Does Pain in the Neonatal Period Influence Motor and Sensory Functions in a Similar Way for Males and Females During Post-Natal Development in Rats?

OBJECTIVE : Early pain experiences can lead to disruption in the long-term responses to pain and in abnormal development and behavior in rodents. We evaluated the sensory and motor development of Wistar rats after exposure to painful stimulation (repetitive needle prickling) immediately after birth. METHODS : Male and female rats were followed up to 6 months of life, and sensory and motor functions were investigated by testing paw withdrawal with von Frey filaments, calibrated forceps (CF), and grip strength (GS) tests. RESULTS : Body weight increased with age and tended to be smaller in pain groups compared with their controls of the same sex. GS values also increased with age in controls but were stable and even decreased in pain groups from 120 up to 180 days. The von Frey filaments test showed higher values on the nonstimulated paws in male and female pain groups, with no differences between sides on the controls. The CF test showed smaller values on the stimulated paws in the pain group, with no differences between sides on the controls. CONCLUSIONS : Pain in the neonatal period influences sensory and motor functions negatively during development in male and female rats, even long term after the painful stimulus is ceased. The neonatal injury-induced hypersensitivity is persistent, and male and female rats respond similarly to the stimulus.

Cortex glial cells activation, associated with lowered mechanical thresholds and motor dysfunction, persists into adulthood after neonatal pain.

We investigated if changes in glial activity in cortical areas that process nociceptive stimuli persisted in adult rats after neonatal injury. Neonatal pain was induced by repetitive needle prickling on the right paw, twice per day for 15 days starting at birth. Wistar rats received either neonatal pain or tactile stimulation and were tested behaviorally for mechanical withdrawal thresholds of the paws and gait alterations, after 15 (P15) or 180 (P180) days of life. Brains from rats on P15 and P180 were immunostained for glial markers (GFAP, MCP-1, OX-42) and the following cortical areas were analyzed for immunoreactivity density: prefrontal, anterior insular, anterior cingulated, somatosensory and motor cortices. Withdrawal thresholds of the stimulated paw remained decreased on P180 after neonatal pain when compared to controls. Neonatal pain animals showed increased density for both GFAP and MCP-1 staining, but not for OX-42, in all investigated cortical areas on both experimental times (P15 and P180). Painful stimuli in the neonatal period produced pain behaviors immediately after injury that persisted in adult life, and was accompanied by increase in the glial markers density in cortical areas that process and interpret pain. Thus, long-lasting changes in cortical glial activity could be, at least in part, responsible for the persistent hyperalgesia in adult rats that suffered from neonatal pain.

Freqüência da profilaxia mecânica para trombose venosa profunda em pacientes internados em uma unidade de emergência de Maceió / Frequency of mechanical prophylaxis for deep venous thrombosis in patients admitted to an emergency room in Maceió, Brazil

CONTEXTO: A trombose venosa profunda (TVP) é uma doença de ocorrência multidisciplinar e freqüente, incluindo as complicações relacionadas a ela, como o tromboembolismo pulmonar (TEP). Sendo a profilaxia mecânica um dos melhores (por seu baixo custo e eficácia comprovada) e mais simples meios para reduzir sua incidência, é de grande relevância que se pesquise sua utilização visando benefícios para o paciente e o serviço hospitalar. OBJETIVO: Determinar a freqüência da utilização da profilaxia mecânica para TVP na Unidade de Emergência Dr. Armando Lages em Maceió (AL). MÉTODOS: Foi realizado um estudo transversal descritivo na unidade durante o período de 8 meses. A amostra foi calculada em 282 pacientes internados nas unidades de enfermarias das diversas especialidades. Os dados foram coletados em prontuários e mediante entrevista ao paciente. No prontuário de cada paciente foi pesquisada a utilização da profilaxia mecânica para TVP, além de diversos fatores para a estratificação do risco, segundo a Sociedade Brasileira de Angiologia e Cirurgia Vascular. O estudo estatístico foi realizado através do software SPSS, utilizando o teste qui-quadrado considerando o valor de p < 0,05. RESULTADOS: Foram analisados 282 pacientes, sendo 181 (64 por cento) homens e 101 (36 por cento) mulheres, com idade média de 54,1 anos. Quanto ao risco, 210 (74,5 por cento) foram classificados como alto risco, 56 (19,8 por cento) como moderado risco e 16 (5,7 por cento) como baixo risco. Do total de pacientes, 234 (83 por cento) não receberam profilaxia e 48 (17 por cento) receberam. Não houve diferença estatística entre os dados obtidos na pesquisa e os encontrados na literatura (p = 0,065). CONCLUSÕES: Apesar de ter sua eficácia comprovada e difundida, a profilaxia mecânica para TVP ainda não atinge níveis satisfatórios de utilização.

BACKGROUND: Deep venous thrombosis (DVT) is a multidisciplinary and frequent disease, also including complications such as pulmonary thromboembolism. Mechanical prophylaxis is one of the best (due to its low cost and proven effectiveness) and simplest means to reduce its incidence; therefore, investigating its use as an attempt to enhance benefits to the patient and hospital service is of great importance. OBJECTIVE: To determine the frequency of mechanical prophylaxis for DVT at the Emergency Room Dr. Armando Lages in Maceió, Brazil. METHODS: A descriptive cross-sectional study at the emergency room was carried out for an 8-month period. The sample was composed of 282 patients admitted to the nursing wards of various specialties. Data were collected from medical records and by patient interview. Each patient"s medical record was searched for use of mechanical prophylaxis for DVT, in addition to several factors for risk stratification, according to the Brazilian Society of Angiology and Vascular Surgery. Statistical analysis was performed using SPSS software and chi-square test, considering p < 0.05. RESULTS: A total of 282 patients were analyzed, 181 (64 percent) men and 101 (36 percent) women, mean age of 54.1 years. Classification of risk was as follows: 210 (74.5 percent) were classified as high risk, 56 (19.8 percent) as moderate risk, and 16 (5.7 percent) as low risk. Of all patients, 234 (83 percent) did not received prophylaxis and 48 (17 percent) did. There was no statistical difference between the data obtained in the research and those found in the literature (p = 0.065). CONCLUSIONs: Despite having its efficacy confirmed, mechanical prophylaxis for DVT has not reached satisfactory levels of use.