Contribuições da fisioterapia na incontinência urinária no climatério / Physiotherapy for urinary incontinence in menopausal women

da incontinência urinária de mulheres no climatério. Trata-se de revisão bibliográfica a partir dos termos climatério, incontinência urinária e fi sioterapia, bem como de suas variantes em inglês, nas bases LILACS, MedLine/PubMed, SciELO e PEdro. Observou- -se que a fisioterapia para mulheres no climatério com incontinência urinária contribui diretamente para melhorias no quadro clínico e controle miccional, sendo a cinesioterapia e o treinamento do assoalho pélvico as técnicas mais mencionadas. Não houve grande aprofundamento nas especificidades do climatério. O estudo conclui que a fisioterapia pélvica pode contribuir de modo decisivo no tratamento da incontinência urinária no climatério, sendo necessárias pesquisas de melhor qualidade metodológica para aprofundar os estudos de fisioterapia e direcioná-los às especificidades desse período.

The objetive to describe the contributions of physiotherapy on Urinary Incontinence in climacteric women. Electronic research by the terms menopause, urinary incontinence and physiotherapy and its variants in Portuguese at the electronic databases LILACS, MedLine/PubMed, SciELO and PEdro. The physiotherapy for climacteric women with urinary incontinence contributes to improvements of voiding control and other symptoms, where kinesiotherapy and pelvic floor muscle training were the most common. There was not much specificities of menopause. Pelvic physiotherapy may contribute decisively to the treatment of Urinary Incontinence in menopause women, but studies with better methodological quality are necessary, especially for the specificities of the menopause.

Invasive head and neck cutaneous squamous cell carcinoma: clinical and histopathological characteristics, frequency of local recurrence and metastasis

BACKGROUND: squamous cell carcinoma is the second most common type of skin malignancy and may evolve to regional lymph node and distant metastases. OBJECTIVE: The objective of this study was to evaluate patients with head and neck cutaneous squamous cell carcinoma to identify its clinical and histopathological characteristics, as well as the frequency of local recurrence and metastasis. METHODS: A retrospective cohort of patients with head and neck cutaneous squamous cell carcinoma. Inclusion criteria: histopathological confirmation, follow-up for longer than one year after diagnosis. Exclusion criteria: immunosuppression; lip and oral cavity squamous cell carcinoma; and non-surgical resection of the lesion. We evaluated demographic, clinical and anatomopathologic findings and explored their associations. RESULTS: Sixty-one patients with 79 tumors and followed by 4.8±3.0 years were selected. The average age was 67.1 years, and 63% of tumors had up to two centimeters. Seven tumors (8.9%) recurred and two of them had positive margins. Recurrence was associated with higher Broders' grade (p<0.01). Two patients (3.3%) had regional lymph node metastases. There were no distant metastases. Seventy tumors were considered to be usual tumors (89.7%), and 68 (87.2%) were classified as Broders' grade 1 and 2. Additionally, 64.1% of tumors had a depth of invasion below four millimeters. Thirteen tumors (16.7%) had positive histological margins. CONCLUSIONS: Most patients had good prognosis in the first year of follow-up, confirming that head and neck cutaneous squamous cell carcinoma has a better prognosis than squamous cell carcinoma of other regions such as mucosa, oral cavity, and internal organs. .

Chronic graft-versus-host disease: clinical presentation of multiple lesions of lichenoid and atrophic pattern / Doenca enxerto contra hospedeiro cronica: apresentacao clinica com inumeras lesoes de padrao liquenoide e de carater atrofico

Graft-versus-host disease is observed mainly in recipients of hematopoietic cell transplantation and is expressed by cutaneous or systemic signals and symptoms. Graft-versus-host disease is clinically classified as acute or chronic. Chronic Graft-versus-host disease occurs in up to 70% of hematopoietic cell transplanted patients and its clinical manifestations have important impact on morbidity and quality of life. The authors report an expressive cutaneous, oral and adnexal involvement in a patient with chronic Graft-versus-host disease with multiple lesions of lichenoid and atrophic pattern.

Doença enxerto contra hospedeiro é observada principalmente em pacientes transplantados de células de origem hematopoiéticas e se expressa por sinais e sintomas cutâneos ou sistêmicos. Clinicamente, a Doença enxerto contra hospedeiro é classificada em aguda ou crônica. As do tipo crônico ocorrem em até 70% dos pacientes e suas manifestações têm impacto importante na morbidade e na qualidade de vida. Os autores relatam caso com extenso comprometimento cutâneo, oral e de anexos cutâneos em paciente com Doença enxerto contra hospedeiro crônica expressa por inúmeras lesões de padrão liquenóide e de atrofia cutânea.