Painful behavior and medicinal cannabis / Comportamento doloroso e cannabis medicinal

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is defined as a complex sensory and emotional experience, and it is one of the most common causes for seeking health care, being the chronic pain one of the most prevalent health conditions in the world today, with millions of people debilitated by symptomatic conditions. The discovery of the endocannabinoid system and its organic effects on pain modulation, especially chronic pain, represented an unknown source of possibilities for the production of drugs that, theoretically, would have great potential to improve the quality of life of individuals with chronic pain. Given this, the general objective of this work was to search the literature for studies that investigated the use of medicinal cannabinoids for the treatment of chronic pain and pain behavior. CONTENTS: This is a narrative review of the literature in which aspects of painful behavior are presented, such as cognitive distortions associated with the experience of pain, and the influence of trauma, stress and psychiatric comorbidities on pain outcomes. The endocannabinoid system influences the modulation of all these points and also the regulation of pain itself. CONCLUSION: This study provides perspectives on painful behavior and how the endocannabinoid system can interfere with different aspects of pain and with the way the patient perceives pain. Further studies on this issue are extremely important.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é definida como uma experiência sensitiva e emocional complexa, e está entre as principais causas de busca por atendimento médico, sendo a dor crônica um dos problemas de saúde mais prevalentes no mundo atual, com milhões de pessoas debilitadas por condições sintomáticas. A descoberta do sistema endocanabinoide e seus efeitos orgânicos na modulação da dor, especialmente a crônica, representou uma fonte desconhecida de possibilidades para a produção de fármacos que, teoricamente, possuiriam grande potencial de melhorar a qualidade de vida de indivíduos portadores de dor crônica. Diante disso, o objetivo geral deste trabalho foi buscar na literatura estudos que investigaram o uso de canabinoides medicinais para o tratamento da dor crônica e do comportamento doloroso. CONTEÚDO: Trata-se de um estudo de revisão narrativa da literatura em que são apresentados aspectos do comportamento doloroso, como as distorções cognitivas associadas à experiência de dor, e a influência do trauma, do estresse e de comorbidades psiquiátricas nos desfechos de dor. O sistema endocanabinoide tem influência na modulação de todos esses pontos e também na própria regulação da dor. CONCLUSÃO: Este estudo traz perspectivas sobre o comportamento doloroso e de como o sistema endocanabinoide pode interferir em diversos aspectos da dor e da forma como o paciente percebe a dor. Mais estudos sobre o assunto são de extrema relevância.

Perfil antropométrico de crianças ribeirinhas de 5 a 10 anos que vivem na ilha de Cotijuba - Pará / Perfil antropométrico de niños ribereños de 5 a 10 años -isla Cotijuba/Pará / Anthropometric profile of riverside childrenfrom 5 to 10 years -Cotijuba island/Pará

RESUMO O objetivo foi estudar o perfil antropométrico de crianças ribeirinhas de 5 a 10 anos que vivem na ilha de Cotijuba - Pará - Brasil. A metodologia utilizada foi uma pesquisa de campo transversal com abordagem quantitativa e características descritivas, composta por 60 crianças de 5 a 10 anos. Em relação à massa corporal, 5% do total da amostra estudada apresentou a maior massa corporal. Nos resultados obtidos a partir do Z-score, por faixa etária, todas as idades listadas na pesquisa tiveram classificação adequada. Em relação à altura, 5% apresentaram a maior estatura. Em relação ao índice de massa corporal (IMC), 5% apresentaram maior massa corporal. Observou-se que as crianças ribeirinhas que participaram do estudo apresentam tendência a baixos índices de obesidade, e possuem um estilo de vida que favorece a prática de atividades físicas.

RESUMEN El objetivo fue estudiar el perfil antropométrico de niños ribereños de 5 a 10 años que viven en la isla de Cotijuba - Pará - Brasil. La metodología utilizada fue una investigación de campo transversal con enfoque cuantitativo y características descriptivas, conformada por 60 niños de 5 a 10 años. En relación a la masa corporal, el 5% del total de la muestra estudiada tuvo la mayor masa corporal. En los resultados obtenidos del Z-score, por grupo de edad, todas las edades enumeradas en la encuesta tenían una clasificación adecuada. En relación a la altura, el 5% tuvo la mayor altura. En cuanto al índice de masa corporal (IMC), el 5% tuvo mayor masa corporal. Se pudo observar que los niños ribereños que participaron del estudio tienen tendencia a bajos índices de obesidad, y tienen un estilo de vida que promueve la práctica de actividades físicas.

ABSTRACT The objective was to study the anthropometric profile of riverine children aged 5 to 10 years who live on the island of Cotijuba - Pará - Brazil. The methodology used was a cross-sectional field investigation with a quantitative approach and descriptive characteristics, made up of 60 children from 5 to 10 years old. Results: in relation to body mass, 5% of the total sample studied had the highest body mass. In the results obtained from the Z-score, by age group, all the ages listed in the survey had an adequate classification. In relation to height, it can be observed that 5% of the total sample studied had the highest height. Regarding the body mass index (BMI), it can be observed that 5% of the total sample studied had the highest body mass. Conclusion: It was observed that the riverine children who participated in the study have a tendency to low obesity rates, but the riverine children, according to the collection of this study, realized that they have a lifestyle that promotes the practice of physical activities.

Multimodal HIIT is more efficient than moderate continuous training for management of body composition, lipid profile and glucose metabolism in the diabetic elderly / El entrenamiento multimodal es más eficiente que el entrenamiento continuo moderado para el manejo de la composición corporal, el perfil de lípidos y el metabolismo de la glucosa en adultos mayores diabéticos

The exercise could play a central role to the fat management and glucose metabolism what can be a critical role in the health status of diabetic people, but the high intense exercise remains with controversial data about their effects. To identify the effect of the multimodal high-intensity interval training on body composition, lipid profile, and glucose metabolism in elderly diabetics. Methods: Elderly diabetic individuals (n = 48) were randomly divided in a Sedentary Control (SC) group, a Moderate-Intensity Continuous Training (MICT) group, and a High-Intensity Interval Training (HIIT) group. MICT and HITT were conducted over 60 days, 3x per week, with 40 minutes of exercise. Blood was collected prior to intervention, at four, and at eight weeks subsequently to assess glucose metabolism and lipid profiles. Body composition was determined before and after the intervention period. To verify the normality Kolmogorov-Smirnov statistical test was performed, followed by student "t" test or two-way ANOVA with Bonferroni's post hoc test with significance of 5 % the Cohen's f test to indicate the magnitude of the differences. HIIT significantly lowered cholesterol and triglyceride levels, and significantly lowered blood glucose and glycosylated haemoglobin levels (p<0.05). MICT and HIIT significantly increased levels of high-density lipoprotein, decreased total body mass and body mass index. HIIT resulted in significantly smaller waist circumferences, waist-to-hip ratios, and weight-to-height ratios over 60 days of training. HIIT is more effective than MICT for improving lipid and glycaemic profiles, decreasing body fat, and improving fat distribution elderly diabetics.

El ejercicio podría desempeñar un papel central en el manejo de la grasa y el metabolismo de la glucosa, lo que puede ser un papel crítico en el estado de salud de las personas diabéticas, pero el ejercicio intenso intenso sigue teniendo datos controvertidos sobre sus efectos. El objetivo del estudio fue identificar el efecto del entrenamiento multimodal de intervalos de alta intensidad sobre la composición corporal, el perfil lipídico y el metabolismo de la glucosa en diabéticos de edad avanzada. Los individuos diabéticos de edad avanzada (n = 48) se dividieron aleatoriamente en un grupo de control sedentario (SC), un grupo de entrenamiento continuo de intensidad moderada (MICT) y un grupo de entrenamiento de intervalos de alta intensidad (HIIT). MICT y HITT se realizaron durante 60 días, 3 veces por semana, con 40 minutos de ejercicio. Se recogió sangre antes de la intervención, a las cuatro y a las ocho semanas posteriormente para evaluar el metabolismo de la glucosa y los perfiles de lípidos. La composición corporal se determinó antes y después del período de intervención. Para verificar la normalidad se realizó la prueba estadística de Kolmogorov-Smirnov, seguida de la prueba "t" de Student o ANOVA de dos vías con la prueba post hoc de Bonferroni con una significancia del 5 % de la prueba f de Cohen, indicando las diferencias. HIIT redujo significativamente los niveles de colesterol y triglicéridos, además de reducir de manera importante los niveles de glucosa en la sangre y la hemoglobina glicosilada (p <0.05). MICT y HIIT aumentaron significativamente los niveles de lipoproteína de alta densidad, disminuyeron la masa corporal total y el índice de masa corporal. HIIT resultó en circunferencias de cintura significativamente más pequeñas, relaciones cintura-cadera y relaciones peso-altura durante 60 días de entrenamiento. HIIT es más efectivo que MICT para mejorar los perfiles de lípidos y glucémicos, disminuir la grasa corporal y mejorar la distribución de grasa en los diabéticos de edad avanzada.

Effects of a 20-week concurrent training program on bone metabolism in elderly women / Efecto de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores

The present study evaluated the effect of a 20-week concurrent training program on bone metabolism in elderly women. The sample consisted of 51 elderly women living in the municipality of Muriaé (MG), distributed into two groups: a concurrent training group (CTG = 25), with an average age of 69.44 ± 6.82 years, and a control group (CG = 26), with mean age of 68.30 ± 6.34 years. Biophysical parameters were determined based on weight, height and body mass index. Bone metabolism was assessed by collecting second-morning urine samples before and after intervention to analyze levels of the biochemical marker deoxypyridinoline (DPD), which quantifies bone resorption. Results: The results showed a post-intervention decline in DPD content in the GTC when compared to controls (p = 0.007) and an improvement in the variables weight, BMI and DPD between the GTC and GC (p = 0.000). Conclusion: Concurrent training was efficient in improving bone metabolism in the elderly population studied.

El presente estudio evaluó los efectos de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores. La muestra fue compuesta por 51 mujeres adultas mayores, residentes en el municipio de Muriaé (MG), voluntarias, distribuidas en dos grupos, un grupo participó en entrenamiento concurrente (GTC=25), con una edad media de 69,44±6,82 años y un grupo control (GC=26) con una media de 68,30±6,34 años. Los parámetros biofísicos se determinaron por medio del peso corporal, la estatura e índice de masa corporal. Para la evaluación del metabolismo óseo, se realizó la recolección de la orina matinal en el pre y post-test, utilizando como reactivo el marcador bioquímico de deoxipiridinolina (DPD) que cuantifica la reabsorción ósea. Los resultados mostraron una reducción en la concentración de DPD en el GTC cuando se compararon los grupos (p = 0,007) y la mejora de las variables, peso corporal, IMC y DPD entre el GTC y el GC en el post-test (p = 0,000). Se percibe que el entrenamiento concurrente, para las mujeres adultas mayores fue eficiente en la mejoría de las condiciones de salud del metabolismo óseo.

Efeitos de 20 semanas de treinamento combinado na capacidade funcional de idosas / Effects of 20 weeks of combined training on the functional capacity of elderly / Efectos de 20 semanas de entrenamiento combinado en la capacidad funcional de mujeres ancianas

Resumo O estudo baseou-se em avaliar os efeitos de 20 semanas de treinamento combinado na capacidade funcional de idosas; 66 foram divididas por randomização em dois grupos, um grupo treinamento combinado (GTC, n = 33, com 69,12 ± 7 anos) e outro grupo controle (GC, n = 33, com 69,21 ± 6,60 anos). O período de intervenção da pesquisa ocorreu durante 20 semanas. A avaliação da CF foi feita pela Escala de Atividade da Vida Diária (AVD) proposta por Katz, associada à Escala das Atividades Instrumentais da Vida Diária (AIVD) proposta por Lawton. Para o treinamento de força muscular, usou-se carga máxima entre 70-85% de 1RM e no treinamento de resistência cardiovascular optou-se pelo uso de 70-89% da FC de reserva. Os resultados apresentam melhorais estatisticamente significativas na escala de CF de Lawton (Δ% = 21,04%, p = 0,007) e na escala de CF de Katz, (Δ% = 7,31%, p < 0,001) comparados com os do GC. Os resultados possibilitam concluir que a prática do treinamento combinado melhorou a CF de idosas.

Abstract The study was based on evaluating the effects of 20 weeks of concurrent training on the functional capacity of elderly. 66 elderly women were divided by randomization into two groups, a concurrent training group (CTG, n = 33, with 69,12 ± 7,00 years) and a control group (CG, n = 33, with 69,21 ± 6,60 years). The study intervention period occurred during 20 weeks. The evaluation of the CF was made by the Daily Life Activity Scale (ADL) proposed by Katz, associated with the Scale of Instrumental Activities of Daily Living (IADL) proposed by Lawton. For muscle strength training, maximum load was used between 70-85% of 1RM and in cardiovascular resistance training, 70-89% of reserve HR was used. The results show statistically significant improvement in CF Lawton scale (Δ% = 21,04%, p = 0,007) and CF scale Katz (Δ% = 7.31%, p < 0,001) compared to the control group. The results allow to conclude that the practice of concurrent training improved CF elderly.

Resumen El estudio se basó en la evaluación de los efectos de 20 semanas de entrenamiento combinado en la capacidad funcional (CF) de mujeres ancianas. Se dividió a 66 mujeres ancianas en dos grupos de forma aleatoria: un grupo de entrenamiento combinado (GEC, n = 33, con 69,12 ± 7,00 años) y un grupo control (GC, n = 33, con 69,21 ± 6,60 años). El período de la intervención fue 20 semanas. La evaluación de la CF se llevó a cabo con la Escala de Actividades de la Vida Diaria (AVD), propuesta por Katz, relacionada con la Escala de Actividades Instrumentales de la Vida Diaria (AIVD), propuesta por Lawton. Para el entrenamiento de la fuerza muscular se utilizó una carga máxima del 70-85% de 1RM y para el entrenamiento cardiovascular se optó por el uso del 70-89% de la reserva de la FC. Los resultados muestran una mejora estadísticamente considerable en la escala de la CF de Lawton (Δ% = 21,04%, p = 0,007) y la escala de la CF de Katz (Δ% = 7,31%, p < 0,001) en comparación con el grupo control. Los resultados permiten concluir que la práctica de entrenamiento combinado mejoró la CF de las mujeres ancianas.

Giant-cell tumor: analysis on the importance of early diagnosis and the epidemiological profile / Tumor de células gigantes: análise sobre importância do diagnóstico precoce e perfil epidemiológico

This study aimed to ascertain the relationship between early diagnosis of giant-cell tumors (GCT) and their prognosis, by correlating the time of symptom onset with the staging of the injury (through the Campanacci classification at the time of diagnosis), and with the type of treatment. The secondary objective of the study was to outline the epidemiological profile of patients with GCT in the region where the data were gathered, and to compare them with data in the literature. METHODS: The authors present an evaluation on 61 patients diagnosed with bone GCT, with regard to the site of involvement, age, initial symptoms, time of symptom onset, classification and type of treatment, among patients attended between May 1994 and August 2009. RESULTS: The threshold indicated as the limit for Campanacci stage I tumors to be the commonest diagnosis, with a 98.2% chance that the treatment would be non-aggressive, was 2 months after symptom onset. This finding was statistically significant (p = 0.017). Every additional month increased the chance that a patient would be diagnosed with an advanced-stage tumor by 10.94%, in relation to the chances of having the other two stages of the tumor. CONCLUSION: The study result not only suggests that the alternative hypothesis that the earlier the diagnosis of GCT is, the less severe the lesion will be, has been confirmed; but also especially predicts the relationship between the time of symptom appearance and the severity of the tumor.

Presumir a relação entre o diagnóstico precoce do tumor de células gigantes (TCG) e o seu prognóstico, relacionar o tempo de surgimento dos sintomas com o estadiamento da lesão, por meio da classificação de Campanacci no momento do diagnóstico, e com tipo de tratamento. O objetivo secundário do estudo é traçar o perfil epidemiológico dos pacientes com TCG da região onde foram colhidos os dados e compará-lo com dados da literatura. MÉTODOS: Avaliação de 61 pacientes diagnosticados com tumor de células gigantes ósseo quanto ao local de acometimento, idade, sintomatologia inicial, tempo do surgimento dos sintomas, classificação e tipo de tratamento em pacientes atendidos entre maio de 1994 e agosto de 2009. RESULTADO: Aponta o marco de dois meses após o início da sintomatologia como data limite, quando seria mais comum o diagnóstico de tumor estágio I de Campanacci e com 98,2% de chance de ser tratado de modo não agressivo, dados com relevância estatística (p = 0,017). A cada aumento de um mês a chance de um paciente ser diagnosticado com tumor em estágio avançado é 10,94% maior do que em relação aos outros dois estágios do tumor. CONCLUSÃO: O resultado do estudo sugere não somente a confirmação da hipótese opcional de que quanto mais precoce o diagnóstico de TCG, menos grave é a lesão, mas, principalmente, prediz a relação do tempo de surgimento do sintoma com a gravidade do tumor.

O impacto do programa de atividades físicas menopausa em forma na qualidade de vida de idosos / The impact of a post-menopausal physical activities program in the quality of life of elderly women

Objetivo: avaliar o impacto de atividades físicas do Programa Menopausa em Forma sobre a qualidade de vida de idosas. Material emétodos: O presente estudo tem caráter longitudinal, quase-experimental. A amostra de 323 idosas (idade=69 ±5,53 anos), não institucionalizadas, pós-menopáusicas, pertencentes à Casa do Idoso no município de Belém – Pará – Brasil, praticou uma das atividades(dança ou caminhada) durante dez meses. O protocolo utilizado na avaliação da qualidade de vida foi o WHOQOL-OLD. Ambas as atividades foram realizadas três vezes na semana, durante uma hora, no período de dez meses...

Objecive: This study aimed to evaluate the impact of post-menopausal physical activity Program Form on the quality of life of elderly women. Methods: This study has a longitudinal quasi-experimental. The sample of 323 elderly (age = 69 ± 5.53 years), non-institutionalized, post-menopausal women, belonging to the House for the Elderly in the city of Belém - Pará - Brazil, engaged in an activity (dance orwalk) for ten months. The protocol used in assessing the quality of life was the WHOQOL-OLD. Both activities were held three times a week for an hour, within ten months. The level of significance was p <0.05...

Quantitative analysis of cardiac lesions in chronic canine chagasic cardiomyopathy

Lesions observed in chronic chagasic cardiopathy frequently produce electrocardiographic alterations and affect cardiac function. Through a computerized morphometrical analysis we quantified the areas occupied by cardiac muscle, connective and adipose tissues in the right atrium of dogs experimentally infected with Trypanosoma cruzi. All of the infected dogs showed chronic myocarditis with variable reduction levels of cardiac muscle, fibrosis and adipose tissue replacement. In the atrial myocardium of dogs infected with Be78 and Be62 cardiac muscle represented 34 and 50 percent, fibrosis 28 and 32 percent and adipose tissue 38 and 18 percent, respectively. The fibrosis observed was both diffuse and focal and mostly intrafascicular, either partially or completely interrupting the path of muscle bundles. Such histological alterations probably contributed to the appearance of electrocardiographic disturbances verified in 10 out 11 dogs which are also common in human chronic chagasic cardiopathy. Fibrosis was the most important microscopic occurrence found since it produces rearrangements of collagen fibers in relation to myocardiocytes which causes changes in anatomical physiognomy and mechanical behavior of the myocardium. These abnormalities can contribute to the appearance of cardiac malfunction, arrythmias and congestive cardiac insufficiency as observed in two of the analyzed dogs. Strain Be78 caused destruction of atrial cardiac muscle higher than that induced by strain Be62