Tratamento da dor em feridas crónicas : revisão sistemática de literatura

Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2012Influenciada por fatores fisiológicos, psicológicos, emocionais e sociais, a dor é um fenómeno multidimensional, complexo, subjetivo e percetivo. Em feridas crónicas, a dor constitui uma grande preocupação tanto para os doentes como para os profissionais de saúde, sendo o seu controlo fundamental para a qualidade dos cuidados. Neste sentido, é necessário desenvolver investigações que, simultaneamente, promovam uma melhor compreensão do tema e estabeleçam estratégias eficazes e adequadas ao controlo da dor nestes doentes. Este estudo é uma revisão sistemática de literatura e tem como objetivos rever de forma sistemática as estratégias atualmente existentes para o tratamento da dor em doentes com feridas crónicas; identificar quais as estratégias mais eficazes para tratar a dor nestes doentes; e verificar a existência de linhas orientadoras. Foram incluídos no estudo 13 artigos, pesquisados em bases de dados eletrónicas, publicados entre 2008 e Junho de 2011. Os participantes são indivíduos com 18 anos ou mais e que tenham feridas crónicas do tipo úlceras de pressão, úlceras venosas de perna e úlceras de pé diabético. Os resultados obtidos mostram que as feridas crónicas serão sempre dolorosas, e que nos cabe a nós, profissionais de saúde, ajudar a otimizar os cuidados, reduzindo o desconforto e melhorando a qualidade de vida do doente através de uma combinação de medidas farmacológicas e não-farmacológicas. Constatou-se que existe um leque relativamente variado de opções para o tratamento da dor em feridas crónicas, embora algumas delas não sejam viáveis para aplicação nos serviços públicos de saúde. No seguimento da mesma linha de investigação, e dado que não existem documentos orientadores nesta área, sugere-se de futuro a elaboração de um protocolo de atuação e posterior aplicação em várias unidades hospitalares para a realização de estudos multicêntricos que nos ajudem a criar métodos de controlo da dor mais adequados e eficazes em doentes com feridas crónicas. Influenced by physiological, psychological, emotional and social factors, pain is a multidimensional, complex, subjective and perceptual phenomenon. In chronic wounds, pain is a major concern both for patients and for health professionals, being your control key to quality of care. In this sense, it is necessary to develop research that simultaneously promote a better understanding of the issue and establish appropriate and effective strategies to control pain in these patients. This study is a systematic literature review and aims to systematically review the strategies currently exist for the treatment of pain in patients with chronic wounds, identify the most effective strategies to treat pain in these patients and check the existence of guidelines. The study included 13 articles searched in electronic databases, published between 2008 and June 2011. Participants are aged 18 years or older and have chronic wounds type pressure ulcers, venous leg ulcers and diabetic foot ulcers. The results show that chronic wounds are always painful, and that up to us, health professionals, help to optimize care, reducing discomfort and improving the quality of life of patients through a combination of pharmacological and non-pharmacological measures. It was found that there is a relatively diverse range of options for the treatment of pain in chronic wounds, although some of them are not feasible for application in public health system. Following the same line of investigation, and since there are no guidelines in this area, it is suggested in the future the development of a protocol acting and subsequent application in many hospitals to perform multicenter studies that help us to create methods of pain control most appropriate and effective in patients with chronic wounds.Influenced by physiological, psychological, emotional and social factors, pain is a multidimensional, complex, subjective and perceptual phenomenon. In chronic wounds, pain is a major concern both for patients and for health professionals, being your control key to quality of care. In this sense, it is necessary to develop research that simultaneously promote a better understanding of the issue and establish appropriate and effective strategies to control pain in these patients. This study is a systematic literature review and aims to systematically review the strategies currently exist for the treatment of pain in patients with chronic wounds, identify the most effective strategies to treat pain in these patients and check the existence of guidelines. The study included 13 articles searched in electronic databases, published between 2008 and June 2011. Participants are aged 18 years or older and have chronic wounds type pressure ulcers, venous leg ulcers and diabetic foot ulcers. The results show that chronic wounds are always painful, and that up to us, health professionals, help to optimize care, reducing discomfort and improving the quality of life of patients through a combination of pharmacological and non-pharmacological measures. It was found that there is a relatively diverse range of options for the treatment of pain in chronic wounds, although some of them are not feasible for application in public health system. Following the same line of investigation, and since there are no guidelines in this area, it is suggested in the future the development of a protocol acting and subsequent application in many hospitals to perform multicenter studies that help us to create methods of pain control most appropriate and effective in patients with chronic wounds

Effect of Cynara cardunculus L. var. altilis (DC) in inflammatory bowel disease

Cynara cardunculus L. var. altilis (DC) is a plant generally associated as an ingredient in the Mediterranean diet. The polyphenols present in this plant provide pharmacological and nutritional properties. C. cardunculus L. has been used throughout animal studies, which demonstrated an anti-inflammatory effect. Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Since there is not a known cure, the research of new possible pharmacological approaches is essential. This study aims to evaluate the effect of an aqueous extract of C. cardunculus L. dry leaves in a 2,4,6-Trinitrobenzenesulfonic acid (TNBS)-induced colitis model. Methods: CD-1 mice with TNBS-induced colitis received an intraperitoneal (IP) administration of C. cardunculus L. once per day for 4 days. Results: The C. cardunculus L. demonstrated a beneficial effect in this experimental model of IBD with anti-inflammatory action through the reduction of tumor necrosis factor (TNF)-α levels. It also demonstrated a beneficial influence on the extra-intestinal manifestations related to IBD, with the absence of significant side effects of its use. Conclusions: The extract of C. cardunculus L. dry leaves can become an interesting tool for new possible pharmacological approaches in the management of IBD.info:eu-repo/semantics/publishedVersio