842 resultados para Úlcera Cutânea


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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To establish guidelines based on cientific evidences for the management of cryopyrin associated periodic syndromes. The Guideline was prepared from 4 clinical questions that were structured through Pico (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 1215 articles were retrieved and evaluated by title and abstract; from these, 42 articles were selected to support the recommendations. 1. The diagnosis of Caps is based on clinical history and clinical manifestations, and later confirmed by genetic study. Caps may manifest itself in three phenotypes: FCAS (mild form), MWS (intermediate form) and Cinca (severe form). Neurological, ophthalmic, otorhinolaryngological and radiological assessments may be highly valuable in distinguishing between syndromes; 2. The genetic diagnosis with NLRP3 gene analysis must be conducted in suspected cases of Caps, i.e., individuals presenting before 20 years of age, recurrent episodes of inflammation expressed by a mild fever and urticaria; 3. Laboratory abnormalities include leukocytosis and elevated serum levels of inflammatory proteins; 4. Targeted therapies directed against interleukin-1 lead to rapid remission of symptoms in most patients. However, there are important limitations on the long-term safety. None of the three anti-IL-1β inhibitors prevents progression of bone lesions.

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Pós-graduação em Cirurgia Veterinária - FCAV

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Pós-graduação em Ciência Animal - FMVA

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Foi atendido no Hospital Veterinário “Luiz Quintiliano de Oliveira”, o felino Nick, SRD, de quatro meses de idade, pesando 700 gramas, com histórico de trauma por arranhadura em bulbo ocular esquerdo. Ao exame físico específico, evidenciou-se úlcera profunda e prolapso de íris, sendo então indicada a enucleação. Ao exame físico geral, observou-se freqüência cardíaca (FC) de 160 batimentos.min-1, frequência respiratória (f) de 80 movimentos.min-1, tempo de preenchimento capilar menor do que dois segundos, temperatura retal (TR) de 39,2oC e mucosas normocoradas. Como medicação pré-anestésica, empregou-se acepromazina (0,04 mg.kg-1) e metadona (0,3 mg.kg-1), administradas pela via intramuscular. A veia femoral esquerda foi cateterizada com cateter 24G para administração de Ringer com Lactato de sódio (10 mL.kg-1.h- 1 ). A indução foi realizada por máscara facial tendo-se como agente o isofluorano em fluxo diluente de 100 mL.kg-1.min-1 de oxigênio a 100%, seguida de intubação orotraqueal com sonda n o 2,5 sem cuff. Seguiu-se a manutenção anestésica com a mesma mistura da indução, administrada por meio de circuito anestésico sem reinalação de gases, do tipo Baraka, mantendose o paciente sob ventilação assistida. Ato contínuo, realizou-se a técnica anestésica peribulbar de punção única inferior, utilizando-se lidocaína 2% com vasoconstritor (3mg.kg-1) associada a bupivacaína 0,5% sem vasoconstritor (0,8mg.kg-1), perfazendo um volume total de 0,3ml.kg-1 . Uma agulha 13x4,5 foi introduzida em todo o seu comprimento com o bisel voltado para a órbita, no terço lateral do fórnice conjuntival inferior da órbita esquerda, administrando-se a associação dos agentes anestésicos locais, seguida de compressão manual da área para facilitar a difusão dos mesmos. Durante o procedimento anestésico, realizou-se a monitoração da FC, f, pressão arterial sistólica (PAS), TR e saturação periférica da hemoglobina (SpO2). O tempo total de anestesia e cirurgia foi de 30 e 20 minutos, respectivamente, e a SpO2, concentração de isofluorano e TR mantiveram-se em 99±1%, 1,7±0,8% e 37,4±1,5oC, respectivamente. O plano anestésico manteve-se estável, sem a necessidade de resgate analgésico. Não houve a ocorrência de reflexo óculo-cardíaco (ROC) frente à manipulação do nervo óptico, o que pode ser atribuída provavelmente ao bloqueio peribulbar. A anestesia regional é frequentemente empregada para cirurgias oftálmicas em humanos, como a facoemulsificação, sendo que o manejo anestésico pode contribuir para o sucesso do procedimento. Pode-se concluir que, também na espécie felina, o bloqueio peribulbar pode ser uma boa alternativa para a realização de protocolos de anestesia balanceada para procedimentos oftálmicos.

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The oral and oropharyngeal cancer is aggressive and, in Brazil, the incidence is considered one of the world’s tallest, the most common of head and neck. It affects males more intensively and 70% of cases are in adults over 50 years of age. It is located usually on the floor of the mouth and tongue. Therefore, the purpose of this study is to report a case of male patient, 78 years of age, leukoderma who sought hospital care. Reported frequent smoking and alcoholism. On physical examination headgear, there was the presence of lymph node fixed, painless 1.5 to 2 cm in diameter in the submandibular region. Physical examination intraoral ulcer was found at about 5 cm at its greatest extent, localized to the left oral floor region of the oropharynx, reddish, hardened edges, surface and bottom corrugated carton. The differential diagnosis suggested was traumatic ulcer, paracoccidioidomycosis and squamous cell carcinoma. The approach employed was obtained by incisional biopsy and the piece sent to histopathological analysis, confirming the case of squamous cell carcinoma. The treatment consisted in clarifying the patient about the disease and the need to search for an oncology center. It is concluded that the oral clinical examination is accurate in all major injuries to mouth, even if the chief complaint does not focus on this. In individuals at high risk examination should be systematic and individuals with suspicious lesions should be referred to specialist consultation.

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Muscle activity has been studied indirectly through analyses of temperature variation in skin surface temperature on the masticatory muscles. These procedure may be an important tool for clinical evaluation and assessment of the evolution of temporomandibular disorders, as well as monitoring the adopted protocol. Thus, its utilization for identified pathological alterations on blood circulation and/or on metabolic activity in subcutaneous tissues, such as the masticatory muscles, is justified. The aim of this study was to investigate the effect of occlusal splints’ thickness on the variation of surface temperature of the anterior temporal and masseter muscles during rest and clenching. It were analyzed 20 symptomatic subjects (10 males and 10 females) selected through the Research Diagnostic Criteria (RDC) questionnaire. Temperature expressed in degrees Celsius (ºC) was measured on the surface of both muscles measured with the aid of a digital thermometer with an infrared radiation reading system. The surface temperature of the anterior temporal and masseter muscles presented significant reduction during teeth clenching in relation to the mandibular rest position. However, there were no significant differences between conditions with and without occlusal splint or between the different thicknesses of splints analyzed. Masticatory muscles showed a considerable similar behavior for both sides, and no significant distinctions were observed between male and female patients.

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El control de los riesgos ergonómicos es parte del paquete de medidas de Buenas Prácticas de Laboratorio y Bioseguridad. De este modo, la mala postura, la iluminación o ventilación inadecuadas , prolongada jornada de trabajo, la monotonía y la actividad repetitiva, intensa rutina, el control de la productividad , el estrés y el trabajo por la noche son factores a los riesgos ergonómicos. Como se relacionan a los elementos físicos y de organización también pueden interferir con la comodidad y la salud del personal de laboratorio. Riesgos ergonómicos no sólo pueden generar trastornos psicológicos y fisiológicos que causan graves daños a la salud, sino también comprometer la productividad del laboratorio y reducir el equipo de seguridad , ya que producen cambios en el cuerpo y el estado emocional, tales como trastornos o lesiones relacionadas con el cansancio físico producido por el trabajo repetitivo, dolor muscular, alteraciones del sueño, diabetes, trastornos de los nervios , la taquicardia , las enfermedades del aparato digestivo (gastritis y úlcera ), tensión, ansiedad, problemas de espalda y la hipertensión. En este trabajo se propone una secuencia de actividad laboral (gimnasia) en el intervalo de tiempo pequeño, respetando las instalaciones y el espacio físico disponible en el ambiente del trabajo, como una estrategia para mejorar la calidad de vida laboral, para aumentar la productividad, mejorar la disposición a trabajar y para aumentar el conocimiento del cuerpo y de la interacción social.

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The increase of elderly population in Brazil and all around the world shows the need of reviewing the health cares in order to get a better quality of life. Objective: To evaluate lifestyle and health care of elderly participants of UNATI, Franca, SP. Methods: Sixty elderlies answered a questions about socio-economic issues, health care, food consumption habits and lifestyle, after, they were submitted to anthropometric and laboratory tests. Results: There was a prevalence of women (85%), aged between 60-69 years old (60%), up to high school (60%), retired (65%), income up to 5 minimum wage (73.4%). Most seniors assessed medical care (65%) were in use of long-term medicines (78.3%), they reported to control blood pressure (80%) and to not smoke (100%). About 71.7% people believed to have a healthy diet, 97% took meals at home, 85% chose and prepared their own food, 65% had 5-6 meals/day, 63% drank 1L of water/day, 90% had bowel function and 43.3% practices a regular physical activity. Only 13.3% have done hormone replacement therapy, 18.3% take dietary supplements and 21.7% drink alcoholic drinks. The participants presented a BMI of 27.49 ± 4.5kg/m², prevalence of overweight and eutrophy, which values decreased with age. Leg circumference (LC) (36.27 ± 3.84 cm), Arm circumference (AC) (31.39 ± 4.08 cm) and triceps skinfolds (TS) (20.58±7.54mm) values were suit in most cases (96.7, 85 and 83.3%, respectively). Serum total cholesterol values were 198.53 ± 35.2mg/dL, 55% were considered optimum. About 63.3% and 68.3% of the elderlies, respectively, presented a high density lipoproteins (HDL) (53.58± 10.9mg/dL) and triglycerides (TG) (143.97 ± 92.37mg/dL) according to the recommendation and 51.7% of the elderlies had normal glycemia, 38.3% had risk and 10% showed high blood glucose, indicating diabetes. Conclusion: Many elderlies had body mass index (BMI) above normal, indicating overweight or obesity, but the participants can be considered healthy because of AC, LC and TS values, diet habits, health care and lifestyle.

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Although the regular practice of physical exercise for the maintenance of the nutritional state and quality of life is important, it is not a common habit among the elderly, especially those of the lower income social bracket. The objective was to characterize and compare according to social-economic conditions and anthropometric indexes of the nutritional state of the elderly who regularly practice and those who do not practice exercises, offered at no cost, in the Northern zone of São José do Rio Preto-SP. In this study, 110 elderly women participated, of which 60 (group P) exercised regularly and 50 did not (group NP). Group P participated in a special gym program, free of charge, for at least 2 years, 2 to 3 times a week, one hour a day. Group NP was recruited from the same location as Group P. The comparison between the groups of elderly women was proportionately distributed according to marital status, level of education, means of locomotion, results of body mass index (IMC), waist to hip ratio (RCQ) and calf circumference, using the chi-square test. Comparisons were also made of average age, per capita family income, individual income, IMC, arm and triceps skin fold measured by t-Test. Differences were not found in all the comparisons made. The variables that stood out were the IMC (overweight) and RCQ (risk of chronic diseases) results, which were above what was expected, and the high frequency of walking and riding buses for both groups of elderly women (about 60%). We came to the conclusion that the low-intensity exercise program evaluated made no difference in the nutritional profi le of the elderly who also used walking as a means of getting around.

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Psychogenic Excoriation is a psychodermatosis characterized by skin alterations connected to mental processes, which are more common in women. It generates a considerable physical and psychosocial discomfort to the patient, because of the skin lesions. These patients assume to injure their own skin, and it differentiates this diagnosis from the factual dermatitis. This acknowledgement facilitates the insertion of these patients in psychotherapeutic processes, including fast psychotherapy, which can benefit them, especially in hospital contexts such as hospital ambulatories specialized in dermatology. Fast dynamic psychotherapies are described, analyzed and recommended to a psychogenic excoriation patient while introducing the process plan indicated to her. It relates to the clinical study of cases with medical records, psycho interviews and results of the FPI (Factor Personality Inventory). Based on these data, a fast psychotherapy is suggested with defined focus, aim and time, with a therapeutic plan according to what’s recommended in this type of treatment. The main objective is the symptom alleviation besides self-knowledge and insights, clarifying the most important identified psychodynamic conflicts. It’s also suggested that the suggested fast psychotherapy process could well result in important therapeutic gains to the analyzed patient.