The mechanisms underlying the pronociceptive effect of paradoxical sleep deprivation (PSD) are not known. In this study, we asked whether PSD increases tonic nociception in the formalin test, decreases the antinociceptive effect of morphine administered into the periaqueductal gray matter (PAG), and disrupts endogenous descending pain modulation. PSD for either 24 or 48 h significantly increased formalin-induced nociception and decreased mechanical nociceptive paw withdrawal threshold. The maximal antinociceptive effect induced by morphine (0.9-9 nmol, intra-PAG) was significantly decreased by PSD. The administration of a low dose of the GABAA receptor antagonist, bicuculline (30-300 pmol, intra-PAG), decreased nociception in control rats, but not in paradoxical-sleep-deprived ones. Furthermore, the administration of the cholecystokinin (CCK) 2 receptor antagonist, YM022 (0.5-2 pmol) in the rostral ventral medulla (RVM), decreased nociception in paradoxical-sleep-deprived rats but not in control ones. While a dose of the CCK 2 receptor agonist, CCK-8 (8-24 pmol intra-RVM), increased nociception in control rats, but not in paradoxical-sleep-deprived ones. In addition, the injection of lidocaine (QX-314, 2%, intra-RVM) decreased nociception in sleep-deprived rats, but not in control rats, while the lesion of the dorsolateral funiculus prevented the pronociceptive effect of PSD. Finally, PSD significantly increased c-Fos expression in the RVM. Therefore, PSD increases pain independently of its duration or of the characteristic of the nociceptive stimulus and decreases morphine analgesia at the PAG. PSD appears to increase pain by decreasing descending pain inhibitory activity and by increasing descending pain facilitatory activity.
RESUMONa era atual, em que os smartphones vêm ganhando espaço no meio médico, é fundamental a avaliação científica da real eficácia e reprodutibilidade dessas novas tecnologias. Nesse contexto, nosso objetivo foi avaliar, de forma inédita no nosso país, o esfigmomanômetro acoplado ao smartphone (Withings Blood Pressure Monitor) em comparação com outros métodos (esfigmomanômetros de mercúrio, aneróide e digital). Foram selecionados de forma aleatória 45 alunos sadios do curso de Medicina da UFPR e realizadas três medidas por aparelho, sendo comparadas entre as quatro modalidades, em ordem aleatória e em cada aluno. Também foi avaliada a preferência de método entre smartphone e digital. Os dados obtidos foram analisados nos modelos tStudent pareado e oneway Anova, com significância de p<0.05. Obtivemos 576 medidas; na comparação individual das medidas, em relação à pressão arterial sistólica (PAS), quando confrontados cada aparelho entre si, o smartphone não apresentou diferença significativa com os demais métodos (p > 0,05), seja em cada leitura por aluno ou entre os diferentes métodos. Quanto à pressão arterial diastólica (PAD), houve diferença significativa entre o smartphone e os demais aparelhos (p<0.05). Na análise específica das médias repetidas em cada aluno por cada método, em relação à PAD, o smartphone foi o único a diferir significativamente de todos os outros métodos, existindo uma variabilidade entre cada medida. Quanto à análise de preferência, os quesitos tempo de medida, desconforto à compressão do manguito e apresentação visual das medidas não influenciaram significativamente a escolha, sendo que 51,9% optaram pelo smartphone e 29,6% pelo digital.Palavras-chave: Medida da pressão arterial, smartphone, automedida da pressão arterial. ABSTRACTNowadays, smartphones are increasingly gaining space in the medical environment, the scientific evaluation of the real efficacy and reproducibility of this new technology is essential. In this context, our goal was to evaluate, unprecedently in our country, the smartphone linked sphygmomanometer (Withings Blood Pressure Monitor) with other methods (mercury, aneroid and digital sphygmomanometers). 45 healthy medical students were randomly selected from UFPR (Universidade Federal do Paraná), and three measures by each modality were taken and compared between them, in random order and on each person. The preference for self-measurement method between digital and smartphone linked sphygmomanometers was also evaluated. The obtained data were analyzed through paired t-Student and oneway Anova models, with significance of p<0,05. We obtained 576 measures; in the individual comparison of them, in relation to the systolic blood pressure (SBP), when equipments were confronted between each other, the smartphone didn't present significant difference with the other methods (p>0,05), be in each measure by student or between methods. Regarding diastolic blood pressure (DBP), there was significant difference between smartphone's measurements in relation to all other equipment...
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