Melatonin and glucocorticoids are key hormones in determining daily rhythmicity and modulating defense responses. In nocturnal animals, corticosterone peaks at light/dark transition,while melatonin peaks at the middle of the night in both nocturnal and diurnal animals. The crosstalk between adrenal and pineal glands under inflammatory conditions indicates that corticosterone potentiates nocturnal melatonin synthesis by reducing the activity of NFκB. This transcription factor, which modulates the expression of a key enzyme in melatonin synthesis, is sharply reduced at the entrance of darkness in the rat pineal gland. In this study, we established the basis for understanding the crosstalk between adrenal and pineal glands in physiological conditions. Here we show that the expression of 70 out of 84 genes implied in defense responses exhibit a sharp reduction exactly at the entrance of darkness. Mifepristone impair the changes of 13 out of 84 genes, suggesting that the rhythm of corticosterone modulates pineal phenotype, as mifepristone also reduces the expression of Aanat and the nocturnal synthesis of melatonin. Therefore, darkness-induced synthesis of the pineal hormone, besides being controlled by the central clock located in the hypothalamus, is also influencedby glucocorticoids through the regulation of NFκB transcriptional program.

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Objective: To characterize painful procedures, analgesic strategies, vital signs, and pain scores in hospitalized newborns. Method: This is a primary, observational, prospective clinical study, developed in a Brazilian public hospital. Demographic data, painful procedures, pain relief measures, vital signs, and pain scores were collected from the clinical records of 90 newborns admitted to the intensive care unit and evaluated between admission and the third day of admission. For statistical analysis, the software Statistic Package for the Social Sciences and the R Software were used. Results: Newborns underwent 2,732 painful procedures, 540 non-pharmacological and 216 pharmacological strategies. The most frequently performed procedure was the heel prick (20.96%). The most commonly recorded non-pharmacological strategy was dim lighting (28.33%) and continuous fentanyl (48.83%) was the main pharmacological measure adopted. Pain score and vital signs show variability in the period evaluated. Conclusion: Despite the high number of painful procedures, pain assessment records do not reflect procedural pain and the use of analgesic strategies was insufficient.

Conflitos de interesse: nada a declarar. ResumoObjetivo: Identificar os principais biomarcadores salivares descritos, assim como as técnicas empregadas para coleta das amostras de saliva, em estudos relacionados à avaliação da dor em pacientes submetidos a procedimentos dolorosos ou portadores de patologias dolorosas.Métodos: Revisão integrativa da literatura, realizada pelas buscas bibliográficas nas bases Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, CINAHL e EMBASE, com recorte temporal de 2009 a 2019 e período de coleta de dados entre outubro e novembro de 2019. Foram utilizados Descritores em Saúde (DeCs)e Medical SubjectHeadings (MeSH), para responder à pergunta norteadora: Quais são e como são utilizados os biomarcadores salivares na avaliação da dor? Foi realizada uma análise descritiva dos artigos, sendo os dados extraídos e registrados em uma planilha desenvolvida para o presente estudo.Resultados: Das 126 publicações identificadas, 22 artigos foram incluídos para a análise. Constatou-se que os artigos são, majoritariamente, desenvolvidos com adultos durante realização de procedimentos dolorosos ou portadores de patologias dolorosa. Os principais biomarcadores salivares avaliados foram a alfa-amilase e o cortisol, e as principais técnicas para coleta de saliva foram o Salivette ® e a coleta passiva.Conclusão: Os estudos indicam que a mensuração objetiva da dor é um desafio. Os principais biomarcadores salivares descritos são o cortisol e a alfa-amilase, sendo o Salivette ® a principal técnica utilizada para coleta das amostras de saliva. A dosagem das moléculas salivares é incipiente e empregada de forma complementar na avaliação da dor em pacientes de diferentes faixas estárias, submetidos à procedimentos dolorosos ou portadores patologias dolorosas.

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