OBJECTIVE:To analyze the pattern of use of medications use in aged people and associate it with socioeconomic aspects and with the self-rated health. METHODS:A population-based cross-sectional design study with 934 elderly people from Goiania, Midwestern Brazil, between December 2009 and April 2010. Data were collected through a questionnaire. The dependent variable was the number of medications consumed and the independent variables were sex, marital status, education, type of residence, age, income, and self-rated health. Drugs were classifi ed according to the Anatomical Therapeutic Chemical Classifi cation. The inappropriate drugs for the elderly were identifi ed according to the Beers-Fick criteria. The tests used were Chi-square and Fisher's exact test, p was considered signifi cant when < 0.05. RESULTS:The elderly consumed 2,846 medicines (3.63 medications/person). The most commonly consumed were those which act in the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and selfmedication was 35.7%. The most used drugs for self-medication were analgesics (30.8%), 24.6% of the elderly consumed drug considered inappropriate. Women, widows, those aged 80 or over and with worse self-rated health were more likely to practiced more polypharmacy. Most self-medication was associated with lower levels of education and worse self-rated health. CONCLUSIONS:The pattern of drug use by the elderly was similar to that found in the elderly in other regions of Brazil. The number of drugs used, the prevalence of self-medication and practice of polypharmacy and inappropriate drug use were within the national average.

Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with women's ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section. Methods. A prospective longitudinal study with 1,062 women submitted to cesarean section. We collected sociodemographic, clinical, surgical, and health behavior data. We used the 11-point Numerical Pain and the Hospital Anxiety and Depression Scales. We performed logistic analysis to identify predictors of moderate to severe postoperative pain. Results. The incidence of moderate-severe postoperative pain was 78.4% (CI: 95%: 75.9%–80.8%). The preoperative anxiety (OR = 1.60; CI 95%: 1.22–2.30) and intrathecal morphine with fentanyl (OR = 0,23; CI 95%: 0.08–0.66) were significantly associated with moderate-severe postoperative pain report. Conclusion. The preoperative anxiety increases the risk of moderate-severe postoperative pain in women submitted to cesarean section. The intrathecal morphine with fentanyl added to bupivacaine was a protective factor against this pain.

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OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status. METHOD: cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%. RESULTS: The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001). CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.

A coleta de dados fundamenta a sistematização da assistência de enfermagem, metodologia que permite ao enfermeiro aplicar os conhecimentos técnico-científicos que embasam a profissão. Este estudo objetivou elaborar um instrumento de coleta de dados visando o registro de forma eficiente e validá-lo em sua forma aparente e de conteúdo. Investigamos os sinais e sintomas freqüentemente encontrados em clientes de um Centro de Terapia Intensiva-Adulto e os categorizamos em Necessidades Humanas Básicas. Posteriormente, o instrumento foi submetido a validações aparente e de conteúdo. Com relação à estrutura do instrumento, foi detectada a necessidade de reduzí-lo, tornando-o mais prático. Quanto ao conteúdo, os juízes concordaram que este seria suficiente para o estabelecimento dos diagnósticos de enfermagem, favorecendo o desenvolvimento da sistematização da assistência ao paciente crítico, em Centro de Terapia Intensiva.

This study developed a pain evaluation scale and validated it for the Portuguese language.Development of the inventory -308 readily available pain descriptors -were searched in international literature and validated by six judges. One hundred descriptors of acute pain and 100 descriptors of chronic pain were found, which were used in the next stage. Statistical validation -493 health professionals and 146 patients experiencing acute and chronic pain participated in the study. Instructions, pain descriptors and respective definitions, pen and measuring tape were provided to participants. Psychophysical methods were used to establish categories, magnitude and cross-modality matching using line-length. Results revealed the ranking of the most frequently used descriptors of acute and chronic pain, with power equal to 0.99, close to the predicted (one), using line-length estimations. The Multidimensional Pain Evaluation Scale is thus validated for the Portuguese language. Escala Multidimensional de Evaluación del Dolor (EMEDOR)Los objetivos de este estudio fueron elaborar una escala de evaluación del dolor y validarla para la lengua portuguesa. Elaboración de inventario -fueron investigados 308 descriptores del dolor en la literatura mundial y, a partir de estos, seis jueces realizaron la validación aparente y de contenido. Como resultados fueron encontrados 100 descriptores del dolor agudo y 100 del crónico, los cuales fueron utilizados en la próxima etapa. Validación estadística -participaron 493 profesionales de la salud y 146 portadores de dolor agudo y de crónico. Se usó, como material, instrucciones a los participantes, descriptores de dolor y sus definiciones, lápiz y cinta de medir. Fueron utilizados métodos psicofísicos: estimación de categorías, estimación de magnitudes y emparejamiento intermodal con modalidad en largo de líneas. Los resultados muestran escalonamiento de los descriptores de mayor caracterización para el dolor agudo y para el dolor crónico, fue encontrado exponente igual a 0,99, próximo al predicho (uno) al utilizar el largo de líneas y estimativas numéricas. Fue validado para la lengua portuguesa la Escala Multidimensional de Evaluación del Dolor (EMEDOR).Descriptores: Descriptores; Dolor; Dimensión del Dolor.

This study investigates the prevalence of self-medication among undergraduate nursing students seeking to relieve pain and characterizes the pain and relief obtained through the used medication. This epidemiological and cross-sectional study was carried out with 211 nursing students from a public university in Goiás, GO, Brazil. A numerical scale (0-10) measured pain intensity and relief. The prevalence of self-medication was 38.8%. The source and main determining factor of this practice were the student him/herself (54.1%) and lack of time to go to a doctor (50%), respectively. The most frequently used analgesic was dipyrone (59.8%) and pain relief was classified as good (Md=8.5;Max=10;Min=0).The prevalence of self-medication was higher than that observed in similar studies. Many students reported that relief obtained through self-medication was good, a fact that can delay the clarification of a diagnosis and its appropriate treatment.Descriptors: Pain; Self Medication; Students, Nursing. Prevalencia y caracterización de la práctica de automedicación para alivio del dolor entre estudiantes universitarios de enfermeríaLos objetivos de este estudio fueron estimar la prevalencia de automedicación entre estudiantes universitarios de enfermería con dolor y caracterizar la experiencia dolorosa y el alivio obtenido por medio de los fármacos utilizados. Se trata de un estudio epidemiológico seccional, del cual participaron 211 estudiantes de una universidad pública de Goiás, en Brasil. El dolor y el alivio fueron medidos por medio de una Escala Numérica (0-10). La prevalencia de automedicación fue de 38,8%. La fuente generadora y los factores determinantes prevalentes de esta práctica fueron el propio estudiante (54,1%) y la falta de tiempo para ir al médico (50%), respectivamente. La dipirona fue el analgésico más utilizado (59,8%) y el alivio del dolor clasificado como bueno (Md=8,5;Máx=10;Mín=0). La prevalencia de la automedicación fue mayor que aquella observada en estudios semejantes y para muchos estudiantes el alivio fue bueno, hecho que puede retardar la elucidación del diagnóstico y del tratamiento adecuado del dolor.

Tenofovir disoproxil fumarate (TDF) is a first-line drug used in patients with highly active retroviral disease; however, it can cause renal failure associated with many tubular anomalies that may be due to down regulation of a variety of ion transporters. Because rosiglitazone, a peroxisome proliferator-activated receptor-gamma agonist induces the expression of many of these same transporters, we tested if the nephrotoxicity can be ameliorated by its use. High doses of TDF caused severe renal failure in rats accompanied by a reduction in endothelial nitric-oxide synthase and intense renal vasoconstriction; all of which were significantly improved by rosiglitazone treatment. Low-dose TDF did not alter glomerular filtration rate but produced significant phosphaturia, proximal tubular acidosis, polyuria and a reduced urinary concentrating ability. These alterations were caused by specific downregulation of the sodium-phosphorus cotransporter, sodium/hydrogen exchanger 3 and aquaporin 2. A Fanconi's-like syndrome was ruled out as there was no proteinuria or glycosuria. Rosiglitazone reversed TDF-induced tubular nephrotoxicity, normalized urinary biochemical parameters and membrane transporter protein expression. These studies suggest that rosiglitazone treatment might be useful in patients presenting with TFV-induced nephrotoxicity especially in those with hypophosphatemia or reduced glomerular filtration rate.