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Transcranial direct current electrical stimulation in combination with aerobic exercise:A pilot study in post-COVID-19 systemic autoimmune rheumatic patients

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World Journal of Rheumatology 2023年第1期11卷 1-12页

作者： Rafael Giovani Missé Alexandre Moura dos Santos Isabela Bruna Pires Borges Marlise Sítima Mendes Simões Lorenza Rosa Silvério Bruna Lindoso Correia Ana Wook Sook Kim Aline Marques Caetano Sandra Gofinet Pasoto Carla Gonçalves Schahin Saad Diogo Souza Domiciano Clarice Tanaka Julia Maria D’Andrea Greve Abrahão Fontes Baptista Samuel Katsuyuki Shinjo division of Rheumatology Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil Departamento de Fisioterapia Fonoaudiologia e Terapia OcupacionalHospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloNúcleo de Assistência e Pesquisa em NeuromodulaçãoSao PauloBrazil Laboratório de Estudos do Movimento Instituto de Ortopedia e TraumatologiaHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloBrazil

BACKGROUND Systemic autoimmune rheumatic diseases(SARDs)are a group of diseases with multiorgan involvement and a high prevalence of chronic pain and *** with SARDs and post-coronavirus disease 2019(COVID-19)syndrome experience aggravation of *** this context,it is essential to establish strategies to reduce chronic pain and fatigue and improve quality of *** To assess the efficacy of transcranial direct current stimulation(tDCS)for the treatment of fatigue and pain-associated post-COVID-19 syndrome in patients with *** This study included nine patients with different types of *** patients had reverse transcription-polymerase chain reaction(RT-PCR)test confirmed COVID-19 as well as significant,persistent fatigue and pain that began to worsen after *** tDCS was administered in five daily sessions(2mA,20 min).Concomitantly,patients were involved in aerobic exercise *** participants were evaluated using specific questionnaires and strength assessment by handgrip and physical function by timed-up-and-go test and sit-to-stand test at baseline(within one week before tDCS protocol),and one week after tDCS *** all procedures,the patients’treatments remained *** The sample comprised eight women and one man with a mean age of 48.7±9.6 *** the tDCS protocol,pain and fatigue significantly improved on the visual analog scale(Pphysical function also improved 9.5±2.7 vs 6.8±0.8(P=0.001)for timed-up-go-test and 10.3±3.7 vs 15.1±4.0(P=0.037)for sit-to-stand *** of the patients experienced any adverse *** The present study showed that tDCS in combination with aerobic exercise was effective in improving physical function,and reducing fatigue/pain in SARDs patients with post-COVID-19 syndrome.

关键词： Autoimmune diseases COVID-19 Fatigue Neuromodulation physical function Rheumatic diseases Pain

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More than Meets the Eye: A Qualitative Investigation of the Complex Weight History Constructions of Brazilian Women Who Underwent Bariatric Surgery

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Journal of Psychological Research 2023年第4期5卷 50-67页

作者： Mariana Dimitrov Ulian Ramiro Fernandez Unsain Ruth Rocha Franco Marco Aurélio Santo Alexandra Brewis Sarah Trainer Cindi SturtzSreetharan Amber Wutich Bruno Gualano Fernanda Baeza Scagliusi School of Public Health University of São PauloDepartment of NutritionSão PauloSP01246-904Brazil Pediatric Endocrinology Unit Children’s InstituteHospital das Clínicas of the School of MedicineUniversity of São PauloSão PauloSP05403.000Brazil Bariatric and Metabolic Surgery Unity Digestive System Surgery DivisionUniversity of São PauloSão PauloSP05403.000Brazil School of Human Evolution and Social Change Arizona State UniversityTempeAZ85281United States of America Seattle University SeattleWA98122United States of America University of São Paulo Applied Physiology&Nutrition Research GroupSão PauloSP05403.000 Brazil

Most studies on bariatric surgery identify personal factors such as“non-compliance”to lifestyle changes as the cause of weight gain and subsequent inability to lose *** qualitative studies suggest that weight loss patients have complicated relationships with both self and weight,with significant emotional and psychological *** how do patients themselves understand the trajectories of their weight gain as related to intrinsic versus extrinsic factors?A qualitative analysis examined the aspects involved in the construction of higher body weight from the perspectives and life experiences of Brazilian women who underwent bariatric surgery,considering that Brazil has previously been reported as a highly anti-fat ***,semi-structured interviews were conducted with thirty women(15 aged 33-59 and 15 aged 63-72).Data were analyzed identifying the regular,expressive,and meaningful significance units identified through the *** it was expected that different life events were reported as crucial to the perceived aetiology of individual weight gain stories,the participants reported that the emotional aspects had more *** extremely high value attached to having a particular body weight negatively influenced the participants’concept of identity and harmed their interactions and understanding of what it meant to be fully loved and *** of the participants underscored the importance of food in women’s lived experiences and explanations of weight *** this somatic response being dysfunctionally directed to food,this mechanism seemed to be vital to keeping them alive and engaged in the ***,the participants faced layered vulnerabilities,which decreased their opportunities to access resources aimed at better body weight *** approaches that consider emotional and physical care strategies must be proposed to this population.

关键词： Mental health Bariatric surgery Obesity Body weight Stigma Brazil Qualitative investigation

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