ABSTRACT
A mucocele é uma patologia das glândulas salivares menores que acomete frequentemente a cavidade oral. Clinicamente, apresenta-se como um aumento de volume circunscrito, submucoso, assintomático e de cor rósea ou azulada. A escolha do tratamento da mucocele dependerá de alguns fatores importantes da lesão, tais como tamanho, localização e profundidade. A excisão cirúrgica convencional é a técnica mais utilizada para tratamento de mucoceles e a recidiva é uma das principais complicações desta abordagem. A técnica de Shira, que consiste na injeção cuidadosa de material hidrocolóide dentro da lesão com o objetivo de delimitá-la e removê-la por completo, diminui as chances de recorrência desta patologia. O objetivo deste trabalho é relatar um caso clínico de mucocele de grande volume em lábio inferior que foi tratada cirurgicamente com a técnica de Shira, discutir algumas formas de tratamento para mucoceles em região labial, dando ênfase às vantagens da técnica de Shira.
The mucocele is a pathology of the salivary glands that often affects the oral cavity. Clinically, it presents as an increase in volume circumscribed, submucosal, asymptomatic and in pink or blue. The choice of treatment will depend mucocele of some importante factors of injury, such as size, location and depth. The conventional surgical excision is the most used technique for the treatment of mucoceles and recurrence is a major complication of this approach. A technique that consists of injecting Shira careful hydrocolloid material within the lesion in order to enclose it and remove it completely diminishes the chances of recurrence of this disease. The objective of this study is to report a case of mucocele large volume bottom lip which was treated surgically using the technique of Shira and discuss some forms of treatment for mucoceles in lip region, emphasizing the advantages of the technique Shira.
ABSTRACT
OBJECTIVE:To describe urodynamic abnormalities in HTLV-1 infected individuals presenting urinary symptoms and verify if these findings and quality of life (QOL) evaluation correlate with overall neurological impairment. MATERIALS AND METHODS: From January/2001 to May/2004, 324 HTLV-1 seropositive subjects were evaluated to determine the occurrence of urinary symptoms. Urodynamic testing was performed in those who complained of frequency, urgency, or incontinence. They went through a complete clinical, neurological, and urological examination to investigate symptoms and signs of myelopathy. Neurological disability was assessed by Expanded Disability Status Scale (EDSS). RESULTS: From the 324 patients evaluated, 78 underwent the urodynamic testing. Fifty-seven individuals were females (73.1 percent) and age ranged from 23 to 76 years (mean = 48.7 years; SD ± 11.6). Urodynamic testing was abnormal in 63 patients (80.8 percent). The major abnormality was detrusor overactivity (DO), observed in 33 individuals (33/63; 52.4 percent), followed by detrusor-external sphincter dyssynergia (DESD), diagnosed in 15 subjects (15/63; 25.4 percent). HAM/TSP patients had significantly more DESD than the HTLV-I carriers (p = 0.005; OR = 5.5; CI: 1.6 to 19.4). QOL was severely compromised in HAM/TSP patients. CONCLUSIONS: Prominent urodynamic abnormalities were identified in individuals genuinely considered as HTLV-I carriers, suggesting an early compromise of the urinary tract; whereas HAM/TSP patients presented urodynamic findings, which posed a potential risk to the upper urinary tract (dyssynergia). Urodynamic evaluation should be performed in all HTLV-I-infected individuals with voiding complaints.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Paraparesis, Tropical Spastic/complications , Urinary Bladder, Overactive/etiology , Urination Disorders/etiology , Carrier State , Paraparesis, Tropical Spastic/physiopathology , Quality of Life , Severity of Illness Index , Urodynamics , Urinary Bladder, Overactive/physiopathology , Urination Disorders/physiopathologyABSTRACT
O objetivo deste estudo consiste em avaliar a prevalência de anticorpos antimicrossomais (AAM), a função tireóidea e a ocorrência de sintomas relacionados ao hipotireoidismo em pacientes com esclerose multipla (EM). Em um grupo de 21 pacientes com EM, foi realizado exameclínico, foram dosados o TSH, T4 e T4 livre e pesquisados AAM. A média de idade foi 41,05 anos e a média de tempo de doença foi 85,9 meses. Os sintomas relacionados ao hipotireoidismo foram fadiga, fraqueza, letargia e parestesias. Os AAM foram encontrados em 4 pacientes (19 por cento). O tempo de doença foi dividido em três períodos: <60 meses (3 pacientes AAM+/7AAM-), 60-120 meses (8 pacientes AAM-) e >120 meses (1 paciente AAM+/2 AAM-). Dois pacientes apresentaram níveis de T4 livre diminuídos, porém com T4 e TSH normais. Em 1 paciente, constatou-se hipotireoidismo subclínico, e em outro, hipotireoidismo clássico. Conclui-se que na avaliação dos pacientes com EM, em vista da falta de precisão na avaliação clínica do hipotireoidismo ocasionada pela sobreposição de sintomas referentes à EM, devam ser incorporadas as dosagens das provas de função tireóidea (PFT) e dos AAM.