Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.

BACKGROUND: Empathy in the patient-provider relationship is associated with important outcomes in healthcare practice. Our aim was to translate and validate Warmometer, a visual tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese. DESIGN AND SETTING: Cross-sectional study conducted at an antenatal clinic of a public university hospital in São Paulo, Brazil. METHODS: The instrument was translated into Brazilian Portuguese and culturally adapted. It was tested for reliability and validity among 32 pregnant women, between June 2015 and January 2016. To assess construct validity, it was correlated with the Consultation and Relational Empathy (CARE) scale (gold standard for patient-provider relationships) and the Interpersonal Reactivity Index (IRI). RESULTS: The translated version of Warmometer had good face and content validity, low intra-observer reproducibility (intraclass correlation coefficient, ICC: 0.224; 95% confidence interval, CI -0.589 to 0.621;P = 0.242) and high inter-observer reproducibility (ICC: 0.952; 95% CI 0.902 to 0.977; P < 0.001). There was a strong correlation between Warmometer and CARE ( r = 0.632) and a weak correlation between Warmometer and IRI ( r = 0.105). CONCLUSIONS: Warmometer was translated, culturally adapted and validated for use in Brazilian Portuguese. The translated version is a reliable tool for assessing the degree of empathy perceived by the patient in a patient-provider relationship.

Background: Drugs used in preterm labor (PTL) have side effects. Research into new tocolytic agents is recommended. The plant Bryophyllum pinnatum (Lam.) Oken (Kalanchoe pinnata (Lam.) Pers) is used in Anthroposophic Medicine for PTL, insomnia, and emotional disturbances. The aim of this study was to evaluate the effects of B. pinnatum mother tincture (MT) on Wistar rats and their fetuses throughout pregnancy. Method: Sixty animals were divided into 6 equal groups: controls C1 and C2 received 1 and 25 × the maximum daily dose of a 30% ethanol / water solution, serving as vehicle of B. pinnatum MT; B1 and B2 received 1 and 25 × the maximum daily dose of B. pinnatum MT; and B3 and B4 received 50 and 100 × B. pinnatum concentrate. The following parameters were assessed: weight gain; maternal and fetal mortality; implantations and resorptions; number and weight of fetuses and placentas; major external fetal malformations. Results: Rat weight gain (excluding fetal and placental weight) was higher in group B4 and lower in group B2. There were no maternal or fetal deaths and no group differences in implantations and resorptions or number and weight of fetuses and placentas. No macroscopic fetal abnormalities were observed at the 4 dosage levels investigated. Conclusion: Daily administration of B. pinnatum MT at high doses to pregnant Wistar rats interfered with maternal weight gain and did not interfere with fetal compartment.

Kalanchoe pinnata (Crassulaceae) is a medicinal plant distributed in several areas of the World. Their leaves have been used, in folk medicine, for anxiety and sleep disorders among other proposes. Chemically, this plant is composed by organic acids, flavonoids, bufadienolides, triterpenoids and some ubiquitous compounds. In this study, the fresh leaves of K. pinnata were extracted in an accelerated solvent extraction (ASE) system using H 2 O (cold and hot) as well as with EtOH:H 2 O 1:1. The obtained crude extracts were analyzed by HPLC-UV-MS. As a result, were identified organic acids and flavonoids, these beingand trans-p-coumaryl glutaric acid the main compounds in the studied extracts. Obtained results revealed the predominance of flavonoids in extracts prepared using hot H 2 O (70.26 ± 2.19%) or EtOH:H 2 O 1:1 (74.65 ± 5.39%) while a reduction in the amount of these compounds was observed in the extracts prepared using cold H 2 O (54.41 ± 2.93%). Additionally, crude extracts from leaves of K. pinnata extracted with hot H 2 O and EtOH:H 2 O 1:1 showed in vitro cytotoxicity on five tested cancer cell lines: murine melanoma (B16F10), human melanoma (A2058), human cervical carcinoma (HeLa), human leukemia (HL-60), and human glioblastoma (U87-MG), with IC 50 values in the range of 10.6 ± 2.5 -91.3 ± 7.2 g/mL. On the other hand, the extract prepared using cold H 2 O displayed reduced potential. These crude extracts were also tested against human foreskin fibroblasts (non-tumorigenic cells) showing IC 50 values ranging from 79.5 to 90.2 g/mL. In conclusion, our results showed the impact that different extraction methods have on the chemical composition and pharmacological activity, which are notable for the anticancer activity associated to flavonoids.

<b><i>Introduction:</i></b> <i>Bryophyllum pinnatum</i> is widely used in folk medicine. It has neuropharmacological, anti-inflammatory, immunomodulatory, antidiabetic, hepatoprotective, and nephroprotective effects, among others. It also acts on uterine contractility. It is prescribed by practitioners of anthroposophic medicine for preterm labor, insomnia, and emotional disorders, and has other potential uses in obstetrics. As all drugs currently used in preterm labor have side effects, new tocolytic agents remain an area of active research. <b><i>Objective:</i></b> To evaluate the effect of <i>B. pinnatum</i> mother tincture (MT) on albino rats and their offspring throughout pregnancy from a biochemical and histological standpoint. <b><i>Methods:</i></b> Longitudinal, prospective, randomized controlled bioassay. This is the second stage of a trial that investigated 60 animals distributed across six equal groups: controls C1 and C2, which received 1 and 25 times the vehicle dose (30% ethanol), B1 and B2 (1- and 25-fold doses of <i>B. pinnatum</i> MT), and B3 and B4 (which received 50- and 100-fold doses of <i>B. pinnatum</i> concentrate). At this stage, blood chemistry parameters (glucose, alanine aminotransferase [ALT], aspartate aminotransferase [AST], creatinine, and blood urea nitrogen) were measured in dams, as well as histological aspects of dam liver, kidney, placenta, and uterine tissue and fetal liver, kidney, heart, and brain. <b><i>Results:</i></b> No differences were found between group B1 (therapeutic dose) and its control C1 in relation to glucose, AST, ALT, and creatinine. Group B2 exhibited lower glucose levels than groups C1, B3, and B4. There was no difference in AST across groups. Groups B3 and B4 exhibited higher ALT levels than groups C1 and B1. Groups B1–B4 exhibited higher urea nitrogen levels than group C1. Creatinine levels were higher in groups B2 and B3 than group C1. On morphological evaluation, fatty infiltration of the liver was observed in the alcoholic vehicle control groups (C1 and C2). <b><i>Conclusions:</i></b> Daily administration of <i>B. pinnatum</i> at therapeutic doses (group B1) to pregnant albino rats appears to be safe, with reduced glucose at dose B2, elevated ALT at doses B3 and B4, and increased urea at doses B1 to B4 and creatinine at B2 and B3, but never exceeding the normal reference range. It was not associated with histological changes in specimens of the maternal or fetal structures of interest.

A implantação de Política Nacional de Práticas Integrativas e Complementares (PNPIC), no Sistema Único de Saúde (SUS), vem de encontro à transdisciplinaridade, quando se pretende oferecer saúde à população de uma forma multimodal, como ocorre na Medicina Antroposófica, com olhar integrativo entre os diversos profissionais. A atuação no tripé ensino-assistência-pesquisa da universidade pode ser favorável à maior promoção e harmonização entre as disciplinas, durante a assistência pré-natal, resultando na gestante mais preparada para o trabalho de parto.

Pregnancy-associated melanoma is defined as melanoma diagnosed during pregnancy or within 1 year of delivery. The association of pregnancy with melanoma is well known, but its underlying molecular mechanisms of association are poorly understood. The aim was to assess the expression of apoptosis-related genes in melanoma tumors during pregnancy in an attempt to elucidate the molecular mechanisms underlying apoptosis-driven activation of melanoma cells in this period. Mice were allocated across two experimental groups (nonpregnant and pregnant) and implanted with the melanoma cell line BF16-F10. Tumor tissue was collected for RNA extraction and purification, and gene expression was quantified using the mouse apoptosis RT2ProfilerTM PCR array. Different intracellular apoptotic pathways were activated (positively or negatively) by pregnancy in tumor cells: intrinsic (21.5%), extrinsic (32%), caspase (14%), apoptosis (21.5%), and caspase-activated DNase (11%). The proportion of upregulated genes for each of these pathways was 100, 30, 50, 17, and 0%, respectively. MetaCore software was then used to analyze gene ontology processes and pathways by building networks. Among the gene ontology processes, the majority of differentiated genes were related to the apoptotic process. The main pathway activated by pregnancy was the intrinsic one (genes Api-5, Bcl2-L1, Birc-2, Birc-3, Bok, and Trp53bp2). Pregnancy activates the intrinsic apoptosis pathway to stimulate caspases 7 and 9, but the final balance is inhibition of apoptosis mechanisms. In mice, pregnancy cannot promote or worsen melanoma.

BACKGROUND AND OBJECTIVES: Considering that a single approach does not encompass all symptoms of fibromyalgia syndrome and so indicated therapy is multidisciplinary, this study aimed at observing the efficacy of Structural Integration Rolfing method, of acupuncture, and of the combination of both techniques for relieving pain, anxiety and depression and for improving quality of life of fibromyalgia patients.