Pain symptoms in patients with severe cerebral palsy: Prevalence among patients with higher degree of locomotor impairment Clarissa de Albuquerque Botura, Franciele Queiroz Ames, Ana Clara de Albuquerque Botura, Luiz Eduardo Bersani-Amado, Aline Vieira Scarlatelli Lima Bardini, Roberto Kenji Nakamura Cuman Tropical Journal of Pharmaceutical Research, 2017 Purpose: To evaluate the presence of pain in patients diagnosed with severe cerebral palsy (CP) according to the degree of motor function impairment.Methods: A cross-sectional study was conducted on students of the Association of Parents and Friends of Exceptional Children (APAE) diagnosed with cerebral palsy and with severe locomotor disability (GMFCS levels IV and V). The study included students of both genders and of any age. After signing the consent form, a structured questionnaire was administered to parents or caregivers to collect data on the history of the illness and the Paediatric Pain Profile (PPP). A score ≥ 14 out of a possible 60 points suggests the presence of pain.Results: A total of 93 subjects were evaluated. Of the 44 subjects classified with GMFCS level IV, 12 (21.4 %) suffer pain and among the 49 subjects classified with level V, 44 (78.6 %) had pain symptoms (ICDDN ≥ 14, PR = 3.29, 95 % CI 2.01 - 5.38, p < 0.01).Conclusion: The results show that pain is prevalent in individuals with severe CP. Furthermore, it is more prevalent in patients with a higher degree of locomotor impairment (GMFCS – level V).Keywords: Cerebral palsy, Pain measurement, Locomotor disability, Gross motor function classification system (GMFCS)
The authors reply Paulo Fontoura Freitas, Bianca Carvalho Moreira, Andre Luciano Manoel, Ana Clara de Albuquerque Botura Cadernos De Saude Publica, 2015
The position of the Brazilian Federal Board of Medicine on incentives for reimbursement of childbirth care and the impact on cesarean rates Paulo Fontoura Freitas, Bianca Carvalho Moreira, Andre Luciano Manoel, Ana Clara de Albuquerque Botura Cadernos De Saude Publica, 2015 O estudo buscou investigar como o incentivo à remuneração ao parto, preconizado pelo Conselho Federal de Medicina (CFM) do Brasil, influencia as taxas de cesariana. Foi investigada uma amostra consecutiva de 600 puérperas. A proporção de cesarianas na amostra foi de 59,2%, sendo 92,3% entre as mulheres tendo parto e pré-natal com o mesmo profissional. As taxas de cesariana foram significativamente mais elevadas exatamente naqueles grupos com maior prevalência do mesmo profissional, ou seja, idade mais avançada (RP = 1,65), maior escolaridade (RP = 1,25), pré-natal privado (RP = 1,39) ou por convênio (RP = 1,43), cesariana prévia (RP = 2,78) e admitidas precocemente (RP = 1,93). O entendimento do CFM de que o incentivo ao acompanhamento presencial do trabalho de parto, pago à parte, para o mesmo obstetra que realizou o pré-natal, funcionará como incentivo ao parto normal, está exatamente na contramão de nossos resultados, mostrando que as mulheres atendidas pelo mesmo profissional no pré-natal e parto são exatamente aquelas que apresentam as taxas de cesariana mais elevadas.
Effect of ultrasound associated with calendula gel on restorative activity in experimental muscular injuries Diego Da Silva Ricoldy, Ana Clara de Albuquerque Botura, Juliano Yasuo Oda, Orlando Seiko Takemura Acta Scientiarum Health Sciences, 2010 Several techniques have been proposed as treatment for muscular injuries, and therapeutic ultrasound is one of the most used. Besides the effects of ultrasound, it also facilitates drug flow trough the tissues (phonophoresis). Calendula is a phytotherapic which presents healing elements, popularly used on injury treatments. The objective of this study was to evaluate ultrasound effectiveness, phonophoresis, and the influence of the topic application of the gel with Calendula officinalis extract, in the recovery from experimental muscular injury in rats. After the injured front tibial muscle was treated during five days, a histological analysis of the muscle was performed and the injury area was determined. The results indicated that all the ultrasound/Calendula-treated groups presented better evolution in the injury, sinasce they presented more fibroblasts, neovascularization and myoblasts in relation to the control group. As to the injured area, only the group in which the ultrasound was added to Calendula presented a significantly smaller area. In all, the obtained data demonstrate that in the experimental model studied, phonophoresis was more indicated for muscle injury treatment.
