uma síndrome dolorosa crônica, de vasta sintomatologia e  grande impacto na vida dos pacientes. Seu tratamento nem sempre é satisfatório, além de poder gerar efeitos colaterais relacionados ao uso contínuo de medicamentos analgésicos ou adjuvantes. Por caracterizar uma preocupação de saúde pública mundial, diversos estudos vem sendo conduzidos na busca de novas alternativas de tratamento, dentre os quais estão as plantas medicinais. Desta forma, objetivou-se realizar um rastreamento das pesquisas já desenvolvidas e patenteadas, avaliando-se as utilizações de plantas medicinais no manejo dos sintomas clínicos da fibromialgia. A prospecção foi realizada no European Patent Office, no World Intellectual Property Organization, no Derwent World Patents Index e no Banco de dados do Instituto Nacional de Propriedade Industrial do Brasil A classificação internacional mais abundante nessa prospecção foram A61K e A61P. Dentre os maiores depositantes estão República da Koreia, Estados Unidos e a Organização Mundial da Propriedade Intelectual. Observou-se ainda existência de um número aumentado de depósitos no período de 2008 a 2012. Entretanto, quando a pesquisa refere-se ao tratamento da patologia, o número de patentes é extremamente reduzido, tornando o seu uso uma lacuna tecnológica a ser explorada.</p

Female urinary incontinence: quality of life comparison on reproductive age and postmenopausal period

Introduction: urinary incontinence (UI) is defined as any involuntary leakage of urine and their symptoms can affect womens quality of life (QoL). Objectives: to compare incontinent women´s QoLin reproductive age (G1) with those in post menopausal period(G2). Material and methods: a descriptive and retrospective study involved 86 women with UI complaints. Clinical, sociodemographic, obstetrical and gynecological antecedents were collected. Pelvic floor evaluation was conducted by digital palpation and QoL was evaluated by Kings Health Questionnaire (KHQ). Mann-Whitney and t Student test were used to compare QoL domains. Results: 36 women in reproductive age (G1) 42.9 (± 7,4) years and 50 women in postmenopausal period (G2) 61,6 (± 9,3) years were assessed. The G2 showed significantly more nocturia (p = 0,0057), urge incontinence (p = 0,0061) and enuresis (0,0021) symptoms, whereas in G1 bladder pain and voiding difficulties were more significant. KHQ domains showed statistical differences in: general health perception (G1 26,4 ± 16,8 versus G2 38,0 ± 16.2; p = 0,0019) and emotions (G1 15,1 ± 31,3 versus G2 38,9 ± 37,5; p =0,0051). Conclusion: UI affects negatively QoLin women. Women on postmenopausal period showed higher impact on the QoLdomains related to general health perception and emotions