Uso da Homeopatia como opção terapêutica no pós-cirúrgico em medicina veterinária

Este trabalho consiste em uma revisão bibliográfica de algumas opções terapêuticas homeopáticas que o clínico-cirurgião veterinário tem a disposição para o uso em seu dia-a-dia profissional, mostrando opções de medicamentos homeopáticos que, em determinados casos clínicos, podem substituir medicações alopáticas ou serem associadas à estas, visando a um melhor efeito farmacológico clínico, principalmente naqueles casos em que há uma contraindicação pela situação clínica do paciente do uso da medicação alopática preconizada. (AU)

This work consists of a literature review of some homeopathic treatment options that clinical veterinary surgeon has available for use in your day-to-day professional showing homeopathic options that in some clinical cases, may replace allopathic medications or being associated with the latter, with a view to a better clinical pharmacological effect, especially in those cases where there is a contraindication the patient's clinical situation advocated the use of allopathic drugs. (AU)

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury.

This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8%). Another 20 patients (18.3%) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.

Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury / Dor neuropática em pessoas com lesão medular residentes em Curitiba (Brasil)

This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2 percent (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8 percent). Another 20 patients (18.3 percent) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.

Estudo transversal descritivo em pacientes com lesão medular que residem em Curitiba, Paraná, Brasil. O objetivo foi avaliar as características da dor em pacientes com lesão medular acompanhados em Centros de Reabilitação de referência na cidade. Os sujeitos envolvidos na pesquisa foram 109 pacientes adultos com lesão medular. Foi avaliada a presença de dor, principalmente dor neuropática, mediante aplicação do Questionário DN4, um instrumento universal traduzido e validado para o português. A Escala Visual Analógica (EVA) também foi usada para avaliar a intensidade da dor. A prevalência de dor nos 109 pacientes avaliados foi de 31,2 por cento, ou seja, 34 pacientes. Destes, nove apresentaram dor nociceptiva classificada como músculo-esquelética, quatro dor visceral e um paciente apresentou dor mista, totalizando 14 pacientes (12,8 por cento). Além disso, 20 pacientes (18,3 por cento) apresentaram dor neuropática, cumprindo os critérios para este tipo de dor com uma contagem superior a 4/10 para o DN4. Sobre as características dos pacientes com dor neuropática, a maioria era do sexo masculino, abaixo de 40 anos, paraplégico com lesão incompleta e tempo de evolução entre um e cinco anos de lesão. A etiologia predominante foi perfuração por arma de fogo e a intensidade da dor era severa, com EVA superior a cinco. Este estudo confirma parcialmente outros estudos publicados sobre o tema. Pesquisas deste tipo são importantes para entender o perfil destes pacientes com a finalidade de estabelecer estratégias para uma reabilitação com foco no tratamento e manejo adequado da dor.

Comportamentos espontâneos e induzidos em ratos com dor neuropática por constrição crônica do nervo ciático / Spontaneous and induced behaviors in rats with neuropathic pain by chronic sciatic nerve constriction

JUSTIFICATIVA E OBJETIVOS: A dor neuropática é uma condição frequente e desafiadora no que concerne ao tratamento, necessitando assim do uso de modelos experimentais para a melhor compreensão de seus mecanismos. O objetivo deste estudo foi reproduzir cirurgicamente o modelo de constrição crônica do nervo ciático e quantificar os comportamentos auto-dirigidos sugestivos de dor neuropática crônica experimental durante quatro semanas.MÉTODO: Foram utilizados 21 ratos Wistar divididos em três grupos: normal (n = 7), pseudo-cirúrgico (n = 7) e cirúrgico (n = 7). No grupo pseudo-cirúrgico, procedeu-se apenas a exposição bilateral do nervo ciático, sem lesioná-los. No grupo cirúrgico procedeu-se a exposição do nervo ciático à direita e então constrição com fio mononylon 4.0 em quatro locais, separados por 2 mm de distância. No membro esquerdo, fez-se apenas exposição do nervo ciático, sem lesioná-lo. RESULTADOS: A análise dos comportamentos revelou um aumento significativo (p < 0,05) de coçar-se e morder-se nos membros posteriores direito e esquerdo (em espelho), com predomínio à direita. Além disso, houve diminuição significativa de empinar-se e exploratórios como correr, andar, farejar, e aumento significativo de descansar/dormir e congelar-se. A análise dos testes térmicos revelou presença de alodínia (40º C) e hiperalgesia (46º C) nos membros posteriores direito e esquerdo.CONCLUSÃO: O modelo induziu mononeuropatia ciática dolorosa expressa por comportamentos espontâneos sugestivos de dor crônica, além de alodínia e hiperalgesia.

BACKGROUND AND OBJECTIVES: Neuropathic pain is a frequent and challenging condition in terms of management, thus requiring the use of experimental models to better understand its mechanisms. This study aimed at surgically reproducing chronic sciatic nerve constriction model and at quantifying self-directed behaviors suggestive of experimental chronic neuropathic pain during four weeks.METHOD: Twenty-one Wistar rats were divided in three groups: normal (n = 7), pseudo-surgical (n = 7) and surgical (n = 7). The pseudo-surgical group was submitted to bilateral sciatic nerve exposure without injury. The surgical group was submitted to right sciatic nerve exposure and constriction with mononylon thread 4.0 in four sites 2 mm apart from each other. Left sciatic nerve was exposed without injury. RESULTS: Behavioral analysis has shown significant increase (p < 0.05) in scratching and biting right and left hind limbs (in mirror), predominantly to the right. In addition there has been significant decrease in rearing up and exploratory behaviors such as running, walking and sniffing, and significant increase in resting / sleeping and freezing. Thermal tests analysis has shown allodynia (40º C) and hyperalgesia (46º C) in right and left hind limbs. CONCLUSION: The model has induced painful sciatic single neuropathy expressed by spontaneous behaviors suggestive of chronic pain, in addition to allodynia and hyperalgesia

Chewing-like as a possible behavior of persistent orofacial pain in the experimental temporomandibular dysfunction / Mastigação (chewing-like) como possível comportamento de dor orofacial persistente na disfunção temporomandibular experimental.

BACKGROUND AND OBJECTIVES: Stimulations with formalin in the orofacial region can be related to transient or subacute nociceptive activity and behavioral changes. The evaluation of behavioral changes induced by persistent or chronic irritating nociceptive substance has not yet been described.METHOD: Complete Freund's Adjuvant (CFA) was injected in the temporomandibular joint (TMJ) region of rats and analyzed comparing it to the groups treated with saline and 2.5% formalin. In addition, behaviors such as grooming, freezing, rest/sleeping and chewing-like were electronically observed and quantified.RESULTS: It was shown that the chewing-like behavior was significantly increased and that it was inhibited by indometacin (5 mg/kg) and morphine (4 mg/kg). CONCLUSION: These results suggest that chewing-like may be a possible behavior of persistent or chronic orofacial pain, and may be a tool for clinical-pharmacological studies.

JUSTIFICATIVA E OBJETIVOS: Estímulos com formalina na região orofacial podem estar relacionados com a atividade nociceptiva e as alterações comportamentais transitórias ou subagudas. A avaliação de comportamentos sob ação de substância irritante nociceptiva persistente e crônica ainda não foi descrita.MÉTODO: Foi feita injeção de adjuvante completo de Freund (ACF) na região da articulação temporomandibular (ATM) de ratos e foi analisada comparando-a com os grupos tratados com salina e formalina a 2,5%. Além disso, foram observados e quantificados eletronicamente os comportamentos grooming, freezing, rest/sleeping e chewing-like (mastigação). RESULTADOS: Observou-se que o comportamento mastigação (chewing-like) estava significativamente aumentado e que ele foi inibido pela indometacina (5 mg/kg) e morfina (4 mg/kg).CONCLUSÃO: Esses resultados sugerem ser o chewing-like um possível comportamento de dor orofacial persistente, oferecendo-se como instrumento para análise clínico-farmacológica