Transcranial direct current stimulation is more effective than pregabalin in controlling nociceptive and anxiety-like behaviors in a rat fibromyalgia-like model.

OBJECTIVES: Despite the fact that fibromyalgia, a widespread disease of the musculoskeletal system, has no specific treatment, patients have shown improvement after pharmacological intervention. Pregabalin has demonstrated efficacy; however, its adverse effects may reduce treatment adherence. In this context, neuromodulatory techniques such as transcranial direct current stimulation (tDCS) may be employed as a complementary pain-relieving method. Consequently, the purpose of this study was to evaluate the effect of pregabalin and tDCS treatments on the behavioral and biomarker parameters of rats submitted to a fibromyalgia-like model. METHODS: Forty adult male Wistar rats were divided into two groups: control and reserpine. Five days after the end of the administration of reserpine (1 mg/kg/3 days) to induce a fibromyalgia-like model, rats were randomly assigned to receive either vehicle or pregabalin (30 mg/kg) along with sham or active- tDCS treatments. The evaluated behavioral parameters included mechanical allodynia by von Frey test and anxiety-like behaviors by elevated plus-maze test (time spent in opened and closed arms, number of entries in opened and closed arms, protected head-dipping, unprotected head-dipping [NPHD], grooming, rearing, fecal boluses). The biomarker analysis (brain-derived neurotrophic factor [BDNF] and tumor necrosis factor-α [TNF-α]) was performed in brainstem and cerebral cortex and in serum. RESULTS: tDCS reversed the reduction in the mechanical nociceptive threshold and the decrease in the serum BDNF levels induced by the model of fibromyalgia; however, there was no effect of pregabalin in the mechanical threshold. There were no effects of pregabalin or tDCS found in TNF-α levels. The pain model induced an increase in grooming time and a decrease in NPHD and rearing; while tDCS reversed the increase in grooming, pregabalin reversed the decrease in NPHD. CONCLUSIONS: tDCS was more effective than pregabalin in controlling nociception and anxiety-like behavior in a rat model-like fibromyalgia. Considering the translational aspect, our findings suggest that tDCS could be a potential non-pharmacological treatment for fibromyalgia.

Gene Expression and Prognostic Value of NADPH Oxidase Enzymes in Breast Cancer.

NADPH oxidase enzymes (NOX) are involved in all stages of carcinogenesis, but their expression levels and prognostic value in breast cancer (BC) remain unclear. Thus, we aimed to assess the expression and prognostic value of NOX enzymes in BC samples using online databases. For this, mRNA expression from 290 normal breast tissue samples and 1904 BC samples obtained from studies on cBioPortal, Kaplan-Meier Plotter, and The Human Protein Atlas were analyzed. We found higher levels of NOX2, NOX4, and Dual oxidase 1 (DUOX1) in normal breast tissue. NOX1, NOX2, and NOX4 exhibited higher expression in BC, except for the basal subtype, where NOX4 expression was lower. DUOX1 mRNA levels were lower in all BC subtypes. NOX2, NOX4, and NOX5 mRNA levels increased with tumor progression stages, while NOX1 and DUOX1 expression decreased in more advanced stages. Moreover, patients with low expression of NOX1, NOX4, and DUOX1 had lower survival rates than those with high expression of these enzymes. In conclusion, our data suggest an overexpression of NOX enzymes in breast cancer, with certain isoforms showing a positive correlation with tumor progression.

Evaluation of the mobile application "Descomplicando a Amamentação" by family members of newborns. / Evaluación de la aplicación móvil Descomplicando a Amamentação por familiares de recién nacidos.

to evaluate the semantics, appearance and usability of the mobile application "Descomplicando a Amamentação" for family members of newborns.applied methodological study, developed with 20 family members of newborns users of educational technology, including pregnant women, postpartum women and family members of newborns. An evaluation instrument containing questions about semantics and appearance was applied, in addition to the System Usability Scale to evaluate usability. In data analysis, the Agreement Index was used, with a cutoff point of 0.8 (80%).when evaluating semantics and appearance, the application achieved a Global Agreement Index of 0.99 (99%), varying from 0.95 (95%) to 1.0 (100%) between the items evaluated. In usability, a global average of 93 was achieved, presenting the best usability achievable in all system characteristics.the technology was considered understandable, relevant, and efficient, as well as easy to use and low inconsistency with high user satisfaction, demonstrating excellent potential for families.

Efetividade de um programa multiprofissional de tratamento da obesidade durante a pandemia de COVID-19: Aplicação do Monitoramento Remoto da Enfermagem

Objetivo: Verificar a efetividade do monitoramento remoto da enfermagem associada a um programa multi-profissional de tratamento de obesidade na melhora dos biomarcadores cardiometabólicos e indicadores da aptidão física relacionada à saúde de adultos com obesidade acompanhados durante a pandemia da COVID-19. Métodos: Estudo caracterizado como um Ensaio Clínico Pragmático, realizado em um município do Sul do Brasil, com 22 mulheres, com idade entre 18 e 50 anos, portadores de telefone celular com acesso ao aplicativo WhatsApp® durante 16 semanas. Foram realizadas avaliações pré e pós intervenção por meio de exames labo-ratoriais, capazes de determinar os biomarcadores cardiometabólicos: HDL, triglicerídeos, LDL, colesterol total, glicemia, hemoglobina glicada, insulina, Homa-IR, Homa-β, PCR-us; e de testes capazes de avaliar os níveis da aptidão física relacionada à saúde: composição corporal, aptidão cardiorrespiratória, força muscular e flexibili-dade. Os dados obtidos foram analisados através do teste t para amostras pareadas e correlacionados a partir do valor de delta absoluto de cada variável por meio da correlação de Pearson. Os resultados foram considerados significantes quando o valor de p foi < 0,05. Este estudo possui parecer favorável do Comitê Nacional de Ética em Pesquisas. Resultados: Foram observadas melhoras significativas nos níveis de glicemia, insulina, Homa-IR e HDL, bem como nos indicadores de aptidão cardiorrespiratória e força muscular. Conclusão: O monitoramento remoto da enfermagem associado a um programa multiprofissional de tratamento de obesidade é uma inter-venção efetiva na melhoria dos biomarcadores cardiometabólicos e dos indicadores da AFRS.

Objetivo: Evaluar la efectividad del monitoreo remoto de enfermería, en asociación con un programa multiprofesional de tratamiento de la obesidad, para mejorar los biomarcadores cardiometabólicos y los indicadores de aptitud física relacionados con la salud en adultos obesos durante la pandemia de COVID-19.Métodos: Se llevó a cabo un Ensayo Clínico Pragmático en un municipio del sur de Brasil, con la participación de 22 mujeres de edades comprendidas entre los 18 y 50 años, que contaban con teléfonos móviles con acceso a la aplicación WhatsApp® durante un período de 16 semanas. Se realizaron evaluaciones pre y postintervención mediante exámenes de laboratorio, que permitieron determinar los biomarcadores cardiometabólicos: HDL, triglicéridos, LDL, colesterol total, glucemia, hemoglobina glucosilada, insulinemia, Homa-IR, Homa-β, hs-CRP; y pruebas para evaluar los niveles de aptitud física relacionados con la salud: composición corporal, aptitud cardiorrespiratoria, fuerza muscular y flexibilidad. Los datos obtenidos se analizaron utilizando la prueba t para muestras pareadas y se correlacionaron mediante la correlación de Pearson, a partir del valor delta absoluto de cada variable. Se consideraron resultados significativos cuando el valor de p fue < 0,05. Este estudio recibió la aprobación del Comité Nacional de Ética en Investigación.Resultados: Se observaron mejoras significativas en los niveles de glucosa en sangre, insulina, Homa-IR y HDL, así como en los indicadores de aptitud cardiorrespiratoria y fuerza muscular.Conclusión: El monitoreo remoto de enfermería, en asociación con un programa multidisciplinario de tratamiento de la obesidad, resulta en una intervención eficaz para mejorar los biomarcadores cardiometabólicos y los indicadores de aptitud física relacionados con la salud.

Objective: To verify the effectiveness of remote nursing monitoring associated with a multi-professional obesity treatment program to improve cardiometabolic biomarkers and health-related physical fitness indicators in obese adults followed during the COVID-19 pandemic. Methods: The study was characterized as a Pragmatic Clinical Trial, carried out in a municipality in the south of Brazil. It involved 22 women aged between 18 and 50 years, who had cell phones with access to the WhatsApp® application for 16 weeks. Pre- and post-intervention evaluations were carried out through laboratory tests capable of determining cardiometabolic biomarkers: HDL, triglycerides, LDL, total cholesterol, glycemia, glycated hemoglobin, insulinemia, Homa-IR, Homa-β, hs-CRP. As well as tests capable of assessing the levels of physical fitness related to health: body composition, cardiorespiratory fitness, muscle strength and flexibility. The data obtained were analyzed using the t-test for paired samples and correlated from the absolute delta value of each variable using Pearson's correlation. Results were considered significant when the p value was <0.05. This study received a favorable opinion from the National Research Ethics Committee. Results: The study observed significant improvements in blood glucose, insulin, Homa-IR and HDL levels, as well as in indicators of cardiorespiratory fitness and muscle strength. Conclusion: Remote nursing monitoring associated with a multidisciplinary obesity treatment program is an effective intervention for improving cardiometabolic biomarkers and AFRS indicators.

Efeitos de um programa multiprofissional de tratamento da obesidade com treinamento aquático sobre parâmetros bioquímicos, composição corporal e aptidão física em adultos

Diante ao preocupante cenário mundial sobre a obesidade e a importância de intervenções multiprofissionais para mudança no estilo de vida da população com obesidade. O Objetivo foi analisar os efeitos de um programa multiprofissional para tratamento da obesidade com treinamento aquático, nos parâmetros bioquímicos, composição corporal e da aptidão física de adultos obesidade severa. O estudo foi conduzido por equipe multiprofissional com profissionais de Educação Física, Nutrição, Psicologia e Medicina, durante 24 semanas, com 16 indivíduos classificados com obesidade severa (IMC > 40 kg/m2). As Intervenções do programa proposto no estudo foram realizadas através treinamento aquático de exercícios aeróbicos associados com a orientação nutricional e psicológica. Foi analisada diminuição significativa no índice de Proteína C Reativa (mg/L) (p=0,0439); no percentual de gordura (%), ao final das 24 semanas do programa de tratamento (p=0,0136), também houve aumento significativo na força de pressão manual (kg) com 16 semanas (p=0,0006) e 24 semanas (p=0,0014). Este estudo apresentou resultados significativos na melhora dos parâmetros bioquímicos, composição corporal e da aptidão física em adultos com obesidade severa, justificando o quanto programas de tratamentos que visam a mudanças nos hábitos alimentares e estilo de vida são de grande importância para a saúde pública.

Ante el preocupante panorama mundial de la obesidad y la importancia de intervenciones multiprofesionales para el cambio en el estilo de vida de la población con obesidad, este estudio tiene como objetivo analizar los efectos de un programa multiprofesional para el tratamiento de la obesidad mediante entrenamiento acuático en parámetros bioquímicos, composición corporal y aptitud física en adultos con obesidad severa. El estudio fue llevado a cabo por un equipo multiprofesional compuesto por profesionales de Educación Física, Nutrición, Psicología y Medicina, durante un período de 24 semanas. Participaron 16 individuos clasificados con obesidad severa (IMC > 40 kg/m2). Las intervenciones del programa propuesto en el estudio incluyeron ejercicios aeróbicos acuáticos junto con orientación nutricional y psicológica. Se evidenció una disminución significativa en el índice de Proteína C Reactiva (mg/L) (p=0.0439); en el porcentaje de grasa (%), al final de las 24 semanas del programa de tratamiento (p=0,0136), también se evidencio un aumento estadísticamente significativo de la fuerza de presión manual (kg) con 16 semanas (p=0,0006) e 24 semanas (p=0,0014). Este estudio presentó resultados significativos en la mejora de los parámetros bioquímicos, composición corporal y aptitud física en adultos con obesidad severa, lo que justifica la importancia de los programas de tratamiento que se centran en los cambios en los hábitos alimentarios y el estilo de vida para la salud pública.

In the context of the concerning global prevalence of obesity and the critical need for multidisciplinary interventions to drive lifestyle changes among individuals with obesity, this study aims to investigate the effects of a comprehensive multidisciplinary program, including aquatic training, on biochemical parameters, body composition, and physical fitness in severely obese adults. Over a period of 24 weeks, a team of diverse professionals in Physical Education, Nutrition, Psychology, and Medicine collaborated on this research. The study enrolled sixteen participants with severe obesity (BMI > 40 kg/m2). The interventions encompassed aquatic aerobic exercises, accompanied by nutritional and psychological guidance. Significant improvements were observed in the C-Reactive Protein index (mg/L) (p=0.0439), with a notable reduction in body fat percentage (%) after the 24-week treatment program (p=0.0136). Additionally, manual pressure force (kg) displayed a statistically significant increase at 16 weeks (p=0.0006) and 24 weeks (p=0.0014). These compelling findings underscore the remarkable progress in biochemical parameters, body composition, and physical fitness among severely obese adults, underscoring the critical importance of treatment programs targeting dietary and lifestyle changes for public health improvement. By adopting a multidisciplinary approach, this study emphasizes the effectiveness of comprehensive interventions in addressing the complex challenges posed by severe obesity. In summary, this research reinforces the significance of implementing multidisciplinary programs to foster lifestyle modifications and provides valuable insights into tackling severe obesity in adult populations. By highlighting the pivotal role of holistic interventions, this study contributes to the ongoing global efforts to combat the escalating obesity epidemic.

Evaluación de la aplicación móvil Descomplicando a Amamentação por familiares de recién nacidos / Evaluation of the mobile application "Descomplicando a Amamentação" by family members of newborns / Avaliação do aplicativo móvel "Descomplicando a Amamentação" por familiares de recém-nascidos

Objetivo: evaluar la semántica, la apariencia y la usabilidad de la aplicación móvil Descomplicando a Amamentação por familiares de recién nacidos. Método: estudio metodológico aplicado, desarrollado con 20 familiares de recién nacidos ususrios de la tecnología educativa, siendo embarazadas, puérperas y familiares de recién nacidos. Se aplicó un instrumento evaluativo conteniendo preguntas sobre la semántica y la apariencia, además de la System Usability Scale para evaluación de la usabilidad. En el análisis de los datos se utilizó el Índice de Concordancia, con un punto de corte igual a 0,8 (80%) Resultados: en la evaluación de la semántica y de la apariencia, la aplicación alcanzó un Índice de Concordancia Global de 0,99 (99%), presentando una variación de 0,95 (95%) a 1,0 (100%) entre los ítems evaluados. En la usabilidad, se alcanzó una media global de 93, presentando la mejor usabilidad alcanzable en todas las características del sistema. Conclusión: se consideró la tecnología comprensible, relevante, pertinente y eficiente, además de fácil utilización y baja inconsistencia con alta satisfacción de los usuarios, demostrando excelente potencial de uso por las familias

Objective: to evaluate the semantics, appearance and usability of the mobile application "Descomplicando a Amamentação" for family members of newborns. Method: applied methodological study, developed with 20 family members of newborns users of educational technology, including pregnant women, postpartum women and family members of newborns. An evaluation instrument containing questions about semantics and appearance was applied, in addition to the System Usability Scale to evaluate usability. In data analysis, the Agreement Index was used, with a cutoff point of 0.8 (80%). Results: when evaluating semantics and appearance, the application achieved a Global Agreement Index of 0.99 (99%), varying from 0.95 (95%) to 1.0 (100%) between the items evaluated. In usability, a global average of 93 was achieved, presenting the best usability achievable in all system characteristics. Conclusion: the technology was considered understandable, relevant, and efficient, as well as easy to use and low inconsistency with high user satisfaction, demonstrating excellent potential for families.

Objetivo: avaliar a semântica, a aparência e a usabilidade do aplicativo móvel "Descomplicando a Amamentação" por familiares de recém-nascidos. Método: estudo metodológico aplicado, desenvolvido com 20 membros familiares de recém-nascidos usuários de tecnologia educacional, incluindo gestantes, puérperas e familiares de recémnascidos. Aplicou-se um instrumento avaliativo contendo questões sobre a semântica e a aparência, além da System Usability Scale para avaliação da usabilidade. Na análise dos dados, utilizou-se o Índice de Concordância, com ponto de corte igual a 0,8 (80%). Resultados: na avaliação da semântica e da aparência, o aplicativo alcançou um Índice de Concordância Global de 0,99 (99%), apresentando variação de 0,95 (95%) a 1,0 (100%) entre os itens avaliados. Na usabilidade alcançouse média global de 93, indicando melhor grau alcançável em todas as características do sistema. Conclusão: a tecnologia é compreensível, relevante, pertinente e eficiente, além da fácil utilização e baixa inconsistência com elevada satisfação pela amostra investigada, mostrando excelente potencial de uso pelas famílias.

IS THERE AN ASSOCIATION BETWEEN AFFECTIVE TEMPERAMENT AND MORBID OBESITY IN CANDIDATES FOR BARIATRIC SURGERY? / EXISTE ASSOCIAÇÃO ENTRE TEMPERAMENTO AFETIVO E OBESIDADE MÓRBIDA EM CANDIDATOS À CIRURGIA BARIÁTRICA?

Introduction: Numerous studies have demonstrated a strong relationship between obesity and psychiatric diseases, especially mood disorders. However, few have evaluated the correlation between morbid obesity and affective temperament. Objective: To study the existence of affective temperament in morbidly obese individuals before surgical treatment of obesity. Methods: The material for reading and analysis was selected from research on virtual platforms focusing on affective temperaments (hyperthymia, dysthymia and cyclothymia). A search was carried out for descriptors related to the topic ("temperament, morbid obesity, bariatric surgery, mood disorders" and their equivalents in English with AND or OR search), considering the title and/or abstract, and then reading the work in full. Results: The most common psychiatric comorbidities in overweight and obesity were mood, anxiety and binge eating disorders. The estimated prevalence of affective temperaments in morbidly obese people is about 65%. Conclusion: The prevalence of affective temperaments is higher in morbidly obese people, candidates for bariatric surgery, compared to the general population. Cyclothymic temperament is the most common in the morbidly obese patient population.

Introdução: Inúmeros estudos têm demonstrado forte relação entre obesidade e doenças psiquiátricas, especialmente doenças do humor. Contudo, poucos avaliaram a correlação entre obesidade mórbida e temperamento afetivo. Objetivo: Estudar a existência de temperamento afetivo em obesos mórbidos antes do tratamento cirúrgico da obesidade. Métodos: O material para leitura e análise foi selecionado a partir de pesquisa em plataformas virtuais com foco nos temperamentos afetivos (hipertimia, distimia e ciclotimia). Inicialmente foi realizada busca por descritores relacionados ao tema (temperamento, obesidade mórbida, cirurgia bariátrica, transtornos do humor" e seus equivalentes em inglês com busca AND ou OR), considerando o título e/ou resumo, e a seguir a leitura do trabalho na íntegra. Resultados: As comorbidades psiquiátricas mais frequentes no sobrepeso e obesidade foram os transtornos do humor, de ansiedade e da compulsão alimentar. A prevalência estimada de temperamentos afetivos em obesos mórbidos é cerca de 65%. Conclusão: A prevalência de temperamentos afetivos é maior em obesos mórbidos, candidatos a cirurgia bariátrica, em comparação a população geral. O temperamento ciclotímico é o mais comum na população de pacientes com obesidade mórbida.

Preemptive transcranial direct current stimulation induces analgesia, prevents chronic inflammation and fibrosis, and promotes tissue repair in a rat model of postoperative pain.

This study evaluated the effects of previous exposure to Transcranial Direct Current Stimulation (tDCS) on nociceptive, neuroinflammatory, and neurochemical parameters, in rats subjected to an incisional pain model. Forty adult male Wistar rats (60 days old; weighing âˆ¼ 250 g) were divided into five groups: 1. control (C); 2. drugs (D); 3. surgery (S); 4. surgery + sham-tDCS (SsT) and 5. surgery + tDCS (ST). Bimodal tDCS (0.5 mA) was applied for 20 min/day/8 days before the incisional model. Mechanical allodynia (von Frey) was evaluated at different time points after surgery. Cytokines and BDNF levels were evaluated in the cerebral cortex, hippocampus, brainstem, and spinal cord. Histology and activity of myeloperoxidase (MPO) and N-acetyl-ß-D-glucosaminidase (NAGase) were evaluated in the surgical lesion sites in the right hind paw. The results demonstrate that the surgery procedure increased BDNF and IL-6 levels in the spinal cord levels in the hippocampus, and decreased IL-1ß and IL-6 levels in the cerebral cortex, IL-6 levels in the hippocampus, and IL-10 levels in the brainstem and hippocampus. In addition, preemptive tDCS was effective in controlling postoperative pain, increasing BDNF, IL-6, and IL-10 levels in the spinal cord and brainstem, increasing IL-1ß in the spinal cord, and decreasing IL-6 levels in the cerebral cortex and hippocampus, IL-1ß and IL-10 levels in the hippocampus. Preemptive tDCS also contributes to tissue repair, preventing chronic inflammation, and consequent fibrosis. Thus, these findings imply that preemptive methods for postoperative pain management should be considered an interesting pain management strategy, and may contribute to the development of clinical applications for tDCS in surgical situations.

Estratégias de prevenção e promoção em saúde mental para enfermagem diante da pandemia da covid-19 / Prevention and promotion strategies in mental health for nursing in the face of the COVID-19 pandemic / Estrategias de prevención y promoción en salud mental para enfermería ante la pandemia del covid-19

Conclusão: Acolhimento, escuta ativa, reconhecimento social, oferta de serviços de saúde mental, melhorias na organização do trabalho e estímulo à adoção de hábitos de vida saudáveis são ações que podem ser adotadas por gestores no ambiente laboral com os profissionais de enfermagem diante da pandemia da covid-19

Conclusion:Welcoming, active listening, social recognition, offering mental health services, improvements in work organization, and encouraging the adoption of healthy lifestyle habits are actions that can be adopted by managers in the work environment with nursing professionals in the face of the COVID-19 pandemic

Conclusión: acogida, escucha activa, reconocimiento social, oferta de servicios de salud mental, mejora en la organización del trabajo y fomento de la adopción de hábitos de vida saludables son acciones que pueden adoptar los gestores en el trabajo con los profesionales de enfermería ante la pandemia de covid -19

Alkaline Treatment Investigation for Sedge Fibers (Cyperus malaccensis): A Promising Enhancement.

Natural fibers have some advantages in comparison to synthetic fibers, especially because they are more environmentally friendly. For this reason, using them as a reinforcement for polymeric matrices is growing exponentially. However, they present the disadvantage of having the hydrophilic nature, which strongly reduces the interface interaction. Sedge fibers have been investigated when reinforcing an epoxy matrix in terms of ballistic properties and mechanical performance. Aiming to enhance the fiber-matrix interface, an alkali treatment was proposed. The group conditions were divided into three NaOH concentrations (3%, 5%, and 10%), as well as the three periods of immersion (24, 48, and 72 h). Therefore, nine different conditions were investigated in terms of their thermal behaviors, chemical structures, physical structures, and morphological aspects. Based on TGA curves, it could be noticed that treatments related to 3% NaOH for 24 h and 48 h exhibited better thermal stability properties. For the time of 48 h, better thermal stability with for a decay of the thermal DSC curve was shown for all treatment conditions. The FTIR spectra has shown a reduction of waxes for higher NaOH concentrations. The XRD diffractogram exhibited an increase in the crystallinity index only for 5% NaOH and an immersion time of 48 h. The morphological aspects of fibers treated with 5% and 10% of NaOH have shown that the treatments have damaged the fiber, which highlighted the crystallinity index reductions.

Cumulus-oocyte complexes from sows show differences in lipid metabolism compared to cumulus-oocyte complexes from prepubertal gilts during in vitro maturation.

This study aimed to evaluate the effects of donor age on lipid metabolism during in vitro maturation (IVM) of pigs cumulus-oocyte complexes (COCs). We evaluated transcript levels of genes, the percentage of ooplasm occupied by lipid droplets (LD) and evaluated DNA methylation in COCs from sows and prepubertal gilts. Transcript levels of six genes (ACACA, ACSS2, FASN, FABP3, SLC27A4, PLIN2), which were analyzed in cumulus cells (CCs), increased after 44 h of IVM in the sow group. In the gilt group, only FASN expression increased, while NR3C1 expression decreased after IVM. The measurement of LD in oocytes showed an accumulation of lipids in sow oocytes during IVM, while gilt oocytes showed a decrease in LD. FABP3 and NR3C1 methylation patterns exhibited a demethylation pattern in CCs and oocytes from gilts and sows and showed statistical differences between groups. CCs from sows had a better capacity to change transcription levels of the major genes involved in lipid metabolism during IVM than CCs from gilts. This difference may be involved in accumulation of lipids, acquisition of competence, and maturation of enclosed oocytes. Our results contribute to a better understanding of mechanisms involved in lipid metabolism and acquisition of competence in porcine COCs.

Dexmedetomidine Alone or Combined With Morphine for Epidural Anesthesia in Bitches Undergoing Elective Ovariohysterectomy.

The purpose of this study was to assess perioperative analgesia provided by the combination of epidural dexmedetomidine and morphine in bitches undergoing elective ovariohysterectomy. Twenty-four bitches were included in the study and allocated into 3 groups: GM, morphine 0.1 mg/kg; GD, dexmedetomidine 2 µg/kg; and GDM, dexmedetomidine and morphine at the same doses. All solutions were diluted in saline to a total of 0.36 mL/kg. Heart rate (HR), respiratory rate (FR) and systolic blood pressure (SAP) were recorded prior to epidural analgesia (TB), immediately following epidural analgesia (TEA), at surgical incision (TSI), at the first ovarian pedicle clamping (TOP1), at the second pedicle clamping (TOP2), at uterine stump clamping (TUC), at the start of abdominal cavity closure (TSC) and at the end of skin closure (TEC). Rescue analgesia with fentanyl was administered at 2 µg/kg IV if nociception corresponding to a 20% increase of any cardiorespiratory variables was noted. Postoperative pain assessment was performed using a modified composite Glasgow pain scale along the first 6 hours following the end of surgery. Numeric data were compared using ANOVA for repeated measures followed by Tukey test and ovarian ligament relaxation was analyzed using chi-square test under 5% significance. No differences were found on FR among times or groups, although HR showed significant differences between GM and GD at TSI, TOP1, TOP2, TSC and TEC and between GM and GDM at TEA and TSI (significantly lower HR values recorded in dexmedetomidine groups). Differences among time points were found on HR between TB and TEA in GD and on PAS between TOP1 and TSC in GM and between TOP1 and TUC in GDM (P < .05). Ovarian ligament relaxation was significantly more present in groups using dexmedetomidine, although the number of rescue analgesia administrations did not differ among groups. Kaplan-Meyer analysis failed to show significant differences on time of rescue analgesia administration among groups (P > .05). In conclusion, the combination of epidural dexmedetomidine and morphine is a more interesting choice for elective ovariohysterectomy in bitches for producing analgesia comparable to that of each drug alone, with noticeable relaxation of ovarian ligaments and lesser cardiovascular consequences.

Association of low-dose naltrexone and transcranial direct current stimulation in fibromyalgia: a randomized, double-blinded, parallel clinical trial.

INTRODUCTION: Fibromyalgia is a complex, generalized, and diffuse chronic musculoskeletal pain. Pharmacological approaches are widely used to relieve pain and increase quality of life. Low-Dose Naltrexone (LDN) was shown to increase the nociceptive threshold in patients with fibromyalgia. Transcranial Direct Current Stimulation (tDCS) is effective for pain management. OBJECTIVE: The purpose of this study was to evaluate the analgesic and neuromodulatory effects of a combination of LDN and tDCS in patients with fibromyalgia. METHODS: This was a randomized, double-blinded, parallel, placebo/sham-controlled trial (NCT04502251; RBR-7HK8N) in which 86 women with fibromyalgia were included, and written informed consent was obtained from them. The patients were allocated into four groups: LDN + tDCS (n = 21), LDN + tDCS Sham (n = 22), placebo + tDCS (n = 22), and placebo+tDCS Sham (n = 21). The LDN or placebo (p.o.) intervention lasted 26 days; in the last five sessions, tDCS was applied (sham or active, 20 min, 2 mA). The following categories were assessed: sociodemographic, Visual Analog Pain Scale (VAS), Pain Catastrophizing Scale (PCS), State-Trait Anxiety Inventory (STAI), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI-II), Profile of Chronic Pain Scale (PCP:S), Pain Pressure Threshold (PPT), and Conditioned Pain Modulation (CPM). Blood samples were collected to analyze BDNF serum levels. RESULTS: At baseline, no significant difference was found regarding all measurements. VAS pain was significantly reduced in the LDN + tDCS (p = 0.010), LDN + tDCS Sham (p = 0.001), and placebo+tDCS Sham (p = 0.009) groups. In the PCP:S, the LDN+tDCS group showed reduced pain frequency and intensity (p = 0.001), effect of pain on activities (p = 0.014) and emotions (p = 0.008). Depressive symptoms reduced after all active interventions (p > 0.001). CONCLUSION: Combined LDN+tDCS has possible benefits in reducing pain frequency and intensity; however, a placebo effect was observed in pain using VAS, and further studies should be performed to analyze the possible association.

Involvement of GABAergic, glutamatergic, opioidergic, and brain-derived neurotrophic factor systems in the trigeminal neuropathic pain process.

Trigeminal neuropathic pain (TNP) is an intense pain condition characterized by hyperalgesia and allodynia; however, its neural mechanisms are not completely understood. Its management is complex, and studies that investigate its biochemical mechanisms are important for improving clinical approaches. This study aimed to evaluate the involvement of GABAergic, glutamatergic, and opioidergic systems and brain-derived neurotrophic factor (BDNF) levels in the TNP process in rats. TNP is induced by chronic constriction injury of the infraorbital nerve (CCI-ION). Nociceptive responses were evaluated using the facial von Frey test before and after the administration of GABAergic and opioidergic agonists and glutamatergic antagonists. The rats were divided into vehicle-treated control (C), sham-surgery (SS), and CCI-ION groups, and then subdivided into the vehicle (V)-treated SS-V and CCI-ION-V groups, SS-MK801 and CCI-ION-MK801, treated with the N-methyl-d-aspartate receptor selective antagonist MK801; SS-PB and CCI-ION-PB, treated with phenobarbital; SS-BZD and CCI-ION-BZD, treated with diazepam; SS-MOR and CCI-ION-MOR, treated with morphine. BDNF levels were evaluated in the cerebral cortex, brainstem, trigeminal ganglion, infraorbital branch of the trigeminal nerve, and serum. CCI-ION induced facial mechanical hyperalgesia. Phenobarbital and morphine reversed the hyperalgesia induced by CCI-ION, and the CCI-BZD group had an increased nociceptive threshold until 60 min. CCI-ION-GLU increased the nociceptive threshold at 60 min. Cerebral cortex and brainstem BDNF levels increased in the CCI-ION and SS groups. Only the CCI group presented high levels of BDNF in the trigeminal ganglion. Our data suggest the involvement of GABAergic, glutamatergic, and opioidergic systems and peripheral BDNF in the TNP process.

Association of low-dose naltrexone and transcranial direct current stimulation in fibromyalgia: a randomized, double-blinded, parallel clinical trial

Abstract Introduction Fibromyalgia is a complex, generalized, and diffuse chronic musculoskeletal pain. Pharmacological approaches are widely used to relieve pain and increase quality of life. Low-Dose Naltrexone (LDN) was shown to increase the nociceptive threshold in patients with fibromyalgia. Transcranial Direct Current Stimulation (tDCS) is effective for pain management. Objective The purpose of this study was to evaluate the analgesic and neuromodulatory effects of a combination of LDN and tDCS in patients with fibromyalgia. Methods This was a randomized, double-blinded, parallel, placebo/sham-controlled trial (NCT04502251; RBR-7HK8N) in which 86 women with fibromyalgia were included, and written informed consent was obtained from them. The patients were allocated into four groups: LDN + tDCS (n = 21), LDN + tDCS Sham (n = 22), placebo + tDCS (n = 22), and placebo+tDCS Sham (n = 21). The LDN or placebo (p.o.) intervention lasted 26 days; in the last five sessions, tDCS was applied (sham or active, 20 min, 2 mA). The following categories were assessed: sociodemographic, Visual Analog Pain Scale (VAS), Pain Catastrophizing Scale (PCS), State-Trait Anxiety Inventory (STAI), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI-II), Profile of Chronic Pain Scale (PCP:S), Pain Pressure Threshold (PPT), and Conditioned Pain Modulation (CPM). Blood samples were collected to analyze BDNF serum levels. Results At baseline, no significant difference was found regarding all measurements. VAS pain was significantly reduced in the LDN + tDCS (p = 0.010), LDN + tDCS Sham (p= 0.001), and placebo+tDCS Sham (p= 0.009) groups. In the PCP:S, the LDN+tDCS group showed reduced pain frequency and intensity (p= 0.001), effect of pain on activities (p= 0.014) and emotions (p= 0.008). Depressive symptoms reduced after all active interventions (p > 0.001). Conclusion Combined LDN+tDCS has possible benefits in reducing pain frequency and intensity; however, a placebo effect was observed in pain using VAS, and further studies should be performed to analyze the possible association.

Percepção de enfermeiras sobre a identificação do paciente como segurança na assistência a criança hospitalizada / Percepción del personal de enfermería de la identificación del paciente como medida de seguridad en la atención a los niños hospitalizados / Perception of nurses on patient identification as safety in the care of hospitalized child

Objetivo: identificar a percepção de enfermeiras que atuam em unidade pediátrica sobre medidas de segurança do paciente. Método: estudo qualitativo, descritivo e exploratório, realizado em um hospital público de Pernambuco, Brasil. Participaram seis enfermeiras atuantes na pediatria. A coleta de dados foi realizada entre novembro e fevereiro de 2021 mediante entrevistas semiestruturadas, a análise dos dados foi realizada por meio da investigação do conteúdo. Resultados: identificou-se três categorias a partir da análise dos resultados, sendo elas a percepção das enfermeiras sobre segurança do paciente, as barreiras de identificação do paciente na unidade pediátrica e a pulseiras de identificação: estratégia para mitigar erros na unidade pediátrica. Considerações finais: foi possível perceber que as enfermeiras acreditam na importância da identificação dos pacientes como uma estratégia para minimizar a ocorrência de erros relacionados a medicamentos e enfatizam que esse ato proporciona uma segurança maior aos profissionais durante a execução dos procedimentos.

Objetivo: identificar la percepción de las enfermeras que trabajan en una unidad pediátrica sobre las medidas de seguridad del paciente. Método: estudio cualitativo, descriptivo y exploratorio, realizado en un hospital público de Pernambuco, Brasil. Participaron seis enfermeras que trabajaban en la unidad pediátrica. La recogida de datos se llevó a cabo entre noviembre y febrero de 2021 mediante entrevistas semiestructuradas, el análisis de datos se realizó mediante investigación de contenido. Resultados: se identificaron tres categorías a partir del análisis de los resultados, siendo éstas la percepción de las enfermeras sobre la seguridad del paciente, las barreras de identificación del paciente en la unidad pediátrica y las barreras de identificación: estrategia para mitigar los errores en la unidad pediátrica. Consideraciones finales: Fue posible notar que las enfermeras creen en la importancia de la identificación del paciente como estrategia para minimizar la ocurrencia de errores relacionados a la medicación y destacan que este acto proporciona mayor seguridad a los profesionales durante la ejecución de los procedimientos.

Objective to identify the perception of nurses who work in a pediatric unit about patient safety measures. Method: qualitative, descriptive and exploratory study, conducted in a public hospital in Pernambuco, Brazil. Six pediatric nurses participated. Data collection was conducted between November and February 2021 through semi-structured interviews; data analysis was conducted through content investigation. Results: three categories were identified from the analysis of the Results: nurses' perception of patient safety, patient identification barriers in the pediatric unit, and identification wristbands: a strategy to mitigate errors in the pediatric unit. Final considerations: it was possible to realize that nurses believe in the importance of patient identification as a strategy to minimize the occurrence of medication-related errors and emphasize that this act provides greater safety to professionals during the execution of procedures.

Virtualization of psychological emergency care in mental health in the COVID-19 pandemic / Virtualização dos cuidados emergenciais psicológicos em saúde mental na pandemia da COVID-19

Objective The health and humanitarian emergency caused by the COVID-19 pandemic and the measures of physical distancing and social isolation adopted required new modes of care in mental health. This article aims to define the possibilities and challenges of virtualizing emergency care, specifically psychologist on duty service and psychological first aid. Method An integrative literature review was carried out from 2016 to 2021 in databases. Results A total of thirteen articles were selected, which culminated in the themes: emergency care practices in times of crisis; and implementation of virtualization with its potential and limits. Conclusion One can conclude that virtual care is a way to democratize access to mental health services, but this process has limitations. However, further studies are needed to increase the reach of virtual care in emergency mental health care, in order to allow maximization of the potential of this modality.

Objetivo A emergência sanitária e humanitária causada pela pandemia da COVID-19 e as medidas de distanciamento e isolamento social adotadas exigiram novos modos de cuidado em saúde mental. O presente artigo objetiva descrever as possibilidades e os desafios da virtualização dos cuidados emergenciais, especificamente o plantão psicológico e os primeiros cuidados psicológicos. Método Foi realizada revisão integrativa da literatura no período de 2016 a 2021 em bancos de dados. Resultados Foram selecionados 13 artigos, que culminaram nos temas: práticas de cuidado emergencial em momentos de crise; e implementação da virtualização com suas potencialidades e limites. Conclusão Conclui-se que os atendimentos virtuais são uma forma de democratizar o acesso aos serviços de saúde mental, mas esse processo apresenta limitações. Em todo caso, é preciso realizar mais estudos para aumentar o alcance dos atendimentos virtuais nos cuidados emergenciais em saúde mental, para que seja possível maximizar as potencialidades dessa modalidade.

Perspectiva de enfermeiras obstetras: utilização de métodos não farmacológicos para alívio da dor do parto / Obstetric nurses' perspective: use of nonpharmacologicalmethods for the relief of labor pain / Perspectiva del personal de enfermería obstétrica: uso de métodos no farmacológicos para el alivio del dolor de parto

Objetivos: Compreender a perspectiva de enfermeiras obstetras sobre a utilização de métodos não farmacológicos para alívio da dor do parto. Métodos: Trata-se de uma pesquisa qualitativa, descritiva e exploratória, realizada com enfermeiras obstetras, convidadas por meio eletrônico e entrevistadas via Google Duo. Os dados foram analisados pelo software IRAMUTEQ e submetidos à técnica de análise de conteúdo. Resultados: Participaram da pesquisa nove enfermeiras, nas falas as palavras que mais ocorreram foram: parto natural, humanizado, massagem, enfermagem, bola, alívio, chuveiro e acompanhante. Na análise de conteúdo surgiram três categorias: Importância do parto natural; Métodos que humanizam o parto; Alívio da dor; Importância da enfermagem no parto humanizado. Conclusão: O parto natural oferece benefícios mesmo sendo a via mais dolorosa, por isso, a utilização dos métodos que humanizam o parto diminui a dor, a tensão, auxiliam no relaxamento, aceleram as fases latente e ativa, também favorecendo uma experiência de parto positiva. (AU).

Objectives: To understand the perspective of obstetric nurses on the use of nonpharmacological methods for the relief of labor pain. Method: This is a qualitative, descriptive and exploratory research, conducted with obstetric nurses, invited electronically and interviewed via Google Duo. Data were analyzed using IRAMUTEQ software and submitted to the content analysis technique. Results: Nine nurses participated in the research, and the words that occurred the most were: natural childbirth, humanized, massage, nursing, ball, relief, shower, and companion. In the content analysis three categories emerged: Importance of natural childbirth; Methods that humanize childbirth; Pain relief; Importance ofnursing in humanized childbirth. Conclusion: Natural childbirth offers benefits even though itis the most painful route, so the use of methods that humanize childbirth decreases pain, tension, assists in relaxation, accelerates the latent and active phases, also favoring a positive birth experience. (AU).

Objetivos: Comprender la perspectiva de las enfermeras obstetras sobre el uso de métodos nofarmacológicos para el alivio del dolor de parto. Método: Se trata de una investigación cualitativa, descriptiva y exploratoria, realizada con enfermeras obstétricas, convocadas por vía electrónica y entrevistadas vía Google Duo. Los datos se analizaron con el software IRAMUTEQ y se sometieron a la técnica de análisis de contenido. Resultados: Participaron de la pesquisa nueve enfermeras, en las cuales las palabras que más aparecieron fueron: parto natural, humanizado, masaje, enfermería, bola, alívio, chuveiro y acompañante. En el análisis de contenido surgieron tres categorías: Importancia del parto natural; Métodos que humanizanel parto; Alivio del dolor; Importancia de la enfermería en el parto humanizado. Conclusión: El parto natural ofrece beneficios aunque la vía sea más dolorosa, por lo que la utilización de los métodos que humanizan el parto disminuyen el dolor, la tensión, ayudan a la relajación, aceleran las fases latentes y activas, favoreciendo también una experiencia de parto positiva. (AU).

Short-term effectiveness of transcranial direct current stimulation in the nociceptive behavior of neuropathic pain rats in development.

Neuropathic pain (NP) is caused by a lesion that triggers pain chronification and central sensitization and it can develop in a different manner, dependent of age. Recent studies have demonstrated the efficacy of transcranial direct current stimulation (tDCS) for treating NP. Then, we aimed to investigate the effects of tDCS and BDNF levels in neuropathic pain rats in development, with 30 days old in the beginning of experiments. Eight-five male Wistar rats were subjected to chronic constriction injury. After establishment of NP, bimodal tDCS was applied to the rats for eight consecutive days, for 20 minutes each session. Subsequently, nociceptive behavior was assessed at baseline, 14 days after surgery, 1 day and 7 days after the end of tDCS. The rats were sacrificed 8 days after the last session of tDCS. An increase in the nociceptive threshold was observed in rats in development 1 day after the end of tDCS (short-term effect), but this effect was not maintained 7 days after the end of tDCS (long-term effect). Furthermore, brain derived neurotrophic factor (BDNF) levels were analyzed in the frontal cortex, spinal cord and serum using ELISA assays. The neuropathic pain model showed an effect of BDNF in the spinal cord of rats in development. There were no effects of BNDF levels of pain or tDCS in the frontal cortex or serum. In conclusion, tDCS is an effective technique to relieve nociceptive behavior at a short-term effect in neuropathic pain rats in development, and BDNF levels were not altered at long-term effect.

Transmídia na enfermagem pediátrica para orientações aos familiares no enfrentamento da COVID-19: relato de experiência / Transmedia en enfermería pediátrica para orientación a familiares en el enfrentamiento al COVID-19: relato de experiencia / Transmedia in pediatric nursing for guidance to family members in coping with COVID-19: experience report

Objetivo: descrever a experiência da transmídia na enfermagem pediátrica para orientações aos familiares sobre os cuidados aos recém-nascidos e às crianças no enfrentamento da covid-19. Método: relato de experiência sistematizado em cinco tempos (ponto de partida, perguntas iniciais, recuperação do processo vivido, reflexão de fundo e pontos de chegada), oriundo de um projeto de iniciação tecnológica, com dados do período de agosto 2021/junho 2022, sobre a publicação de conteúdos transmidiáticos, referentes aos cuidados na infância em tempos de covid-19, tendo como público-alvo os familiares de recém-nascidos e crianças. Resultados: conteúdos foram criados e publicados em diversas mídias sociais (Instagram, Facebook, Spotify, Youtube e WhatsApp), permitindo durante a pandemia, o compartilhamento, de forma convergente, de orientações científicas fidedignas e confiáveis. Conclusão: a transmídia na enfermagem pediátrica mostrou-se inovadora, dinâmica e proveitosa, além de baixo custo e grande potencial de abrangência.

Objective: to describe the experience of transmedia in pediatric nursing for guidance to family members on care for newborns and children in coping with covid-19. Method: experience report systematized in five stages (starting point, initial questions, recovery of the lived process, background reflection and points of arrival), from a technological initiation project, with data from the period of August 2021/June 2022, on the publication of transmedia content, referring to childhood care in times of covid-19, with the target audience being family members of newborns and children. Results: content was created and published on several social media (Instagram, Facebook, Spotify, Youtube and WhatsApp), allowing during the pandemic the convergent sharing of reliable scientific guidelines. Conclusion: transmedia in pediatric nursing proved to be innovative, dynamic and profitable, in addition to low cost and great potential for coverage.

Objetivo: describir la experiencia de transmedia en enfermería pediátrica para orientar a los familiares sobre el cuidado del recién nacido y del niño en el enfrentamiento al covid-19. Método: relato de experiencia sistematizado en cinco etapas (punto de partida, preguntas iniciales, recuperación del proceso vivido, reflexión de antecedentes y puntos de llegada), de un proyecto de iniciación tecnológica, con datos del período agosto 2021/junio 2022, a partir de la publicación de contenido transmedia, referente al cuidado de la infancia en tiempos de covid-19, siendo el público objetivo familiares de recién nacidos y niños. Resultados: se crearon y publicaron contenidos en diversas redes sociales (Instagram, Facebook, Spotify, Youtube y WhatsApp), que permitieron, durante la pandemia, compartir, de forma convergente, orientaciones científicas fidedignas y confiables. Conclusión: el transmedia en enfermería pediátrica demostró ser innovador, dinámico y fructífero, además de ser de bajo costo y con gran potencial de cobertura.