Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making. Answering the question “what is the pain generator” among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet Joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.

Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety. Given this complexity, the diagnostic evaluation of patients with CLBP can be very challenging and requires complex clinical decision-making. Answering the question "what is the pain generator" among the several structures potentially involved in CLBP is a key factor in the management of these patients, since a mis-diagnosis can generate therapeutical mistakes. Traditionally, the notion that the etiology of 80% to 90% of LBP cases is unknown has been mistaken perpetuated across decades. In most cases, low back pain can be attributed to specific pain generator, with its own characteristics and with different therapeutical opportunity. Here we discuss about radicular pain, facet Joint pain, sacro-iliac pain, pain related to lumbar stenosis, discogenic pain. Our article aims to offer to the clinicians a simple guidance to identify pain generators in a safer and faster way, relying a correct diagnosis and further therapeutical approach.

Resumo Objetivo: analisar a prevalência e os fatores associados ao distúrbio de voz em professores. Métodos: estudo transversal com 317 professores. Utilizou-se o questionário Condição de Produção Vocal do Professor. A variável dependente foi o distúrbio de voz autorreferido. Foram realizadas análises bivariada, estratificada e regressão múltipla de Poisson. Resultados: a prevalência do distúrbio de voz foi de 81%. Para o estrato dos professores do ensino fundamental, apenas a poeira (RP = 1,37; IC = 1,12-1,69) foi associada ao distúrbio de voz. Para o estrato dos demais professores, as variáveis ritmo de trabalho estressante (RP = 1,81; IC = 1,17-2,82), estresse no trabalho (RP = 2,47; IC = 1,20-5,07), trabalho repetitivo (RP = 1,18; IC = 1,01-1,38), levar trabalho para casa (RP = 1,80; IC = 1,01-3,79) e escola ruidosa (RP = 1,41; IC = 1,03-1,92) apresentaram associações com distúrbio de voz. Na análise múltipla, estresse no trabalho (RP = 1,50; IC = 1,05-2,15), poeira (RP = 1,21; IC = 1,06-1,39) e falar carregando peso (RP = 1,16; IC = 1,05-1,28) permaneceram associadas ao distúrbio de voz, exceto o tempo de profissão maior ou igual a 10 anos (RP = 0,88; IC = 0,79-0,98), que apresentou efeito protetor. Conclusão: a prevalência de distúrbio de voz entre os professores é alta e os fatores associados relacionam-se ao ambiente e à organização do trabalho.

Intra-hospital transport of brain-injured NICU patients may present some hazards even if performed by skilled personnel with specialized equipment. In Trauma Centers such as ours, an improvement in the frequency of neuromonitoring [intra-cranial pressure (ICP) and end-tidal CO2 (ET(CO(2)))] during transport is recommended.

& AbstractObjective: The transversus abdominis plane (TAP) block is a relatively simple regional anesthesia technique which entails the injection of local anesthetics (LA) into the interfascial plane between the internal oblique and transversus abdominis muscles, where nerves supplying the anterolateral abdominal wall course.

Minicatheter seems to be easy, safe, and efficient when used to control pain after fibular free-flap harvesting.

A voz no teatro é a parte central do processo de criação e preparação de atores, por isso é importante o estudo e domínio do aparelho fonador e de seus recursos técnicos por parte dos mesmos para a realização de aquecimento e desaquecimento vocal. Participaram desta pesquisa 26 atores, profissionais e amadores, integrantes de grupos de teatro de Cuiabá. Observou-se que os atores possuem conhecimentos sobre a importância de se realizar os exercícios vocais, porém nem todos realizam. Há necessidade de orientação, informação e divulgação sobre os hábitos e técnicas vocais, e o papel do fonoaudiólogo no âmbito teatral.

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