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1.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 119-128, Dec. 2021.
Article in Spanish | LILACS | ID: biblio-1352967

ABSTRACT

Introducción: La sarcoidosis es una enfermedad inflamatoria, granulomatosa de etiología desconocida. Puede afectar cualquier órgano siendo la afectación pulmonar la más frecuente. La piel se compromete en aproximadamente 30% de los casos, pudiendo ser inicial o único. La sarcoidosis es muy rara en el Paraguay. Objetivos: Realizar una revisión de los casos de sarcoidosis observados en el Servicio de Dermatología del Hospital Nacional en el periodo 2010-2020; determinando sus características demográficas, clínicas, laboratoriales y evolutivas. Materiales y métodos: Estudio retrospectivo, descriptivo y observacional. Resultados: Se diagnosticaron 5 casos, todas mujeres de raza blanca, con edades que oscilaban de 41 a 63 años. Las formas clínicas fueron papulosa en 3 casos, en placa 1 y mixta 1. Las lesiones cutáneas eran asintomáticas y estaban ubicadas preferentemente en rostro (4 casos). El compromiso sistémico se objetivó en las primeras consultas en 2 casos (pulmonar, ocular y ganglionar en 1 y del aparato lagrimal en otro). En todos los casos el diagnóstico se fundamentó en la correlación clínico-histológica, con el hallazgo de los granulomas sarcoides. Todos recibieron clobetasol tópico, 3 pacientes ciclos de prednisona y 2 hidroxicloroquina. La evolución fue favorable en 3 casos y 2 no volvieron a sus controles. Conclusión: La sarcoidosis con manifestaciones cutáneas es rara en nuestro Servicio, pero representa un desafío diagnóstico, que debe ser oportuno para diferenciarla de otras patologías más prevalentes en nuestro medio


Introduction: Sarcoidosis is an inflammatory, granulomatous disease of unknown etiology. It can affect any organ, lung involvement being the most frequent. The skin is compromised in approximately 30% of the cases, and can be initial or unique. Sarcoidosis is very rare in Paraguay. Objectives: To carry out a review of the sarcoidosis cases observed in the Dermatology Service of the National Hospital in the period 2010-2020; determining their demographic, clinical, laboratory and evolutionary characteristics. Materials and methods: Retrospective, descriptive and observational study. Results: 5 cases were diagnosed; all white women; with ages ranging from 41 to 63 years. The clinical forms were papular in 3 cases, in plate 1 and mixed 1. The skin lesions were asymptomatic and were preferably located on the face (4 cases). Systemic involvement was observed in the first consultations in 2 cases (pulmonary, ocular and lymph node in 1 and the lacrimal apparatus in another). In all cases the diagnosis was based on the clinical-histological correlation, with the finding of sarcoid granulomas. All received topical clobetasol, 3 patients received prednisone cycles and 2 hydroxychloroquine. The evolution was favorable in 3 cases and 2 did not return to their controls. Conclusion: Sarcoidosis with skin manifestations is rare in our Service, but it represents a diagnostic challenge that must be timely to differentiate it from other more prevalent pathologies in our setting


Subject(s)
Sarcoidosis , Pathology , Skin , Demography , Disease , Dermatology , Diagnosis , Laboratories
2.
Medicina UPB ; 40(2): 67-74, 13 oct. 2021. tab, Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1342233

ABSTRACT

En los últimos años se ha evidenciado un aumento en la incidencia y prevalencia de la enfermedad inflamatoria intestinal, que comprende dos entidades: la enfermedad de Crohn y la colitis ulcerativa. Ambas, y paradójicamente su tratamiento, pueden desencadenar manifestaciones cutáneas con una amplia variedad de manifestaciones clínicas en piel, que son un reto diagnóstico para el médico. Solo el conocimiento de estos fenotipos clínicos permitirá el diagnóstico temprano, con el objetivo de lograr el abordaje diagnóstico y el tratamiento oportunos y de evitar secuelas a largo plazo.


In recent years, there is evidence of an increase in the incidence and prevalence of inflammatory bowel disease, in which two entities are involved: Chron disease and ul-cerative colitis. Both of these diseases and, paradoxically, their treatment with anti-TNF may trigger skin manifestations, whose variety of clinical presentations on the skin can represent a diagnostic challenge for the clinician. Only the knowledge of these clinical phenotypes will allow an early diagnosis to be carried out, in order to achieve a timely diagnostic approach and treatment, and to avoid long-term sequelae.


Nos últimos anos, tem havido um aumento na incidência e prevalência da doença infla-matória intestinal, que compreende duas entidades: doença de Crohn e colite ulcerosa. Ambos, e paradoxalmente o seu tratamento, podem desencadear manifestações cutâ-neas com uma grande variedade de manifestações clínicas na pele, o que constitui um desafio diagnóstico para o médico. Somente o conhecimento desses fenótipos clínicos permitirá o diagnóstico precoce, com o objetivo de alcançar uma abordagem diagnóstica e terapêutica oportuna e evitar sequelas a longo prazo.


Subject(s)
Humans , Inflammatory Bowel Diseases , Phenotype , Signs and Symptoms , Skin , Skin Manifestations , Disease , Colitis
3.
Nursing (Säo Paulo) ; 24(277): 5775-5784, jun.2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1253487

ABSTRACT

Objetivo: identificar fatores associados a lesões de pele decorrentes de cirurgias urológicas robóticas versus convencionais em adultos/idosos. Método: revisão integrativa, etapas: Construção do protocolo de pesquisa; Formulação da pergunta - prática baseada em evidência, utilizando o acrônimo PICO; Definição dos descritores das estratégias de busca em cada uma das bases de dados selecionadas, que deviam ser variadas; Determinação, seleção e revisão dos critérios de inclusão e exclusão; Avaliação crítica dos estudos; Coleta de dados utilizando instrumentos que analisassem em pares; e Síntese dos resultados/dados agrupados por semelhança. Resultados: a estratégia de busca gerou 207 artigos. Resultando para análise final 7 artigos. Conclusão: são necessários novos estudos clínicos, que abordem os prejuízos e benefícios relacionados ao posicionamento cirúrgico robótico e abertos, direcionando assim, intervenções de enfermagem acuradas aos pacientes sob maior risco.(AU)


Objective: to identify factors associated with skin lesions resulting from robotic versus conventional urological surgery in adults / elderly. Method: integrative review, stages: Construction of the research protocol; Formulation of the question - evidence-based practice, using the acronym PICO; Definition of search strategy descriptors in each of the selected databases, which should be varied; Determination, selection and review of inclusion and exclusion criteria; Critical evaluation of studies; Data collection using instruments that analyzed in pairs; and Summary of results / data grouped by similarity. Results: the search strategy generated 207 articles. Resulting in 7 articles for final analysis. Conclusion: further clinical studies are needed, addressing the losses and benefits related to robotic and open surgical positioning, thus directing accurate nursing interventions to patients at higher risk.(AU)


Objetivo: identificar los factores asociados a las lesiones cutáneas resultantes de la cirugía urológica robótica versus convencional en adultos / ancianos. Método: revisión integradora, etapas: construcción del protocolo de investigación; Formulación de la pregunta - práctica basada en evidencia, utilizando el acrónimo PICO; Definición de descriptores de estrategias de búsqueda en cada una de las bases de datos seleccionadas, que deben ser variadas; Determinación, selección y revisión de criterios de inclusión y exclusión; Evaluación crítica de estudios; Recolección de datos utilizando instrumentos que se analizaron por parejas; y Resumen de resultados / datos agrupados por similitud. Resultados: la estrategia de búsqueda generó 207 artículos. Resultando en 7 artículos para el análisis final. Conclusión: se necesitan más estudios clínicos que aborden las pérdidas y beneficios relacionados con el posicionamiento quirúrgico robótico y abierto, dirigiendo así intervenciones de enfermería precisas a los pacientes de mayor riesgo.(AU)


Subject(s)
Humans , Skin/injuries , Robotic Surgical Procedures , Perioperative Nursing , Data Collection
4.
Arq. ciências saúde UNIPAR ; 25(2): 95-103, maio-ago. 2021.
Article in Portuguese | LILACS | ID: biblio-1252352

ABSTRACT

Objetivo: Averiguar a eficácia da Escala de Braden como instrumento norteador na assistência para prevenção de lesão por pressão em indivíduos acamados no âmbito domiciliar. Método: Trata-se de um estudo descritivo com abordagem quantitativa com coleta de dados realizada em domicílio por meio de entrevista e inspeção da pele de 41 participantes. Resultados: A incidência de lesão por pressão foi de 7%. Constatou-se que os indivíduos acamados em domicílio com alto risco, na escala de Braden, não mostraram incidência de lesão por pressão, enquanto os que apresentaram risco moderado houve incidência. Conclusão: Apesar de ser um instrumento bastante utilizado pelos profissionais da área da saúde, o presente trabalho demonstrou que a alta sensibilidade e especificidade da Escala de Braden é questionável. Os cuidados foram essênciais para essa baixa incidência de lesão por pressão, diminuindo sua associação com a idade e tempo de acamado.


Objective: investigate the effectiveness of the Braden Scale as a guiding instrument in assisting in the prevention of pressure injury in bedridden individuals at home. Method: This is a descriptive study with a quantitative approach, with data collected at home through interviews and skin inspection of 41 participants. Results: There was an incidence of 7% of pressure injuries. It was found that individuals at high risk at home, according to the Braden scale, did not show incidence of pressure injuries, while those with moderate risk presented such incidence. Conclusion: Despite being widely used by health professionals, this study demonstrated that the high sensitivity and specificity of the Braden Scale is questionable. Care was essential for this low incidence of pressure injuries, reducing its association with age and bedridden time.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Pressure Ulcer/prevention & control , Bedridden Persons , Primary Health Care/methods , Skin , Comorbidity , Caregivers , Home Nursing/methods
5.
Infectio ; 25(2): 130-134, abr.-jun. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250079

ABSTRACT

Resumen El género Malassezia comprende levaduras lipofílicas, comensales de la piel de humanos y animales, responsables de infecciones dermatológicas y sistémicas, particularmente en recién nacidos pretérmino hospitalizados en Unidades de Cuidados Intensivos Neonatal (UCIN) con catéteres venosos centrales, antibióticos de amplio espectro y nutrición parenteral rica en lípidos. La información acerca de las fungemias por este microorganismo es limitada, sin embargo, la mayoría de infecciones invasivas reportadas en la literatura han sido asociadas con M. furfur y M. pachydermatis. Se reporta un caso de fungemia por M. sympodialis en un recién nacido pretérmino hospitalizado en la UCIN de un hospital colombiano con sospecha clínica de sepsis neonatal, antibioticoterapia de amplio espectro y hemocultivos de rutina negativos. El aislamiento fue susceptible a fluconazol y voriconazol, y resistente a anfotericina B. Existen pocos reportes de fungemia producida por M. sympodialis, pero todos concuerdan en que es una levadura subestimada en individuos con factores predisponentes.


Abstract The genus Malassezia comprises lipophilic yeasts, commensals of the skin of humans and animals, responsible for dermatological and systemic infections, particu larly in preterm infants hospitalized in Neonatal Intensive Care Units (NICU) with central venous catheters, broad-spectrum antibiotics and parenteral nutrition rich in lipids. Information about fungemia by this microorganism is limited, however, the majority of invasive infections reported in the literature have been associated with M. furfur and M. pachydermatis. A case of M. sympodialis fungemia is reported in a preterm newborn hospitalized in the NICU of a Colombian hospital with clinical suspicion of neonatal sepsis, broad-spectrum antibiotic therapy and negative routine blood cultures. The isolation was susceptible to fluconazole and voriconazole, and resistant to amphotericin B. There are few reports of fungemia produced by M. sympodialis, but all agree that it is an underestimated yeast in individuals with predisposing factors.


Subject(s)
Humans , Male , Infant, Newborn , Intensive Care Units, Neonatal , Fungemia , Malassezia , Skin , Yeasts , Colombia , Neonatal Sepsis , Infections
6.
Infectio ; 25(2): 120-129, abr.-jun. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1250078

ABSTRACT

Abstract Seborrheic dermatitis (SD) is a chronic inflammatory disease that that is difficult to manage and with a high impact on the individual's quality of life. Besides, it is a multifactorial entity that typically occurs as an inflammatory response to Malassezia species, along with specific triggers that contribute to its pathophysiology. Sin ce the primary underlying pathogenic mechanisms include Malassezia proliferation and skin inflammation, the most common treatment includes topical antifungal keratolytics and anti-inflammatory agents. However, the consequences of eliminating the yeast population from the skin, the resistance profiles of Malassezia spp. and the effectivity among different groups of medications are unknown. Thus, in this review, we summarize the current knowledge on the disease´s pathophysio logy and the role of Malassezia sp. on it, as well as, the different antifungal treatment alternatives, including topical and oral treatment in the management of SD.


Resumen La dermatitis seborreica (DS) es una enfermedad inflamatoria crónica, con un elevado impacto en la calidad de vida del individuo. Además, DS es una entidad multifactorial que ocurre como respuesta inflamatoria a las levaduras del género Malassezia spp., junto con factores desencadenantes que contribuyen a la fisio patología de la enfermedad. Dado que el mecanismo patogénico principal involucra la proliferación e inflamación generada por Malassezia spp., el tratamiento más usado son los agentes tópicos antifúngicos y antiinflamatorios. Sin embargo, se desconocen las consecuencias de eliminar la población de levaduras de la piel, los perfiles de resistencia de Malassezia spp. y la efectividad entre grupos diferentes de medicamentos. Por tanto, en esta revisión de la literatura, resumimos el conocimiento actual sobre la fisiopatología de la enfermedad y el papel de Malassezia sp., así como de las diferentes alternativas de tratamiento antifúngico tanto tópico como oral en el manejo de la DS.


Subject(s)
Humans , Male , Female , Dermatitis, Seborrheic , Malassezia , Skin , Pharmaceutical Preparations , Inflammation , Anti-Inflammatory Agents
7.
Online braz. j. nurs. (Online) ; 20: e20216481, 05 maio 2021. ilus
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1255197

ABSTRACT

OBJETIVO: Avaliar a efetividade do ângulo de fase medido por bioimpedância elétrica como preditor para avaliação de cicatrização em pacientes com lesões cutâneas ou risco de desenvolvê-las. MÉTODO: Revisão sistemática operacionalizada segundo metodologia Joanna Briggs Institute, recomendações checklist PRISMA. A amostra contemplou pacientes acima de 18 anos com lesões cutâneas variadas. RESULTADOS: Quatro estudos demonstraram o uso do ângulo de fase para o desfecho cicatrização e um estudo apontou uma possível relação do ângulo de fase com previsão de surgimento e risco de lesão por pressão. Foram obtidos pontos de cortes para determinadas lesões. Por não ter sido possível metanálise, se propõe a realização de estudos primários sobre o tema deste estudo. CONCLUSÃO: Apesar de serem poucos os trabalhos científicos com o tema proposto, foi possível demonstrar evidência moderada para o desfecho "cicatrização" e baixa para o desfecho "risco de lesão". Registro no PROSPERO com número CRD420201549.


OBJECTIVE: To assess the effectiveness of the phase angle measured by electrical bioimpedance as a predictor for healing evaluation in patients with skin lesions or risk of developing them. METHOD: A systematic review operationalized according to Joanna Briggs Institute methodology, PRISMA checklist recommendations. The sample included patients over 18 years old with varied skin lesions. RESULTS: Four studies demonstrated the use of phase angle for the healing outcome and one study indicated a possible relationship between phase angle and the prediction of the onset and risk of pressure ulcer. Cut-off points were obtained for certain lesions. As it was not possible to perform a meta-analysis, it is proposed to conduct primary studies on the theme of this study. CONCLUSION: Although there are few scientific papers with the theme proposed, it was possible to demonstrate moderate evidence for the "healing" outcome and low evidence for the "risk of lesion" outcome. Registration in PROSPERO with number CRD420201549.


OBJETIVO: Evaluar la efectividad del ángulo de fase medido por bioimpedancia eléctrica como predictor para la evaluación de la cicatrización en pacientes con lesiones cutáneas o riesgo de desarrollarlas. MÉTODO: Revisión sistemática realizada según la metodología del Joanna Briggs Institute, recomendaciones checklist PRISMA. La muestra incluyó a pacientes mayores de 18 años con diferentes lesiones cutáneas. RESULTADOS: Cuatro estudios demostraron el uso del ángulo de fase para el resultado cicatrización y un estudio señaló una posible relación entre el ángulo de fase y la previsión de la aparición y el riesgo de lesión por presión. Se obtuvieron puntos de corte para ciertas lesiones. Como no fue posible realizar un metaanálisis, se propone realizar estudios primarios sobre el tema de este estudio. CONCLUSIÓN: Aunque hay pocos estudios científicos sobre el tema propuesto, fue posible demostrar evidencia moderada para el resultado "cicatrización" y baja para el resultado "riesgo de lesión". Inscripción en PROSPERO con número CRD420201549.


Subject(s)
Humans , Skin/injuries , Wound Healing , Electric Impedance , Pressure Ulcer
8.
Rev. colomb. gastroenterol ; 36(supl.1): 91-97, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251554

ABSTRACT

Resumen Los pacientes con dermatomiositis presentan un mayor riesgo de asociación con patología maligna subyacente, sin conocerse una causa precisa de esta relación. Son múltiples las posibles localizaciones anatómicas, entre las que se incluyen los ovarios, mamas, zona gástrica, zona colorrectal, sangre, pulmones y próstata. Se presenta el caso de una mujer de 58 años que durante el estudio de pérdida anormal de peso manifestó debilidad muscular grave y alteraciones dermatológicas asociadas con el hallazgo de adenocarcinoma del colon transverso.


Abstract Patients with dermatomyositis are more likely to have an underlying malignancy, although the exact cause of this association is unknown. There are multiple possible anatomical sites, including ovaries, breasts, stomach, colorectum, blood, lungs, and prostate. We present the case of a 58-year-old woman who during abnormal weight loss study showed severe muscle weakness and skin alterations, associated with finding of adenocarcinoma of the transverse colon.


Subject(s)
Humans , Female , Middle Aged , Colorectal Neoplasms , Colon, Transverse , Dermatomyositis , Skin , Weight Loss , Literature
9.
Rev. colomb. gastroenterol ; 36(supl.1): 12-18, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251540

ABSTRACT

Resumen Las vasculitis leucocitoclásticas se definen como el daño e inflamación de las paredes vasculares, son aquellas vasculitis de pequeños vasos que anatomopatológicamente presentan leucocitoclasia y puede observarse como una manifestación extraintestinal de la enfermedad inflamatoria intestinal. En la colitis ulcerativa se presentan en menor frecuencia, por inmunocomplejos generados en la mucosa intestinal debido a la exposición del tejido linfoide submucoso a antígenos fecales; podrían precipitarse en las paredes de los pequeños vasos. Se pueden asociar con Clostridium difficile, que es un bacilo grampositivo esporulado, anaerobio estricto, que se encuentra normalmente en el medio ambiente y produce colitis, que se manifiesta como un cuadro diarreico presentado después de la ingesta de antibióticos y altera la flora bacteriana común de este órgano. El caso se trata de un paciente 36 años de edad con cuadro de diarreas líquidas con moco y escaso sangrado; se realizó un estudio endoscópico y anatomopatológico en el que se observó colitis ulcerativa con coproparasitario positivo para antígeno de C. difficile, y en su hospitalización presentó lesiones dérmicas petequiales y necróticas en el cuarto dedo de la mano izquierda, que en la biopsia dio como resultado vasculitis de pequeños vasos. En este artículo se revisan de forma práctica los aspectos relacionados con la fisiopatología, histología, tratamiento y diagnósticos de la manifestación extraintestinal dermatológica rara, como la vasculitis leucocitoclástica en pacientes con colitis ulcerativas asociadas con Clostridium.


Abstract Leukocytoclastic vasculitis is defined as the damage and inflammation of the vascular walls. The term refers to vasculitis of the small vessels that anatomopathologically present leukocytoclasia and it can be seen as an extra-intestinal manifestation of inflammatory bowel disease. In ulcerative colitis, it occurs less frequently due to immune complexes produced in the intestinal mucosa by exposure of the submucosal lymphoid tissue to fecal antigens, which could precipitate in the walls of the small vessels. This condition can be associated with Clostridium difficile, which is a gram-positive, sporulated, strict anaerobic bacillus, normally found in the environment. It causes colitis that manifests as a diarrheal disease following the ingestion of antibiotics that alter the common bacterial flora of this organ. This is the case report of a 36-year-old patient with liquid diarrhea with mucus and scarce bleeding. Endoscopic and anatomopathological studies were performed, finding ulcerative colitis with positive coproparasite for Clostridium difficile antigen. The patient was hospitalized, and during his stay, he presented with petechiae and necrotic skin lesions on the fourth finger of the left hand. Skin biopsy showed small vessel vasculitis. This article is a practical review of the pathophysiology, histology, treatment, and diagnosis of a rare dermatologic extraintestinal manifestation, namely, leukocytoclastic vasculitis, in patients with C. difficile-associated ulcerative colitis.


Subject(s)
Humans , Male , Adult , Vasculitis , Inflammatory Bowel Diseases , Colitis, Ulcerative , Clostridioides difficile , Skin , Therapeutics , Diarrhea , Fingers , Histology
10.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1337617

ABSTRACT

Las quemaduras son lesiones producidas en un tejido vivo por la acción de diversos agentes físicos: térmicos, eléctricos, radiantes, químicos, cáusticos, agentes biológicos, entre otros. El objetivo del estudio fue describir el perfil epidemiológico de niños entre 2 - 5 años de ambos sexos que ingresaron al Centro Nacional del Quemado y Cirugías Reconstructivas Dr. Arnaldo Bendlin de la ciudad de Asunción-Paraguay en el periodo 2019-2020. Estudio observacional, descriptivo en el que se realizó una revisión retrospectiva de las historias clínicas de los niños de entre 2 a 5 años que sufrieron quemaduras y consultaron en el Centro Nacional del Quemado y Cirugías Reconstructivas Dr. Arnaldo Bendlin entre el 2019 y 2020. Se estudiaron 338 pacientes, de los cuales 299 (54,4%) eran del sexo masculino, 131 (38,8%) de 2 años de edad y 215 (63,6%) del departamento Central. En 255 (75,4%) pacientes, la fuente de la quemadura fue líquido caliente, en 118 (34,9%) la lesión fue en miembros inferiores, y en 276 (81,7%) la quemadura fue de segundo grado. En 323 (95,6%) la quemadura ocurrió en su propio hogar, 337 (99,7%) recibieron tratamiento médico y 8 (2,4%) recibieron balneoterapia. La mayoría de las quemaduras fueron de segundo grado y causadas por líquidos calientes. La localización más frecuente fue en los miembros inferiores. Es urgente implementar programas educacionales en las escuelas, centros comunitarios y medios de comunicación ya que gran parte de los accidentes ocurrieron en el ambiente doméstico pudiendo ser evitados


Burns are injuries produced in living tissue by the action of various physical agents: thermal, electrical, radiant, chemical, caustic, biological agents, among others. The objective of this study was to describe the epidemiological characteristics of male and female children aged 2 - 5 years admitted to the Centro Nacional del Quemado y Cirugías Reconstructivas "Dr. Arnaldo Bendlin" in the city of Asunción, Paraguay in the period 2019-2020. An observational, descriptive study consisting in a retrospective review of medical records of children between 2 and 5 years of age who suffered burns and consulted at the Centro Nacional del Quemado y Cirugías Reconstructivas "Dr. Arnaldo Bendlin" between 2019 and 2020 was carried out. A total of 338 patients were studied, 299 (54.4%) were male, 131 (38.8%) were 2 years old and 215 (63.6%) were from the Central department. In 255 (75.4%) patients, the source of the burn was hot liquid, in 118 (34.9%) the injury was in the lower limbs and 276 (81.7%) had second-degree burns. In 323 (95.6%), the burn occurred in their own home, 337 (99.7%) received medical treatment and 8 (2.4%) balneotherapy. The majority of the cases had second-degree burns and was caused by hot liquids. The most common location was in the lower limbs. It is urgent to implement educational programs in schools, community centers and the media since a large part of the accidents occurred in the domestic environment and can be prevented


Subject(s)
Humans , Male , Female , Child, Preschool , Pediatrics , Burns , Skin , Accidents
11.
Säo Paulo med. j ; 139(2): 186-189, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1181004

ABSTRACT

ABSTRACT CONTEXT: Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology of these lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. CASE REPORT: Here, we report a case of eruptive cherry angiomas, which was thought to have developed due to COVID-19, with a papulovesicular rash on distal extremities that progressed over time to reticular purpura. CONCLUSION: The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.


Subject(s)
Humans , Male , Female , Middle Aged , Purpura/virology , Skin/virology , Skin Diseases, Viral/virology , Exanthema/virology , COVID-19/complications , COVID-19/virology , Hemangioma/virology , Skin/drug effects , Skin/pathology , Treatment Outcome , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/therapy , COVID-19 Testing , SARS-CoV-2 , COVID-19/drug therapy , COVID-19/therapy
12.
São Paulo; SMS; 20210000.
Monography in Portuguese | LILACS, ColecionaSUS, SMS-SP, SMS-SP | ID: biblio-1152129
13.
Rev. Soc. Bras. Med. Trop ; 54: e04612020, 2021. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1143887

ABSTRACT

Abstract We report a case of envenomation by Dendrobates tinctorius in the northwest of the Amazon Forest. The patients were two men, who presented with numbness in the right arm and slight numbness in the lower lip, respectively. Dendrobates tinctorius secretions contain pumiliotoxin, one of several toxins found in the dendrobatidis skin, which interferes with muscle contraction and causes locomotor difficulties. Although Dendrobatidae is a family of anurans known for their venom, few studies describe the symptoms of envenomation in humans.


Subject(s)
Animals , Male , Anura , Poisons , Skin , Brazil
14.
Article in English | WPRIM | ID: wpr-879972

ABSTRACT

Melkersson-Rosenthal syndrome (MRS) is a rare neuro-muco-cutaneous syndrome, which is characterized by recurrent orofacial swelling, recurrent facial paralysis and fissured tongue. It has a high prevalence in young adults. Up to now, the etiology of MRS is still not clear, it may related to infection, immune deficiency and hereditary factors. The pharmacological therapy and surgery are the main treatment. Corticosteroids seems to be the drug of choice for MRS patient, but the specific dosage and therapeutic effect have not yet been determined. Surgeries of lips provide excellent results in persistentlip edema MRS cases. This article reviews the research progress on MRS, focusing on its epidemiology, etiology, histopathological characteristics, clinical manifestations, classification, diagnostic criteria, differential diagnosis and treatment, to provide information for its early diagnosis and appropriate treatment.


Subject(s)
Adrenal Cortex Hormones , Diagnosis, Differential , Humans , Lip , Melkersson-Rosenthal Syndrome/drug therapy , Skin , Young Adult
15.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58(n.esp): e174252, 2021. ilus
Article in English | ID: biblio-1348192

ABSTRACT

Donkeys (Equus asinus) face a global crisis. The health, welfare, and even survival of donkeys are being compromised as the demand for their skins increases. It is driven by the production of ejiao, a traditional Chinese remedy believed by some to have medicinal properties. It is estimated that the ejiao industry currently requires approximately 4.8 million donkey skins per year. Since there is no productive chain for donkey skin production outside of China, the activity is extractive and has resulted in the decimation of donkeys. Gestation is 12 months in donkeys, increasing the risk of extinction if such practices are not controlled. In this scenario, the donkeys are collected (purchased for low prices, stolen, and collected from the side of the roads) and are then often transported for long distances, usually without water, food, or rest. The trade, in Brazil, poses significant biosecurity risks, particularly because examinations are rarely conducted and therefore infectious diseases, such as glanders and infectious anemia, remain undetected. Furthermore, in chronic stress situations, the immune system is suppressed, increasing the biosecurity risk, especially because donkeys are a silent carrier of diseases. Rarely there is traceability with animals from different origins being put together in "fake farms", before being delivered to slaughterhouses. The opportunistic strategy of collecting animals, or buying for low prices, keeping them without access to food and veterinary assistance, is what makes this trade profitable. Our experience in donkey welfare and the global skin trade suggest that it will be enormously challenging and cost-prohibitive to run a trade at the standards required to be considered humane, sustainable, and safe. Although donkeys are being blamed for the involvement in road accidents, it is not an ethical solution to maintain this trade as an alternative. Moreover, the ecological role of donkeys in native ecosystems has not been elucidated, and some studies indicate they could even have a positive effect. Regardless of the future the donkeys will have; we must guarantee a life with the least dignity to the animals under our responsibility.(AU)


Os jumentos (Equus asinus) estão enfrentando uma crise global. A saúde, o bem-estar e até a sobrevivência dos jumentos estão sendo comprometidos à medida que a demanda por suas peles aumenta. A atividade é impulsionada pela produção de ejiao, um remédio tradicional chinês que algumas pessoas acreditam possuir propriedades medicinais. Estima-se que a indústria de ejiao demande atualmente cerca de 4,8 milhões de peles de jumento por ano. Uma vez que não existe uma cadeia produtiva fora da China, a atividade é extrativista e resultou na drástica redução das populações. A gestação dos jumentos é de 12 meses, aumentando o risco de extinção se tais práticas não forem controladas. Neste cenário, os jumentos são recolhidos (comprados a preços baixos, roubados e recolhidos à beira das estradas) e são frequentemente transportados para longas distâncias, normalmente sem água, comida ou descanso. O comércio no Brasil apresenta riscos significativos de biossegurança, principalmente porque os exames raramente são realizados e, portanto, doenças infecciosas, como mormo e anemia infecciosa equina, permanecem sem detecção. Além disso, em situações de estresse crônico, o sistema imunológico é suprimido, aumentando o risco de biossegurança, principalmente porque os jumentos são portadores silenciosos de doenças. Raramente há rastreabilidade, e os animais de diferentes origens acabam sendo colocados em "fazendas fantasma", antes de serem entregues aos abatedouros. A estratégia oportunista de coletar animais, ou comprar por preços irrisórios, mantendo-os sem acesso a alimentação e assistência veterinária, é o que torna esse comércio lucrativo. Nossa experiência em bem-estar de jumentos e no comércio global de peles sugere que será extremamente desafiador e com custo proibitivo administrar um comércio dentro dos padrões exigidos para ser considerado humano, sustentável e seguro. Embora os jumentos sejam responsabilizados pelo envolvimento em acidentes rodoviários, não é uma solução ética manter este comércio como uma alternativa. Além disso, o papel ecológico dos jumentos nos ecossistemas nativos não foi elucidado, e alguns estudos indicam que eles podem até ter um efeito positivo. Independentemente do futuro que os jumentos terão, devemos garantir uma vida com o mínimo de dignidade aos animais sob nossa responsabilidade.(AU)


Subject(s)
Animals , Skin , Animal Welfare , Abattoirs , Commerce , Equidae/anatomy & histology , Containment of Biohazards , Veterinary Medicine , Containment of Biohazards
16.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58(n.esp): e171512, 2021. tab
Article in English | ID: biblio-1348261

ABSTRACT

The present study identified the main endoparasites present in donkeys (Equus asinus) used in skin exploitation located in Cando municipality, Bahia State, Northeast of Brazil. The samples were collected from September 2019. Feces were collected from the rectal ampulla of 34 animals, macroscopically visualized for parasitic forms, and microscopically evaluated to identify endoparasites forms using the McMaster method. Parasitological results were associated with sex, age, and bodyweight Stata Corp LLC 14. Endoparasites were found in 82.3% of the animals, with the egg count ranging from 50 to 1050 eggs per gram (EPG). The sole presence of superfamily Trichostronglylidae was observed in 67.6% of the donkeys, in 8.8% co-infected by Trichostronglylidae and Eimeria spp., while Trichostronglylidae and Strongyloides westeriwas detected in 2.9%, and simultaneous infection by Trichostronglylidae, Strongyloides westeri, and Oxyuris equi was observed in 2.9%. The occurrence of parasitic infections varies according to nutritional status, age, sex, and environmental exposure (p>0.05). A high occurrence of infection was observed in young animals and those with lower body weight.(AU)


O presente trabalho identificou os principais endoparasitas em jumentos utilizados em uma exploração de pele localizada no município de Canudos, Estado da Bahia, Nordeste do Brasil. As amostras foram colhidas no período de setembro de 2019. Fezes de 34 jumentos, colhidas diretamente da ampola retal, foram visualizadas macroscopicamente para formas parasitárias e avaliadas microscopicamente para identificar endoparasitos pela técnica de McMaster. Os resultados parasitológicos foram associados com sexo, idade e peso corporal pelo Stata Corp LLC 14. Endoparasitas foram encontrados em 82,3% dos animais, com contagem de ovos variando de 50 a 1050 ovos por grama (OPG). Presença de unicamente parasitos da superfamília Trichostronglylidae foi observada em 67,6% dos jumentos, 8,8% estavam coinfectados por Trichostronglylidae e Eimeria spp., 2,9% por Trichostronglylidae e Strongyloides westeri e 2,9% apresentaram presença simultânea de Trichostronglylidae, Strongyloides westeri e Oxyuris equi. A ocorrência de infecções parasitárias varia de acordo com a idade, sexo e exposição ambiental (p>0.05). Observou-se alta ocorrência de animais infectados nos animais jovens e naqueles com menor peso corporal.(AU)


Subject(s)
Parasitic Diseases , Skin , Strongyloides , Commerce , Equidae , Eimeria , Body Weight
17.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58(n.esp): e175262, 2021.
Article in English | ID: biblio-1348285

ABSTRACT

Growing demand for ejiao ­ gelatin produced from donkey skin and used in Traditional Chinese Medicine ­ is putting global donkey populations at risk and threatening the livelihoods of millions of people that depend on them in lower and middle-income countries. Hundreds of thousands of donkeys are slaughtered for their skins and exported annually, mostly from Africa to China. However, the trade is spreading across the globe, including Brazil. This article highlights the appalling welfare conditions for donkeys caught up in both the legal and illegal trade, as well as the effects on vulnerable people and the potential for disease spread and hazards to human health.(AU)


A crescente demanda por ejiao ­ uma gelatina produzida a partir da pele de jumento e usada na medicina tradicional chinesa ­ está colocando em risco as populações globais de jumentos e ameaçando a subsistência de milhões de pessoas que dependem delas em países de renda média e baixa. Centenas de milhares de jumentos são abatidos para obter suas peles e exportados anualmente, principalmente da África para a China. No entanto, o comércio está se espalhando pelo globo, inclusive para o Brasil. Este artigo destaca as péssimas condições de bem-estar para os jumentos apanhados no comércio legal e ilegal, bem como os efeitos sobre as pessoas vulneráveis e o potencial de propagação de doenças e riscos para a saúde humana.(AU)


Subject(s)
Animals , Skin , Commerce , Equidae , Risk Factors
18.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58(n.esp): e174674, 2021. ilus
Article in English | ID: biblio-1348282

ABSTRACT

About 800 donkeys that were confined in a restrictive area used in a manner comparable to a warehouse for receiving donkeys for slaughter were abandoned. After receiving reports of mistreatment, civilians acted to save the animals. A task force was organized that planned veterinary and zootechnical actions and activities for daily health management, feeding, and clinical care to attend to the abandoned donkeys. Positive cases were diagnosed for glanders, equine infectious anemia, equine herpesvirus, and equine babesiosis. The objective of this communication is to bring to the attention of the scientific community the interventions in the area of animal health and welfare, to address the episode of northeast donkeys that were victims of international trade. It is fundamental to change the approach related to the management of donkeys in Brazil, and appeal to the necessity to identify ethical and sustainable ways to incorporate donkeys in Brazil in the 21st century.(AU)


Cerca de 800 jumentos confinados em uma área utilizada como entreposto de recebimento e encaminhamento de jumentos para abate foram abandonados. Após denúncias de maus tratos, a sociedade civil atuou para salvar os animais. Foi constituída uma força tarefa que planejou ações e atividades veterinárias e zootécnicas atuando diariamente no manejo sanitário, na alimentação e nos cuidados clínicos na assistência aos jumentos abandonados. Foram diagnosticados casos positivos de mormo, anemia infecciosa equina, herpesvírus equino e babesiose equina. O objetivo desta comunicação foi relatar para a comunidade científica as intervenções nas áreas de saúde e bem-estar animal no episódio dos jumentos nordestinos vítimas do comércio internacional. É fundamental mudar a abordagem em relação ao manejo de jumentos no Brasil e apelar para a necessidade de identificar maneiras éticas e sustentáveis de incorporar os jumentos no Brasil do século 21.(AU)


Subject(s)
Skin , Babesiosis , Animal Welfare , Disease Outbreaks , Equidae , Sanitary Profiles
19.
Braz. j. med. biol. res ; 54(6): e10722, 2021. graf
Article in English | LILACS | ID: biblio-1285669

ABSTRACT

Continuous industrial productivity and modern societies have resulted in excess artificial light. The altered circadian rhythm causes many diseases. During intrauterine life, the mother's maternal melatonin rhythm has a major role in influencing organ development. The aim of this study was to investigate the effect of maternal exposure to constant light on the structure and ultrastructure of neonatal skin. Twenty pregnant New Zealand rabbits were divided into two groups (n=10 each): control group (12-h light/dark) and constant light group (24-h light). Plasma maternal melatonin and corticosterone during pregnancy were determined. At the end of the experiment, the dorsal skin of the neonates of both groups was collected and prepared for histological, morphometric, and transmission electron microscopic study. Histological and morphometric results of skin of neonates from the constant light group revealed statistically significantly reduced epidermal thickness, decreased number of hair follicle, increased surface area of collagen, and decreased proliferating cell nuclear antigen (PCNA) positive cells. Ultrastructural examination showed wide intercellular spaces and disrupted desmosomal junctions in the epidermis. Earlier stages of hair follicles were also observed with indented shrunken nuclei, vacuolization, and swollen mitochondria. Dermal fibroblasts with dilated cisternae of rough endoplasmic reticulum containing electron-dense material were detected. Maternal melatonin was significantly reduced in the constant light group while maternal corticosterone showed no significant difference between groups. Therefore, normal maternal circadian rhythm is a key factor for the integrity of neonatal skin structure.


Subject(s)
Animals , Female , Pregnancy , Rabbits , Skin , Melatonin , Circadian Rhythm , Microscopy, Electron, Transmission , Epidermis
20.
Braz. j. med. biol. res ; 54(6): e10745, 2021. graf
Article in English | LILACS | ID: biblio-1285666

ABSTRACT

Episodic angioedema with eosinophilia (EAE) is a rare condition characterized by recurrent attacks of angioedema and urticaria accompanied by a marked elevation of peripheral eosinophil count. We report the case of a young female patient diagnosed with EAE associated with urticarial vasculitis. A 40-year-old female patient was admitted to our institution due to recurrent episodes of cheek and eyelid angioedema in the previous year. Episodes of facial angioedema lasted for two months with spontaneous remission afterwards. In addition, she presented pruritic and painful skin eruptions of erythematous circles, which persisted for longer than 24 h, that were palpable, somewhat purplish, and more pronounced on the face, arms, and trunk. Laboratory investigation showed a sustained elevation of white cell counts with marked eosinophilia. Serum IgM, IgE, and IgA were normal; IgG was slightly elevated. C1-esterase inhibitor and tryptase test were normal. Reverse transcriptase-polymerase chain reaction was performed for detection of FIP1L1-PDGFRA and BCR-ABL rearrangements. None of these alterations were found. Skin biopsies were suggestive of urticarial vasculitis. The patient was submitted to esophagogastroduodenoscopy, which showed mild chronic gastritis, with no eosinophilic infiltration. Cardiac dimensions and function were normal. Abdominal ultrasound and total body CT-scan failed to show lymphadenopathy, organomegaly, and tumors. We report the first case of association between episodic angioedema with eosinophilia and urticarial vasculitis. It is possible that both conditions share a physiopathological mechanism, suggesting that it is not just a chance association.


Subject(s)
Humans , Female , Adult , Urticaria/complications , Vasculitis , Eosinophilia/complications , Angioedema/complications , Angioedema/diagnosis , Skin
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