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1.
Arch. argent. pediatr ; 120(5): e226-e230, oct. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1395843

ABSTRACT

Los hemangiomas infantiles (HI) son los tumores benignos más frecuentes de la infancia; la variante segmentaria es rara y se asocia con un mal pronóstico. Una de sus principales complicaciones es la ulceración durante la fase de crecimiento del tumor, a pesar de no presentar características macroscópicas compatibles con una lesión agresiva. El manejo en estos casos es dificultoso e impone la necesidad de asociar múltiples estrategias, algunas orientadas específicamente a impedir la proliferación del hemangioma y otras orientadas a la curación de la herida, el manejo del dolor y la prevención de la infección agregada. Presentamos dos casos a fin de comunicar nuestra experiencia respecto del manejo de dicha patología y su evolución final.


Infantile hemangiomas (IHs) are the most common benign tumors of childhood, and segmental ones are rare and associated with a poor prognosis. While these tumors look harmless, one of their main related complications is ulceration during tumor growth. The management in these cases is extremely challenging, requiring a combination of multiple approaches, some specifically aimed at preventing the proliferation of the hemangioma and others aimed at wound care, pain management, and prevention of further infection. Here we discuss two cases to narrate our experience on the management of this condition and its outcome.


Subject(s)
Humans , Female , Infant, Newborn , Skin Neoplasms/drug therapy , Skin Ulcer/etiology , Skin Ulcer/drug therapy , Hemangioma/complications , Propranolol , Ulcer/etiology , Administration, Oral , Treatment Outcome , Hemangioma/drug therapy
2.
Rev. med. vet. zoot ; 69(2): 121-128, mayo-ago. 2022. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1395015

ABSTRACT

RESUMEN La información sobre la presentación y los factores predisponentes del síndrome de úlcera gástrica en mulas (SUGM) es escasa en comparación con el síndrome de úlcera gástrica en equinos (SUGE) y asnales. Debido a la naturaleza multifactorial de este síndrome, la helicobacteriosis ha sido estudiada en otras especies. El objetivo de este trabajo fue establecer la presencia de Helicobacter spp. en mucosa gástrica de mulas a través de la prueba rápida de la ureasa (PRU) y de análisis histopatológico. Menos del 27% de las muestras reaccionaron a la PRU, con tiempos prolongados de reacción, y al Agar Urea (prueba de oro), con menor porcentaje de positividad. La histopatología reveló procesos inflamatorios crónicos, sin presencia de bacterias curvoespiraladas. Las PRU no fueron conclusivas en la determinación de Helicobacter spp., comportamiento similar reportado en equinos. Se requieren exámenes diagnósticos más específicos y procedimientos complementarios orientados a explorar por regiones del estómago en la consideración del número de muestras representativas.


ABSTRACT Information on the presentation and predisposing factors of Mule Gastric Ulcer Syndrome (MGUS) is scarce, compared to Equine Gastric Ulcer Syndrome (EGUS) and donkeys. Within the multifactorial nature of this syndrome, helicobacteriosis has been studied in other species. The objective of this work was to establish the presence of Helicobacter spp. in gastric mucosa of mules, through the rapid urease test (RUT) and histopathological analysis. Less than 27% of the samples reacted to RUTs, with prolonged reaction times, and Urea Agar (gold test), with a lower percentage of positivity. Histopathology revealed chronic inflammatory processes, without the presence of curved-spiral bacteria. The RUTs were not conclusive in the determination of Helicobacter spp., a similar behavior reported in horses. More specific diagnostic tests and complementary procedures are required to explore the regions of the stomach in consideration of the number of representative samples.


Subject(s)
Stomach Ulcer , Ulcer , Urease , Helicobacter , Equidae , Horses , Syndrome , Bacteria , Gastric Mucosa , Methods
3.
Acta odontol. Colomb. (En linea) ; 12(2): 126-135, Jul-Dec. 2022. ilus, ilus, ilus
Article in Spanish | LILACS | ID: biblio-1397586

ABSTRACT

Introducción: el granuloma ulcerativo traumático con eosinofilia estromal es una afección benigna, crónica y autolimitante, que por su evolución clínica puede estar sujeta a confusión diagnóstica. Por ello, el caso que aquí se comparte expone particularidades de esta afección y su respuesta al tratamiento para permitir un mejor conocimiento de esta lesión. Se describen las características clínicas e histopatológicas y su evolución ante la terapéutica empleada. Se presenta una paciente femenina de seis años, con antecedentes de salud y de dientes neonatales, que hace tres meses manifiesta dos úlceras en mucosa sublingual que no cicatrizan ni mejoran al tratamiento anterior. Se indicaron estudios hematológicos, se realizó biopsia incisional de la lesión con su estudio histopatológico e inmunohistoquímico. Se obtuvo eosinofilia estromal y ausencia de linfocitos anómalos CD30. El tratamiento incluyó aplicación de corticosteroides tópicos e intralesionales, experimentando remisión de la lesión. Se mantiene la paciente bajo seguimiento clínico, sin recidiva de lesión. Conclusiones: el granuloma ulcerativo traumático con eosinofilia estromal es una lesión autolimitante que puede ser confundida con otras lesiones ulcerativas de la cavidad bucal, por lo que su estudio histopatológico resulta imprescindible para su diagnóstico. Asimismo, su análisis inmunohistoquímico es indispensable para precisar su naturaleza y probable evolución. El adecuado y exhaustivo proceso diagnóstico constituye una herramienta vital para lograr su identificación.


Background: Traumatic ulcerative granuloma with stromal eosinophilia is a benign, chronicle and self-healing lesion, which can be misdiagnosed for its clinical evolution, for this reason, this case report is carried out, showing particularities of this disease and its response in front to the treatment, giving a better identifcation of the lesion, were described the clinical and histopathological fndings of a case. A feminine patient, six years old, with neonatal health and dental history. She has presented during three months two ulcerative lesions in sublingual mucosa, which do not improve with the previous treatment. Hematological studies and biopsy were carried out, the incisional biopsy was analyzed with immunohistochemical test, the results were stromal eosinophilia and absence of anomalous lymphocytes CD30. She was treated with topical and intralesional corticosteroids, experiencing remission of the lesion. The patient had a long clinical follow up without recidive. Traumatic ulcerative granuloma with stromal eosinophilia is a self-healed lesion that needs a histopathological and inmunohistochemical analysis for an adequate diagnosis. The correct diagnostic sequence is a vital tool to achieve its identification.


Subject(s)
Female , Child , Ulcer , Eosinophilia , Granuloma , Biopsy , Immunohistochemistry
4.
Cuad. Hosp. Clín ; 63(1): 50-54, jun. 2022.
Article in Spanish | LILACS | ID: biblio-1399683

ABSTRACT

Se reporta el caso de un paciente pediátrico con quemaduras de segundo grado profundo en muslo derecho, con superficie corporal quemada del 8% por agua caliente, que recibió terapia celular como estrategia terapeútica alternativa. Tras procedimiento terapeútico con injertos de piel, se evidenció remanente una úlcera secundaria a quemadura (7 x 4 cm); por lo que, se procedió a valoración para terapia con células madres mesenquimales autólogas procedentes de médula ósea. Se realizó 8 sesiones de sembrado de células madre. La respuesta y evolución fueron favorables, la regeneración de tejidos se dio desde la profundidad hacia la superficie y desde el lateral a medial de la úlcera. Se evidenció revascularización y posterior epitelización de la zona afectada, sin secuelas de cicatrización.


Case report of a pediatric patient with deep second degree burn wounds on the right thigh, body surface area burnt 8% due to boiling water, who received cell therapy as an alternative therapeutic strategy. After a therapeutic procedure with skin grafts, a remaining burn wound (7 x 4 cm) was evidenced; consequently, an assessment for therapy using autologous mesenchymal stem cells derived from bone marrow was made. It was performed 8 sessions of somatic stem cells seeding. Results were favorable, tissue regeneration occurred from the depth to the surface, and from the lateral to medial side of the burn wound. Revascularization and subsequent epithelialization in the affected area were evidenced, without scarring repercussion.


Subject(s)
Burns , Stem Cells , Ulcer , Body Surface Area
5.
Rev. colomb. enferm ; 21(1): 1-22, mayo 1, 2022.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1380075

ABSTRACT

Introducción: las úlceras vasculares son lesiones que se desarrollan principalmente en miembros inferiores, se acompañan de dolor continuo e incapacitante, dificultan la movilidad, alteran la propia imagen corporal y pueden interferir en las actividades de la vida diaria. Las úlceras venosas son graves, ocasionadas por insuficiencia venosa crónica e hipertensión venosa permanente, y la persona que las padece debe recibir cuidados de enfermería integrales, que contribuyan al autocuidado. Objetivo:describir las estrategias que debe tener en cuenta el profesional de enfermería para la promoción del autocuidado en personas con úlceras vasculares venosas. Metodología: revisión integrativa de la literatura. Se realizó búsqueda en bases de datos y recursos electrónicos: Medline a través de PubMed Health, Epistemonikos y SciELO. Se incluyeron artículos de investigación y de revisión relacionados con el problema en estudio, publicados en inglés, portugués o español en el periodo 2010-2020. Estudio sin riesgo, se respetan los derechos de autor. Resultados: se analizó una muestra constituida por 41 publicaciones. Los temas principales producto del análisis fueron: proceso de atención de enfermería y autocuidado, familiarizándose con la úlcera venosa y las opciones terapéuticas, conocimiento de la terapia de compresión, práctica de los estilos de vida saludables. Conclusiones: el cuidado de enfermería al paciente con úlcera venosa debe comenzar por reconocer a la persona desde una perspectiva holística y en reciprocidad con su entorno, lo que implica un proceso de atención integral que va más allá de la úlcera y valora al paciente como un sujeto activo en el cuidado, para que se familiarice con su herida y esté en capacidad de detectar señales de mejoría o de alarma, así como de conocer la terapia de compresión y opciones terapéuticas y de llevar a su cotidianidad la práctica de estilos de vida saludables


Introduction: Venous ulcers are lesions developed mainly on the lower limbs. They cause continuous and disabling pain, impair mobility, alter self-image, and interfere with daily life activities. Venous ulcers are serious. They are caused by chronic venous insufficiency and permanent venous hypertension. People suffering from venous ulcers should receive comprehensive nursing care that contributes to self-care. Objective: To describe the strategies nursing professionals should consider for promoting self-care in people with venous ulcers. Method: Integrative review of the literature. Databases and electronic resources were searched: Medline using PubMed, Health, Epistemonikos, and SciELO. Research and review articles related to the study problem, published in English, Portuguese, or Spanish between 2010 and 2020, were included. This is a risk-free study, and copyrights were respected. Results: A sample of 41 publications was analyzed. The main themes derived from the analysis were the nursing care process and self-care, getting familiar with venous ulcers and therapeutic options, knowledge of compression therapy, and practice of healthy lifestyles. Conclusions: Nursing care for patients with venous ulcers should begin by recognizing a person from a holistic perspective and reciprocally with their environment. This approach implies a comprehensive care process that goes beyond the ulcer and values patients as active subjects of care so that they become familiar with their wounds and detect signs of improvement or warning. They can also know about compression therapy and therapeutic options and take the practice of healthy lifestyles into their daily lives.


Introdução: As úlceras vasculares são lesões que se desenvolvem principalmente nos membros inferiores, são acompanhadas de dor contínua e incapacitante, dificultam a mobilidade, alteram a própria imagem corporal e podem interferir nas atividades da vida diária. As úlceras venosas são graves, causadas pela insuficiência venosa crônica e hipertensão venosa permanente, e a pessoa que as sofre deve receber cuidado de enfermagem integral que contribua para o autocuidado. Objetivo: Descrever as estratégias que o profissional de enfermagem deve levar em consideração para promover o autocuidado em pessoas com úlceras vasculares venosas. Metodologia: Revisão integrativa da literatura. Realizou-se busca nas bases de dados e recursos eletrônicos: Medline por meio do PubMed Health, Epistemonikos SciELO. Foram incluídos artigos de pesquisa e revisão relacionados ao problema em estudo, publicados em inglês, português ou espanhol, no período 2010-2020. Estudo sem risco, os direitos autorais são respeitados. Resultados: Foi analisada uma amostra de 41 publicações. Os principais tópicos resultantes da análise foram: processo de atenção de enfermagem e autocuidado, familiarização com a úlcera venosa e as opções terapêuticas, conhecimento da terapia compressiva, prática de estilos de vida saudáveis. Conclusões: O cuidado de enfermagem ao paciente com úlcera venosa deve começar por reconhecer à pessoa desde uma perspectiva holística e em reciprocidade com seu meio, o que implica um processo de atendimento integral que vai além da úlcera e valoriza ao paciente como sujeito ativo no cuidado para que ele se familiarize com sua ferida e seja capaz de detectar sinais de melhora ou alarme, bem como aprender sobre terapia compressiva e as opções terapêuticas e praticar estilos de vida saudáveis em sua vida diária.


Subject(s)
Ulcer , Varicose Ulcer , Vascular Diseases , Nursing Care , Compression Bandages
6.
Más Vita ; 4(1): 165-178, mar. 2022. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1372282

ABSTRACT

El abordaje de un problema de salud tan importante, frecuente y de no fácil solución como es el pie diabético, mejora cuando se constituye un equipo multidisciplinar, ya que en general son varios los profesionales sanitarios implicados en el diagnóstico y tratamiento de este síndrome, cirujanos, endocrinólogos, infecciosos, ortopedas, podólogos y enfermeros; del entendimiento y colaboración de todos ellos debe surgir la mejor manera de encauzarlo correctamente. Objetivo: Analizar los factores quirúrgicos, emocionales y cuidado integral tras la cirugía del pie diabético. Material y método: Revisión bibliográfica con características de estudio de abordaje cualitativo, descriptivo, transversal. Se revisaron serie de revistas con artículos cuyas variables se situaran en pacientes diagnosticados con diabetes mellitus. Resultados: Mujeres 55 y en hombres 45 años, edad media fue 54 años. Sin embrago, la asociación de la edad con el cumplimiento de las conductas de autocuidado en la muestra de pacientes con DM tipo 2 amputados no fue estadísticamente significativa. Así mismo, estos factores influyen en la adherencia al autocuidado de la diabetes, específicamente con las prácticas relacionadas con el cuidado de los pies, correspondiente con una mayor dificultad en la comprensión de las indicaciones. Conclusiones: Se observa en forma general un cumplimiento inadecuado a las conductas de autocuidado para la prevención del pie diabético en la muestra de pacientes diabéticos amputados a pesar de que, la mayoría de las conductas son de bajo costo y requieren poco esfuerzo, evidenciándose escaso acompañamiento por parte del personal sanitario a esta población(AU)


The approach to a health problem as important, frequent and difficult to solve as the diabetic foot, improves when a multidisciplinary team is constituted, since in general there are several health professionals involved in the diagnosis and treatment of this syndrome. surgeons, endocrinologists, infectious, orthopedists, podiatrists and nurses; from the understanding and collaboration of all of them, the best way to channel it correctly must emerge. Objective: To analyze the surgical, emotional and comprehensive care factors after diabetic foot surgery. Material and Method: Bibliographical review with study characteristics of a quantitative, descriptive, cross-sectional approach. A series of journals with articles whose variables were located in patients diagnosed with diabetes mellitus were reviewed. Results: Women 55 and men 45 years, mean age was 54 years. However, the association of age with compliance with self-care behaviors in the sample of amputated patients with type 2 DM was not statistically significant. Likewise, these factors influence adherence to diabetes self- care, specifically with practices related to foot care, related to greater difficulty in understanding the indications. Conclusions: Inadequate compliance with self-care behaviors for the prevention of diabetic foot is generally observed in the sample of amputated diabetic patients, despite the fact that most of the behaviors are low-cost and require little effort, showing little follow-up. by health personnel to this population(AU)


Subject(s)
Self Care , Diabetic Foot/surgery , Diabetic Foot/complications , Nursing Care , Ulcer , Diabetes Mellitus , Amputation
7.
J. coloproctol. (Rio J., Impr.) ; 42(1): 59-62, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1375766

ABSTRACT

Abstract It is uncertain whether terminal ileum intubation should be performed routinely during colonoscopy, as there is uncertainty regarding its diagnostic value. The aim of the present study is to assess the diagnostic yield of terminal ileum intubation during colonoscopy according to indications for colonoscopy. This is a cross-sectional study in which the results of 294 total colonoscopy procedures were reviewed; ileal intubation was performed in 269 (91.49%) patients. The indications for colonoscopy, the results of ileoscopy, and the histopathological results of ileal biopsies were evaluated. A total of 54 (20%) out of 269 patients who had successful intubation into the terminal ileumshowed macroscopic abnormalities on the terminal ileum. Biopsies were positive in 4 out of 54 (7.4%); all were of Crohn disease. Two were erosions (9.5%.) and 2 were ulcers (18.8%). The two erosions were presented as abdominal pain, abdominal pain and alternating bowel motion. Those with ulcers were presented with diarrhea and perianal disease. Conclusions Considering the low diagnostic yield of ileal intubation during colonoscopy, the decision to performileoscopy or not during colonoscopy needs to bemade on a case-by-case basis. However, routine ileal intubation, brief attempts should be considered despite low diagnostic yield. (AU)


Subject(s)
Humans , Colonoscopy/methods , Ileum/pathology , Ulcer/diagnosis , Crohn Disease , Abdominal Pain , Cross-Sectional Studies , Intubation, Gastrointestinal
8.
Rev. colomb. gastroenterol ; 37(1): 90-94, Jan.-Mar. 2022. graf
Article in English | LILACS | ID: biblio-1376910

ABSTRACT

Abstract Balantidium coli is the largest protozoan and the only ciliated parasite that infects humans. It causes balantidiasis, a disease humans acquire by fecal-oral transmission from its usual host: the pig. We report the case of an immunocompetent schoolgirl who presented with peritonitis due to intestinal perforation, with perianal ulceration secondary to polyparasitism caused by Balantidium coli, Enterobius vermicularis, and Trichuris trichiura. It is a rare, potentially preventable complication with extremely high mortality rates. The patient required eight surgical interventions.


Resumen Balantidium coli es el protozoario más grande y el único parásito ciliado que infecta a los seres humanos. Es el causante de la balantidiasis, enfermedad adquirida por los humanos por transmisión fecal-oral desde su hospedero habitual: el cerdo. Reportamos el caso de una escolar inmunocompetente, que presentó peritonitis por perforación intestinal, con ulceración perianal secundaria a poliparasitismo por Balantidium coli, Enterobius vermicularis y Trichuris trichiura. Esta es una complicación poco frecuente, potencialmente prevenible y con tasas de mortalidad extremadamente altas. La paciente requirió 8 intervenciones quirúrgicas.


Subject(s)
Humans , Female , Child , Parasites , Balantidium , Ulcer , Trichuris , Enterobius , Coliforms , Intestinal Perforation , Peritonitis , Surgical Procedures, Operative , Mortality , Research Report
9.
Article in English | LILACS | ID: biblio-1399699

ABSTRACT

Introduction: The diagnosis of ulcerative colitis is relatively complex because the symptoms are similar to those seen in several other diseases. Objective: To report a case of rectal chlamydial infection whose initial symptoms resembled ulcerative colitis. Case report: A 50-year-old male patient presented with diarrhea, blood and mucus in the stools, and an ulcer in the rectum. The histopathological exam pointed to chronic, unspecified inflammation. After a broad serological screening, with Immunoglobulin M positive for Chlamydia and a high titer of immunoglobulin G, the patient was treated with antibiotics and is clinically cured. Later, he remained Immunoglobulin M positive, but the titers of immunoglobulin G lowered considerably. Chlamydia has been shown to live in the gut microbiota, which could explain the case. Conclusion: It is important to search for chlamydial infection as a differential diagnosis of ulcerative colitis.


Introdução: A retocolite ulcerativa é uma condição clínica de diagnóstico relativamente complexo, uma vez que apresenta sinais e sintomas comuns a muitas outras doenças. Objetivo: Relatar um caso de infecção anorretal por clamídia, cujos sintomas iniciais se pareciam com os de retocolite ulcerativa. Relato de caso: Paciente de 50 anos, do sexo masculino, apresentou-se com diarreia, muco e sangue nas fezes, e úlcera no canal anorretal. O exame histopatológico mostrou um processo inflamatório crônico e inespecífico, então procedeu-se a amplo rastreamento sorológico, que revelou Imunoglobulina M positivo para clamídia e altos títulos de Imunoglobulina G. O paciente foi tratado com antibióticos e encontra-se clinicamente curado. No seguimento, permanece com Imunoglobulina M positivo, mas os títulos de Imunoglobulina G decresceram consideravelmente. Bactérias do gênero Chlamydia têm sido reportadas como parte da microbiota intestinal, o que poderia explicar tal comportamento sorológico. Conclusão: É importante rastrear por clamídia como diagnóstico diferencial das suspeitas de retocolite ulcerativa


Subject(s)
Humans , Ulcer , Inflammatory Bowel Diseases , Chlamydia , Proctocolitis , Sexually Transmitted Diseases , Colonoscopy
10.
Rev Rene (Online) ; 23: e72429, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1387144

ABSTRACT

RESUMO Objetivo analisar o processo cicatricial de úlceras venosas tratadas com bota de Unna. Métodos estudo longitudinal, prospectivo, com 14 indivíduos acometidos de úlcera venosa crônica, acompanhados em quatro momentos distintos. A coleta de dados foi realizada com base no perfil clínico, sociodemográfico e avaliação clínica das lesões. Dados analisados por meio dos testes de Friedman. Para a comparação das médias, utilizou-se o teste dos postos assinalados de Wilcoxon e, para as comparações múltiplas, utilizou-se a correção de Bonferroni (p<0,05). Resultados o teste post hoc de Bonferroni revelou redução nos escores de dor (p=0,038), quantidade de exsudato (p=0,005) e borda seca (p=0,044). Observou-se melhora da cicatrização por meio da escala Pressure Ulcer Scale for Healing (p=0,004) após uso da bota de Unna entre o primeiro e quarto momento. Conclusão houve redução dos indicadores da Pressure Ulcer Scale for Healing , dor, quantidade de exsudato e borda seca da lesão em paciente em uso de bota de Unna depois de quatro semanas. Contribuições para a prática: evidencia-se a necessidade de manejar indicadores como classificação de Pressure Ulcer Scale for Healing , dor, quantidade de exsudato e borda seca com base na Bota de Unna.


ABSTRACT Objective to analyze the healing process of venous ulcers treated with an Unna's boot. Methods longitudinal study, prospective, with 14 individuals with chronic venous ulcers, followed at four different moments of time. Data collection was based on clinical and sociodemographic profile and clinical evaluation of the lesions. Data were analyzed using the Friedman test. Wilcoxon's signed ranks test was used to compare means, and for multiple comparisons Bonferroni's correction was used (p<0.05). Results the Bonferroni post hoc test revealed a reduction in pain scores (p=0.038), amount of exudate (p=0.005) and dry border (p=0.044). Improvement in healing was observed by means of the Pressure Ulcer Scale for Healing (p=0.004) after use of the Unna boot between the first and fourth moments. Conclusion there was a reduction in the Pressure Ulcer Scale for Healing indicators, pain, amount of exudate and dry border of the lesion in patients using Unna's boot after four weeks. Contributions to practice the need to manage indicators such as Pressure Ulcer Scale for Healing classification, pain, amount of exudate, and dry border based on the Unna Boot is highlighted.


Subject(s)
Technology , Ulcer , Varicose Ulcer , Wound Healing , Lower Extremity
11.
Einstein (Säo Paulo) ; 20: eRC6541, 2022. graf
Article in English | LILACS | ID: biblio-1360395

ABSTRACT

ABSTRACT Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.


Subject(s)
Humans , Female , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Epstein-Barr Virus Infections , COVID-19 , Ulcer/drug therapy , Herpesvirus 4, Human , COVID-19 Testing , SARS-CoV-2 , Genitalia
12.
Chinese Journal of Burns ; (6): 393-399, 2022.
Article in Chinese | WPRIM | ID: wpr-936025

ABSTRACT

Extracellular vesicles are nanoparticles secreted by most eukaryotic cells and play important roles in material transport and information transmission between cells, involved in inflammation, angiogenesis, antigen presentation, cell apoptosis, cell differentiation, and other biological processes. The culture supernatant of mesenchymal stem cells is rich in extracellular vesicles, and the extracellular vesicles can regulate the formation of new blood vessels, a key step in wound healing and tissue repair. The persistence of diabetic ulcers is closely related to the blocked formation of wound vascular network. This article reviews the role of extracellular vesicles derived from mesenchymal stem cells in promoting angiogenesis of diabetic ulcers, in order to provide a new idea for the treatment of diabetic ulcers.


Subject(s)
Diabetes Complications , Diabetes Mellitus , Extracellular Vesicles , Humans , Mesenchymal Stem Cells , Neovascularization, Pathologic , Ulcer , Wound Healing/physiology
13.
Article in Chinese | WPRIM | ID: wpr-928616

ABSTRACT

OBJECTIVES@#To study the clinical manifestations and gastroscopic characteristics of upper gastrointestinal ulcer in children.@*METHODS@#A retrospective analysis was performed for the children who underwent gastroscopy and were found to have upper gastrointestinal ulcer for the first time at the Endoscopy Center of Shengjing Hospital, China Medical University, from January 2011 to May 2021. According to the cause of the disease, they were divided into primary ulcer group (primary group; n=148) and secondary ulcer group (secondary group; n=25). The clinical data were compared between the two groups.@*RESULTS@#A total of 173 children with upper gastrointestinal ulcer were enrolled, with a male/female ratio of 3.9:1. Compared with girls, boys had significantly higher proportions of duodenal ulcer and primary ulcer (P<0.05). Compared with the children aged below 6 years, the children aged 6-14 years had higher proportions of duodenal ulcer and primary ulcer and lower proportions of giant ulcer and multiple ulcers. Of the 148 children in the primary group, 95 (64.2%) had Helicobacter pylori infection. Abdominal pain was the most common clinical symptom and was observed in 101 children (68.2%). Duodenal ulcer was common and was observed in 115 children (77.7%), followed by gastric ulcer in 25 children (16.9%) and esophageal ulcer in 7 children (4.7%). Multiple ulcers were observed in 32 children (21.6%). Seventy children (47.3%) experienced complications, among which bleeding was the most common complication and was observed in 63 children (43.6%). Of the 25 children in the secondary group, abdominal pain was the most common clinical symptom and was observed in 9 children (36.0%), with a significantly lower incidence rate than the primary group (P<0.05); foreign body in the digestive tract was the most common cause of ulcer and was observed in 17 children (68%), followed by abdominal Henoch-Schönlein purpura in 5 children (20.0%) and Crohn's disease in 3 children (12.0%). The secondary group had a significantly higher proportion of multiple ulcer or giant ulcer than the primary group (P<0.05).@*CONCLUSIONS@#Upper gastrointestinal ulcer is more common in boys than girls, and duodenal ulcer and primary ulcer are more common in boys. Children aged 6-14 years often have duodenal ulcer and primary ulcer, and giant ulcer and multiple ulcers are relatively uncommon. Primary ulcer in children has a variety of clinical manifestations, mainly abdominal pain, and duodenal ulcer is relatively common, with bleeding as the main complication. The clinical symptoms and endoscopic manifestations of secondary ulcer are closely associated with the primary causes, and it is more likely to induce huge ulcers and multiple ulcers.


Subject(s)
Abdominal Pain , Child , Duodenal Ulcer/epidemiology , Endoscopy, Gastrointestinal/adverse effects , Female , Helicobacter Infections/diagnosis , Helicobacter pylori , Humans , Male , Retrospective Studies , Ulcer
14.
Chinese Journal of Burns ; (6): 558-562, 2022.
Article in Chinese | WPRIM | ID: wpr-940960

ABSTRACT

Studies have shown that autoimmune disease (AID)-related ulcers are disease complications that lead to serious poor prognosis such as infection and disability. It is difficult to make a clear diagnosis and there are contradictions between the applications of immunosuppressive therapy and anti-infectious therapy. Improper diagnosis and immunosuppressive therapy can easily delay the timing of anti-infectious therapy and surgery for patients, which bring adverse effects on the prognosis of patients. This paper reviews the concept, clinical characteristics and treatment suggestions of each subtype of AID-related ulcers, in order to provide more ideas for AID-related ulcers' clinical diagnosis and treatment.


Subject(s)
Autoimmune Diseases/therapy , Humans , Ulcer/complications
15.
Chinese Journal of Burns ; (6): 501-505, 2022.
Article in Chinese | WPRIM | ID: wpr-940952

ABSTRACT

The global prevalence and incidence of autoimmune diseases are increasing year by year, and the autoimmune diseases have become a major threat to public health. In the progression of the diseases, persistent and complex abnormal immune responses often lead to long-term unhealed skin ulcers, which not only affect the life quality of patients, but also lead to the aggravation of primary diseases. Therefore, doctors in burn surgery and other wound repair surgeries should pay attention to the understanding of autoimmune diseases. In the treatment of autoimmune disease-related ulcers, it is recommended to formulate a unified treatment plan according to the law of occurrence and development of the diseases, and multidisciplinary cooperation is needed to accelerate wound healing and improve the quality of wound healing.


Subject(s)
Autoimmune Diseases/therapy , Humans , Quality of Life , Skin Ulcer/therapy , Ulcer , Wound Healing
16.
Cambios rev. méd ; 20(2): 19-24, 30 Diciembre 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1368220

ABSTRACT

INTRODUCCION. El paciente crítico presenta mayor riesgo de lesiones por presión, su incidencia en cuidados intensivos continúa elevada y variable, a pesar de su prevención. En Ecuador se desconoce la realidad de esta complicación. OBJETIVO. Realizar una caracterización demográfica y epidemiológica a los pacientes críticos con lesiones por presión. MATERIALES Y MÉTODOS. Estudio descriptivo, retrospectivo. De una población de 2 087 ingresados en la Unidad de Adultos Área de Cuidados Intensivos del Hospital de Especialidades Carlos Andrade Marín, se recolectaron datos demográficos y epidemiológicos de 147 registros de historias clínicas físicas y electrónicas de pacientes que presentaron lesiones por presión, en el periodo 01 de enero al 31 diciembre 2018. Los datos fueron analizados en el programa estadístico International Business Machines Statistical Package for the Social Sciences, versión 22. RESULTADOS. La mediana de edad fue 66 años; sexo hombre 63,3%, pre obesidad 40,8%, hipertensos 37,6% y diabéticos 23,8%. Más del 60,0% recibieron ventilación mecánica invasiva, sedantes y drogas vasoactivas, la mediana del Acute Physiology and Chronic Health disease Classification System II fue 20 (IQ 14-27), mortalidad 34,0%. La prevalencia de lesiones por presión fue 7,0% y la incidencia 3,49%. En la localización de las lesiones por presión: en región sacra 62,6%, talón 24,0% y cara 7,5%; 59,2% estadío 2 y 5,4% estadío 3. Al comparar los grupos de lesiones por presión no adquiridas versus adquiridas hubo diferencia estadísticamente significativa en duración de hospitalización previa a la detección de lesiones por presión (p<0,001), duración de hospitalización (p=0,003), localización de lesiones por presión en sacro (p=0,02), cara (p=0,02) y estadío 3 de lesiones por presión (p=0,03), en el resto de variables no se encontró diferencias. CONCLUSIÓN. La prevalencia de lesiones por presión está en los estándares aceptados a nivel internacional, su frecuencia y estadíos son similares a otros reportes, gracias a las medidas de prevención y control adoptadas por la Unidad.


INTRODUCTION. A patient at a critical situation has a higher risk of pressure injuries, and their incidence in intensive care continues being high and variable, despite its prevention. In Ecuador the reality of this complication is unknown. OBJECTIVE. To perform a demographic and epidemiological characterization of critically ill patients with pressure injuries. MATERIALS AND METHODS. Descriptive, retrospective study. From a population of 2 087 admitted to the Adult Unit Intensive Care Area of the Carlos Andrade Marín Specialties Hospital, demographic and epidemiological data were collected from 147 records of physical and electronic Medical Records of patients who pressure injuries, in the period January 1 to December 31, 2018. The data were analyzed in the statistical program International Business Machines Statistical Package for the Social Sciences, version 22. RESULTS. Median age was 66 years; male sex 63,3%, pre-obese 40,8%, hypertensive 37,6% and diabetic 23,8%. More than 60,0% received invasive mechanical ventilation, sedatives and vasoactive drugs, the median of the Acute Physiology and Chronic Health disease Classification System II was 20 (IQ 14-27), mortality 34,0%. The prevalence of pressure injuries was 7,0% and incidence 3,49%. The location of pressure injuries were: the sacral region 62,6%, heel 24,0% and face 7,5%; 59,2% stage 2 and 5,4% stage 3. When comparing the groups of non-acquired versus acquired pressure lesions, there was a statistically significant difference in hospital-stay lengths prior to the detection of pressure lesions (p<0,001), hospital-stay lengths (p=0,003), location of pressure lesions in sacrum (p=0,02), face (p=0,02) and stage 3 of pressure lesions (p=0,03); no differences were found in the rest of the variables. CONCLUSION. The prevalence of pressure injuries remains within international accepted standards, their frequency and stages are similar to other reports.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Skin , Ulcer , Critical Illness , Skin Care , Pressure Ulcer , Intensive Care Units , Respiration, Artificial , Sacrococcygeal Region , Wounds and Injuries , Heel , Comorbidity , Demography , Critical Care , Ecuador , Face , Critical Care Nursing , Analgesia
17.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 98-107, 28 dec. 2021.
Article in English | LILACS | ID: biblio-1352336

ABSTRACT

Cutaneous manifestations of dermatomyositis are unusual and difficult to treat. This study aimed to report a case of cutaneous manifestations of dermatomyositis treated with hyperbaric oxygen. We present a case of dermatomyositis in a 44-year-old female with pain ulcers in her left leg for 17 months, refractory to an exclusive clinical treatment, who underwent a hyperbaric oxygen therapy (HBOT) breathing O2 100%, 90 minute sessions, six days a week, at 2.4 ATA. HBOT therapy proved to be highly efficacious in wound healing in this case and HBOT should be considered as a treatment in the assistance given to such patients.


Manifestações cutâneas da dermatomiosite são raras e difíceis de ser tratadas. O objetivo deste estudo é relatar um caso de manifestações cutâneas da dermatomiosite tratadas com oxigenioterapia hiperbárica, ocorrido em uma paciente de 44 anos, sexo feminino, com úlceras dolorosas em seu membro inferior esquerdo por 17 meses. O caso foi refratário ao tratamento clínico exclusivo e a paciente submetida a tratamento de oxigenioterapia hiperbárica (HBOT), respirando oxigênio a 100%, em sessões de noventa minutos, seis dias por semana, a 2,4 ATA. O HBOT mostrou ser altamente eficaz na cicatrização da lesão neste caso e deve ser um tratamento considerado no cuidado desses pacientes.


Las manifestaciones cutáneas de la dermatomiositis son inusuales y difíciles de tratar. El objetivo de este estudio fue reportar un caso de manifestaciones cutáneas de dermatomiositis tratadas con oxigenoterapia hiperbárica. Presentamos un caso de dermatomiositis en una mujer de 44 años con úlceras dolorosas en su pierna izquierda durante 17 meses, refractaria a un tratamiento clínico exclusivo, que se sometió a oxigenoterapia hiperbárica (HBOT) respirando O2 100%, sesiones de 90 minutos, seis días a la semana, a 2,4 ATA. La terapia con HBOT demostró ser muy eficaz en la cicatrización de heridas en este caso y la HBOT debe considerarse como un tratamiento en la asistencia brindada a estos pacientes.


Subject(s)
Humans , Female , Skin Manifestations , Ulcer , Dermatomyositis , Research Report , Hyperbaric Oxygenation
18.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 50-55, set.-dez. 2021.
Article in Portuguese | LILACS, BBO | ID: biblio-1291673

ABSTRACT

A pandemia gerada pelo SARS-CoV-2 gerou uma série de estudos sobre essa nova doença. Este cenário proporcionou mudanças na odontologia, modificando a forma de atendimento e a rotina do consultório. O conhecimento sobre as implicações desse vírus no sistema estomatognático pode fornecer informações valiosas no conhecimento sobre o mecanismo dessa doença na cavidade oral. Dessa forma, foi realizada uma revisão de literatura, a fim de discutir os efeitos do COVID-19 na cavidade oral. No entanto, há poucas evidências na literatura sobre a correlação da COVID-19 e manifestações orais. Pode-se concluir que o vírus possui reflexo na cavidade oral, apresentando diferentes alterações, tais como: úlceras, periodontite, alterações do paladar, infecções oportunistas, dentre outras. Ainda se faz necessária a realização de mais estudos, para compreensão dos mecanismos fisiopatológicos da doença. Além disso, o trabalho ressalta a importância do cirurgião-dentista no ambiente hospitalar, para diagnóstico e conduta no tratamento dessas manifestações na cavidade oral(AU)


The SARS-CoV-2 pandemic has spawned several studies on this new disease. This scenario provided changes in Dentistry by modifying the form of care and the routine of the office. The knowledge about the implications of this virus in the stomatognathic system can provide valuable information in the knowledge about the mechanism of this disease in the oral cavity. Thus, a literature review was carried out to discuss the effects of COVID-19 on the oral cavity. However, there is little evidence in the literature about the correlation between COVID-19 and oral manifestations. It can be concluded that the virus is reflected in the oral cavity, such as ulcers, periodontitis, changes in taste, opportunistic infections, among others. Further studies are still needed to understand the pathophysiological mechanisms of the disease. Besides, the work highlights the importance of the Dental Surgeon in the hospital environment for diagnosis and management in the treatment of these manifestations in the oral cavity(AU)


Subject(s)
Oral Manifestations , Dental Care , COVID-19 , Periodontitis , Ulcer , Opportunistic Infections , Stomatognathic System , Dentists , Mouth
19.
Arq. Asma, Alerg. Imunol ; 5(4): 426-432, out.dez.2021. ilus
Article in English, Portuguese | LILACS | ID: biblio-1399808

ABSTRACT

Relatamos o caso de um paciente do sexo masculino, que iniciou quadro de úlceras em trato gastrointestinal, associado a febre recorrente e diarreia com muco e sangue aos 10 meses de vida, suspeitado inicialmente de doença inflamatória intestinal, no entanto, não apresentou melhora do quadro com terapia imunossupressora, sendo realizada investigação para erro inato da imunidade. Nos exames laboratoriais, apresentou níveis baixos de IgG e IgA e níveis elevados de IgM e neutropenia persistente. Diante disso, foi realizado teste genético que confirmou diagnóstico de síndrome de hiper-IgM ligada ao X. Os erros inatos da imunidade podem se manifestar com doenças do trato gastrointestinal, de forma relativamente frequente, devendo entrar como diagnóstico diferencial de diarreia crônica. Inclusa nesse grupo de doenças, as síndromes de hiper-IgM constituem um grupo heterogêneo de doenças, possuindo em comum níveis significativamente baixos ou ausentes de IgG e IgA e níveis normais ou elevados de IgM, o que predispõe a infecções e febre recorrente; além de outras alterações laboratoriais, como neutropenia, que pode estar associada a úlceras no trato gastrointestinal e proctite, simulando apresentação clínica de doença inflamatória intestinal. Para o paciente relatado, foi iniciada terapia com imunoglobulinas de forma periódica, além de antibioticoprofilaxia para infecções, evoluindo com resposta clínica satisfatória. O artigo possui objetivo principal de alertar para o diagnóstico diferencial de erros inatos da imunidade diante do quadro apresentado, visando o diagnóstico precoce e a instituição da terapia adequada.


We report the case of a male patient, who started with ulcers in the gastrointestinal tract, associated with recurrent fever and diarrhea with mucus and blood at 10 months of life, initially suspected of inflammatory bowel disease, however, he did not improve the condition with immunosuppressive therapy, being investigated for inborn error of immunity. In laboratory tests, he had low levels of IgG and IgA and high levels of IgM and persistent neutropenia. Therefore, a genetic test was performed and confirmed the diagnosis of X-linked hyper IgM syndrome. Inborn errors of immunity can manifest relatively frequently with diseases of the gastrointestinal tract, and should be included as a differential diagnosis of chronic diarrhea. Included in this group of diseases, hyper-IgM syndromes constitute a heterogeneous group of diseases, having in common significantly low or absent levels of IgG and IgA and normal or high levels of IgM, which predispose to infections and recurrent fever; in addition to other laboratory alterations, such as neutropenia, which may be associated with ulcers in the gastrointestinal tract and proctitis, simulating the clinical presentation of inflammatory bowel disease. For the reported patient, therapy with immunoglobulins was started periodically, in addition to antibiotic prophylaxis for infections, evolving with a satisfactory clinical response. The main objective of the article is to alert to the differential diagnosis of inborn errors of immunity in view of the presented condition, aiming at early diagnosis and the institution of adequate therapy.


Subject(s)
Humans , Male , Infant , Immunoglobulin M , Inflammatory Bowel Diseases , Diagnosis, Differential , Hyper-IgM Immunodeficiency Syndrome, Type 1 , Relapsing Fever , Ulcer , Immunoglobulin A , Immunoglobulin G , Immunosuppression Therapy , Antibiotic Prophylaxis , Early Diagnosis , Dihydrotachysterol , Infections
20.
An. bras. dermatol ; 96(5): 613-616, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345145

ABSTRACT

Abstract Protothecosis is a rare disease caused by achlorophilic algae of the genus Prototheca spp. In general, three clinical forms are observed: cutaneous, articular and systemic. The cutaneous form is the most common one. This study describes a patient with isolated erythematous papules and erythematous papular plaques in the scapular regions, with a previous histopathological diagnosis of cryptococcosis. New tests were conclusive for the diagnosis of protothecosis, caused by Prototheca wickerhamii.


Subject(s)
Humans , Prototheca , Skin Diseases, Infectious/diagnosis , Diabetes Mellitus , Ulcer
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