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BACKGROUND AND OBJECTIVES:The Integrative and Complementary Practices were implemented in the Unified Health System as adjunctive modalities in the treatment of pain. This article focuses on crenotherapy and hydrotherapy, whose agents are the natural mineral waters and common for the rehabilitation of functional alterations. The scarcity of these practices for the treatment of pain in the literature justifies this review. This study aimed to check the scientific productions about the efficacy of balneology/balneotherapy/crenotherapy and hydrotherapy in the treatment of pain. CONTENTS: It is an integrative review, carried out in May 2018, searching in the electronically available scientific articles, in full, in the LILACS, Pubmed, BVS and CINAHL database in periodicals published in the last 10 years focusing on crenotherapy and hydrotherapy for pain relief, in the Portuguese, English and Spanish language. The descriptors used were: "Pain", "Balneology", "Crenotherapy", "Hydrotherapy" "Efficacy"; "Effectiveness" in the three languages, combined with the Boolean expressions AND/Y/E and OR/O/U/OU, finding 2306 articles, of which 111 were identified, and only 27 met the inclusion criteria, analyzed and incorporated the evidence that emerged in pain relief. CONCLUSION: This study showed that most of the evidence emerged from the studies analyzed regarding the efficacy of hydrotherapy and balneology in pain pictures focused on levels 1 to 3. Of the 27 studies, 18 showed the efficacy of hydrotherapy and eight of balneology in the pain symptomatology and one in relation to the lack of knowledge of the use of these complementary therapies in pain relief.

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Introduction: Low-level laser therapy (LLLT) is effective in preventing fatigue and in stimulating the microcirculation and cellular activity. In this study, we examined the effect of LLLT on injured tibial muscle in vivo by assessing muscle function during fatigue. Methods: Twenty-four male mice were used. Each mouse received an injection of sterile 0.9% saline solution (50 µL) in the right tibialis anterior muscle, after which the tendon of the muscle was exposed, connected to an isometric transducer and subjected to a resting tension of 1 g. A bipolar electrode was attached to the tibial nerve for electrical stimulation. The mice were randomly allocated to one of two groups: G1 (control: 3 h -n=8 and 9 h -n=5) and G2 (treated with GaAlAs laser, λ660 nm, 35 mW, 0.6 J, 17 s: 3 h -n=6 and 9 h -n=5). Results: In G1 mice, the amplitude of the tetanic contracture in response to induced fatigue remained unchanged during six consecutive tetani. The amplitude of the tetanic contractions in response to electrical stimulation (4-8 mV) was also unchanged. These results indicated muscle intactness in response to the load imposed by tetanus. In G2 mice, there was an increase in the amplitude of contraction after 3 h and 9 h when compared to G1 at 83% tetanus. Conclusion: These results indicate that exposure of muscle to LLLT enhanced the contractile force and increased the resistance to muscle fatigue without causing morphological damage to cellular structures.

Objetivos: Levantar produções científicas que abordem na temática as cardiopatias congênitas em pós-operatório, com ênfase nos cuidados dispensados aos pacientes. Averiguar a relevância deste tema como agente facilitador do cuidado, direcionando os mesmos, promovendo maior bem-estar na prática assistencial de enfermagem. Métodos: Foram utilizados estudos científicos completos nacionais e internacionais sobre a temática referida. Os dados foram coletados nas bases de dados: Lilacs, Scielo e Medline, pesquisados entre os anos de 1993 e 2013. Resultados: Foram selecionados 15 estudos referentes às temáticas cardiopatias congênitas, cirurgias cardíacas e cuidados de enfermagem. Observa-se uma maior produção no ano de 2010 (26,6%). Cinco estudos (33,3%) atenderam aos objetivos para “cardiopatias congênitas”, e apenas quatro (26,7%) atenderam ao tema “cuidados de enfermagem no período pós-operatório para cirurgia cardíaca”. Conclusão: Os estudos englobando cuidados em pós-operatório de cardiopatias congênitas, em especial nos adultos, apresentam-se escassos, com discreto crescimento atual. Alguns apontaram o desenvolvimento da população adulta com cardiopatia congênita, o que comprova a necessidade de pesquisas e investimentos nesta área, com vistas ao melhor cuidado deste universo.Palavras-chave: cardiopatias congênitas, cirurgia cardíaca, cuidados de enfermagem.

BACKGROUND AND OBJECTIVES: Very often, chronic pain is undermanaged in patients with chronic non-malignant pain due to its complexity, and the long term success of the treatment is difficult. This study aimed at understanding nurses' perception about administering opioids to relieve chronic non-malignant pain (CNMP). METHOD: After the Ethics Committee approval, participated in this study clinical nurses with experience in managing chronic pain patients, who answered a questionnaire about using opioids for CNMP. RESULTS: Participated in this study 60 nurses, of whom 56.7% identified patients' pain by their complaints, 40% reported that dipirone was the drug used to treat CNMP, 50% reported that massage was the non-pharmacological therapy to treat CNMP, most have mentioned morphine and tramadol as the most widely used opioids to relieve chronic non-cancer pain, 50% stated that they evaluate pain intensity and administer prescribed opioids if needed when the pain is moderate or severe, 60% of nurses believe that opioids interfere with patients' rehabilitation, most have mentioned addiction (65%) and respiratory depression (46.7%) as the best known side-effects and 61.7% have stated that they have no restriction for the use of opioids to treat CNMP. CONCLUSION: Most nurses have no restriction for the administration of opioids for CNMP patients.

Introduction: Envenomation by Bothrops snakes can produce local pain, edema, hemorrhage and myonecrosis.However, standard antivenom therapy is generally ineffective in neutralizing these effects so that alternative methods of treatment have been investigated. In experimental animals, low-level laser therapy (LLLT) attenuates the local effects of Bothrops venoms, but the benefits of LLLT on muscle function after envenomation are unclear. In this study, we examined the influence of LLLT on the contractile activity of mouse skeletal muscle injected with venom from Bothrops jararaca, the principal cause of snakebite in southeastern Brazil. Methods: Twenty-seven male mice were used. Mice were injected with venom (40 μg in 50 μl) in the right anterior tibialis muscle, after which the muscle tendon was exposed, connected to an isometric transducer and subjected to a resting tension of 1 g. A bipolar electrode was attached to the tibial nerve for electrical stimulation. The mice were randomly allocated to five groups: A -Control (n = 3), B -Venom 3 h (n = 6), C -Venom 9 h (n = 6), D -Venom + Laser 3 h (n = 6), E -Venom + Laser 9 h (n = 6). Results: The two groups that received LLLT post-venom showed improved muscle contraction and contracture in relation to muscle treated with venom alone. Conclusion: These results indicate that LLLT can improve muscle function after damage induced by B. jararaca venom.

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