BACKGROUND AND OBJECTIVES:The prevalence of chronic pain has been increasing in the world, and it is considered the most underestimated health care problem impacting the quality of life. Furthermore, there is little consensus regarding the burden of chronic pain in Brazil. The present study aimed to investigate the prevalence of chronic pain in the general Brazilian adult population, and the socio-demographic, clinical, medical conditions and pain locations on the body. METHODS: A cross-sectional Internet-based survey was conducted in a nationally representative sample of Brazil adults to estimate the prevalence, sociodemographic correlates and characteristics of chronic pain in the Brazilian population. Twenty--seven-thousand and three hundred forty-five (27,345) representative residents were contacted. RESULTS: From 27,345 individuals, 20,830 (76.17%) presented chronic, recurrent, or long-lasting pain, lasting for at least 6 months. Nearly half of the respondents were 65 years older (48.15%) and the prevalence was higher in females (84,60%) than males (16.40%). The prevalence of primary chronic lower back pain was 59.85%; of primary rheumatoid arthritis was (59.78%) and primary osteoarthritis pain was 69.02%. Half of the respondents with chronic pain experienced daily pain, and average (past 3 months) pain intensity was moderate at 57.28%. CONCLUSION: Chronic pain affects more than two-thirds of the population of Brazil. Our findings revealed a high prevalence and severity of chronic pain and suggested that it is a public health problem in Brazil. Risk factors are being a woman, advanced age and low levels of household income. There is a need for improved health policies in Brazil for patients with chronic pain. RESUMO JUSTIFICATIVA E OBJETIVOS:A prevalência de dor crônica tem aumentado no mundo e é considerada o problema de saúde mais subestimado, com impacto na qualidade de vida. Além disso, há pouco consenso em relação à carga da dor crônica ao sistema de saúde no Brasil. O presente estudo teve como objetivo investigar a prevalência de dor crônica na população adulta geral brasileira e as condições sociodemográficas, clínicas, médicas e a localização corporal da dor. METODOS: Foi realizado um estudo transversal, em questionário pela internet em uma amostra nacionalmente representativa de adultos do Brasil, para estimar a prevalência e características da dor crônica na população brasileira. Vinte e sete mil e trezentos e quarenta e cinco (27.345) residentes representativos foram contatados. RESULTADOS: Dos 27.345 indivíduos, 20.830 (76,17%) apresentaram dor crônica, recorrente ou duradoura com duração de pelo menos 6 meses. Quase metade dos entrevistados tinham mais de 65 anos de idade (48,15%) e a prevalência era maior nas mulheres (84,60%) do que nos homens (16,40%). A prevalência de dor lombar crônica primária foi de 59,85%; de artrite reumatoide primária foi (59,78%) e dor primária oriunda de osteoartrite foi de 69,02%. Metade dos entrevistados com dor crônica apresentava dor diária e a intensidade da dor...

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Maternal separation is a widely accepted model for studying long-term behavioral changes produced by events during early life and its association with changes in pain sensitivity. Thus, our objective was to evaluate sensitivity to pain, under different stimuli in adult male and female rats that had undergone early life maternal separation. Animals were subjected to maternal separation from postnatal day (PND) 2-15. Maternal behavior and litter weight were evaluated during this period. Sensitivity to pain was assessed in offsprings during adulthood by exposing them to stimuli, including formalin (5%; 20μl), a hot plate, and the electronic von Frey test, 4, 7, 10, and 24h after the administration of saline or Freund's complete adjuvant (CFA) injection. Maternal separation did not affect maternal behavior or litter weight during PND 2-15. However, experiencing maternal separation increased pain sensitivity in the rats subjected to formalin by increasing number of flinches and licking time Further, females appeared more sensitive than males to thermal stimuli, as they showed a decrease in latency in the hot plate test. In this test, male and female offsprings that were exposed to early life maternal separation and received the CFA injection also showed a reduction in latency to react to the painful stimuli. In the von Frey test, there was a reduction in withdrawal threshold in maternal separation animals injected with CFA, thus demonstrating a greater sensitivity to the mechanical stimuli. In conclusion, experiencing early life maternal separation increased pain sensitivity in adult offsprings. Thus, our data are important to understand the impact of environmental influences, such as stressful life events during critical developmental periods, on pain vulnerability.

Background:Digestive complications in enteral nutrition (EN) can negatively affect the nutrition clinical outcome of hospitalized patients. Diarrhea and constipation are intestinal motility disorders associated with pharmacotherapy, hydration, nutrition status, and age. The aim of this study was to analyze the frequency of these intestinal motility disorders in patients receiving EN and assess risk factors associated with diarrhea and constipation in hospitalized patients receiving exclusive EN therapy in a general hospital.Materials and Methods:The authors performed a sequential and observational study of 110 hospitalized adult patients fed exclusively by EN through a feeding tube. Patients were categorized according to the type of intestinal transit disorder as follows: group D (diarrhea, 3 or more watery evacuations in 24 hours), group C (constipation, less than 1 evacuation during 3 days), and group N (absence of diarrhea or constipation). All prescription drugs were recorded, and patients were analyzed according to the type and amount of medication received. The authors also investigated the presence of fiber in the enteral formula.Results:Patients classified in group C represented 70% of the study population; group D comprised 13%, and group N represented 17%. There was an association between group C and orotracheal intubation as the indication for EN (P < .001). Enteral formula without fiber was associated with constipation (logistic regression analysis: P < .001).Conclusion:Constipation is more frequent than diarrhea in patients fed exclusively by EN. Enteral diet with fiber may protect against medication‐associated intestinal motility disorders. The addition of prokinetic drugs seems to be useful in preventing constipation.

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