Objetivo: Ejemplificar la valoración del estrés, distrés, y coping percebidos por pacientes con heridas de difícil cicatrización (HDC), atendidos en un servicio de Terapia Enterostomal: heridas, ostomias e incontinencias. Método: Estudio secundario, observacional y prospectivo de 10 pacientes adultos con HDC, atendidos entre dos a seis consultas. Fueron aplicados el Formulário de datos sociodemográficos y clínicos; el Inventario Breve del Dor (sensibilidad - BPIS e interferencia - BPII); el Instrumento de Valoración de la Herida de Bates Jensen – BWAT; y la Escala de Estrés Percebido - PSS, la cual incluye coping e distrés. Los datos fueron expresados en promedios. Resultados: Los pacientes tenían HDC principalmente en los membros inferiores, con duración de 21,2 meses; BWAT 23,7; BPIS 4; BPII 3,2. El estrés fue caracterizado por un PSS total de 28,5 puntos, con coping 16 y distrés de 16,4 puntos. En la última consulta fue identificada la diminuición de 4,3 pontos en la BWAT; 0,8 en la BPIS; 7,6 puntos en la PSS con 5,3 en el distrés. La BPII aumentó 0,7 y el coping 2,2. Conclusión: La herida parece interferir en el nivel de estrés percibido, es decir, en la dimensión biopsicosocial del paciente. El coping destaca como factor determinante en la percepción del estrés y es esencial un enfoque multidisciplinar para su gestión y para evaluar el distrés.

Objetivo: Exemplificar a avaliação do estresse, distresse e coping percebidos por pacientes com feridas de difícil cicatrização (FDC), atendidos em ambulatório de Estomaterapia. Método: Estudo secundário, observacional e prospectivo de 10 pacientes adultos com FDC, acompanhados durante duas a seis consultas. Foram utilizados Formulário de dados sociodemográficos e clínicos; Inventário Breve de Dor (sensibilidade - BPIS e interferência - BPII); Instrumento de Avaliação da Ferida da Bates Jensen – BWAT e Escala de Estresse Percebido - PSS, incluindo coping e distresse, com dados expressos em médias. Resultados: Os pacientes tinham FDC principalmente em membro inferior, com duração de 21,2 meses; BWAT 23,7; BPIS 4; BPII 3,2. O estresse foi caracterizado por PSS total de 28,5 pontos, distresse de 16,4 e coping 16. Na última consulta foi observada diminuição de 4,3 pontos na BWAT; 0,8 na BPIS; 7,6 pontos na PSS com 5,3 no distresse. A BPII aumentou 0,7 e o coping 2,2. Conclusão: A ferida parece interferir no nível de estresse percebido, ou seja, na dimensão biopsicossocial do paciente. O coping se destaca como um fator determinante na percepção do estresse e uma abordagem multidisciplinar é essencial para o seu manejo e para a avaliação do distresse.

Objective: To exemplify the stress, distress, and coping assessment perceived by patients with hard-to-heal wounds (HHW) receiving treatment in a Stomatherapy outpatient clinic. Methods: Observational, prospective secondary study involved 10 adult patients with HHW, who were followed over two to six consultations. The following tools were used: sociodemographic and clinical data form; Brief Pain Inventory (sensitivity - BPI-S and interference - BPI-I); Bates-Jensen Wound Assessment Tool (BWAT); Perceived Stress Scale (PSS), which included measures of coping and distress with data expressed as means. Results: Patients primarily had HHW located on the lower extremities, with a duration of 21.2 months; BWAT score was 23.7; BPI-S was 4; and BPI-I was 3.2. Stress was characterized by a total PSS score of 28.5 points, with a distress score of 16.4 and a coping score of 16. In the final consultation, there was a decrease of 4.3 points in BWAT; 0.8 points in BPI-S; and 7.6 points in PSS, with a 5.3 point reduction in distress. The BPI-I increased by 0.7, and coping improved by 2.2. Conclusion: The wound seems to interfere with the level of perceived stress, i.e. the patient's biopsychosocial dimension. Coping stands out as a determining factor in the perception of stress, and a multidisciplinary approach is essential for its management and assessment of distress.

ABSTRACT: Buccal mucosal grafts are versatile in medical practice, documented minimally despite potential in otolaryngology, ophthalmology, dermatology, plastic surgery and urology. They offer advantages such as being hairless, easily obtained, and infection-resistant, with a thin, highly vascularized epithelial layer aiding absorption and reducing contracture risk. Complications from oral donor sites, like pain and sensory changes, are known, relevant in conditions such as Fournier's gangrene, necessitating urgent surgical intervention and often reconstruction. We present a case report of a 45-year-old male with Fournier's gangrene treated jointly by urology and maxillofacial surgery. Buccal mucosal grafts were harvested from the inner cheek mucosa for simultaneous urethral reconstruction. The procedure preserved the parotid duct, obtaining a graft comprising mucosal, submucosal, and glandular tissues, applied to the urethral defect with bovine dermis coverage. Postoperative recovery was uneventful, with successful catheter removal in 2 weeks and complete donor site healing in 6 months. Buccal mucosal grafts prove effective in complex reconstruction, offering structural integrity and minimal morbidity. Despite challenges like graft contraction and limited tissue availability in severe cases, buccal mucosal grafts are favored for reliability and patient satisfaction in reconstructive needs, notably urethral reconstruction. The evidence shows a high success rate in most of the uses of buccal mucosal grafts, so it is recommended as an effective and safe graft for extraoral reconstructions, particularly urethral reconstruction, where the Maxillofacial Surgeon is part of the interdisciplinary team. Awareness of potential complications and procedural limitations ensures optimal outcomes and patient care.

RESUMEN: Los injertos de mucosa bucal son versátiles en la práctica médica, documentados mínimamente a pesar de su potencial en otorrinolaringología, oftalmología, dermatología, cirugía plástica y urología. Ofrecen ventajas como la ausencia de vello, facilidad de obtención y resistencia a infecciones, con una capa epitelial delgada y altamente vascularizada que favorece la absorción y reduce el riesgo de contractura. Se conocen complicaciones de los sitios donantes orales, como dolor y cambios sensoriales, que son relevantes en condiciones como la gangrena de Fournier, que requieren intervención quirúrgica urgente y a menudo reconstrucción. Presentamos el reporte de caso de un hombre de 45 años con gangrena de Fournier tratado de manera conjunta por Urología y Cirugía maxilofacial. Se obtuvo injertos de mucosa bucal de la mucosa interna de la mejilla para la reconstrucción uretral simultánea. El procedimiento preservó el conducto parotídeo, obteniendo un injerto que comprendía tejidos mucosos, submucosos y glandulares, aplicado al defecto uretral con cobertura de dermis bovina. La recuperación postoperatoria curso sin complicaciones, con la retirada exitosa del catéter a las 2 semanas y la completa cicatrización del sitio donante en 6 meses. Los injertos de mucosa bucal demuestran ser efectivos en reconstrucciones complejas, ofreciendo integridad estructural y mínima morbilidad. A pesar de los desafíos, como la contracción del injerto y la disponibilidad limitada de tejido en casos severos, los injertos de mucosa bucal son preferidos por su fiabilidad y satisfacción del paciente en necesidades reconstructivas, especialmente en la reconstrucción uretral. La evidencia muestra una alta tasa de éxito en la mayoría de los usos de injertos de mucosa bucal, por lo que se recomienda como un injerto eficaz y seguro para reconstrucciones extraorales, particularmente en la reconstrucción uretral, donde el cirujano maxilofacial forma parte del equipo interdisciplinario. La conciencia sobre las posibles complicaciones y limitaciones del procedimiento asegura resultados óptimos y un adecuado cuidado del paciente.

Abstract Introduction: Recent evidence indicates that mindfulness-based programs (MBPs) improve overall well-being and the ability to cope with kidney failure and hemodialysis stressors. However, intradialytic MBPs are poorly investigated. Objective: The aim of this study was to describe the study protocol, evaluate the feasibility and perceived effects of the Hemomindful Program. Methods: The results presented are from a mixed-methods randomized controlled trial. Thirty-two adults with kidney failure were randomized into the Hemomindful Program, which consisting of 8 weekly individual sessions of 1 hour delivered at chairside during hemodialysis combined with the treatment as usual (TAU), or TAU alone. Feasibility was assessed based on retention of the study protocol, adherence to the Hemomindful Program, its safety, and participant satisfaction. Semi-structured interviews were conducted with participants in the intervention arm immediately following treatment. Data were analyzed using descriptive statistics and discursive textual analysis. Results: The overall rate of adherence to the study protocol was 84.38%. Among the participants in the Hemomindful Program (n = 16), 15 had four or more sessions (93.7%) and 12 completed the protocol (75%). Degree of importance attributed to the intervention was 8.58 (SD = 2.06) and intention to maintain the formal and informal mindfulness practices after the intervention was 6.67 (SD = 2.93) and 8.5 (SD = 2.31). The qualitative analysis indicated satisfaction with the perceived changes (greater awareness in daily activities, less reactivity, management of pain and discomfort) and the structure of the program. Conclusion: The Hemomindful Program showed positive indicators of feasibility, with good retention, acceptability and safety. Introduction mindfulnessbased (MBPs wellbeing well being stressors However investigated Objective Methods mixedmethods mixed methods trial Thirtytwo Thirty two TAU, , (TAU) alone safety Semistructured Semi structured Results 8438 84 38 84.38% n 16, 16 16) 93.7% 937 93 7 (93.7% 75%. 75 75% . (75%) 858 58 SD 2.06 206 2 06 667 6 67 6.6 2.93 293 85 5 8. 2.31. 231 2.31 31 2.31) greater activities reactivity discomfort program Conclusion (TAU 843 3 84.38 93.7 9 (93.7 (75% 2.0 20 0 66 6. 2.9 29 23 2.3 84.3 93. (93. (75 2. 84. (93 (7 (9 (

Resumo Introdução: egundo evidências recentes, os programas baseados em mindfulness (PBM) melhoram o bem-estar geral e a capacidade de lidar com a insuficiência renal e os fatores de estresse na hemodiálise. Entretanto, PBM intradialíticos são pouco investigados. Objetivo: Descrever o protocolo do estudo, avaliar a viabilidade e efeitos percebidos do Programa Hemomindful. Métodos: Os resultados apresentados são de um ensaio clínico randomizado de métodos mistos. Trinta e dois adultos com insuficiência renal foram randomizados para o Programa Hemomindful, que consiste em 8 sessões individuais semanais de 1 hora realizadas na cadeira durante a hemodiálise, combinadas com o tratamento usual (TAU), ou TAU isolado. A viabilidade foi avaliada conforme retenção do protocolo, adesão ao Programa Hemomindful, sua segurança e satisfação do participante. Realizamos entrevistas semiestruturadas com participantes do braço de intervenção imediatamente após o tratamento. Dados foram analisados utilizando estatísticas descritivas e análise textual discursiva. Resultados: A taxa geral de adesão ao protocolo foi de 84,38%. Entre os participantes do Programa (n = 16), 15 realizaram quatro ou mais sessões (93,7%) e 12 completaram o protocolo (75%). O grau de importância atribuído à intervenção foi 8,58 (DP = 2,06) e a intenção de manter as práticas formais e informais de mindfulness após a intervenção foi 6,67 (DP = 2,93) e 8,5 (DP = 2,31). A análise qualitativa indicou satisfação com as mudanças percebidas (maior consciência nas atividades diárias, menor reatividade, manejo da dor e desconforto) e com a estrutura do programa. Conclusão: O Programa Hemomindful apresentou indicadores positivos de viabilidade, com boa retenção, aceitabilidade e segurança. Introdução recentes (PBM bemestar bem estar hemodiálise Entretanto investigados Objetivo estudo Métodos mistos TAU, , (TAU) isolado participante discursiva Resultados 8438 84 38 84,38% n 16, 16 16) 93,7% 937 93 7 (93,7% 75%. 75 75% . (75%) 858 58 DP 2,06 206 2 06 667 6 67 6,6 2,93 293 85 5 8, 2,31. 231 2,31 31 2,31) maior diárias reatividade desconforto programa Conclusão (TAU 843 3 84,38 93,7 9 (93,7 (75% 2,0 20 0 66 6, 2,9 29 23 2,3 84,3 93, (93, (75 2, 84, (93 (7 (9 (

A huge number of South Africans, including Christians, are emigrating to the Western world, which is experiencing a serious regression in Christianity. Unfortunately, the contribution made by South African Christian emigrants has not been sufficiently examined; hence there is no literature on this particular topic. Given this, the objective of this article was to provide a comprehensive discussion of the contemporary emigration situation in South Africa and assess how South African emigrants can evangelise the post-Christendom West, which is, fortunately, still Christian and Christian tolerant. The article dialogued with relevant literature to accomplish the proposed objective and provide an overview of the push and pull factors of why South Africans emigrate to the United Kingdom, Australia, the United States of America, New Zealand and many other countries, all of which used to send missionaries abroad, but they are now experiencing exponential growth in atheism. Further, the article discussed the unprecedented growth of Christianity in Africa, particularly South Africa, in contrast to the opposite trends in the Western world, thus, establishing how South African Christian emigrants can contribute towards evangelising the post-Christendom West, according to the biblical notion that God advances his kingdom through migration in centripetal and centrifugal ways. Thus, although the emigration of South African Christians to the West is associated with pain and sorrow, it is not an accident, but God uses it in his scheme to accomplish his redemptive purposes and plans for the world. In this case, emigration in South Africa is viewed as a missiological opportunity. INTRADISCIPLINARY AND/OR INTERDISCIPLINARY IMPLICATIONS: The focus of the article is interdisciplinary, that is, it discusses the emigration phenomenon in South Africa (migration) and its contribution to the advancement of God's Kingdom to the West (missiology). The article challenges South African Christian emigrants to the Western world to perceive their migration as an evangelical and missiological opportunity.

BACKGROUND: The pectoralis minor muscle (PMM) length is critical for shoulder movement and stability, often implicated in dysfunction and pain. The pectoralis minor index (PMI) quantifies this muscle's length relative to body dimensions. Typical PMI values range from 10.0 cm to 12.5 cm in healthy adults, with data for Kenyan populations. OBJECTIVES: This study aimed to establish baseline PMI values among healthy 18-24-year-old university students in Kenya, examining variations by side dominance and sex to support clinical assessments. METHOD: A cross-sectional descriptive study recruited 289 healthy young adults from Jomo Kenyatta University of Agriculture and Technology (JKUAT) using stratified and simple random sampling. Data were collected through a self-developed, interviewer-administered questionnaire, achieving a 93.4% response rate. PMI values were measured in three postures: supine, relaxed, and standing. RESULTS: In the standing relaxed position, the PMI mean was 10.6 cm on the dominant side and 11.2 cm on the non-dominant side, with significant variation indicated by a 95% confidence interval. A paired t-test revealed a significant difference between dominant and non-dominant sides (p < 0.0001). CONCLUSION: Baseline PMI values for Kenyan young adults show significant differences by dominance and sex. These findings provide a foundational reference for assessing PMI in clinical settings, supporting physiotherapists and clinicians in evaluating and treating shoulder dysfunction using precise muscle length data. CLINICAL IMPLICATIONS: Establishing baseline PMI values assists physiotherapists in identifying deviations, enabling targeted interventions for shoulder dysfunction.

RESUMO Objetivo: Analisar o efeito do método reequilíbrio toracoabdominal (RTA) na biomecânica respiratória, desconforto respiratório, sensação dolorosa e parâmetros fisiológicos em recém-nascidos prematuros moderados, comparando-os com grupo controle. Métodos: Ensaio clínico randomizado realizado em unidade de terapia intensiva neonatal. A avaliação constou da Escala de Dor Infantil Neonatal, parâmetros fisiológicos, boletim de Silverman-Andersen, cirtometria torácica e ângulo de Charpy. Os recém-nascidos foram randomizados para o grupo RTA (n=17) ou para o grupo controle (n=13) e submetidos à técnica de aceleração de fluxo expiratório lento (AFEL). A avaliação de um único atendimento foi realizada em três momentos: antes, depois e 30 minutos depois da intervenção. Resultados: Na comparação intergrupos, houve diferença significativa na frequência respiratória 30 minutos após a intervenção (p=0,03). Não houve diferenças significativas nas comparações intra e intergrupos para dor e desconforto respiratório. No ângulo de Charpy, houve diferença significativa no grupo RTA, entre as avaliações 1 e 2 (p=0,01). O grupo RTA apresentou diferença significativa (p=0,03) entre as avaliações 1 e 3 para a cirtometria de linha axilar e entre as avaliações 2 e 3 no processo xifoide. No grupo controle, houve diferença significativa da linha axilar entre as avaliações 1 e 2 (p=0,04) e 2 e 3 (p<0,001). Conclusões: O método RTA apresentou efeito positivo na frequência respiratória e na biomecânica respiratória quando comparado ao grupo controle. Em ambos os grupos, as técnicas não promoveram desconforto respiratório ou sensação dolorosa, tornando-as seguras para essa população.

ABSTRACT Objective: To analyze the effect of the thoracoabdominal rebalancing (TAR) method on respiratory biomechanics, respiratory discomfort, pain sensation, and physiological parameters in moderate preterm newborns, compared to a control group. Methods: This randomized clinical trial was conducted in a neonatal intensive care unit. The evaluation included: Neonatal Infant Pain Scale, physiological parameters, Silverman-Andersen score, and biomechanics (thoracic cirtometry and Charpy angle). The newborns were randomized into the TAR group (n=17) or control group (n=13) and subjected to the slow expiratory flow acceleration technique (SEFA). The evaluation of a single session was performed three times: before, after, and 30 minutes after the intervention. Results: In the intergroup comparison, there was a significant difference in respiratory rate 30 minutes after the intervention. There was no significant difference in intra- and intergroup comparisons for pain and respiratory discomfort. Regarding biomechanics, there was a significant difference in the TAR group in the Charpy angle (between assessments 1 and 2), in the axillary cirtometry (between assessments 1 and 3), and in the xiphoid process (between assessments 2 and 3). In the control group, a significant difference was observed in the axillary line (between assessments 1 and 2; 2 and 3). Conclusions: The TAR method showed a positive effect on respiratory rate and respiratory biomechanics when compared to the control group. In both groups, the techniques did not promote respiratory discomfort or pain sensation, making them safe techniques for this population.

Abstract Background: This study examines the impact of Phα1β, a spider peptide derived from the venom of Phoneutria nigriventer, on the Kv11.1 potassium channel in HEK293 cells transfected with the human ERG potassium channel. Phα1β inhibits high-voltage calcium channels and acts as an antagonist of the TRPA1 receptor, both of which play crucial roles in pain transduction pathways. Over the past 15 years, our research has demonstrated the potential of Phα1β, in both its native and recombinant forms, as a promising analgesic drug through preclinical tests conducted on rodent pain models. Regulatory agencies require the evaluation of new drugs on human ERG channels. Methods: To assess hERG potassium channel inhibition, we utilized the FLIPR® Potassium Assay, a commercially available kit. The assay involved testing the effects of Phα1β alongside the well-established hERG potassium channel blocker dofetilide, which served as a positive control. The viability of HEK-293 cells was assessed using the colorimetric MTT reduction test (3-(4, dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), whereby viable cells reduce the MTT salt, forming a formazan complex within their mitochondria, as previously described. Results: Phα1β was tested at concentrations of 56, 225, 450, and 900 pMol, resulting in a discreet inhibition of hERG potassium channel activity at higher concentrations, approximately 13.47%, with an IC50 value exceeding 900 pMol. Dofetilide, administered at concentrations ranging from 0.0001 to 10 µM, displayed a concentration-dependent inhibition of the hERG potassium channel, with a mean IC50 value of 0.1642 µM (0.1189-0.2282 µM). To evaluate cytotoxicity, HEK293-hERG cells were exposed to Phα1β concentrations of 56/900 pMol for 24 hours, resulting in no significant alteration in cell viability. Conclusion: Our findings indicate that even at high concentrations, Phα1β does not impede the functionality of the hERG potassium channel nor affect cell viability.

Resumo Introdução: O exercício físico regular promove o alívio da dor, reduzindo a facilitação central dos mecanismos álgicos. Objetivo: Avaliar o efeito de diferentes frequências de exercício físico (uma, duas ou três vezes por semana) em diferentes modalidades (treinamento aeróbico, treinamento de alongamento e treinamento de força), na dor na articulação do joelho e no nível de independência em pessoas com osteoartrite de joelho. Métodos: Este artigo é um estudo transversal e utilizou o STROBE-Checklist: estudos transversais. Foram avaliados 193 idosos. Foram analisadas dor e independência funcional. Resultados: Para a variável dor, houve diferença estatística a favor da intervenção nas comparações controle versus força 1 e 2 vezes por semana e alongamento 3 vezes por semana, já na variável Lawton, apenas a comparação controle versus aeróbico 1 vez por semana não se mostrou estatisticamente diferente. Conclusão: A modalidade de exercício e a frequência semanal parecem afetar a percepção da dor, exercícios de alongamento realizados três vezes por semana, bem como exercícios de fortalecimento muscular, independente da frequência semanal são eficientes na analgesia da dor articular. A prática de exercícios de força muscular, independente da frequência semanal e exercícios aeróbicos e de alongamento pelo menos duas vezes por semana, aumenta e/ou mantém as AIVD. Nível de Evidência II; Estudos Transversais.

Abstract Background: Regular physical exercise promotes pain relief, reducing the central facilitation of pain mechanisms. Objective: Evaluate the effect of different frequencies of physical exercise (once, twice, or three times a week) on different modalities (aerobic training, stretching training, and strength training), on the pain in the knee joint, and on the level of independence on people with knee osteoarthritis. Methods: Is cross-sectional and used the STROBE-Checklist: cross-sectional studies. A total of 193 elderly people were evaluated, pain and functional independence were analyzed. Results: For the pain variable, there was a statistical difference in favor of the intervention in the comparisons control versus strength 1 and 2 times a week and stretching 3 times a week already in the Lawton variable, only the comparison control versus aerobic 1 time a week did not prove to be statistically dignified. Conclusion: The exercise modality and the weekly frequency seem to affect the perception of pain, stretching exercises performed three times a week, as well as muscle strengthening exercises, regardless of weekly frequency are efficient in joint pain analgesia. Practicing muscle strength exercises, regardless of weekly frequency and aerobic and stretching exercises at least twice a week, increases and/or maintains IADL. Level of Evidence II; Cross-sectional Study.

RESUMO JUSTIFICATIVA E OBJETIVOS: Define-se dismenorreia primária (DP) como dor no abdômen inferior que ocorre antes ou durante a menstruação, não relacionada a doenças ou patologias. Os estudos existentes que investigaram potenciais fatores de risco para o desenvolvimento da DP e a sua incidência em vários grupos são fragmentados, controversos ou excessivamente amplos, colocando desafios à análise. Este estudo objetivou identificar potenciais fatores de risco para o desenvolvimento da DP através de um estudo de caso-controle com base na literatura. MÉTODOS: Seguindo o Strengthening the Reporting of Observational Studies in Epidemiology, (STROBE), este estudo caso-controle, de um ano, teve como objetivo estabelecer relações entre variáveis de DP e categorias de dor (leve, moderada e intensa) em 252 mulheres brasileiras. RESULTADOS: A regularidade do ciclo e intensidade do fluxo menstrual, a procura pela assistência médica e o uso de analgésicos demonstraram significância estatística (p=0,00) nas diferentes categorias de dor. Por outro lado, fatores como tabagismo, consumo de álcool, dieta diária, e as outras variáveis estudadas não foram estatisticamente relevantes. Embora, não se observou nenhuma significância estatística nessas variáveis, certas observações ainda podem ser feitas comparando o presente estudo com outros semelhantes. CONCLUSÃO: Este estudo ofereceu informações valiosas sobre os fatores de risco, intensidade da dor, padrões de fluxo menstrual e comportamento de procura ao tratamento associados à DP. Abordar estes fatores e melhorar a compreensão sobre a DP, pode melhorar o bem-estar e a qualidade de vida das mulheres afetadas por esta condição ginecológica comum.

ABSTRACT BACKGROUND AND OBJECTIVES: Primary dysmenorrhea (PD) is defined as lower abdominal pain occurring before or during menstruation, unrelated to other diseases. Existing studies investigating potential risk factors for PD development and its incidence in various groups have been fragmented, controversial, or overly broad, posing challenges for analysis. Therefore, this study aims to identify potential risk factors for PD development through a literature-based case-control study. METHODS: Following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), this one-year case-control study aimed to establish relationships between PD variables and pain categories (light, moderate, and severe) among 252 Brazilian women. RESULTS: The regularity of the menstrual cycle, intensity of menstrual flow, seeking medical assistance, and use of pain drugs demonstrated statistical significance (p=0.00) across different pain categories. Conversely, factors such as smoking, alcohol consumption, daily diet, physical activity, regular menstrual cycle, previous pregnancy, active sex life, family history of PD, pain site, and the time of onset of PD after the first menstrual cycle were not statistically significant within the pain categories. Although no statistical significance was observed, certain observations can still be drawn by comparing this study with similar ones. CONCLUSION: This study offers valuable insights into the risk factors, pain intensity, menstrual flow patterns, and treatment-seeking behavior associated with PD. By addressing these factors and improving our understanding of PD, we can enhance the well-being and quality of life of women affected by this common gynecological condition.

Abstract An association between bruxism and musculoskeletal disorders, such as neck pain, has been established. This study investigated the association of possible sleep bruxism (PSB) activities, including grinding, bracing, and thrusting, with smartphone use, smartphone-induced neck pain, and sleep features. This cross-sectional study involved 403 Brazilian adolescents aged 11 to 19 years. A self-administered questionnaire was used to assess the severity of PSB, smartphone use, smartphone-induced neck pain, and sleep features (sleep duration and quality and history of nightmares). Sociodemographic factors, as well as snoring and drooling on the pillow, were considered potential confounders and were assessed based on reports from parents/caregivers. Participants were selected using multiple-stage sampling. Descriptive analysis and multinomial regression were performed (p ≤ 0.05). Adolescents reporting nightmares at least once a month (OR = 3.402; 95%CI: 1.315–8.802) and sometimes experiencing smartphone-induced neck pain (OR: 3.697, 95%CI: 1.103–12.388) were more likely to report moderate/severe grinding. Drooling on the pillow (OR = 3.105, 95%CI: 1.316–7.329), poor/fairly good sleep quality (OR = 2.717, 95%CI: 1.279–5.770), and smartphone-induced neck pain (OR = 3.227, 95%CI: 1.121–9.285) were associated with mild bracing. Adolescents experiencing nightmares once a week (OR = 3.209, 95% CI: 1.202– 8.565) had a higher prevalence of mild thrusting. Self-reported smartphone-induced neck pain, nightmares, poor/fairly good sleep quality, and drooling on the pillow were associated with a higher prevalence of PSB activities among Brazilian adolescents. Clinicians and researchers are encouraged to include assessments of smartphone use and sleep features in anamnesis, promoting a comprehensive approach to PSB, from diagnosis to treatment.

RESUMO JUSTIFICATIVA E OBJETIVOS: Atualmente existem evidências conflitantes tanto para a atividade física quanto para o exercício físico na relação com o impacto da fibromialgia (FM). O objetivo deste estudo foi correlacionar níveis de atividade física, gravidade da doença e dor em mulheres com FM. MÉTODOS: Trata-se de um estudo transversal com 93 mulheres diagnosticadas com FM, com média de idade de 49,1±10,3 anos. O Questionário Revisado de Impacto da Fibromialgia (FIQR) foi utilizado para avaliar o impacto da doença no estado de saúde das mulheres. Para avaliar o nível de atividade física, utilizou-se a versão curta do Questionário Internacional de Atividade Física (IPAQ). A Escala Numérica de Avaliação da Dor (END) foi utilizada para avaliar a intensidade da dor das participantes. RESULTADOS: Diferenças significativas foram encontradas entre os grupos, no tocante a gravidade dos sintomas (F = 9,471; p<0,001; n2=0,174) e intensidade da dor (F = 5,074; p=0,008; n2=0,101), desfavoráveis ao grupo sedentário (p<0,05). Correlações inversas significativas foram encontradas em avaliações de níveis de atividade física em intensidades leve e moderada, FIQR e dor (rs = -0,20 a -0,30). CONCLUSÃO: Mulheres sedentárias são impactadas de maneira muito severa pela doença e podem apresentar níveis mais elevados de dor. Correlações fracas e moderadas entre os níveis de atividade física, impacto da doença e intensidade da dor sugerem que a prática de atividade física em intensidades leve e moderada pode ser uma intervenção importante no tratamento da FM.

ABSTRACT BACKGROUND AND OBJECTIVES: Currently, there is conflicting evidence regarding both physical activity and exercise in relation to the impact of fibromyalgia (FM). The aim of this study was to correlate levels of physical activity, disease severity, and pain in women with FM. METHODS: This is a cross-sectional study with 93 women diagnosed with FM, with an average age of 49.1±10.3 years. The Revised Fibromyalgia Impact Questionnaire (FIQR) was used to assess the impact of the disease on the women’s health status. To evaluate the level of physical activity, the short version of the International Physical Activity Questionnaire (IPAQ) was used. The Numeric Pain Rating Scale (NPRS) was used to assess the intensity of the participants’ pain. RESULTS: Significant differences were found between the groups in terms of symptom severity (F = 9.471; p<0.001; n2=0.174) and pain intensity (F = 5.074; p=0.008; n2=0.101), which were unfavorable to the sedentary group (p<0.05). Significant inverse correlations were found in assessments of physical activity levels at light and moderate intensities, FIQR and pain (rs = -0.20 to -0.30). CONCLUSION: Sedentary women are severely impacted by the disease and may experience higher levels of pain. Weak to moderate correlations between physical activity levels, disease impact, and pain intensity suggest that engaging in physical activity at light and moderate intensities may be an important intervention in the management of FM.

RESUMO JUSTIFICATIVA E OBJETIVOS: A fibromialgia (FM) refere-se a uma condição dolorosa crônica com etiologia multifatorial, que impacta negativamente na vida de seus portadores e muitas vezes é refratária ao tratamento convencional. O objetivo do presente estudo foi relatar uma série de casos com uso de óleo essencial de Protium heptaphyllum (OEBB) para controle da dor e ansiedade de fibromiálgicos. RELATO DOS CASOS: Trata-se de uma série de casos pertencentes a um estudo experimental, aberto e autocontrolado, objetivando comprovar a eficácia e relevância do uso da aromaterapia via inalatória para a melhoria da qualidade de vida de mulheres portadoras de FM. Para isso, foi utilizado o óleo essencial obtido pela destilação por arraste a vapor da resina de OEBB. Foram selecionadas 5 mulheres acima de 50 anos com diagnóstico médico confirmado e em tratamento insuficiente com as terapêuticas tradicionais para verificar a eficácia da inalação do óleo essencial de OEBB. As pacientes foram avaliadas através do Questionário de Impactos da Fibromialgia (QIF) e da Escala Analógica Visual (EAV) antes e após a aromaterapia e os resultados foram comparados por meio do Teste T para duas amostras relacionadas. As evidências demonstraram que a inalação de OEBB não foi eficaz para diminuir a intensidade das crises álgicas (p>0,05). No entanto, ficaram comprovados benefícios em relação a melhorias na qualidade de vida como aumento da disposição, melhora do ânimo e do humor, sono reparador e diminuição da ansiedade em 46,78% (p<0,01), conforme demonstrado na pontuação obtida no QIF. CONCLUSÃO: Conclui-se que a aromaterapia via inalatória apresenta um efeito positivo para controle das comorbidades causadas pela fibromialgia. No mais, a aromaterapia é uma prática complementar que deve ser considerada uma potente adjuvante às terapias tradicionais, devendo sua indicação ser estimulada pelos serviços de saúde públicos e privados.

ABSTRACT BACKGROUND AND OBJECTIVES: Fibromyalgia (FM) refers to a chronic pain condition with a multifactorial etiology, which negatively impacts the lives of its sufferers and is often refractory to conventional treatment. The aim of this study is to report a series of cases using Protium heptaphyllum (OEBB) essential oil to control pain and anxiety in FM sufferers. CASE REPORTS: This is a case series of an experimental, open and self-controlled study aimed at proving the efficacy and relevance of using aromatherapy via inhalation to improve the quality of life of women with fibromyalgia (FM). For this purpose, the essential oil obtained by steam distillation of resin OEBB was used. Five women over the age of 50 with a confirmed medical diagnosis and insufficient treatment with traditional therapies were selected to verify the efficacy of inhaling OEBB essential oil. The patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and the visual analog scale (VAS) before and after aromatherapy and the results were compared using the T-test for two related samples. The evidence showed that OEBB inhalation was not effective in reducing the intensity of pain crises (p>0.05). However, there was evidence of benefits in relation to improvements in quality of life, such as an increase in disposition, improvement in mood, restorative sleep and a reduction in anxiety in 46.78% (p<0.01), as demonstrated by the score obtained on the FIQ. CONCLUSION: It can be concluded that aromatherapy via inhalation has a positive effect on controlling the comorbidities caused by fibromyalgia. Furthermore, aromatherapy is a complementary practice that should be considered a powerful adjunct to traditional therapies, and its indication should be encouraged by public and private health services.

RESUMO JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi mapear as práticas de segurança do uso de morfina para o controle da dor em pacientes oncológicos paliativos. CONTEÚDO: Trata-se de uma revisão de escopo que seguiu a metodologia do Instituto Joanna Briggs (JBI) para responder à pergunta: quais as evidências sobre as práticas de segurança do uso de morfina para o controle da dor em pacientes oncológicos paliativos? A busca foi realizada nas bases de dados Medline, LILACS, Scopus, Embase, Web of Science, Cochrane e CINAHL, bem como na literatura cinzenta. Os títulos e resumos foram avaliados por dois revisores independentes, e os trabalhos selecionados foram lidos na íntegra. Os dados extraídos estão apresentados em forma de tabelas acompanhadas de resumo narrativo. Dos 21 artigos selecionados, foram identificadas 14 práticas de gestão dos serviços no uso da morfina, 24 práticas de segurança relacionadas à prescrição de morfina, 15 práticas de segurança relacionadas ao preparo e administração de morfina, e caracterizados 16 riscos e 8 reações adversas. CONCLUSÃO: Por meio das práticas identificadas, os profissionais podem planejar um cuidado seguro, gerenciando riscos, reações adversas e promovendo um melhor controle da dor oncológica.

ABSTRACT BACKGROUND AND OBJECTIVES: The objective of this study was to map the safety practices of morphine use for pain control in palliative cancer patients. CONTENTS: This is a scoping review that followed the methodology of the Joanna Briggs Institute (JBI) to answer the question: what is the evidence on safety practices for the use of morphine for pain control in palliative cancer patients? The search was carried out in the Medline, LILACS, Scopus, Embase, Web of Science, Cochrane and CINAHL databases, as well as in the gray literature. The titles and abstracts were evaluated by two independent reviewers, and the selected papers were read in full. The data extracted is presented in the form of tables accompanied by a narrative summary. The 21 articles selected identified 14 service management practices in the use of morphine, 24 safety practices related to the prescription of morphine, 15 safety practices related to the preparation and administration of morphine and characterized 16 risks and 8 adverse reactions. CONCLUSION: Through the identified practices, professionals can plan safe care, managing risks, adverse reactions, and promoting better control of cancer pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Altas concentrações de radicais livres podem danificar ácidos nucleicos, proteínas e lipídios e o seu acúmulo pode estar envolvido na hipersensibilidade à dor. O objetivo deste estudo foi avaliar o efeito das vitaminas C e E como adjuvantes no tratamento da dor neuropática. MÉTODOS: Foram incluídos 98 pacientes com dor neuropática, classificados pelo Douleur Neuropathique 4 Questions (DN4), randomizados em dois grupos, controle e intervenção. O grupo controle recebeu 150 mg de pregabalina e o grupo intervenção150 mg de pregabalina associada a 500mg de vitamina C e 400mg de vitamina E. O tratamento e acompanhamento dos participantes foi de 12 semanas. Na avaliação inicial, os pacientes responderam ao Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) para avaliar a funcionalidade dos membros superiores; a qualidade de vida foi descrita utilizado o World Health Organization Quality of Life-Bref (WHOQOL-bref) e a avaliação da dor foi mensurada através da escala analógica visual (EAV). Após 12 semanas de tratamento, os pacientes responderam aos mesmos instrumentos. RESULTADOS: Oitenta e seis pacientes concluíram o tratamento. As perdas de participação na amostra foram por abandono do tratamento (n=7) ou por efeito adverso à pregabalina (n=5). O grupo intervenção apresentou resultados superiores em comparação com o grupo de controle. As comparações múltiplas entre grupos e momentos para os escores avaliados demonstraram uma diferença média do pré-tratamento para o pós-tratamento somente no grupo de intervenção (p < 0,05), com redução média no Quick-DASH e no EAV e um aumento médio no WHOQOL. CONCLUSÃO: Foi observado que o uso da vitamina C e E, em associação com a pregabalina, apresentou um efeito analgésico maior quando comparado ao uso isolado da pregabalina.

ABSTRACT BACKGROUND AND OBJECTIVES: High concentrations of free radicals can damage nucleic acids, proteins and lipids and their accumulation may be involved in hypersensitivity to pain. The objective of this study was to evaluate the effect of vitamins C and E as adjuvants in the treatment of neuropathic pain. METHODS: This study included 98 patients with neuropathic pain, classified by the Douleur Neuropathique 4 Questions (DN4), randomized into two groups: control and intervention. The control group received 150 mg of pregabalin and the intervention group 150 mg of pregabalin combined with 500 mg of vitamin C and 400 mg of vitamin E. Treatment and follow-up of the participants lasted 12 weeks. At the initial assessment, the patients answered the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) to assess upper limb functionality; quality of life was described using the World Health Organization Quality of Life-Bref (WHOQOL-bref) and pain assessment was measured using the visual analogue scale (VAS). After 12 weeks of treatment, the patients responded to the same instruments. RESULTS: 86 patients completed treatment. Losses of participation in the sample were due to abandonment of treatment (n=7) or adverse effects to pregabalin (n=5). The intervention group presented superior results compared to the control group. Multiple comparisons between groups and moments for the evaluated scores demonstrated a mean difference from pre-treatment to post-treatment only in the intervention group (p < 0.05), with a mean reduction in Quick-DASH and VAS and a mean increase from WHOQOL. CONCLUSION: It was observed that the use of vitamin C and E in combination with pregabalin had a greater analgesic effect than the use of pregabalin alone.

RESUMO JUSTIFICATIVA E OBJETIVOS: O uso de aparelhos ortodônticos é constantemente associado a sintomas de disfunção temporomandibular (DTM). Nesse sentido, o presente estudo visou investigar o desenvolvimento de sintomas de DTM em pacientes submetidos a tratamento ortodôntico com lifting oclusal. MÉTODOS: Trata-se de um estudo longitudinal, quantitativo e descritivo; 40 pacientes com indicação de tratamento ortodôntico participaram do estudo. Eles foram avaliados: antes do início do tratamento ortodôntico (T0), 24 horas (T1) e 30 dias (T2) após a instalação do elevador oclusal. A avaliação dos sintomas foi realizada por meio da aplicação do questionário de sintomas DC/TMD. A avaliação dos fatores psicossociais foi realizada por meio do teste “WISE Clinicians” (Web Based Interdisciplinary Symptom Evaluation). Os dados foram digitados em uma planilha do Microsoft Excel para análise estatística por meio do teste Qui-quadrado, com nível de significância de 5%. RESULTADOS: Na avaliação do T1, 42,50% (n=17) dos pacientes relataram sentir qualquer tipo de dor e 57,50% (n=23) não sentiram dor alguma. No T2, a proporção de pacientes que manifestaram dor foi de 30% (n=12), enquanto 70% (n=28) não manifestaram nenhum sintoma; 10% (n=10) dos pacientes relataram dor nos dois momentos; 37,50% (n=15) não manifestaram dor em nenhum momento da avaliação; 32,50% (n=13) apresentaram dor no primeiro momento e após a segunda avaliação não manifestaram mais dor. CONCLUSÃO: Pode-se concluir que o levantamento oclusal não foi significativo em termos de dor na maioria dos pacientes e quando comparado ao grupo controle.

ABSTRACT BACKGROUND AND OBJECTIVES: The use of orthodontic appliances is constantly associated with symptoms of temporomandibular disorder (TMD). In this sense, the present study aimed to investigate the development of TMD symptoms in patients undergoing orthodontic treatment with occlusal lifting. METHODS: This is a longitudinal, quantitative and descriptive study; 40 patients with an indication for orthodontic treatment, participating in the study. They were evaluated: before the start of orthodontic treatment (T0), 24 hours (T1) and 30 days (T2) after installation of the occlusal elevator. Symptom assessment was carried out by applying the DC/TMD symptom questionnaire. The assessment of psychosocial factors was carried out using the “WISE Clinicians” test (Web Based Interdisciplinary Symptom Evaluation). The data were entered into a Microsoft Excel spreadsheet for statistical analysis using the Chi-Square test, with a significance level of 5%. RESULTS: In the T1 assessment, 42.50% (n= 17) of patients reported feeling any type of pain and 57.50% (n= 23) did not feel any pain. At T2, the proportion of patients who reported pain was 30% (n= 12), while 70% (n= 28) did not show any symptoms; 10% (n=10) of patients reported pain at both times; 37.50% (n=15) did not experience pain at any time during the assessment; 32.50% (n=13) assessed pain at the first moment and after the second assessment they no longer expressed pain. CONCLUSION: It can be concluded that occlusal lifting was not significant in terms of pain in most patients and when compared to the control group.