No abstract

Depression and anxiety were seen as the main triggers of FM symptoms, but a significant proportion of the subjects perceived work strain as the initial trigger.We also observed a delay of a few years in seeking medical help and examination by a rheumatologist.

SummaryThere is common agreement that fibromyalgia (FM) is an extremely heterogeneous entity. Patients differ in their clinical symptoms, endocrine and immune parameters. In this study we evaluated endocrine and immunological features of distinct subsets of FM patients. In contrast to previous attempts to identify subsets of FM patients, based solely on their psychological and cognitive features, herein we propose to separate FM patients by genetic features. Allelic expression of the polymorphic promoter region of the serotonin transporter (5-HTTLPR) was analysed as a relevant genetic factor for FM. Seventy-five patients meeting the American College of Rheumatology criteria and 27 healthy age-matched controls participated in this study. All controls and FM patients were submitted to genotyping of 5-HTTLPR. Twenty-seven FM patients, who were able to discontinue hypnotic, sedative or psychotropic prescription medications for at least 2 weeks, were then subdivided into L (homozygote LL) or S groups (genotypes LS and SS). They were evaluated for salivary cortisol levels, absolute number of leucocyte subpopulations, including natural killer (NK) cells and activated T and B lymphocytes. Both groups presented decreased cortisol levels, more intense in the L group, increased all B lymphocytes subsets and reduced CD4 + CD25 high T lymphocytes. The L group had increased CD4 + CD25 low activated T lymphocytes, while the S group displayed elevated CD4 + human leucocyte antigen D-related (HLA-DR) + activated T lymphocytes and decreased NK cells. We demonstrate that genetic factors may help to identify FM individuals with differentially altered frequencies of immune cells.

Avaliou-se a produção de alface em solo tratado com doses de lodo de esgoto como fonte de matéria orgânica em experimento em casa de vegetação da Universidade Federal do Espírito Santo. o delineamento experimental foi inteiramente casualizado, com cinco repetições e os tratamentos: solo sem adubação (testemunha) e solo+lodo de esgoto em doses crescentes de 33,3; 66,6; 99,9 e 133,2 g dm-3 em base seca. As plantas foram cultivadas, individualmente, em vasos contendo 6 dm³ de substrato. O crescimento da parte aérea e o aumento de matéria fresca nas folhas das plantas foram estatisticamente superiores ao controle e a regressão indica a possibilidade da utilização de doses mais elevadas de lodo de esgoto.

Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation.