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Chaves C, Bittencourt PCT, Pelegrini A. Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. PAIN MEDICINE 2021; 21:2212-2218. [PMID: 33118602 PMCID: PMC7593796 DOI: 10.1093/pm/pnaa303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective To determine the benefit of a tetrahydrocannabinol (THC)-rich cannabis oil on symptoms and quality of life of fibromyalgia patients. Methods A double-blind, randomized, placebo-controlled clinical trial was conducted for eight weeks to determine the benefit of a THC-rich cannabis oil (24.44 mg/mL of THC and 0.51 mg/mL of cannabidiol [CBD]) on symptoms and quality of life of 17 women with fibromyalgia, residents of a neighborhood with a low socioeconomic profile and a high incidence of violence in the city of Florianopolis, Brazil. The initial dose was one drop (∼1.22 mg of THC and 0.02 mg of CBD) a day with subsequent increases according to symptoms. The Fibromyalgia Impact Questionnaire (FIQ) was applied at pre- and postintervention moments and in five visits over eight weeks. Results There were no significant differences on baseline FIQ score between groups. However, after the intervention, the cannabis group presented a significant decrease in FIQ score in comparison with the placebo group (P = 0.005) and in comparison with cannabis group baseline score. (P < 0.001). Analyzing isolated items on the FIQ, the cannabis group presented significant improvement on the “feel good,” “pain,” “do work,” and “fatigue” scores. The placebo group presented significant improvement on the “depression” score after intervention. There were no intolerable adverse effects. Conclusions Phytocannabinoids can be a low-cost and well-tolerated therapy to reduce symptoms and increase the quality of life of patients with fibromyalgia. Future studies are still needed to assess long-term benefits, and studies with different varieties of cannabinoids associated with a washout period must be done to enhance our knowledge of cannabis action in this health condition.
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Affiliation(s)
- Carolina Chaves
- Public Health School, Municipal Health Secretary, Florianopolis, Brazil
| | | | - Andreia Pelegrini
- Department of Physical Education, Santa Catarina State University, Florianopolis, Brazil
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Centurion NB, Peres RS, Santos EJRD. SIGNIFICADOS SOBRE SEXUALIDADE EM MULHERES COM FIBROMIALGIA: RESSONÂNCIAS DA RELIGIOSIDADE E DA MORALIDADE. PSICOLOGIA EM ESTUDO 2020. [DOI: 10.4025/psicolestud.v25i0.44849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A fibromialgia é uma síndrome reumatológica predominantemente feminina e que pode acarretar prejuízos em diferentes esferas da vida. Desse modo, pesquisas sobre a sexualidade desta população têm sido desenvolvidas, com foco, sobretudo, em seus aspectos objetivos. Porém, a sexualidade é atravessada também por fatores mais subjetivos, de ordem psicológica e sociocultural. Assim, este estudo teve como objetivo compreender as ressonâncias da religiosidade e da moralidade nos significados sobre sexualidade de um conjunto de mulheres com fibromialgia. Trata-se do recorte de uma pesquisa mais ampla, determinado pela ocorrência de resultados que não foram visados diretamente. O presente estudo foi norteado pelas propostas do método clínico-qualitativo e contou com a participação de seis mulheres com fibromialgia. A coleta de dados teve como locus um grupo psicanalítico de discussão. As gravações em áudio dos encontros do grupo foram transcritas e constituíram o corpus, tendo sido examinadas segundo os procedimentos metodológicos estabelecidos pela análise de conteúdo. Os resultados revelam que os significados sobre sexualidade, entre a maioria das participantes, são acentuadamente influenciados por restrições estabelecidas pela doutrina cristã e pela denominada ‘moral sexual civilizada’. Tais restrições não dizem respeito à síndrome propriamente dita e, talvez por essa razão, têm sido pouco exploradas na literatura especializada. Logo, recomenda-se, em prol da integralidade do cuidado, que profissionais de saúde e pesquisadores, no trabalho que desenvolvem junto a mulheres com fibromialgia, dediquem maior atenção às possíveis ressonâncias da religiosidade e da moralidade nos significados sobre sexualidade.
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de Assis MR, Dos Santos Paiva E, Helfenstein M, Heymann RE, Pollak DF, Provenza JR, Ranzolin A, Rezende MC, Ribeiro LS, Souza EJR, Martinez JE. Treatment data from the Brazilian fibromyalgia registry (EpiFibro). Adv Rheumatol 2020; 60:9. [PMID: 31964420 DOI: 10.1186/s42358-019-0108-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND EpiFibro (Brazilian Epidemiological Study of Fibromyalgia) was created to study patients with fibromyalgia (FM). Patients were included since 2011 according to the classification criteria for FM of the American College of Rheumatology of 1990 (ACR1990). OBJECTIVE To analyze the therapeutic measures prescribed by Brazilian physicians. MATERIALS AND METHODS Cross-sectional study of a multicenter cohort. The therapeutic measures were described using descriptive statistics. RESULTS We analyzed 456 patients who had complete data in the registry. The mean age was 54.0 ± 11.9 years; 448 were women (98.2%). Almost all patients (98.4%) used medications, 62.7% received health education, and less than half reported practicing physical exercise; these modalities were often used in combination. Most patients who practiced exercises practiced aerobic exercise only, and a significant portion of patients combined it with flexibility exercises. The most commonly used medication was amitriptyline, followed by cyclobenzaprine, and a minority used medication specifically approved for FM, such as duloxetine and pregabalin, either alone or in combination. Combinations of two or three medications were observed, with the combination of fluoxetine and amitriptyline being the most frequent (18.8%). CONCLUSION In this evaluation of the care of patients with FM in Brazil, it was found that the majority of patients are treated with a combination of pharmacological measures. Non-pharmacological methods are underused, with aerobic exercise being the most commonly practiced exercise type. The most commonly prescribed single drug was amitriptyline, and the most commonly prescribed combination was fluoxetine and amitriptyline. Drugs specifically approved for FM are seldom prescribed.
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Affiliation(s)
- Marcos Renato de Assis
- Faculdade de Medicina de Marília (FAMEMA), Av. Monte Carmelo, 800, Marília / São Paulo, Brazil, CEP 17519-03001402-000. .,Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.
| | - Eduardo Dos Santos Paiva
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Universidade Federal do Paraná, Curitiba, Brazil
| | - Milton Helfenstein
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Roberto Ezequiel Heymann
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniel Feldman Pollak
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jose Roberto Provenza
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Pontifícia Universidade Católica de Campinas (PUCCAMP), Campinas, Brazil
| | - Aline Ranzolin
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Universidade Federal de Pernambuco, Recife, Brazil
| | - Marcelo Cruz Rezende
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Santa Casa de Campo Grande, Campo Grande, Brazil
| | - Luiz Severiano Ribeiro
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Instituto de Previdência dos Servidores do Estado de Minas Gerais, Minas Gerais, Brazil
| | - Eduardo José R Souza
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Santa Casa de Belo Horizonte, Horizonte, Brazil
| | - José Eduardo Martinez
- Sociedade Brasileira de Reumatologia (SBR), Av. Brigadeiro Luís Antônio, 2466 - Jardim Paulista, São Paulo - SP, 01402-000, Brazil.,Pontifícia Universidade Católica de São Paulo (PUC-SP), São Paulo, Brazil
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Rocha FAC, Landim JIVD, da Rocha LN. Advances in rheumatology practice in Brazil. Rheumatol Int 2018; 39:1125-1134. [PMID: 30506466 DOI: 10.1007/s00296-018-4211-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
Despite resilient inequities, Brazil has seen progressive improvement in health care in the last 25 years. Infectious diseases rendered place to chronic non-communicable diseases as a major cause of death. Existence of traditional schools of medicine and training services in rheumatology helped form a reasonable number of specialists, though irregular distribution due to the economic issues favoring their clustering in major cities. The Brazilian Society of Rheumatology provides continued medical education, helps training rheumatologists, family physicians and other health professionals and has worked to publish national recommendations for the diagnosis and treatment of major rheumatic diseases. Access to medications and health care facilities is provided for most patients, free of direct charge, including biologics. Specialized services for autoimmune and rare diseases, including pediatric rheumatology and autoinflammatory diseases, have improved, particularly in developed centers of the southern best developed parts of the country. A major unmet need is the lack of access to non-pharmacological treatment modalities. In this article, we will summarize some of the strengths and points that need improvement to enhance access to the rheumatological health care in Brazil.
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Affiliation(s)
- Francisco Airton Castro Rocha
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil.
| | - Joaquim Ivo Vasques Dantas Landim
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil
| | - Leila Nascimento da Rocha
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil
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