Background and Objectives Chronic pain affects between 30% and 50% of the world population. Our objective was to estimate the prevalence of chronic pain in Brazil, describe and compare differences between pain types and characteristics, and identify the types of therapies adopted and the impact of pain on daily life. Methods Cross-sectional study of a population-based survey with randomized sample from a private database. The interviews were conducted by phone. 78% of the respondents aged 18 years or more agreed to be interviewed, for a total of 723 respondents distributed throughout the country. Independent variables were demographic data, pain and treatment characteristics, and impact of pain on daily life. Comparative and associative statistical analyses were conducted to select variables for nonhierarchical logistic regression. Results Chronic pain prevalence was 39% and mean age was 41 years with predominance of females (56%). We found higher prevalence of chronic pain in the Southern and Southeastern regions. Pain treatment was not specific to gender. Dissatisfaction with chronic pain management was reported by 49% of participants. Conclusion 39% of interviewed participants reported chronic pain, with prevalence of females. Gender-associated differences were found in intensity perception and interference of pain on daily life activities.
-Objective:To determine the psychological aspects of orofacial pain in trigeminal neuralgia (TN) and temporomandibular disorder (TMD), and associated factors of coping as limitations in daily activities and feelings about the treatment and about the pain. Method: 30 patients were evaluated (15 with TN and 15 with TMD) using a semi-directed interview and the Hospital Anxiety Depression (HAD) scale. Results: TN patients knew more about their diagnosis (p<0.001). Most of the patients with TN considered their disease severe (87%), in opposite to TMD (p=0.004); both groups had a high level of limitations in daily activities, and the most helpful factors to overcome pain were the proposed treatment followed by religiosity (p<0.04). Means of HAD scores were 10.9 for anxiety (moderate) and 11.67 for depression (mild), and were not statistically different between TMD and NT (p=0.20). Conclusion: TN and TMD had similar scores of anxiety and depression, therefore patients consider TN more severe than TMD. Even with higher limitations, patients with TN cope better with their disease then patients with TMD.KEy worDs: trigeminal neuralgia, TMD, surgery, orofacial pain, anxiety, depression, disease perception. avaliação psicológica e enfrentamento na neuralgia trigeminal e disfunção temporomandibularResumo -Objetivo: Comparar aspectos psicológicos de dor orofacial entre neuralgia trigeminal (NT) e disfunção temporomandibular (DTM), e repercussões em atividades diárias, enfrentamento a representação da dor. Método: 30 pacientes foram avaliados (15 com NT, 15 com DTM) utilizando entrevista semi-dirigida e a Escala Hospitalar de Ansiedade e Depressão (HAD). Resultados: Pacientes com NT sabiam melhor sobre seu diagnóstico (p<0,001). A maioria destes considerou sua doença grave (87%), em oposição a pacientes com DTM (p=0,004); ambos tiveram um alto nível de limitações durante atividades diárias, e o tratamento seguido da religiosidade foram considerados os aspectos mais positivos para superação da dor (p<0,04). Não houve diferença estatística entre os grupos quanto a HAD (p=0,20), sendo a média dos índices foi 10,9 para ansiedade (moderada) e 11,67 para depressão (leve). Conclusão: Tanto pacientes com NT como pacientes com DTM apresentaram níveis semelhantes de ansiedade e depressão, entretanto pacientes com NT consideram sua doença mais grave do que os outros doentes. Mesmo com alto grau de limitações, seu enfrentamento da doença é melhor do que o enfrentamento de doentes com DTM.PAlAvrAs-CHAvE: neuralgia trigeminal, DTM, cirurgia, dor orofacial, ansiedade, depressão, representação da doença.
BACKGROUND AND OBJECTIVES: The prevalence of the fibromyalgia syndrome has been estimated in some Brazilian cities and regions, and previous population-based studies investigating this prevalence, as well as the profile of medical consultations are unknown. METHODS: This study used the database constructed by a previous study of authors to identify the prevalence of chronic pain in Brazil. The cases that reported pain for more than 6 months and with a diagnosis of fibromyalgia were selected. The studied descriptive variables were age, intensity and frequency of pain, pain interference in self-care, walking, working, social life, sexual life, sleep quality, if pain causes sadness or depression or influences the emotional aspects. The total sample was evaluated by rheumatologists and pain-expert doctors. RESULTS: Thirteen cases from the initial database were selected since they reported the diagnosis of the prevalence of the fibromyalgia syndrome representing 2% of the initial study population, average age 35.8 years (9.8). The predominance of the fibromyalgia syndrome was in females (n=11). Pain intensity was 7.3 (2.4), the frequency and duration of pain were constant in the majority of the sample (n=9). Most of the cases report a serious pain interference with sleep (n=8), many said that pain interferes with the work (n=5), irritability (5) and finally, some report that pain has a moderate interference in self-care (n=5), walking (n=6), social life (n=6), sexual life (n=5) and causes moderate sadness or depression (n=5). CONCLUSION: The prevalence of the fibromyalgia syndrome was estimated in 2% of the Brazilian population, based on secondary data of a study on chronic pain prevalence in Brazil. The data was collected in 2015-2016. The most reported complaints were intense and daily pain that interferes with sleep. The prevalence of fibromyalgia in Brazil-a population-based study with secondary data of the study on chronic pain prevalence in Brazil A prevalência da fibromialgia no Brasil-estudo de base populacional com dados secundários da pesquisa de prevalência de dor crônica brasileira
BACKGROUND AND OBJECTIVES: Inflammation is a defense response of the body to a cellular damage caused by physical, chemical or biological agents, which triggers, among other factors, pain. Although inflammation plays an important role in the protection and regeneration of tissue injury, inflammatory pain results in decreased quality of life. In view of this, the development of safe and less invasive forms for the treatment of inflammatory pain is of great importance. The objective of this study was to evaluate the antihyperalgesic potential of the culture supernatant of keratinocytes and human fibroblasts in an experimental model of inflammatory hyperalgesia. METHODS: Evaluation of carrageenan induced inflammatory hyperalgesia through the use of electronic von Frey in animal models treated with culture supernatant of keratinocytes and fibroblasts. RESULTS: Local administration of naloxone, a nonselective opioid antagonist, in peripheral tissue, has been observed to inhibit the antihyperalgesic effect of the keratinocyte culture supernatant. Fibroblast culture supernatant on days 1 and 3 reverses for 2 hours the carrageenan induced inflammatory hyperalgesia, which is mediated by µ opioid agonist. CONCLUSION: This study indicates that culture supernatant of fibroblasts and keratinocytes is capable of inducing antinociception in inflammatory hyperalgesia, mediated by the release of Evaluation of the keratinocytes or fibroblasts culture supernatant in an inflammatory hyperalgesia model Avaliação do sobrenadante da cultura de queratinócitos ou fibroblastos em modelo de hiperalgesia inflamatória
BACKGROUND AND OBJECTIVES:Identifying and treating psychosocial, intrapsychic, relational, psychiatric and psychobehavioral factors which influence neuropathic pain nature, severity and persistence are object of scientific concern and a lot has been done in this area; however it is clear the need for further emphasis and disclosure of contents for better professional knowledge. This study aimed at outlining the psychobehavioral and psychosocial scenario by means of literature review, through some theories about pain regulation, via cognitive functioning and stress theories, although it is known that the universe of this study is too broad but the idea is to outline a panoramic view of the field. CONTENTS: Incapacity, distress, painful and unhealthy behaviors and of gains are challenging factors for the treatment of neuropathic pain patients. Notions about thinking distortion, especially caused by pain perception leading to catastrophic thoughts and decreasing the efficacy of other non-addressed interventions, as well as aspects of the psychosocial impact influencing the development of chronicity and maintenance of unhealthy patterns. CONCLUSION: Psychological interventions aiming at changing beliefs and dysfunctional behaviors, incapacities and distress, at changing neuropathic pain perception, treatment of mental decompensations such as depression and anxiety and of recurrences, are critical to manage neuropathic pain patients. It is confirmed that knowledge about adaptations in the rewarding circuits is fundamental for psychological, psychotherapeutic and psychosocial interventions to be more effective, thus preventing problems related to pathological maintenance in cases of neuropathic etiology. Keywords: Cognitive functions, Mental processes, Neuropathic pain, Psychobehavioral factors, Psychosocial factors, Stress. RESUMO JUSTIFICATIVA E OBJETIVOS:Identificar e tratar os fatores psicossociais, intrapsíquicos, relacionais, psiquiátricos e psicocomportamentais que influenciem a natureza, gravidade, persistência da dor neuropática, vem sendo objeto de preocupação científica e muito se tem progredido na área, no entanto, é vigente a necessidade de maior ênfase e divulgação dos conteúdos para melhor conhecimento no meio profissional. O presente artigo visou esboçar o panorama da área psicocomportamental e psicossocial, por meio de levantamento da literatura, através de algumas teorias acerca da regulação de dor, via teorias do funcionamento cognitivo e estresse, embora sabidamente o universo de estudo seja muito amplo, pretende esboçar uma visão panorâmica do campo. CONTEÚDO: A incapacidade, o sofrimento, os comportamentos dolorosos e doentios e dos ganhos são fatores de desafio aos tratamentos do doente com dor neuropática. Noções acerca da distorção do pensamento, particularmente, decorrente da percepção da dor induzindo a pensamentos catastróficos reduzindo a eficácia de outras intervenções não abordadas, bem como aspectos da visão do impacto psicossocial que intervêm no desenvolvimento da cronificaçã...
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