Submitted by Haroudo Xavier Filho (haroudo.xavierfo@ufpe.br) on 2016-03-02T19:04:17Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dayzene - Dissertação de mestrado.pdf: 1828584 bytes, checksum: 8e90c2f0693fdf9ad20b442adcc269c2 (MD5) / Made available in DSpace on 2016-03-02T19:04:17Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dayzene - Dissertação de mestrado.pdf: 1828584 bytes, checksum: 8e90c2f0693fdf9ad20b442adcc269c2 (MD5) Previous issue date: 2015-03-12 / CAPES / Introdução: Os transtornos alimentares e as cefaleias primárias, migrânea e cefaleia do tipo tensional, acometem frequentemente a população infantil e adolescente. Essas condições clínicas parecem compartilhar mecanismos fisiopatológicos semelhantes, relacionados à alteração no metabolismo de neurotransmissores. A associação entre cefaleia e transtorno alimentar foi observada em estudos conduzidos com populações específicas de mulheres adultas. No entanto, não existem pesquisas que evidenciem essa relação na adolescência. Objetivo: Investigar a associação entre as cefaleias primárias (migrânea e cefaleia do tipo tensional) e os sintomas de transtornos alimentares nos adolescentes. Métodos: Tratou-se de um estudo transversal e analítico realizado com 607 adolescentes, sendo 388 meninas (63,9%), com idade variando entre 11 e 18 anos, média de idade de 13,9 anos (IC 95%: 13,7; 14,0), estudantes de escolas públicas estaduais de Recife. Para o rastreamento dos transtornos alimentares foram utilizados dois questionários autoaplicáveis: o Teste de Atitudes Alimentares-26 (EAT-26) e o Teste de Investigação Bulímica de Edimburgo (BITE). A presença e a caracterização da cefaleia foram verificadas por meio de um questionário, baseado nos critérios diagnóstico da Sociedade Internacional de Cefaleia (ICHD-III, versão beta). Resultados: A migrânea esteve presente em 454/607 (74,8%) adolescentes, mostrando associação estatisticamente significativa com o gênero [309/388 (79,6%) meninas vs. 145/219 (66,2%) meninos, p<0,001; 2]. De acordo com o EAT-26, 157/607 (25,9%) adolescentes apresentaram sintomas indicativos de transtornos alimentares, sendo observada diferença estatisticamente significativa entre os gêneros [111/388 (28,6%) meninas e 46/219 (21,0%) meninos, p=0,04; 2]. De acordo com a escala BITE, 221/607 (36,4%) adolescentes apresentaram sintomas indicativos de bulimia nervosa, havendo diferença entre os gêneros [162/388 (41,8%) meninas vs. 59/219 (26,9%) meninos, p<0,001; X2]. Quanto à faixa etária, foi observada uma maior frequência das queixas de migrânea e dos sintomas de bulimia nervosa rastreados pela escala BITE nos adolescentes de 14 a 18 anos, enquanto que os sintomas de transtornos alimentares rastreados pelo Teste de Atitudes Alimentares foram mais evidentes entre os adolescentes de 11 a 13 anos. Houve associação estatisticamente significativa entre a migrânea e os sintomas de transtornos alimentares rastreados pelo EAT-26 [127/454 (28,0%) dos estudantes com migrânea apresentavam EAT positivo, em comparação a 30/153 (19,6%) dos estudantes sem migrânea, p=0,041; 2] e pelo BITE [178/454 (39,2%) estudantes migranosos apresentaram bulimia nervosa, em comparação a 43/153 (28,1%) estudantes sem migrânea, p=0,014; 2]. Na análise multivariada dos possíveis fatores explicativos da bulimia nervosa, meninas migranosas apresentaram 43,7% de chance para desenvolver bulimia nervosa [gênero feminino (ORajustada=1,85; IC 95%: 1,28; 2,66, p<0,001) e migrânea (ORajustada=1,51; IC 95%: 1,0; 2,26, p=0,048]. Conclusão: Migrânea está associada aos sintomas de transtornos alimentares em adolescentes do gênero feminino. / Background: Eating disorders and primary headaches, migraine and tension-type headache, often affect the infant and adolescent population. Those clinical conditions seem to share similar pathophysiological mechanisms, related to changes in neurotransmitter metabolism. The association between headache and eating disorder was observed in studies conducted with specific populations of adult women. However, there are no studies that demonstrate this relation in adolescence. Aims: The aim of this study was to investigate the association between primary headaches (migraine and tension-type headache) and symptoms of eating disorders in adolescents. Methods: We carried out a cross-sectional and analytical study with 607 adolescents (388 girls, 63.9% sample), aged between 11 and 18 years, mean age of 13.9 years (95% CI: 13.7; 14.0), students from state public schools in Recife. For tracing of eating disorders were used two self-reported questionnaires: the Eating Attitudes Test-26 (EAT-26) and the Bulimic Investigatory Test of Edinburgh (BITE). The presence and characterization of headache were verified using a questionnaire based on the diagnostic criteria of the International Headache Society (ICHD-III). Results: Migraine was present on 454/607 (74.8%) adolescents, showing a statistically significant association with gender [309/388 (79.6%) girls vs. 145/219 (66.2%) boys, p<0.001; 2]. According to EAT-26, 157/607 (25.9%) adolescents had symptoms indicative of eating disorders, with significant difference between genders [111/388 (28.6%) girls and 46/219 (21.0%) boys, p=0.04; 2]. According to BITE, 221/607 (36.4%) adolescents had symptoms indicative of bulimia nervosa, with significant difference between genders [162/388 (41.8%) girls vs. 59/219 (26.9%) boys, p<0.001; 2]. In relation to age, a higher frequency of complaints of migraine and of symptoms of bulimia nervosa traced by the Bulimic Test scale in adolescents aged 14 to 18 years was observed, while the symptoms of eating disorders traced by the Eating Attitudes Test were more evident among adolescents aged 11 to 13 years. There was statistically association between migraine and symptoms of eating disorders traced by the EAT-26 [127/454 (28.0%) students with migraine had positive EAT, compared to 30/153 (19.6%) students without migraine, p=0.041] and by the Bulimic Test [178/454 (39.2%) students migraineurs had symptoms of bulimia nervosa, compared to 43/153 (28.1%) students without migraine, p=0.014]. In the multivariate analysis, migraine girls has 43.7% chance of developing bulimia nervosa [gender female (ORadjusted=1.85; 95% CI: 1.28 to 2.66, p<0.001) and migraine (ORadjusted=1.51; 95% CI: 1.0 to 2.26, p=0.048)]. Conclusion: Migraine is associated to symptoms of eating disorders in female adolescents.

Made available in DSpace on 2016-01-26T12:51:18Z (GMT). No. of bitstreams: 1 claudiathomebeletti_dissert.pdf: 580160 bytes, checksum: 663a2cdc74524cec05b176a5c247317d (MD5) Previous issue date: 2007-10-30 / Chronic daily headache (CDH) can be studied according to the psychosomatic perspective. Considering that CDH is a heterogeneous group of headaches and that some comorbidity and emotional factors can trigger the pain such as stress, anxiety and depression; a study that takes into account the emotional overload and its impact on the affected people's lives is very important. Objective: This research aims to investigate the presence of emotional overload in patients with CDH, and the possible reasons which may impair the symptoms as well as to know which are the psychological, social and existential aspects developed by these people. Casuistic and Method: The subjects of this study were 40 patients of both genders, over 18 years of age, who attended the headache clinic of Hospital de Base, Medical School of S?o Jos? do Rio Preto. A semi-structured interview as reference to the Psychosomatic Psychoanalytic Investigation was used. Results: The sample comprised 10% of males and 90% of females, the ages ranging from 24 to 64 years old. Since the majority of interviews were made up of open questions, it was decided to divide the answers into categories. The most frequent categories when they knew the meaning of getting sick were: psychical suffering (35.53%); physical suffering (23.68%); damage at work (19.74%) and social damage (10.52%). Regarding the question about factors related with pain, the main categories were: nervousness (23.16%); preoccupation (15.79%) and tension (11.58%). The question on how the pain was developed, the most frequent categories were: the attempt at self-cure (27.36%), different kinds of pain (16.98%) and affected by emotions (13.2%). The question on the consequences of the pain, the majority reported the interruption of their activities. The length-time of the disease varied between 2 and 40 years with headaches. It was also observed, if the patients with CDH had diagnosis hypotheses regarding their pains or a "personal insight" on the disease. Among them, psychical factors could trigger the pain with 48.84%, and 34.88% of them did not have hypothesis regarding their headaches. Conclusions: In conclusion, there is some emotional overload in patients with CDH, and the typical performance of the psychosomatic disorders and the operating mind control is directly related with the patient?s complaints. It was also observed aspects of depression associated with the emotional functioning of these people. / A cefal?ia cr?nica di?ria (CCD) pode ser estudada de acordo com a perspectiva psicossom?tica. Considerando-se que a CCD ? um grupo heterog?neo de cefal?ias e que algumas comorbidades e fatores emocionais est?o associados como precipitantes da dor, tais como o estresse, a ansiedade e a depress?o; um estudo que leve em conta a sobrecarga emocional e qual o impacto na vida das pessoas afetadas reveste-se de import?ncia. Objetivo: A presente pesquisa visa investigar presen?a de sobrecarga emocional de pacientes portadores de CCD, e os poss?veis motivos agravadores de sintomas, bem como conhecer quais os percursos psicol?gicos, sociais e existenciais desenvolvidos por esses indiv?duos. Casu?stica e M?todo: S?o sujeitos deste estudo 40 pacientes de ambos os sexos, maiores de 18 anos, atendidos no ambulat?rio de cefal?ias do Hospital de Base de S?o Jos? do Rio Preto. Foi utilizado um roteiro de entrevista semi-estruturada, tendo como refer?ncia a Investiga??o Psicossom?tica Psicanal?tica. Resultados: A amostra foi composta por 10% dos sujeitos do sexo masculino e 90% do sexo feminino, com idades variando entre 24 e 64 anos. Por se tratar de entrevistas compostas, em sua maioria por quest?es abertas, optou-se por distribuir as respostas em categorias. Ao conhecer o significado de adoecer, as categorias que mais apareceram foram: sofrimento ps?quico (35,53%); sofrimento f?sico (23,68%); preju?zo no trabalho (19,74%) e preju?zo social (10,52%). Quanto ao questionamento com os fatores que relacionavam a dor, as principais categorias foram: o nervosismo (23,16%); preocupa??o (15,79%) e tens?o (11,58%). Na investiga??o de como se desenvolvia a dor, o que mais se verificou foram: tentativas de auto-cura (27,36%); diferentes tipos de dor (16,98%) e provocadas pelas emo??es (13,2%). A quest?o referente ?s conseq??ncias acarretadas pela dor mostrou que a grande maioria descreveu interromper as atividades. O tempo de doen?a variou entre dois e mais de quarenta anos de dores de cabe?a. Foi observado, ainda, se os portadores de CCD t?m hip?teses diagn?sticas a respeito das suas dores ou ?insight? pessoal sobre a doen?a. Entre elas, fatores ps?quicos poderiam desencadear a dor com 48,84% e 34,88% n?o t?m hip?tese a respeito das suas dores de cabe?a. Conclus?es: Pode-se concluir que existe sobrecarga emocional em pacientes portadores de CCD, e que o funcionamento caracter?stico dos transtornos psicossom?ticos e do pensamento operat?rio est? diretamente relacionado com suas queixas. Tamb?m foram observados aspectos de depress?o relacionados ao funcionamento emocional desses indiv?duos.

Made available in DSpace on 2015-07-22T20:50:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-03-26. Added 1 bitstream(s) on 2015-08-11T03:25:44Z : No. of bitstreams: 1 Publico-10777.pdf: 584483 bytes, checksum: e11ab9839fe48602b080e48c338291cc (MD5) / Introdução: A cefaléia crônica diária é constituída por um grupo de cefaléias, dentre elas a enxaqueca crônica, comórbida com patologias como a depressão, o abuso de medicamentos, a obesidade e, mais recentemente, associada a casos de hipertensão intracraniana idiopática sem edema de papila. Objetivos: Determinar a prevalência de hipertensão intracraniana idiopática sem edema de papila e os níveis liquóricos de glutamato e ácido gama-aminobutírico em pacientes com enxaqueca crônica comparado a outros grupos de pacientes. Métodos: Foram estudados pacientes com enxaqueca crônica, mediante a realização do exame do líquido cefalorraquidiano com medida da pressão de abertura e dosagens dos níveis liquóricos dos aminoácidos glutamato e ácido gama-aminobutírico pela técnica de cromatografia líquida de alta resolução. Resultados: Dos pacientes submetidos a punção lombar, seis pacientes, em grupo de sessenta, tiveram elevação na pressão liquórica maior que 200 mm H20 sem acusar edema de papila à fundoscopia. Os pacientes que abusavam de triptanos mostraram níveis liquóricos de glutamato menores que aqueles com uso abusivo de outros tipos de medicações analgésicas e pacientes que não abusavam de nenhum tipo de medicação. Quanto aos níveis de ácido gamaaminobutírico no líquido cefalorraquidiano, esses foram menores nos pacientes com enxaqueca crônica e depressão quando comparados aos pacientes que tinham apenas enxaqueca crônica. Conclusões: A realização do estudo do líquido cefalorraquidiano foi importante em pacientes com enxaqueca crônica para a exclusão da hipertensão intracraniana idiopática sem papiledema, possibilitando perspectivas futuras para o entendimento da fisiopatogênese e desenvolvimento de novas terapias medicamentosas para a enxaqueca e suas comorbidades. / Introduction: Chronic daily headaches consist of a group of headaches, among them chronic migraine, that is comorbid with depression, overuse of medication, obesity and recently, cases of idiopathic intracranial hypertension without papilloedema. Objectives: To establish idiopathic intracranial hypertension without papilloedema prevalence and glutamate and gamma-aminobutyric acid levels in cerebrospinal fluid from patients with chronic migraine compared to other groups of patients. Methods: We studied patients with chronic migraine, who underwent lumbar puncture to rule out idiopathic intracranial hypertension without papilloedema. Amino acids glutamate and gamma-aminobutyric acid levels were measured by high performance liquid chromatography in cerebrospinal fluid. Results: Six patients, among sixty, had CSF open pressure higher than 200 mm H20 without papilloedema on fundoscopy. Patients who overused triptans had glutamate levels lower than those with abuse of other analgesic types and nonoverusers. The gamma-aminobutyric acid levels in cerebrospinal fluid were lower in depressed patients when compared to patients without depression and controls. Conclusions: The study of the cerebrospinal fluid was important in patients with chronic migraine for the exclusion of idiopathic intracranial hypertension without papilloedema, opening perspectives for the understanding of the physiopathology and development of new drug therapies for migraine and its comorbidities. / TEDE / BV UNIFESP: Teses e dissertações

<p>U poslednje vreme upotreba računara se smatra značajnim okidačem za nastanak primarnih glavobolja. Svi rizikofaktori pri radu na računaru značajni za nastanak glavobolja su nedovoljno jasni i ispitani, te su i strategije prevencije nepoznate. Ciljevi ovog istraživanja su utvrđivanje razlika u prevalenciji primarnih glavobolja kod ispitanika koji koriste i koji ne koriste računar, kao i utvrđivanje uticaja vremena provedenog u radu na računaru i pona&scaron;anja pri radu na računaru na ispoljavanje određenog tipa primarne glavobolje. U studiji preseka finalni uzorak je činilo 1500 ispitanika. Uzorak je podeljen na dve grupe: 1. ispitanici koji koriste računar (95.7%), 2. ispitanici koji ne koriste računar (4.3%). Obe grupe su nadalje podeljene na: 1. one koji imaju glavobolju i 2. one koji nemaju glavobolju. Kod ispitanika koji koriste računar, glavobolju je imalo 69.6% ispitanika, a kod ispitanika koji ne koriste računar 27.4%. Nadalje, kod ispitanika koji koriste računar od glavobolje tenzionog tipa boluje 30.3%, od migrene 16.7%, od verovatno sekundarne glavobolje 14.0% ispitanika. Kod ispitanika koji ne koriste računar od glavobolje tenzionog tipa boluje 19.4%, od migrene 4.8% ispitanika, i od verovatno sekundarne glavobolje 3.2% ispitanika. Utvrđeno je da su korisnici računara imali značajno veću prevalenciju primarnih glavobolja u odnosu na one koji ne koriste računar. Korisnici računara sa glavoboljom u odnosu na one bez glavobolje duže rade na računaru, če&scaron;će ne prave pauzu, a kada je i naprave, one traju kratko, če&scaron;će zauzimaju nepravilan položaj tela. Korisnici računara sa migrenom u odnosu na one sa glavoboljom tenzionog tipa značajno duže vremena provode na računaru kod kuće, ređe prave pauze, a kada ih prave one su kratke, pravilnije sede za računarom, a u pauzi ređe sede i koriste mobilni telefon ili tablet. Prilikom klasifikacije glavobolja izdvojila se grupa od 8.6% ispitanika koji su imali glavobolju koja se nije ispunjavala kriterijume za migrenu, glavobolju tenzionog tipa, ni trigeminalnu autonomnu glavobolju, a nije postojala sumnja da je to sekundarna glavobolja. Obzirom da se ona javljala isključivo kod korisnika računara i da je većina njih izvestila da rad na računaru može biti okidač, ona je svrstana u ostale primarne glavobolje, za koju se pretpostavlja da za njen nastanak upotreba računara ima značajan uticaj. Korisnici računara oboleli od ostalih primarnih glavobolja u odnosu na obolele od migrene vi&scaron;e vremena provode u radu na računaru na poslu, ređe zauzimaju pravilan položaj, ali če&scaron;će prave pauzu, a u odnosu na one sa glavoboljom tenzionog tipa, če&scaron;će izve&scaron;tavaju da vi&scaron;e vremena provode na računaru i na poslu i kod kuće, da nakon dužeg vremena prave pauzu ili nikada, i da im pauze kraće traju, ali da pravilnije sede pri radu na računaru. Na osnovu rezultata može se zaključiti da primarne glavobolje predstavljaju značajan zdravstveni problem kod korisnika računara. U uzorku su detektovani ispitanici sa glavoboljom, koja je bila prisutna samo kod korisnika računara, koja nije ogovarala postojećim kriterijumima klasifikacije ni za jednu primarnu glavobolju i za koju se sumnja da za njen nastanak rad na računaru imao značajan uticaj. Korisnici računara sa glavoboljom se ne pridržavaju definisanih ergonomskih preporuka pri radu na računaru, te se javlja potreba za sprovođenjem sistematske edukacije korisnika računara o ergonomskim preporukama u cilju prevencije ataka glavobolja.</p> / <p>As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on influenced by computer use. Computer users with headaches do not adhere to the defined ergonomic recommendations when working on the computer, hence there is a need for systematic education of computer users on ergonomic recommendations in order to prevent headache attacks.</p>