MANOEL JACOBSEN TEIXEIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Neurologia, Faculdade de Medicina - Docente
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
17 resultados
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- Electrical stimulation of the posterior insular cortex induces opioid and cannabinoid-dependent antinociception and regulates glial cells in the spinal cord(2022) GONÇALVES, Elizamara Santos; MATIELO, Heloísa Alonso; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi de; HAMANI, Clement; DALE, Camila SquarzoniABSTRACT BACKGROUND AND OBJECTIVES: Half of neuropathic pain patients still end up failing clinical treatments. Electrical stimulation of the posterior insular cortex (ESI) modulates sensory and nociceptive circuits. This study evaluated the effects of a range of frequencies of ESI proposed to improve neuropathic pain. METHODS: Male Sprague Dawley rats, 280-340 g, submitted to the chronic constriction of the right sciatic nerve were tested for mechanical sensitivity using the paw pressure and von Frey flaments tests, and for thermal sensitivity using the hot plate test. The rats were submitted to ESI 10, 60 or 100 Hz (one, five or seven ESI, 15 min, 210 µs, 1V), applied to the posterior insular cortex, and were evaluated in the tests before and after ESI, or in follow-up of 48, 72 and 168h. The open field evaluated general activity after ESI 5. The involvment of opioid and cannabinoid testes were evaluated through treatment with naloxone and SR1416A - antagonist and inverse agonist/antagonist of the receptors, respectively, after ESI 5, while activation of astrocytes, marked by glial fibrillary acid protein (GFAP), and of microglia, marked by IBA-1 (glial marker), in the spinal cord evaluated by immunohistochemistry. RESULTS: Data demonstrate that 10, 60, and 100 Hz ESIs modulate mechanical and thermal sensitivity. ESI 5 increased immunoreactivity of GFAP in the spinal cord, without altering IBA-1 (glial marker). Naloxone and SR141716A reversed the antinociception of 60 Hz ESI 5. 60 Hz ESI 7 induced antinociception up to 72h. CONCLUSION: 60 Hz ESI induces opioid and cannabinoid-dependent antinociception and regulates glia. HIGHLIGHTS 60 Hz-delivered ESI was the best analgesic protocol for the insular stimulation. Data showed a prolonged analgesic effect up to 72h after repetitive ESI. ESI regulates glia activation in pain modulatory system.
- Effects of specific hypnotic suggestions on mechanical and thermal sensitivity of healthy volunteers: randomized and double-blind study(2022) OLIVEIRA, Victória Regina da Silva; OLIVEIRA, Inaeh de Paula; ENG, Beatriz Magalhães; TEIXEIRA, Manoel Jacobsen; PUENTES, Fabio; DALE, Camila SquarzoniABSTRACT BACKGROUND AND OBJECTIVES: Hypnotic suggestions for hypoalgesia or analgesia are efficient for relieving different pain conditions, presenting few or no side effects. However, little is known about its direct effect on the modulation of peripheral nociception. The goal of this study was to evaluate the mechanical and thermal response after specific hypnotic suggestions in healthy volunteers. METHODS: This is a randomized double-blinded controlled trial that aimed to evaluate both mechanical and thermal nociception after specific hypnotic suggestions in healthy volunteers. For this, twenty-seven participants were enrolled, according to the following eligibility criteria: age between 18-65 years and absence of pain complaints or psychological disorders. After signed Free Informed Consent Term (FICT) the participants were divided by a computer-generated randomization in three groups: sham group (no induction of hypnosis), hypnosis-induced pain group and hypnosis-induced analgesia group. Susceptibility to hypnosis was assessed through the Waterloo-Stanford Group C (WSGC) scale of hypnotic susceptibility and outcomes included evaluation of questionnaires (Hospital Anxiety and Depression Scale and Short Form Brief Pain Inventory) as well as the examination of mechanical and thermal nociception through the Quantitative Sensory Testing (QST), a tool widely used to investigate somatosensory sensitivity by assessing functions of small A-δ and C nerve sensory fibers, before and after specific hypnotic suggestion for pain and analgesia made by a qualified hypnotherapist. RESULTS: Data demonstrated that specific hypnotic suggestions induced significant changes in mechanical and thermal sensitivity. The pain group revealed an increase in mechanical hyperalgesia and allodynia, while the analgesia group increased pain thresholds to thermal stimulations, being conditioned to withstand temperature changes after hypnosis, demonstrating a modulatory effect for both pain and analgesia sensations in healthy volunteers. CONCLUSION: The evidence presented in this study supports the use of the hypnosis technique as an auxiliary tool in clinical practice. HIGHLIGHTS Specific hypnotic suggestions can modulate peripheral nociception in healthy subjects. Data show a modulatory effect for both pain and analgesia sensations. Hypnosis can be considered a feasible technique for the clinical pain management.
- Fibromyalgia syndrome and gestation. Case report(2014) ZAKKA, Telma Regina Mariotto; YENG, Lin Tchia; TEIXEIRA, Manoel JacobsenBACKGROUND AND OBJECTIVES: The impact of fibromyalgia during gestation is not clearly defined. Its treatment is a challenge for the health team and drug prescription requires care and attention. This study aimed at evaluating treatment possibilities for a patient with chronic pain during gestation. CASE REPORT: Patient with 32 years of age, with fibromyalgia and irritable bowel syndrome, with eight weeks gestation. Patient was being treated for one year in the Ambulatory of Chronic Abdominal, Pelvic and Perineal Pain, from the Interdisciplinary Pain Center of the Hospital. CONCLUSION: Multidisciplinary treatment has involved drug replacement, physiotherapy, acupuncture, psychotherapy, postural and dietary reeducation.
- Avaliação das técnicas cirúrgicas para tratamento da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidt; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: To evaluate the efficacy of surgical treatment of cervical spondylotic myeloradiculopathy in the production of postoperative neurological improvement, measured in points by the scale of JOA (Japanese Orthopaedic Association) and the recovery rate and complications of therapy. METHODS: Analysis of medical records and imaging studies of 200 patients undergoing surgical treatment of cervical myeloradiculopathy in HC-FMUSP, from January 1993 to January 2007. Clinical evaluation was quantified by the scale of the JOA, with an average follow-up of 6 years and 8 months. RESULTS: There was post-operative neurological improvement in the anterior and posterior approach, except in laminectomy without fusion, where late neurological deterioration was observed. The anterior approach showed a significantly higher rate of complications related to poor fusion, intervertebral displacement of the graft, adjacent disc syndrome, dysphonia, dysphagia, poor positioning of the graft and plates, nerve root injury and significant higher rate of re-operation. In the posterior approach, increased occurrence of instability and kyphosis in the postoperative, in laminectomy were found, whereas in laminoplasty these conditions were not observed, presenting similar rates to those found for the anterior approach. There was no improvement in axial pain in the laminoplasties and worsening in laminectomies, whereas in discectomias and corpectomias there was significant relief of symptoms. CONCLUSION: The anterior and posterior routes were effective in producing neurological improvement, except for laminectomy without fusion. The anterior approach produced more complications, but is better for pain treatment.
- Conceito de dor neuropática aguda. O papel do nervi nervorum na distinção entre dores agudas nociceptiva e neuropática(2016) TEIXEIRA, Manoel Jacobsen; ALMEIDA, Daniel Benzecry; YENG, Lin TchiaABSTRACT BACKGROUND AND OBJECTIVES: Several pathophysiological mechanisms are involved in the genesis of neuropathic pain. However, available justifications for its onset are unsatisfying and do not explain the participation of nervi nervorum and nervi vasorum abnormalities on functional aberrations which characterize pain generated by injuries to the peripheral nervous system. There are evidences that nervi nervorum contribute to the development and justify many clinical findings and prophylactic, therapeutic and rehabilitation alternatives related to neuropathic pain. This study aimed at presenting a review of anatomic and functional studies and theories about their objectives and at giving examples of conditions in which nervi nervorum have markedly participated in neuropathic pain generation and maintenance. CONTENTS: Nervi nervorum are a set of unmyelinated or poorly myelinated fibers located in peripheral nerves sheaths which, among other functions, seem to participate in the transmission of evoked sensory information and in the environmental regulation of peripheral nervous system structures. CONCLUSION: Nervi nervorum structural and functional abnormalities may contribute to the onset, maintenance and worsening of neuropathic pain and ""demodulatory"" painful syndromes. Further studies, especially with the application of more specific and sensitive histological, biochemical and electrophysiological methods are necessary to clarify the realities of their biologies.
- Current clinical approach to patients with disorders of consciousness(2016) AMORIM, Robson Luis Oliveira de; NAGUMO, Marcia Mitie; PAIVA, Wellingson Silva; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel JacobsenSummary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.
- Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidth; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: Identify the individual, social, environmental clinical factors and also imaging studies which correlate to the final result of neurological improvement in patients undergoing surgical treatment of cervical spondylotic myelopathy. METHODS: The clinical assessment was quantified by the deficit in JOA scale. We analyzed 200 cases of cervical myeloradiculopathy surgically treated in HC-FMUSP, from January 1993 to January 2007. The mean follow-up was 6 years and 8 months. The analysis was based on radiological criteria of instability by White and Kellgren scale. RESULTS: 80% had improved, 14% stabilized and 6% had worsened. The neurological deterioration was not associated with any clinical, environmental or imaging factor. The neurological improvement was directly proportional to the lower age at surgery, absence of co-morbidity, Hoffman sign, muscular atrophy, spinal cord hyperintensity on MRI, the shortest period of preoperative evolution, better preoperative neurological status and was inversely proportional to the AP diameter of the spinal canal and to multiple cord compressions. An association with smoking was observed. Over 70 years of age, evolution superior to 24 months, muscle atrophy, JOA score equal to or less than seven points and AP canal diameter less than or equal to 6mm were not associated with improvement.
- Could pain understanding by patients help the assessment of trigeminal neuralgia?(2016) SIQUEIRA, Silvia Regina Dowgan Tesseroli de; TEIXEIRA, Manoel Jacobsen; SIQUEIRA, José Tadeu Tesseroli deABSTRACT BACKGROUND AND OBJECTIVES: To observe the efficacy of pain management by means of an educational proposal to address patients with trigeminal neuralgia, which is a chronic pain with high daily activity limitation rates. METHODS: Eight patients being treated of trigeminal neuralgia participated in weekly meetings on pain in a general reference hospital. Patients had uncontrollable pain in spite of treatments so they would come very frequently to the hospital (once every one or two weeks). Patients were invited to participate in a series of meetings (four) to receive information and discuss about the disease and pain. RESULTS: There has been increased interval between appointments for two patients, who went from weekly to biannual visits, and six patients were discharged with controlled symptoms. CONCLUSION: Education on pain has helped its management and coping by patients, by means of understanding their condition, in addition to improving their abilities to deal with it, decreasing hospital visits due to less pain recurrence.
- Termografia por infravermelho na avaliação da dor em paciente com esclerose múltipla Relato de caso(2016) PAPALÉO, Rosa Maria; TEIXEIRA, Manoel Jacobsen; BRIOSCHI, Marcos LealABSTRACT BACKGROUND AND OBJECTIVES: Multiple sclerosis is an autoimmune, inflammatory, demyelinating and chronic disease of the central nervous system. As from the understanding of its pathophysiology and of thermoregulating dysfunctions caused by the disease, it is clear that, whenever possible, infrared thermography should be done. Thermography helps understanding how the disease affects different body areas, by investigating asymmetries, contractures and neurogenic patterns. This study aimed at documenting by infrared thermography a case of multiple sclerosis in crisis of pain. CASE REPORT: Female patient, 63 years old, diagnosed with multiple sclerosis in 2007 after magnetic resonance and lumbar puncture. Six month ago she started complaining of progressive decrease in lower limbs muscle strength in addition to increased spinal pain, especially in lumbar spine and right hemibody. Patient was submitted to new exams (head and cervical spine resonance), which have shown the same pattern found in previous exams, resulting from old injuries by demyelinating substract. Thermometry has shown asymmetry of the whole right hemiboby with central neurogenic patterns and temperature difference (∆T 0.8ºC), thus confirming initial diagnosis. With regard to major complaint, there was asymmetry between paralumbar regions and presence of lumbar paravertebral hyperradiation, suggesting local muscles contracture. CONCLUSION: Multiple sclerosis has a wide range of symptoms, especially the installation of chronic pain and inadequate thermoregulation, which directly interfere with quality of life of patients.
- Dor visceral abdominal: aspectos clínicos(2013) ZAKKA, Telma Mariotto; TEIXEIRA, Manoel Jacobsen; YENG, Lin TchiaBACKGROUND AND OBJECTIVES: Abdomen is the most frequent site for acute or chronic painful syndromes, for referred pain from distant structures or for pain caused by systemic injuries. Abdominal visceral pain is induced by hollow viscera or parenchymal viscera walls stretching or by peritoneal stretching. Complex diagnosis and treatment have motivated this study. Patients with chronic abdominal pain are usually undertreated and underdiagnosed. The interdisciplinary treatment aims at minimizing patients' distress, relieving pain and improving their quality of life. CONTENTS: Since visceral diseases may determine pain of different types and, usually, challenge physicians with regard to their diagnosis and treatment, the authors have described in a practical way painful characteristics and associations with more common diseases. CONCLUSION: The interdisciplinary treatment, with the association of pharmacological measures to physical medicine and rehabilitation procedure and to psychological follow up, decreases distress and inabilities and improves quality of life.