Diagnosis of fibromyalgia: diagnostic feasibility and accuracy of thermography

INTRODUCTION: Studies have suggested using thermography as a resource to diagnose fibromyalgia, although there has been no evidence confirming this hypothesis so far. OBJECTIVE: To evaluate the sensitivity and specificity of computerized infrared thermography as an auxiliary method for diagnosing fibromyalgia. METHODS: It is a diagnostic accuracy studywith cross-sectional design. One hundred and three individuals were evaluated for global pain using the Visual Analogue Scale. The measurement of pain at tender points was assessed by algometry, and skin temperature was assessed by thermography. To evaluate sensitivity and specificity, the analysis was performed using the Receiver Operating Characteristic Curve, measured by the area under the curve with their respective confidence intervals. RESULTS: Thermography has not been very sensitive or specific for pain (tender points) and diagnosis of fibromyalgia, according to the evaluation of the Receiver Operating Characteristic Curve, with an area under the curve equal to or lower than 0.75. CONCLUSION: In this study the thermography was not sensitive and specific as a tool for diagnosing the fibromyalgia syndrome. This study highlights important clinical implications concerning the current methods for diagnosing it, which, despite all efforts, are still subjective and poorly reproducible.

Pé diabético e amputações em pessoas internadas em hospital público: estudo transversal / Diabetic foot and amputations on people in a public hospital: cross-sectional study

INTRODUÇÃO: O pé diabético é uma das mais devastadoras complicações crônicas do diabetes mellitus. Mais de 60% das amputações não traumáticas de membros inferiores ocorre em indivíduos diabéticos. OBJETIVO: Caracterizar sociodemográfica e clinicamente os pacientes hospitalizados por pé diabético, diferenciando o perfil entre amputados e não amputados. MÉTODOS: Estudo transversal conduzido em hospital público no período de janeiro a junho de 2014. Foram incluídos indivíduos internados por pé diabético. Um formulário de dados foi utilizado e preenchido por meio de entrevista com pacientes e revisão de prontuários. Os dados sociodemográficos e clínicos foram analisados de acordo com a amostra total e os grupos de estudo: pacientes amputados e não amputados. Foi feita análise estatística descritiva e inferencial, sendo utilizado o teste de independência do χ2. RESULTADOS: Quarenta e duas pessoas foram hospitalizadas por pé diabético, 26 sofreram amputação (61,9%). Prevaleceu o sexo masculino entre os amputados e o feminino entre os não amputados. A faixa etária predominante foi a de 50 a 69 anos nos dois grupos. Houve associação estatística significativa entre as classificações de Wagner, PEDIS e a frequência de amputação, sendo que quanto maior o grau das classificações, maior a frequência de amputação. CONCLUSÃO: De maneira geral, os dados apresentados por este estudo foram semelhantes aos da literatura. As classificações de Wagner e PEDIS demonstraram-se úteis para identificar a gravidade do pé diabético.

INTRODUCTION: The diabetic foot is one of the most devastating chronic complications of diabetes mellitus. More than 60% of non-traumatic lower limb amputations occur in diabetic people. OBJECTIVE: To characterize sociodemographic and clinically the hospitalized patients for diabetic foot by differentiating the profile between amputees and not amputated subjects. METHODS: A cross-sectional study was conducted in a public hospital from January to June 2014. We have included patients hospitalized due to diabetic foot. A data form was used and completed through interviews with patients and medical record review. The sociodemographic and clinical data were analyzed according to the total sample and study groups: the amputees and not amputated patients. Descriptive and inferential statistical analysiswas done, using the χ2 test of independence. RESULTS: Forty-two people were hospitalized due to diabetic foot and there were, 26 amputees (61.9%). There was a prevalence of males among amputees and women among non-amputees. The predominant age was between 50 and 69 years in both groups. It was observed that there was a statistically significant associationbetween classifications (Wagner and PEDIS) and frequency of amputation, and the higher the degree of classification, the higher the frequency of amputation. CONCLUSION: In general, data presented in this study are similar to the ones in literature. The classifications (Wagner and PEDIS) have shown to be useful to identify the severity of the diabetic foot.

Medicina tradicional chinesa para tratamento de obesidade / Traditional Chinese medicine for treatment of obesity

Introdução: Atualmente, a obesidade é um dos mais graves problemas de saúde pública. O manejo da obesidade pode envolver tratamento dietético, farmacológico, cirúrgico, terapia cognitivo-comportamental e tratamentos heterodoxos. A Medicina Tradicional Chinesa (MTC) faz parte da medicina alternativa e inclui, dentre outras intervenções, massagem, exercícios e acupuntura. Objetivo: Caracterizar as intervenções da MTC em obesidade e observar os desfechos terapêuticos encontrados. Materiais e métodos: Foi realizada uma revisão de artigos sobre o uso da MTC para o tratamento de obesidade nas bases de dados SciELO, BIREME e PubMed. Resultados: As terapêuticas mais frequentemente empregadas foram a acupuntura, a auriculoterapia e a eletroacupuntura. O tratamento com acupuntura deve revigorar o Baço e o Estômago, minimizar secreção para reduzir os lipídios, aliviar o Fígado, regular os Pulmões e encher a essência do Rim. Houve vários estudos que compararam a redução de peso corporal, circunferência abdominal e índice de massa corporal quanto às diferentes abordagens da MTC. Considerações finais: As pesquisas apresentaram resultados pouco divergentes, sendo que a maior parte comprovou o benefício destas terapêuticas, com valores estatisticamente significativos.(AU)

Introduction: Nowadays, obesity is the one of the most serious public health problems. The management of obesity may involve dietary, pharmacological, surgical treatment, cognitive behavioral therapy and unorthodox treatments. Traditional Chinese medicine (TCM) is part of alternative medicine and includes, among other interventions, massage, exercises and acupunture. Objective: To characterize the interventions of TCM in obesity and observe the therapeutic outcomes found. Materials and methods: a review of articles on the use of TCM for the treatment of obesity in the databases SciELO, BIREME, and PubMed was performed. Results: The most frequently used therapies were acupuncture, auricular and electroacupuncture. Treatment with acupuncture should reinvigorate the Spleen and Stomach, minimize secretion to reduce lipids, relieve the Liver, regulate Lungs and fill the Kidney essence. There have been several studies comparing the reduction of body weight, waist circumference and body mass index as the different approaches of TCM. Final Thoughts: The research showed little divergent results, and most provern the benefit of these therapies, with a statistically significant values.(AU)