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São Luís, Brazil

Garcia J.B.S.,Federal University of Maranhao | Rodrigues R.F.,Federal University of Maranhao | Lima S.F.,University Ceuma
Revista Brasileira de Anestesiologia

Background and objectives: In Brazil, palliative care (PC) is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. Experience report: The hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. Conclusion: This experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals. © 2013 Sociedade Brasileira de Anestesiologia. Source

De Farias Rocha F.A.,Federal University of Para | Gomes B.D.,Federal University of Para | De Lima Silveira L.C.,Federal University of Para | De Lima Silveira L.C.,University Ceuma | And 4 more authors.

A new method is presented to determine the retinal spectral sensitivity function S(λ) using the electroretinogram (ERG). S(λ)s were assessed in three different species of myomorph rodents, Gerbils (Meriones unguiculatus), Wistar rats (Ratus norvegicus), and mice (Mus musculus). The method, called AC Constant Method, is based on a computerized automatic feedback system that adjusts light intensity to maintain a constant-response amplitude to a flickering stimulus throughout the spectrum, as it is scanned from 300 to 700 nm, and back. The results are presented as the reciprocal of the intensity at each wavelength required to maintain a constant peak to peak response amplitude. The resulting S(λ) had two peaks in all three rodent species, corresponding to ultraviolet and M cones, respectively: 359 nm and 511 nm for mice, 362 nm and 493 nm for gerbils, and 362 nm and 502 nm for rats. Results for mouse and gerbil were similar to literature reports of S(λ) functions obtained with other methods, confirming that the ERG associated to the AC Constant-Response Method was effective to obtain reliable S(λ) functions. In addition, due to its fast data collection time, the AC Constant Response Method has the advantage of keeping the eye in a constant light adapted state. © 2016 Rocha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

Madeira H.G.R.,Federal University of Maranhao | Garcia J.B.S.,Federal University of Maranhao | Lima M.V.V.,University Ceuma | Serra H.O.,Federal University of Maranhao
Revista Brasileira de Ginecologia e Obstetricia

PURPOSE: To determine the prevalence of low back pain in pregnant women and to describe its characteristics and associated factors. METHODS: The participants were 269 pregnant women in the first to the third trimester of pregnancy, seen at the obstetrics outpatient clinic of a University Hospital in the Brazilian Northeast. We applied a questionnaire in order to obtain data regarding socio-demographic variables, obstetric history and characteristics of low back pain, as well as the Oswestry and Rolland Morris questionnaires to assess disability and a visual analog pain scale to measure pain intensity. RESULTS: The prevalence of low back pain was 73%, with the following characteristics: stabbing (62/31.6%), irradiation (162/82.6%), of daily frequency (105/53.5%), usually starting at night (83/42.3%) when it was also more intense (122/62.2%), and lasting about 1 hour in 118 women (60.2%). Pain improved with rest (100/51%), worsened when the women stood or sat for a long time (86/43.9%) and when they did housework (85/43.4%). The level of disability ranged from "mild" to "moderate" in most cases. Urinary tract infection (p=0.02) and the scores of the Oswestry and Rolland Morris questionnaires showed significant association with the visual analogue pain scale. CONCLUSION: The prevalence of back pain among pregnant women is high, with varying characteristics. The degree of disability is usually moderate and the presence of urinary infection and higher disability scores were associated with greater intensity of low back pain. Source

Bento-Torres N.V.O.,Federal University of Para | Rodrigues A.R.,Federal University of Para | Cortes M.I.T.,Federal University of Amapa | De Oliveira Bonci D.M.,University of Sao Paulo | And 3 more authors.

We have used the Farnsworth-Munsell 100-hue (FM 100) test and Mollon-Reffin (MR) test to evaluate the colour vision of 93 subjects, 30.4 ± 9.7 years old, who had red-green congenital colour vision deficiencies. All subjects lived in Belém (State of Pará, Brazil) and were selected by the State of Pará Traffic Department. Selection criteria comprised the absence of visual dysfunctions other than Daltonism and no history of systemic diseases that could impair the visual system performance. Results from colour vision deficient were compared with those from 127 normal trichromats, 29.3 ± 10.3 years old. For the MR test, measurements were taken around five points of the CIE 1976 colour space, along 20 directions irradiating from each point, in order to determine with high-resolution the corresponding colour discrimination ellipses (MacAdam ellipses). Three parameters were used to compare results obtained from different subjects: diameter of circle with same ellipse area, ratio between ellipse's long and short axes, and ellipse long axis angle. For the FM 100 test, the parameters were: logarithm of the total number of mistakes and positions of mistakes in the FM diagram. Data were also simultaneously analysed in two or three dimensions as well as by using multidimensional cluster analysis. For the MR test, Mollon-Reffin Ellipse #3 (u' = 0.225, v' = 0.415) discriminated more efficiently than the other four ellipses between protans and deutans once it provided larger angular difference in the colour space between protan and deutan confusion lines. The MR test was more sensitive than the FM 100 test. It separated individuals by dysfunctional groups with greater precision, provided a more sophisticated quantitative analysis, and its use is appropriate for a more refined evaluation of different phenotypes of red-green colour vision deficiencies. © 2016 Bento-Torres et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

Fernandes E.S.,University Ceuma | Vong C.T.,Kings College London | Quek S.,Kings College London | Cheong J.,Kings College London | And 8 more authors.
FASEB Journal

The underlying mechanisms of itch are poorly understood. We have investigated a model involving the chemoattractant leukotriene B4 (LTB4) that is up-regulated in common skin diseases. Intradermal injection of LTB4 (0.1 nmol/site) into female CD1 mice induced significant scratching movements (used as an itch index) compared with vehicle-injected (0.1% bovine serum albumin-saline) mice. Intraperitoneal transient receptor potential (TRP) channel antagonist treatment significantly inhibited itch as follows: TRP vanilloid 1 (TRPV1) antagonist SB366791 (0.5 mg/kg, by 97%) and the TRP ankyrin 1 (TRPA1) antagonists TCS 5861528 (10 mg/kg; 82%) and HC-030031 (100 mg/kg; 76%). Leukotriene B4 receptor 2 antagonism by LY255283 (5 mg/kg i.p.; 62%) reduced itch. Neither TRPV1-knockout (TRPV1-KO) nor TRPA1-knockout (TRPA1-KO mice exhibited LTB4-induced itch compared with their wild-type counterparts. The reactive oxygen species scavengers N-acetylcysteine (NAC; 204 mg/kg i.p.; 86%) or superoxide dismutase (SOD; 10 mg/kg i.p.; 83%) also inhibited itch. LTB4-induced superoxide release was attenuated by TCS 5861528 (56%) and HC- 030031 (66%), NAC (58%), SOD (50%), and LY255283 (59%) but not by the leukotriene B4 receptor 1 antagonist U-75302 (9 nmol/site) or SB366791. Itch, superoxide, and myeloperoxidase generation were inhibited by the leukocyte migration inhibitor fucoidan (10 mg/kg i.v.) by 80, 61, and 34%, respectively. Myeloperoxidase activity was also reduced by SB366791 (35%) and SOD (28%). TRPV1-KO mice showed impaired myeloperoxidase release, whereas TRPA1-KO mice exhibited diminished production of superoxide. This result provides novel evidence that TRPA1 and TRPV1 contribute to itch via distinct mechanisms. Source

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