Calcinose distrófica cutânea na doença venosa crônica de membros inferiores / Dystrophic calcinosis cutis in chronic venous disease of the lower limbs

Resumo As úlceras de membros inferiores, secundárias à doença venosa crônica (DVC), constituem um problema significativo de saúde pública no Brasil e representam cerca de 70% do total dessas úlceras. Apesar dos recentes avanços tecnológicos e das diversas opções terapêuticas utilizadas para essas lesões crônicas, existem diversos fatores que podem estar implicados na resistência ao tratamento. A calcificação distrófica cutânea (CDC) é uma condição rara e frequentemente subdiagnosticada, que, quando associada à DVC, pode estar associada à refratariedade no processo cicatricial. Neste artigo, relatamos um caso de CDC em paciente portador de DVC e discutimos a sua etiologia, fisiopatologia e possíveis opções de tratamento.

Abstract Lower limb ulcers secondary to chronic venous disease (CVD) are a significant public health problem in Brazil and account for about 70% of these ulcers. Despite recent technological advances and the various therapeutic options for treatment of these chronic injuries, several factors may be involved in resistance to treatment. Dystrophic calcinosis cutis (DCC) is a rare and often underdiagnosed condition that, when in conjunction with CVD, may be associated with a refractory healing process. In this article, we report a case of DCC in a patient with CVD and discuss its etiology, pathophysiology and possible treatment options.

Tendinitis calcificada del supraespinoso en un triatleta senior / Calcifying tendinitis of the shoulder in senior triathlete

Presentamos el caso de un hombre de 62 años de edad, que practica triatlón con tendinitis calcificada del hombro tratada con inyección de plasma rico en plaquetas...

Atualização na terapêutica da calcinose em dermatomiosite / Update on the treatment of calcinosis in dermatomyositis

Calcinose é uma afecção do tecido conjuntivo classificada em quatro tipos: metastática, idiopática, iatrogênica e distrófica. Esta última é o que acontece, por exemplo, em dermatomiosite, principalmente na forma juvenil, e é caracterizada por uma deposição anormal de sais de cálcio em pele afetada, tecidos subcutâneos, músculos ou tendões, sendo os níveis séricos de cálcio e fósforo normais. O tratamento da calcinose em dermatomiosite continua sendo um desafio, havendo poucas descrições na literatura, de pouca evidência científica. Não se apresenta, até o momento, nenhuma terapia altamente eficaz no combate e resolução dessa comorbidade. No presente trabalho, abordamos o conceito de calcinose, particularmente em dermatomiosite, assim como o seu tratamento descrito na literatura.

Calcinosis is a connective tissue disorder classified into the following four types: metastatic; idiopathic; iatrogenic and dystrophic. Dystrophic calcinosis can occur, for example, in dermatomyositis, mainly in juvenile dermatomyositis, and is characterized by an abnormal deposition of calcium salts in affected skin, subcutaneous tissues, and muscles or tendons, with normal serum levels of calcium and phosphate. The treatment of calcinosis in dermatomyositis remains a challenge, with few descriptions in the literature of low scientific evidence. So far, no therapy has proved to be highly effective in the combat and resolution of that comorbidity. The present study discusses the concept of calcinosis, particularly in dermatomyositis, as well as its treatment described in the literature.

Resultados de la terapia por onda de choque focal en calcificaciones del manguito rotador / Results of focal shock-wave therapy for calcifying tendinitis of the rotator cuff

Introducción: El objetivo del presente trabajo es evaluar, en forma prospectiva, los resultados del tratamiento mediante la aplicación de ondas de choque focales, en un grupo de pacientes con calcificaciones sintomáticas del manguito rotador. Materiales y métodos: Se incluyeron 44 casos consecutivos de calcificaciones localizadas en alguno de los tendones del manguito rotador, en 43 pacientes con cirugías fallidas o tratamiento previo, al menos, por 6 meses, con síntomas persistentes. Resultados: En la evaluación al año, la calcificación había desaparecido completamente en 20 pacientes (45,5 por ciento). En 13 casos (29,5 por ciento), hubo un cambio significativo en el tamaño o la densidad. En 11 casos (25 por ciento), no hubo modificaciones. El dolor, según la escala analógica visual descendió de un promedio de 5,5 a 1,4 (p <0,0001). El puntaje de UCLA pasó de un valor inicial promedio de 15,7 a un valor de 29,3 (p <0,0001). El puntaje de Autoevaluación ASES fue de 84,6 comparado con un valor inicial de 48 (p <0,0001). El 77 por ciento de los pacientes estuvieron satisfechos con el procedimiento. Conclusión: El estudio sugiere que la terapia por onda de choque es una alternativa válida para pacientes que no han respondido al tratamiento conservador ni al quirúrgico

Effect of therapeutic ultrasound on calcific supraspinatus tendinitis.

Calcific tendinitis is an important cause of shoulder pain. There are various modalities used to treat calcific tendinitis. Ultra-Sound therapy (UST) is a non-invasive modality of treatment. It is not costly. The aims of the present study were to see the efficacy of UST on calcific tendonitis. This was a prospective study done at BSMMU, BIRDEM and Rangpur Medical College Hospital. All the cases with duration of illness more than three months, and diameter of stones more than 5mm were included in this study. Out of 26 cases 10(38%) were male, 14(54%) were housewife, 8(31%) were businessmen. UST were given to all cases for 10 minute with 1 to 1.5 W/sq cm for 12 doses. After 12 doses of UST all the patients became free from pain and restriction of movements. Radiographs of 24(92%) cases showed no calculi. Only two patients showed clinical improvement only but radiographs showed no change in caiculi and symptoms returned after one and two months respectively.

Tendinitis cálcica del músculo longus colli: a propósito de un caso / Calcific tendinitis of the longus colli muscle: case report

We report a case of calcific tendinitis of the Longus Colli muscle. We reviewed the differencial diagnosis and performed a literature search. To our knowledge this is the first Chilean report on this unusual disease.

Nosotros reportamos un caso de Tendinitis cálcica del músculo Longus Colli. Se revisa la literatura y los diagnósticos diferenciales. Se trata de una enfermedad infrecuente, según nuestro conocimiento sería el primer caso reportado en la literatura chilena.

The modified Inoue technique: a simple troubleshooting approach to a proximal segment tear of an Inoue balloon.

A tear in the proximal segment of an Inoue balloon was encountered during the dilatation of a calcific mitral stenosis. As a troubleshooting measure, we modified the steps of the standard Inoue technique. The mitral valve was successfully dilated using the same Inoue balloon.

Large subcutaneous calcification in systemic lupus erythematosus: treatment with oral aluminum hydroxide administration followed by surgical excision

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.

Large subcutaneous calcification in systemic lupus erythematosus: treatment with oral aluminum hydroxide administration followed by surgical excision

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.

Tratamento da dermatomiosite juvenil / Treatment of juvenile dermatomyositis

O tratamento da Dermatomiosite Juvenil envolve uma abordagem racional das muitas manifestaçöes clínicas que podem estar presentes como a doença muscular, as alteraçöes cutâneas, o envolvimento de diversos orgäos e a calcinose. O tratamento com drogas é o mais importante mas näo se deve descuidar dos cuidados gerais, da fisioterapia na prevençäo e correçäo das deformidades e, às vezes, da cirurgia corretora de sequelas e alívio de calcinose. O início do controle da doença muscular deve ser feio com corticosteróides administrados por via oral ou endovenosa e, na falha destes, por imunossupressores ou gamaglobulina endovenosa. O texto também aborda as controvérsias a respeito do tratamento da pele e da calcinose, citando algumas opçöes que têm sido relatadas em literatura médica

Terapéutica dermatológica 1995-1996: parte II / Therapeutics dermatological 1995-1996: part II

Se revisa la literatura internacional de Terapéutica Dermátologica correspondiente a los años 1995-1996, seleccionando un grupo de bibliografía que consideramos de interéz

Angioplastía transluminal percutánea de la vena cava inferior / Percutaneous angioplasty of the inferior vena cava

Se describe el caso de una paciente femenina de 65 años de edad, en quien se realizó angioplastía percutánea, con balón, de la vena cava inferior. La paciente tenía calcificación extensa de aurícula derecha, anillo y válvula tricúspide, lo que producía estenosis de la misma. Estaba involucrada la vena cava inferior con obstrucción. Como único factor predisponente a dicha calcificación, es una derivación ventrículo-atrial por cisticercosis cerebral por un periodo prolongado de tiempo (32 años). Se había realizado valvuloplastía tricuspídea percutánea 2 años y medio previamente, con éxito. Se realizó dilatación con balón obteniendo mejoría angiográfica significativa en la obstrucción. Se describe la técnica utilizada, se hace énfasis en lo poco frecuente de esta patología, así como en algunos eventos que sucedieron después de la dilatación. Concluimos que la angioplastía con balón puede ser una alternativa más, a la cirugía convencional en obstrucciones de la vena cava inferior