Abstract
Background: Fibromyalgia (FM) is a non-inflammatory disease with unknown etiology expressed by diffuse musculoskeletal pain, whose definition and management are subjects of controversies. Thus we aimed to review the literature on efficacy and main cortical targets of TMS for FM. Methods: A systematic review was carried out in PubMed databases, along with the terms DeCS/MeSH: “Fibromyalgia AND (Transcranial Magnetic Stimu-lation OR TMS)”. Randomized studies and clinical trials published in the last 10 years were selected. After exclusion, 11 articles remained. Results: The references found for TMS in the treatment of FM indicate average reduction in pain symptoms (29%). TMS showed significant improvement in pain measured by visual analog scale and was more advantageous in clinical and functional improvement, but less efficient in psychiatric conditions. In female patients, active use of repetitive high-frequency TMS was significantly better on pain, quality of life (QoL) and depression. Another study showed that 20 sessions produced significantly lasting pain inhibition and improved QoL when operated at 10 Hz. Moreover, the right dorsolateral prefrontal cortex or the left motor cortex can have antidepressant and pain-modulating effects. Evidence also points to an important improvement in physical and general fatigue, as well as greater chance of clinical improvement in pain intensity. Conclusions: Evidence on TMS for FM available so far is promising, with potential to represent a valuable and safe therapeutic option. However, more and larger studies are needed to elucidate mechanisms and effectiveness better
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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