RESUMO
Chronic lymphedema is both a risk factor for and consequence of erysipelas (cellulitis). We report a case of a 62-year-old woman with rheumatoid arthritis treated with etanercept and prednisone, who developed chronic periorbital lymphedema 2 months after Group A beta-hemolytic streptococcus infection of the face. She had significant ptosis OS and thickened, hyperpigmented periorbital skin. Biopsies were consistent with chronic lymphedema. Of note, on 6 months follow-up, the patient's appearance was improved though she still had residual ptosis. A period of extended observation may be warranted in these cases.
Assuntos
Erisipela/complicações , Dermatoses Faciais/etiologia , Linfedema/etiologia , Doenças Orbitárias/etiologia , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Doença Crônica , Quimioterapia Combinada , Erisipela/diagnóstico , Erisipela/tratamento farmacológico , Etanercepte , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/tratamento farmacológico , Feminino , Humanos , Imunoglobulina G/uso terapêutico , Linfedema/diagnóstico , Linfedema/tratamento farmacológico , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/tratamento farmacológico , Prednisona/uso terapêutico , Receptores do Fator de Necrose Tumoral/uso terapêuticoRESUMO
OBJECTIVES: The purpose of the study was to examine the relationships between cultural variables and diabetes self-care behaviors and glycemic control among African Americans with type 2 diabetes. DESIGN: Cross-sectional survey. METHODS: Questionnaires assessing traditional African-American cultural orientation, ethnic identity, self-identification, and diabetes self-care were administered to a sample of 94 low-income, African-American, inner-city hospital outpatients with type 2 diabetes. Participants were predominantly female (64%), with an average age of 53 years, and most had attained less than or equal to a high school education (66%). RESULTS: No significant relationships were found among ethnic identity, self-identification, glycemic control, and diabetes self-care behaviors. Traditional African-American cultural orientation was significantly associated with decreased dietary adherence scores (P<.03). Increased scores on cultural mistrust were related to decreased dietary adherence scores (P<.002). Traditional food practices showed a non-significant trend toward decreased dietary adherence in conjunction with number of dependents and income (P<.055). CONCLUSIONS: Traditional African-American cultural orientation was found to be associated with decreased dietary adherence scores in a sample of urban African Americans with type 2 diabetes. Assessment of the cultural orientation of African-American patients has the potential to assist providers in designing culturally tailored, diabetes-specific dietary interventions.
