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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356215

ABSTRACT

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.


RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.


ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Health Profile , COVID-19/mortality , Antiviral Agents/therapeutic use , Patients' Rooms , Brazil , Comorbidity , Retrospective Studies , Risk Factors , Azithromycin/therapeutic use , Cough , Dyspnea , Renal Insufficiency/complications , Fever , Interactive Ventilatory Support , Myalgia , COVID-19/therapy , Inpatients/statistics & numerical data , Intensive Care Units , Length of Stay/statistics & numerical data , Hypoxia/complications , Anticoagulants/therapeutic use
2.
Rev. med. Risaralda ; 27(1): 10-20, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280488

ABSTRACT

Resumen Objetivo: Describir la epidemiología de la Leptospirosis en el departamento del Huila durante el período 2011 -2017. Materiales y métodos: Estudio descriptivo de corte transversal, retrospectivo. La población analizada fueron pacientes de los diferentes municipios del departamento del Huila que se reportaron como casos probables o confirmados de leptospirosis. Se estructuraron registros por cada año en bases de datos recopiladas por el área de epidemiología de la Secretaría de Salud del Huila, basadas en las fichas de notificación de vigilancia en salud pública para leptospirosis y generadas por cada Unidad Primaria Generadora de Datos (UPGD) ante la presencia del evento. Los datos fueron discriminados de acuerdo a las variables de interés para el estudio en una nueva base de datos en Excel; tabuladas con el programa estadístico R - Studio 3.3.3 y Epidat 4.2, para luego ser procesados con estadísticos descriptivos y finalmente ser expresados en porcentajes y en tasas de incidencia. Resultados: Se reportaron 268 casos, de los cuales 61 (23%) fueron confirmados por laboratorio y 207 (77%) sospechosos o probables. El 69% de los pacientes presentaron fiebre, mialgias y cefalea como síntomas representativos. El grupo etario más afectado tenía entre 27 y 59 años de edad (44%). La población se caracterizó por ser del área urbana (65%), con mayor frecuencia en hombres (72%). En relación a la ocupación laboral, se encontró mayor frecuencia en agricultores (20%) y en el personal de aseo (17%). Los factores de riesgo evidenciados fueron la presencia de animales domésticos en un 67% de los casos, así como la presencia de ratas en el hogar (51%) y el posible mal manejo del agua. Conclusiones: El incremento en el número de casos de Leptospirosis probablemente está asociado a la mala manipulación del agua y a la presencia de animales en el domicilio.


Abstract Objective: Describe the epidemiology of Leptospirosis in the department of Huila during the years 2011 to 2017. Materials and methods: This article is a descriptive, cross-sectional, retrospective study. The population analyzed were patients from the different municipalities of the department of Huila who were reported as probable or confirmed cases for leptospirosis, structuring records for each year in databases compiled by the epidemiology area of ​​the department's health secretary, based on the public health surveillance notification sheets for leptospirosis, and generated by each Primary Data Generating Unit (UPGD) in the presence of the event; The data were discriminated according to the variables of interest for the study in a new database in Excel; tabulated with the statistical program R - Studio 3.3.3 and Epidat 4.2, to later be processed with descriptive statistics and finally expressed in percentages and incidence rates. Results: 268 cases were reported, which 61 (23%) were confirmed by laboratory and 207 (77%) suspicious or probable. 69% of the patients presented fever, myalgia and headache as representative symptoms. The most affected group range in ages from 27 and 59 (44%). The population was characterized for being part of the urban area (65%), and the cases were more frequent in men (72%). Regarding to employment, it was found that farmers (20%) and the cleaning staff (17%) were the most common cases. The risk factors identified were the presence of domestic animals in 67% of the cases, as well as the presence of rats at home (51%) and the possible poor water management. Conclusions: The increase in the number of cases of Leptospirosis is probably associated with the poor water management and the presence of animals at home.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Zoonoses , Risk Factors , Myalgia , Leptospirosis/epidemiology , Retrospective Studies , Colombia , Fever , Public Health Surveillance , Farmers , Headache , Animals, Domestic
3.
Cienc. tecnol. salud ; 7(3): 381-395, 26 de noviembre 2020. ^c27 cmilus
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1130181

ABSTRACT

La Enfermedad por Coronavirus 2019 (COVID-19) supone un reto sin precedentes para la salud pública. Los médicos deben fortalecer sus habilidades clínicas para combatir esta nueva enfermedad. El objetivo de esta revisión fue describir los signos, síntomas y complicaciones de pacientes con COVID-19. Se realizó una búsqueda en la literatura en la base de datos PubMed incluyendo publicaciones entre 1 de diciembre 2019 y 15 de agosto 2020, sin restricciones de lenguaje, utilizando las palabras clave 'COVID-19' cruzada con 'manifestaciones clínicas', 'signos y síntomas' y 'complicaciones'. Se incluyeron revisiones sistemáticas y meta-análisis, estudios epidemiológicos y series de casos. Se identificaron 1,066 artículos, de los cuales se seleccionaron 71 de acuerdo a los contenidos previamente definidos por los autores. La COVID-19 presenta un curso de leve a moderado y severo-crítico, específicamente en mayores de 65 años con o sin comorbilidades. Los signos y síntomas no son específicos y usualmente se superponen de acuerdo a la edad y a la fase de la enfermedad. Los síntomas más comunes son fiebre, tos y fatiga. Síntomas menos comunes incluyen escalofríos, dolor de garganta, cefalea, mialgias/artralgias, pérdida del gusto y del olfato, diarrea, nausea, vómitos, congestión nasal, palpitaciones, opresión precordial y dolor pleurítico. La sintomatología en niños difiere de la de los adultos y el curso es usualmente benigno y de baja mortalidad. La evaluación clínica de COVID-19 supone un reto hoy en día. Sin embargo, el conocimiento de la historia natural de la enfermedad permite situar los síntomas comunes e inespecíficos en el contexto clínico correcto.


Coronavirus disease 2019 (COVID-19) presents an unprecedented challenge to public health. Physicians must strengthen clinical skills for this new disease. This review aimed to describe the signs, symptoms and complications of patients with COVID-19. A literature search was conducted in the PubMed database, including publications between December 1, 2019, to August 15, 2020, without language restrictions, using the keywords 'COVID-19' crossed with 'clinical manifestations', 'signs and symptoms', and 'complications'. Systematic reviews, meta-analysis, epidemiological studies, and case report series were included. A total of 1,066 articles were identi¬fied, among 71 were selected according to the contents previously defined by the authors. COVID-19 has a mild to moderate or severe-critical course, specifically in over 65 years of age, with or without comorbidities. Signs and symptoms are not specific and usually overlap according to the age and stage of the disease. The most common symptoms are fever, cough, and fatigue. Less common symptoms include chills, sore throat, headache, myalgia/ arthralgia, loss of taste and smell, diarrhea, nausea, vomiting, nasal congestion, palpitations, chest tightness, and pleuritic pain. The symptomatology in children differs from that of adults, and the course is usually benign and low mortality. Clinical evaluation of COVID-19 is challenging today. However, knowledge of the disease's natural history allows placing common and nonspecific symptoms in the correct clinical context.


Subject(s)
Humans , Male , Female , Child , Adult , Middle Aged , Aged , Signs and Symptoms , Betacoronavirus , COVID-19 , Pharyngitis , Cough , Ageusia , Diarrhea , Fever , Myalgia , Headache , Literature , Olfaction Disorders , Nausea
4.
Arq. neuropsiquiatr ; 78(5): 290-300, May 2020. tab, graf
Article in English | LILACS | ID: biblio-1131705

ABSTRACT

ABSTRACT Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.


RESUMO Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Nervous System Diseases/complications , Brain Diseases/complications , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/physiopathology , Coronavirus Infections , Guillain-Barre Syndrome/complications , Ageusia/complications , Pandemics , Myalgia/complications , Olfaction Disorders/complications , Nervous System Diseases/physiopathology
6.
Article in Chinese | WPRIM | ID: wpr-880816

ABSTRACT

OBJECTIVE@#To identify mitochondrial gene variants associated with statin-induced myalgia in Chinese patients with coronary artery disease (CHD).@*METHODS@#This study was conducted in a cohort of 403 patients with CHD receiving rosuvastatin therapy, among whom 341 patients had complete follow-up data concerning myalgia and 389 patients had documented measurements of plasma creatine kinase (CK) level. All these patients underwent genetic analysis using GSA chip for detecting mitochondria gene variants associated with myalgia. A logistic regression model was used to assess the association between 69 mitochondrial single-nucleotide polymorphisms (SNPs) and myopathy in 341 patients. The impact of these mutation sites on CK levels in 389 patients was evaluated by linear regression analysis.@*RESULTS@#G12630A variant was identified to correlate with an increased risk of myalgia in CHD patients (OR: 8.689, 95% @*CONCLUSIONS@#Mitochondrial G12630A variation is associated with statin-induced myalgia in patients with CHD, indicating the necessity of different treatment strategies for patients who carry this risk allele.


Subject(s)
China , Coronary Artery Disease/genetics , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Mitochondria , Myalgia , Polymorphism, Single Nucleotide
8.
Evid. actual. práct. ambul ; 23(2): e002042, 2020. tab
Article in Spanish | LILACS | ID: biblio-1103530

ABSTRACT

Este artículo resume las diferentes formas de presentación clínica de la enfermedad COVID-19 causada por el virus SARS-Co-2 documentadas fundamentalmente en las tres principales revisiones sistemáticas disponibles. Entre las manifestaciones clínicas de frecuente aparición se destacan la fiebre (83 %), la tos (60 %) y la fatiga (38 %), seguidas por las mialgias (29 %), el aumento de la producción del esputo (27 %) y la disnea (25 %). Entre los hallazgos de laboratorio,predominan el aumento de los valores de proteína C reactiva (69 %), la linfopenia (57 %) y el aumento de los niveles de lactato-deshidrogenasa (52 %). Respecto de las manifestaciones radiológicas, tienen especial importancia las opacificaciones en vidrio esmerilado (80 %), la neumonía bilateral (73 %) y la afectación de tres lóbulos pulmonares o más (57 %).Si bien la evidencia sintetizada tiene limitaciones, permite una aproximación actualizada a los conocimientos disponibles sobre la clínica de esta nueva enfermedad en la población adulta. (AU)


This article summarizes the different forms of clinical presentation of COVID-19, caused by the SARS-Co-2 virus, synthesizing the information collected mainly by three published systematic reviews. Frequent clinical manifestations include fever(83 %), cough (60 %), and fatigue (38 %), followed by myalgia (29 %), increased sputum production (27 %) and dyspnea(25 %). Among the laboratory findings, the most common are the increase in C-reactive protein values (69 %), lymphopenia (57 %) and the increase in lactate dehydrogenase levels (52 %).. Most remarkable radiological features include ground glass opacifications (80 %), bilateral pneumonia (73 %) and the involvement of three or more lung lobes (57 %). Although the synthesized evidence has limitations, it allows an updated approach to the available knowledge about the clinical symptoms of this new disease in the adult population. (AU)


Subject(s)
Humans , Adult , Young Adult , Pneumonia, Viral/physiopathology , Coronavirus Infections/physiopathology , Betacoronavirus/pathogenicity , Pneumonia, Viral/complications , Pneumonia, Viral/etiology , Pneumonia, Viral/diagnostic imaging , Sputum , C-Reactive Protein/metabolism , China , Coronavirus Infections/complications , Coronavirus Infections/etiology , Coronavirus Infections/diagnostic imaging , Cough/diagnosis , Cough/physiopathology , Cough/blood , Dyspnea/diagnosis , Dyspnea/physiopathology , Dyspnea/blood , Fatigue/diagnosis , Fatigue/physiopathology , Fatigue/blood , Pandemics , Fever/diagnosis , Fever/physiopathology , Fever/blood , Myalgia/diagnosis , Myalgia/physiopathology , Myalgia/blood , L-Lactate Dehydrogenase/blood , Lymphopenia/blood
9.
J. appl. oral sci ; 28: e20190407, 2020. tab
Article in English | LILACS, BBO | ID: biblio-1090779

ABSTRACT

Abstract This study aimed to evaluate whether the presence of awake bruxism was associated with temporomandibular dysfunction symptoms, pain threshold at pressure, pain vigilance, oral health-related quality of life (OHRQoL), and anxiety and depression symptoms in patients undergoing orthodontic treatment. Methodology This observational study followed patients who had started receiving orthodontic treatment for six months. The following variables were measured three times (at baseline, one month, and six months): pressure pain threshold (PPT) in the right and left masseter, anterior temporalis, and temporomandibular joint (TMJ), and right forearm; pain vigilance and awareness questionnaire; and shortened form of the oral health impact profile (OHIP-14). Anxiety and depression symptoms were measured using the Beck anxiety inventory and the Beck depression inventory, respectively. The patients were divided into two main groups according to the presence (n=56) and absence (n=58) of possible awake bruxism. The multi-way analysis of variance (ANOVA) was applied on the date (p=0.050). Results TMJ and/or muscle pain were not observed in both groups. Time, sex, age group, and awake bruxism did not affect the PPT in the masticatory muscles and pain vigilance (p>0.050). However, the primary effect of awake bruxism was observed when anxiety (ANOVA: F=8.61, p=0.004) and depression (ANOVA: F=6.48, p=0.012) levels were higher and the OHRQoL was lower (ANOVA: F=8.61, p=0.004). Conclusion The patients with self-reported awake bruxism undergoing an orthodontic treatment did not develop TMJ/masticatory muscle pain. The self-reported awake bruxism is associated with higher anxiety and depression levels and a poorer OHRQoL in patients during the orthodontic treatment.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Anxiety/physiopathology , Quality of Life/psychology , Bruxism/psychology , Pain Threshold/psychology , Depression/physiopathology , Self Report , Psychiatric Status Rating Scales , Psychometrics , Severity of Illness Index , Bruxism/physiopathology , Bruxism/therapy , Temporomandibular Joint Disorders/physiopathology , Temporomandibular Joint Disorders/psychology , Analysis of Variance , Pain Threshold/physiology , Statistics, Nonparametric , Myalgia
10.
Infectio ; 23(4): 405-408, Dec. 2019. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1040011

ABSTRACT

Resumen Mujer quien inició tratamiento de rescate de segunda línea para Helicobacter pylori con levofloxacina un gramo cada 12 horas, amoxicilina 500 mg cada 8 horas y lansoprazol 40 mg cada 24 horas. Al quinto día de tratamiento manifestó mialgias generalizadas seguido por artralgias y limitación del movimiento en rodillas y codos. Al séptimo día, sin mejora, la paciente suspende la medicación y presenta resolución completa de los síntomas una semana después. No hubo secuelas, ni complicaciones, ni re-exposición al medicamento. El caso fue clasificado como probable, con un puntaje de siete en la escala de Naranjo. Este caso nos recuerda que la administración de fluoroquinolonas puede asociarse con artralgias y artropatía reversible aguda, y debería ser la primera sospecha diagnóstica en pacientes sin comorbilidad.


Abstract Woman who initiated second-line rescue therapy for Helicobacter pylori with levofloxacin one gram every 12 hours, amoxicillin 500 mg every 8 hours and lansoprazole 40 mg every 24 hours. On the fifth day of treatment, she manifested generalized myalgia followed by bilateral knee and elbow arthralgia with limitation of movements. On the seventh day, without improvement, the patient discontinues the medication and achieve complete resolution of the symptoms one week later. There were no sequelae, no complications, no re-exposure to the drug. The case was classified as probable attaining a score of seven under the Naranjo's scale. This case reminds us that administration of fluoroquinolones may be associated with arthralgia and acute reversible arthropathy and should be the first diagnostic suspicion in patients without comorbidity.


Subject(s)
Humans , Female , Helicobacter pylori , Arthralgia , Levofloxacin , Fluoroquinolones , Myalgia , Gastritis , Anti-Bacterial Agents , Anti-Bacterial Agents/adverse effects
11.
Arq. neuropsiquiatr ; 77(9): 638-645, Sept. 2019. tab
Article in English | LILACS | ID: biblio-1038745

ABSTRACT

ABSTRACT Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. Objective: The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Methods: Electrophysiological parameters were evaluated before and three months after LCI. Moreover, the Numeric Rating Scale (NRS), the Boston Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were administered before and after the injection. A mixture of 1 mL (40 mg) of methylprednisolone and 1 mL of 0.5% bupivacaine were injected blindly on the volar side of the forearm between the tendons of the radial carpal flexor muscle and long palmar muscle. Results: A total of 25 patients (45 hands) were enrolled in the study. Twenty women and five men with a mean age of 49.28 ± 11.37 years were included. A statistically significant difference was noted for improvement of sensory conduction velocities, sensory peak latency, and motor distal latency (p = 0.001) after LCI. A significant difference was recorded between pre- and post-injection for NRS, SSS and FSS scores (p = 0.000). Conclusion: Local corticosteroid injection for CTS provides a short-term improvement in neurophysiological and clinical outcomes such as pain intensity, symptom severity and functional ability.


RESUMO A síndrome do túnel do carpo (STC) é a mononeuropatia mais comum causada pelo aprisionamento do nervo mediano no punho. Opções comuns de tratamento para STC incluem analgésicos orais, splinting, terapia de mão, injeções locais com esteroides ou cirurgia. Objetivo: O objetivo do presente estudo foi avaliar os resultados clínicos e eletrofisiológicos de curto prazo da injeção de corticosteroide local (ICL) em pacientes com STC sintomática. Métodos: Os parâmetros eletrofisiológicos foram avaliados antes e três meses após a ICL. Além disso, a Escala Numérica de Avaliação (NRS), a Escala de Gravidade de Sintomas de Boston (BSS) e a Escala de Status Funcional (FSS) foram administradas antes e após a injeção. Uma mistura de 1 ml (40 mg) de metilprednisolona e 1 ml de bupivacaína a 0,5% foi injetada cegamente no lado do antebraço entre os tendões do músculo flexor radial do carpo e o músculo palmar longo. Resultados: Um total de 25 pacientes (45 mãos) foi incluído no estudo. Vinte mulheres e cinco homens com idade média de 49,28 ± 11,37 anos foram incluídos. Foi observada diferença estatisticamente significante para melhora das velocidades de condução sensitiva, latência de pico sensorial, latência motora distal (p = 0,001) após a ICL. Uma diferença significativa foi registrada entre pré e pós-injeção para os escores NRS, BSS e FSS (p = 0,000). Conclusão: A ICL para STC fornece uma melhoria a curto prazo em resultados neurofisiológicos e clínicos, tais como intensidade da dor, gravidade dos sintomas e capacidade funcional.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Carpal Tunnel Syndrome/physiopathology , Carpal Tunnel Syndrome/drug therapy , Adrenal Cortex Hormones/administration & dosage , Time Factors , Severity of Illness Index , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Follow-Up Studies , Treatment Outcome , Electromyography , Myalgia/physiopathology , Myalgia/drug therapy , Injections, Intramuscular
13.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 384-387, Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1003049

ABSTRACT

SUMMARY Stretching exercises are widely used by the population before sporting activities. One of the most common technique is eccentric exercise. Here, we made a clinical examination of 98 subjects with equinus condition before activity and after 30 min of running (49 participants with previous eccentric exercise and 49 with no previously eccentric exercise). The clinical assessment of the Achilles tendon was based on the pressure pain threshold (PPT). We identified significant PPT changes between the previous eccentric stretching and the non-previous eccentric stretching group in the Achilles tendon evaluations. Based on our findings, we propose that subjects with equinus condition could use eccentric stretching in order to improve the Achilles tendon status.


RESUMO Exercícios de alongamento são amplamente utilizados pela população antes da atividade esportiva. Uma das técnicas mais comuns é o exercício excêntrico. Aqui, fizemos um exame clínico de 98 indivíduos com condição de pé equino antes da atividade e após 30 minutos de corrida (49 corredores com exercício excêntrico anterior e 49 sem exercício excêntrico anterior). A avaliação clínica do tendão de Aquiles foi baseada no limiar de dor à pressão (PPT). Identificamos modificações significativas no PPT entre alongamentos prévios excêntricos e nenhum exercício anterior excêntrico de alongamento para as avaliações do tendão de Aquiles. Com base em nossos achados, propomos que sujeitos com condição de pé equino poderiam fazer alongamentos com exercícios excêntricos para melhorar o status do tendão de Aquiles.


Subject(s)
Humans , Male , Adult , Running/physiology , Achilles Tendon/physiopathology , Pain Threshold/psychology , Muscle Stretching Exercises/methods , Myalgia/prevention & control , Ankle Joint/physiopathology , Reference Values , Reproducibility of Results , Treatment Outcome , Statistics, Nonparametric , Myalgia/physiopathology , Ankle/physiopathology
14.
Article in English | WPRIM | ID: wpr-719457

ABSTRACT

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder of an unknown origin. The role of leptospirosis as a triggering factor for SLE is unknown. This paper reports an uncommon case of SLE following a leptospira infection. A 29-year-old female was referred due to fevers, myalgia, and facial edema with rash. Laboratory investigations revealed a hepatic dysfunction, significantly raised lactate dehydrogenase with marked leukopenia and thrombocytopenia. A diagnosis of leptospirosis was confirmed. The patient was treated with antibiotic therapy for leptospirosis. She developed dyspnea after one week. The echocardiogram revealed global hypokinesia with a decreased ejection fraction. A positivity of antinuclear, anti-DNA, and anti-Smith antibodies, together with clinical and laboratory improvement by steroid therapy, led to the diagnosis of SLE. This case highlights the presence of concurrent SLE and leptospirosis. As the symptoms of SLE are similar to leptospirosis, accurate diagnosis through high suspicion is essential for appropriate treatment.


Subject(s)
Adult , Antibodies , Diagnosis , Dyspnea , Edema , Exanthema , Female , Fever , Humans , Hypokinesia , L-Lactate Dehydrogenase , Leptospira , Leptospirosis , Leukopenia , Lupus Erythematosus, Systemic , Myalgia , Myocarditis , Thrombocytopenia
15.
Article in Chinese | WPRIM | ID: wpr-781673

ABSTRACT

OBJECTIVE@#To observe the effect of the small needle knife through the Zusanli(ST 36) on behavior and hippocampal expression of NLRP3 and IL-1β in myalgia comorbid depressed rats.@*METHODS@#The rat models of myalgia comorbid depression were prepared by intraperitoneal injection of acute reserpine. Twenty-four SD male rats were randomly divided into control group, model group, small needle knife group and amitriptyline group, 6 rats in each group. The open field behavior and mechanical pain threshold of each group were detected. The thermal pain threshold was detected by intelligent hot plate test. The expression of NLRP3 and IL-1β in hippocampus of rats was detected by Western blotting.@*RESULTS@#Compared with the model group, the mechanical pain threshold of the foot was significantly improved in the small needle knife group (0.05). The expressions of NLRP3 and IL-1β in the hippocampus of the model group were significantly increased(0.05).@*CONCLUSIONS@#Small needle knife can improve the pathological state of myalgia comorbid depression caused by reserpine in rats. The mechanism may be related to the inhibition of NLRP3 inflammasome and IL-1β expression in central hippocampus.


Subject(s)
Animals , Hippocampus , Inflammasomes , Interleukin-1beta , Male , Myalgia , NLR Family, Pyrin Domain-Containing 3 Protein , Rats , Rats, Sprague-Dawley
16.
Clinical Endoscopy ; : 620-623, 2019.
Article in English | WPRIM | ID: wpr-785660

ABSTRACT

Endoscopic submucosal dissection (ESD) is widely used for the treatment of colorectal neoplasia in patients who are candidates for endoscopic resection. In particular, pyogenic liver abscess (PLA), although rare, can occur. To our knowledge, there are no reports of PLA cases after ESD. Therefore, we report a rare case of PLA caused by ESD. A 76-year-old man was referred from a local clinic and admitted to our hospital for colonic ESD for a large polypoid mass. During colonoscopy, a 5-cm mass was seen in the cecum. ESD was performed. Four days after the procedure, he complained of myalgia and abdominal discomfort. Computed tomography revealed a 5.4-cm PLA in the medial segments of the liver. He was treated with antibiotics, and a percutaneous drainage catheter was inserted. Here, we report a very rare complication (PLA) after ESD. In conclusion, comprehensive awareness of the development of PLA is needed in ESD cases.


Subject(s)
Aged , Anti-Bacterial Agents , Catheters , Cecum , Colon , Colonic Neoplasms , Colonoscopy , Drainage , Endoscopy , Humans , Liver , Liver Abscess , Liver Abscess, Pyogenic , Myalgia
17.
Article | WPRIM | ID: wpr-763549

ABSTRACT

OBJECTIVE: The aims of this study were to investigate the effects of daily low-dose tadalafil on cognitive function and to examine whether there was a change in cerebral blood flow (CBF) in patients with erectile dysfunction (ED) and mild cognitive impairment. METHODS: Male patients aged 50 to 75 years with at least three months of ED (International Index of Erectile Function [IIEF]-5 score ≤ 21) and mild cognitive impairment (Montreal Cognitive Assessment [MoCA] score ≤ 22) were included in the study. The subjects were prescribed a low-dose PDE5 inhibitor (tadalafil 5 mg) to be taken once daily for eight weeks. Changes in MoCA score and single-photon emission computed tomography (SPECT) study between the two time-points were assessed by paired t tests. RESULTS: Overall, 30 male patients were assigned to the treatment group in this study and 25 patients completed the eight-week treatment course. Five patients were withdrawn due to adverse events such as myalgia and dizziness. Mean baseline IIEF and MoCA scores were 7.52 ± 4.84 and 18.92 ± 1.78. After the eight-week treatment, mean IIEF and MoCA scores were increased to 12.92 ± 7.27 (p < 0.05) and 21.8 ± 1.71 (p < 0.05), respectively. Patients showed increased relative regional CBF in the postcentral gyrus, precuneus, and brainstem after tadalafil administration versus at baseline (p < 0.001). CONCLUSION: The results of this prospective clinical study suggest that daily use of tadalafil 5 mg increases some regional CBF and improves cognitive function in patients with ED and mild cognitive impairment.


Subject(s)
Brain Stem , Cerebrovascular Circulation , Clinical Study , Cognition , Dizziness , Erectile Dysfunction , Humans , Male , Methylenebis(chloroaniline) , Cognitive Dysfunction , Myalgia , Parietal Lobe , Perfusion , Phosphodiesterase Inhibitors , Prospective Studies , Somatosensory Cortex , Tadalafil , Tomography, Emission-Computed
18.
Article in English | WPRIM | ID: wpr-763115

ABSTRACT

PURPOSE: Dose-dense chemotherapy (DD-CT) is a preferred (neo)adjuvant regimen in early breast cancer (BC). Although the results of reported randomized trials are conflicting, a recent meta-analysis showed improved overall and disease-free survival with DD-CT compared to conventional schedules. However, no DD-CT safety data for Korean BC patients are available. This phase II study was conducted to evaluate the safety and efficacy of pegteograstim in Korean BC patients receiving DD-CT. MATERIALS AND METHODS: Patients with operable (stage I-III), histologically confirmed BC received four cycles of intravenous doxorubicin (60 mg/m2) and cyclophosphamide (600 mg/m2) on day 1 every 2 weeks as neoadjuvant or adjuvant therapy. Pegteograstim (6.0 mg) was administered subcutaneously on day 2 of each cycle. The primary endpoint was the incidence of febrile neutropenia (FN). The secondary endpoints were safety and tolerability. RESULTS: Of 63 patients, one (1.6%) developed FN during all cycles of DD-CT. Dose delay was observed in four patients (6.3%) and dose reduction in two (3.2%) during DD-CT. Frequent adverse events (AEs) were nausea, alopecia, generalized muscle weakness, myalgia, mucositis, anorexia, dyspepsia, and diarrhea; most AEs were related to chemotherapy. Grade 3-4 AEs were reported in five of 63 patients (7.9%), and all grade 3 and 4 AEs were related to chemotherapy. Adverse drug reactions possibly linked to pegteograstim were abdominal pain, bone pain, myalgia, generalized muscle weakness, and headache in five of 63 patients (7.9%). CONCLUSION: Dose-dense AC (doxorubicin/cyclophosphamide) chemotherapywith pegteograstim support is a tolerable and safe regimen in Korean early BC patients.


Subject(s)
Abdominal Pain , Alopecia , Anorexia , Appointments and Schedules , Breast Neoplasms , Breast , Cyclophosphamide , Diarrhea , Disease-Free Survival , Doxorubicin , Drug Therapy , Drug-Related Side Effects and Adverse Reactions , Dyspepsia , Febrile Neutropenia , Headache , Humans , Incidence , Mucositis , Muscle Weakness , Myalgia , Nausea
19.
Article in English | WPRIM | ID: wpr-766132

ABSTRACT

OBJECTIVES: Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province. METHODS: The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018. RESULTS: Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively. CONCLUSIONS: Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.


Subject(s)
Bunyaviridae Infections , Diagnosis , Diarrhea , Fever , Humans , Incidence , Korea , Mortality , Myalgia , Patient Selection , Thrombocytopenia , Tick-Borne Diseases
20.
Article in English | WPRIM | ID: wpr-765667

ABSTRACT

Dyslipidemia, highly elevated, low-density lipoprotein (LDL) cholesterol, is a major cardiovascular risk factor. Statins have been proven to effectively reduce the risk of atherosclerotic cardiovascular disease (ASCVD) and are recommended as a first-line therapy for the primary and secondary prevention of ASCVD. However, statins may not be sufficient in decreasing LDL cholesterol levels and pose a significant on-treatment residual risk of major cardiovascular events (i.e., residual cholesterol risk) according to meta-analyses of statin trials. Current guidelines for cholesterol management to achieve additional LDL cholesterol reduction and reduce ASCVD risk recommend two hyperlipidemic agents besides statins. Use of ezetimibe, a cholesterol absorption inhibitor, leads to additional LCL cholesterol reduction and decreased ASCVD risk, when added to statin therapy, without raising significant safety concerns. Furthermore, in combination with a mild-to-moderate statin intensity, ezetimibe is used in situations of statin-associated adverse effects such as myalgia and the combination therapy is relatively safer. Monoclonal antibody of proprotein convertase subtilisin/kexin type 9 (PCSK9), alirocumab, and evolocumab, have been approved to lower LDL cholesterol level. While there are drawbacks to the use of PCSK9 inhibitors, including high cost and adverse events such as injection site reaction, they significantly decreased serum LDL cholesterol levels and thereby ASCVD risks when added to maximally tolerated statin therapy.


Subject(s)
Absorption , Cardiovascular Diseases , Cholesterol , Cholesterol, LDL , Dyslipidemias , Ezetimibe , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Lipoproteins , Myalgia , Proprotein Convertases , Risk Factors , Secondary Prevention
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