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1.
Neurol Sci ; 43(8): 4611-4617, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35141804

RESUMEN

BACKGROUND: COVID-19 pandemic directly impacted the request for hospital care and medical assistance for several diseases worldwide, as occurred with acute ischemic stroke. The present study sought to compare the incidence and severity of acute ischemic stroke (AIS), in addition to sociodemographic, clinical, and radiological characteristics of patients hospitalized in the prepandemic (2018-2019) and pandemic (2020-2021) eras. METHODS: An incidence case-control, observational, and analytical research was carried out in the Stroke Unit of Hospital Governador Celso Ramos, Florianopolis, Santa Catarina, Brazil, including 171 patients admitted with acute ischemic stroke from April 2018 to April 2019 (prepandemic era) and 148 patients between January 2020 and January 2021 (during pandemic). RESULTS: The mean incidence of AIS hospital admissions was significantly lower in the pandemic period (CI 95%, 0.2 to 5.6; p = 0.04), being lower in the lockdown periods and when the incidence of new COVID-19 cases increased. Besides, referring to AIS severity, the mean areas of AIS were larger during the pandemic period (p < 0.01), especially in August, September, December, and January (p < 0.05). Sociodemographic and clinical variables did not show any difference between the two periods of the study. CONCLUSIONS: Hospital admissions for AIS decreased in the COVID-19 pandemic, mostly during months of higher incidences of new COVID-19 cases. When the incidence of admissions diminished, an increase in the severity of AIS was observed, characterized by larger areas. These findings might contribute to other similar referral centers in managing public policies related to stroke.


Asunto(s)
COVID-19 , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Brasil/epidemiología , Control de Enfermedades Transmisibles , Humanos , Accidente Cerebrovascular Isquémico/epidemiología , Pandemias , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Accidente Cerebrovascular/epidemiología
2.
An Bras Dermatol ; 99(1): 34-42, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37634972

RESUMEN

BACKGROUND: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. OBJECTIVE: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. METHODS: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. RESULTS: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01‒1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29‒3.08; p = 0.002) were associated with treatment interruption. STUDY LIMITATIONS: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. CONCLUSIONS: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.


Asunto(s)
Interleucina-6 , Psoriasis , Humanos , Estudios de Cohortes , Calidad de Vida , Interrupción del Tratamiento , Psoriasis/patología , Biomarcadores
3.
Neurohospitalist ; 13(2): 121-129, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37064927

RESUMEN

Background and Purpose: Acute ischemic stroke (AIS) and depression are the major causes of disability and decreased quality of life worldwide. Psychiatric disorders are common after stroke, especially post-stroke depression (PSD), which affects one-third of survivors. Although frequent, little is known about the real complexity of the pathophysiology and the factors associated with PSD. Methods: This research aimed to provide data about risk factors and predictors of PSD 90 days after AIS. A cohort study was conducted in a tertiary stroke center located in southern Brazil. We interviewed 148 patients with AIS who were consecutively hospitalized between January 2020 and January 2021. The Hospital Anxiety and Depression Scale (HADS) was applied during hospitalization and at follow-up 90 days after AIS. Furthermore, sociodemographic, clinical, and radiological variables were investigated. Predictive factors were assessed using univariate and multivariate linear regression. The impact of the COVID-19 pandemic on the data was also evaluated. Results: The frequency of PSD 90 days after AIS was 33.9%. In-hospital symptoms of depression and anxiety each represented a 2-fold risk for PSD at follow-up. Furthermore, the HADS - anxiety score 90 days after AIS was strongly associated with the HADS - depression value 90 days after stroke (R: .71; B: .56; P < .01). Conclusions: The present study highlighted a noteworthy frequency of PSD 90 days after AIS. Psychiatric variables during hospitalization and in the follow-up appeared to be the leading associated factors with PSD. These data might support the determination of which patients require more psychiatric management.

4.
Clin Neurol Neurosurg ; 223: 107505, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36334552

RESUMEN

OBJECTIVES: Ischemic stroke is a remarkable cause of death and disability worldwide. Post-stroke depression (PSD) is the most common psychiatric disturbance after stroke. Despite PSD being a potentially treatable condition, it still requires approaches to improve the early diagnosis. The present study aims to investigate the factors associated and correlated variables associated with PSD during hospitalization. MATERIALS AND METHODS: A retrospective cross-sectional study was conducted in a specialized center of neurology in Santa Catarina, Brazil. 148 patients with acute ischemic stroke hospitalized between January 2020 and February 2021 were included. Sociodemographic, clinical and radiological variables were assessed during hospitalization. The Hospital Anxiety and Depression Scale (HADS) was applied, as well as the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Factors associated were investigated through binary logistic regression and continuous variables through correlation tests. RESULTS: The prevalence of PSD during hospitalization was 31.1%. Factors associated with PSD in the acute phase of the stroke were female sex (OR: 2.6; CI 95%: 1.3-5.4; p < 0.01) and post-stroke anxiety during hospitalization (OR: 4.9; CI 95%: 2.3-10.3; p < 0.01). The variables NIHSS, mRS, and stroke area were positively correlated with HADS - depression values. CONCLUSIONS: This research evidenced a high prevalence of PSD in the acute phase of stroke. Despite the study being conducted during the COVID-19 pandemic, the frequency is similar to the non-pandemic periods. The research provided clues to identify and timely treat patients at greater risk of developing PSD during hospitalization.


Asunto(s)
COVID-19 , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Femenino , Masculino , Estudios Transversales , Depresión/epidemiología , Depresión/etiología , Depresión/diagnóstico , Estudios Retrospectivos , Pandemias , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico
5.
Neurohospitalist ; 12(3): 524-528, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35747764

RESUMEN

Background: This study represents an additional case of a rare entity and complication of COVID-19. Purpose: To further describe COVID's association with acute hemorrhagic leukoencephalopathy (AHL), a variant of acute disseminated encephalomyelitis. Besides, subsequent neuropsychological evaluation is described. Methods: The present case report describes clinical, laboratory, radiological, and electroencephalographic characteristics of AHL triggered by COVID-19, in addition to outcomes in the neuropsychological findings. Results: Radiologic findings of demyelinating lesions in supratentorial white matter permeated by multiple hemorrhagic foci supported the diagnostic of AHL, reinforced by clinical improvement after corticosteroid therapy. Conclusions: There are few similar cases previously reported, and this case highlights the early diagnosis and prompt treatment looking forward to better outcomes in AHL. Further studies are needed to elucidate the involved pathophysiological mechanisms.

6.
An. bras. dermatol ; 99(1): 34-42, Jan.-Feb. 2024. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1527686

RESUMEN

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01-1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29-3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

7.
An Bras Dermatol ; 93(6): 801-806, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30484522

RESUMEN

BACKGROUND: Psoriasis has a significant impact on quality of life (QoL). Sexual life can also be affected, with sexual dysfunction being reported by 25-70% of patients. OBJECTIVES: To determine the occurrence of sexual dysfunction and evaluate QoL in women with psoriasis. METHODS: This case-control study included women aged 18-69 years. The validated Brazilian Portuguese versions of the Female Sexual Function Index (FSFI) and of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered to all participants to assess sexual function and QoL, respectively. Patients with psoriasis underwent clinical evaluation for the presence of comorbidities, especially psoriatic arthritis and other rheumatic manifestations. Location of lesions and the extent of skin involvement were also assessed. RESULTS: The sample consisted of 150 women, 75 with diagnosis of psoriasis and 75 healthy controls. Prevalence of sexual dysfunction was high in women with psoriasis (58.6% of the sample). Prevalence was statistically higher in women with psoriasis than in controls (P = 0.014). The SF-36 domain scores were also lower in women with psoriasis, with role limitations due to physical health, limitations due to emotional problems, and mental health being the most affected domains. STUDY LIMITATIONS: Sample size was calculated to evaluate the association between the occurrence of sexual dysfunction and psoriasis, but it did not include the determination of the possible causes of this dysfunction. CONCLUSIONS: QoL and sexual function were altered in women with psoriasis and should be taken into consideration when assessing disease severity.


Asunto(s)
Psoriasis/psicología , Calidad de Vida/psicología , Disfunciones Sexuales Psicológicas/psicología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Psoriasis/complicaciones , Psoriasis/epidemiología , Índice de Severidad de la Enfermedad , Disfunciones Sexuales Psicológicas/epidemiología , Encuestas y Cuestionarios , Adulto Joven
8.
An Bras Dermatol ; 93(6): 813-818, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30484524

RESUMEN

BACKGROUND: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. OBJECTIVES: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. METHODS: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. RESULTS: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). STUDY LIMITATIONS: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. CONCLUSIONS: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.


Asunto(s)
Psoriasis/diagnóstico , Adulto , Brasil , Características Culturales , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Psoriasis/clasificación , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Traducciones
9.
PLoS One ; 13(10): e0205486, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30308020

RESUMEN

PASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS: 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics. We performed the analysis of semantic equivalence in eight steps. For psychometric equivalence, we evaluated the data quality, reliability, construct validity, well-known groups and discriminant characteristics of the items, as well as a ROC curve to determine optimal PASE-P cutoff points in case identification and their sensitivity / specificity. The final version presented excellent reproducibility (CCI = 0.97) and reliability (Cronbach's alpha> 0.9). A cut-off point of 25 distinguished between patients with and without psoriatic arthritis, with sensitivity of 69.5 and specificity of 86.8. PASE-P proved to be culturally valid and reliable to screen for psoriatic arthritis in Brazilian patients with psoriasis.


Asunto(s)
Artritis Psoriásica/diagnóstico , Artritis Psoriásica/psicología , Tamizaje Masivo/métodos , Adulto , Anciano , Brasil , Estudios Transversales , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Psicometría , Curva ROC , Reproducibilidad de los Resultados , Semántica , Encuestas y Cuestionarios
10.
J Dermatolog Treat ; 29(8): 775-785, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29697004

RESUMEN

PURPOSE: Data on chronic plaque psoriasis severity and its potential clinical and lifestyle implications in the Brazilian population are limited. The primary aim of this study was to assess the clinical severity of plaque psoriasis in Brazil. Further objectives included evaluating potential associations between disease severity and demographic, lifestyle, and clinical characteristics, health-related quality of life (HRQOL), and work productivity. MATERIALS AND METHODS: This observational (non-interventional) cross-sectional study was conducted in 26 dermatologic clinics across 11 Brazilian states. Psoriasis severity was assessed using investigator judgment and Finlay's Rule of Tens: a Psoriasis Area and Severity Index (PASI) score >10, a Body Surface Area (BSA) > 10%, or a Dermatology Life Quality Index (DLQI) score >10. RESULTS: Among 1125 patients, 205 (18.2%) had moderate-to-severe disease. On multiple regression analyses, psoriasis severity was significantly (directly) associated with the presence of physical inactivity and comorbid pain, anxiety, and depression; and significantly (inversely) associated with HRQOL and work productivity. LIMITATIONS: Cross-sectional studies cannot assess temporal trends, and observational studies cannot conclusively determine causality or exclude biases and confounding due to unmeasured variables. CONCLUSIONS: Among Brazilian patients with moderate-to-severe psoriasis, disease severity had far-reaching adverse impacts on lifestyle, comorbidities, HRQOL, and work productivity.


Asunto(s)
Psoriasis/complicaciones , Psoriasis/patología , Adulto , Anciano , Instituciones de Atención Ambulatoria , Brasil , Estudios Transversales , Depresión/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/psicología , Calidad de Vida , Análisis de Regresión , Índice de Severidad de la Enfermedad
11.
J Rheumatol ; 42(5): 829-34, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25729032

RESUMEN

OBJECTIVE: To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers. METHODS: A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist. RESULTS: A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%). CONCLUSION: In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.


Asunto(s)
Artritis Psoriásica/epidemiología , Psoriasis/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia
13.
An. bras. dermatol ; 93(6): 801-806, Nov.-Dec. 2018. tab
Artículo en Inglés | LILACS | ID: biblio-973637

RESUMEN

Abstract: Background: Psoriasis has a significant impact on quality of life (QoL). Sexual life can also be affected, with sexual dysfunction being reported by 25-70% of patients. Objectives: To determine the occurrence of sexual dysfunction and evaluate QoL in women with psoriasis. Methods: This case-control study included women aged 18-69 years. The validated Brazilian Portuguese versions of the Female Sexual Function Index (FSFI) and of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered to all participants to assess sexual function and QoL, respectively. Patients with psoriasis underwent clinical evaluation for the presence of comorbidities, especially psoriatic arthritis and other rheumatic manifestations. Location of lesions and the extent of skin involvement were also assessed. Results: The sample consisted of 150 women, 75 with diagnosis of psoriasis and 75 healthy controls. Prevalence of sexual dysfunction was high in women with psoriasis (58.6% of the sample). Prevalence was statistically higher in women with psoriasis than in controls (P = 0.014). The SF-36 domain scores were also lower in women with psoriasis, with role limitations due to physical health, limitations due to emotional problems, and mental health being the most affected domains. Study limitations: Sample size was calculated to evaluate the association between the occurrence of sexual dysfunction and psoriasis, but it did not include the determination of the possible causes of this dysfunction. Conclusions: QoL and sexual function were altered in women with psoriasis and should be taken into consideration when assessing disease severity.


Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Psoriasis/psicología , Calidad de Vida/psicología , Disfunciones Sexuales Psicológicas/psicología , Psoriasis/complicaciones , Psoriasis/epidemiología , Índice de Severidad de la Enfermedad , Brasil/epidemiología , Estudios de Casos y Controles , Prevalencia , Encuestas y Cuestionarios , Disfunciones Sexuales Psicológicas/epidemiología
14.
An. bras. dermatol ; 93(6): 813-818, Nov.-Dec. 2018. tab
Artículo en Inglés | LILACS | ID: biblio-973641

RESUMEN

Abstract: Background: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. Objectives: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. Methods: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. Results: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). Study limitations: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. Conclusions: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Psoriasis/diagnóstico , Psoriasis/clasificación , Traducciones , Índice de Severidad de la Enfermedad , Brasil , Valor Predictivo de las Pruebas , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Características Culturales , Lenguaje
15.
An Bras Dermatol ; 87(4): 539-44, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22892765

RESUMEN

BACKGROUND: Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. Its prevalence in patients with psoriasis varies from 7 to 42% but its exact prevalence is unknown. OBJECTIVES: Considering the lack of national data related to its diagnosis in patients with psoriasis, this study aims to describe the clinical, laboratorial and radiological manifestations of psoriatic arthritis in these patients. METHODS: We evaluated 133 patients with psoriasis, treated as outpatients. These patients were asked to fill in the forms with data about the disease and were submitted to a clinical evaluation by a dermatologist and a rheumatologist. Suspected cases of arthritis were referred for further investigation and were classified according to presence or absence of psoriatic arthritis according to CASPAR criteria. RESULTS: The number of patients with psoriatic arthritis was 47 (35%), 17 of them were new cases. There was no difference between the groups regarding the type of psoriasis, nail involvement, presence of scalp lesions and psoriatic arthritis. Patients with psoriatic arthritis had more enthesitis and dactylitis (46.7%) than those without arthritis. CONCLUSIONS: Despite the high prevalence of arthritis found, we know that results from epidemiological studies are variable, which limits their use and interpretation. We conclude that more studies are needed to draw a profile of rheumatic manifestations in our population of psoriasis patients.


Asunto(s)
Artritis Psoriásica/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artritis Psoriásica/diagnóstico , Brasil/epidemiología , Estudios Transversales , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Psoriasis/epidemiología , Adulto Joven
17.
Arq Neuropsiquiatr ; 70(9): 700-3, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22990727

RESUMEN

OBJECTIVE: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. METHOD: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. RESULTS: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80%) had partial or no recovery from the neurological signs and symptoms. CONCLUSION: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Enfermedades del Sistema Nervioso/etiología , Adulto , Brasil , Enfermedades Desmielinizantes/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/cirugía , Enfermedades del Sistema Nervioso Periférico/etiología , Deficiencia de Vitamina B 12/complicaciones
19.
ACM arq. catarin. med ; 42(1)jan.-mar. 2013. graf, tab, ilus
Artículo en Portugués | LILACS | ID: lil-673850

RESUMEN

Introdução: O Acidente Vascular Encefálico (AVE) éuma das principais causas de morte no mundo e a primeirano Brasil, resultando em milhares de pacientescom sequelas neurológicas, incapazes de manter suasatividades de vida diária normalmente. O presente estudoteve como objetivo identificar e definir o perfilepidemiológico dos pacientes acometidos com AVE,atendidos em hospital terciário de referência em Neurologia.Métodos: Foram incluídos no estudo os pacientesque sofreram AVE isquêmicos e que foram internadosno Hospital Governador Celso Ramos no período de01 de março a 31 de agosto de 2010. Foram coletadasvariáveis clínicas e demográficas, além de escalas específicaspara avaliação da gravidade do AVE. Resultados:Foram avaliados 47 pacientes, com média de idade de66 anos, sendo 53.2% do sexo feminino, e 87.2% caucasianos.Hipertensão arterial sistêmica foi encontradaem 78.7% dos pacientes, dislipidemia em 40.4% e diabetesmellitus em 29.8%. Hemiparesia foi o sintomade apresentação em 89.4% dos pacientes, e o NIHSSde admissão teve média de 12 pontos, reduzindo paramédia de 6 pontos na alta hospitalar. Da amostra estudada,apenas 6 pacientes foram submetidos à trombólise.Conclusão: No presente estudo foi observada maiorincidência de AVE com o avançar da idade, além dapresença de fatores de risco como hipertensão arterialsistêmica e dislipidemia. Atribuímos a baixa incidênciade trombólise pelo tempo ictus-porta ter sido maior de4.5h na maioria dos pacientes.


Background: Stroke is a leading cause of death worldwideand the first in Brazil, resulting in thousands ofpatients with neurological impairment, unable to maintaintheir daily activities normally. This study aimed toidentify and define the epidemiological profile of affectedpatients with ischemic stroke treated at a tertiaryhospital in Neurology. Methods: The study includedpatients who experienced ischemic stroke and were admittedto the Hospital Governador Celso Ramos in theperiod from 01 March to 31 August 2010. We collecteddemographic and clinical variables, and specific scalesfor assessment of stroke severity. Results: We evaluated47 patients with a mean age of 66 years, 53.2%female and 87.2% Caucasian. Hypertension was foundin 78.7% of patients, dyslipidemia in 40.4% and diabetesmellitus in 29.8%. Hemiparesis was the presentingsymptom in 89.4% of patients, and admission NIHSShad a mean of 12 points, falling to mean of 6 pointsat discharge. Out of the sample, only 6 patients underwentthrombolysis. Conclusion: In this study therewas a higher incidence of stroke with advancing age,and the presence of risk factors such as hypertensionand dyslipidemia. We attribute the low incidence ofstroke thrombolysis by time ictus-gate being greaterthan 4.5h in most patients.

20.
An. bras. dermatol ; 87(4): 539-544, July-Aug. 2012. tab
Artículo en Inglés | LILACS | ID: lil-645320

RESUMEN

BACKGROUND: Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. Its prevalence in patients with psoriasis varies from 7 to 42% but its exact prevalence is unknown. OBJECTIVES: Considering the lack of national data related to its diagnosis in patients with psoriasis, this study aims to describe the clinical, laboratorial and radiological manifestations of psoriatic arthritis in these patients. METHODS: We evaluated 133 patients with psoriasis, treated as outpatients. These patients were asked to fill in the forms with data about the disease and were submitted to a clinical evaluation by a dermatologist and a rheumatologist. Suspected cases of arthritis were referred for further investigation and were classified according to presence or absence of psoriatic arthritis according to CASPAR criteria. RESULTS: The number of patients with psoriatic arthritis was 47 (35%), 17 of them were new cases. There was no difference between the groups regarding the type of psoriasis, nail involvement, presence of scalp lesions and psoriatic arthritis. Patients with psoriatic arthritis had more enthesitis and dactylitis (46.7%) than those without arthritis. CONCLUSIONS: Despite the high prevalence of arthritis found, we know that results from epidemiological studies are variable, which limits their use and interpretation. We conclude that more studies are needed to draw a profile of rheumatic manifestations in our population of psoriasis patients.


FUNDAMENTOS: A artrite psoriásica é uma artrite inflamatória associada à psoríase. Sua prevalência nos pacientes com psoríase de 7 a 42% mas sua exata prevalência ainda é desconhecida. OBJETIVOS: Considerando a escassez de dados nacionais relacionados ao seu diagnóstico em pacientes com psoríase o presente estudo visa descrever o quadro clínico, laboratorial e radiológico da doença nesses pacientes. MÉTODOS: Foram avaliados 133 pacientes com diagnóstico de psoríase acompanhados no ambulatório de Psoríase: Esses pacientes foram submetidos ao preenchimento de fichas com dados sobre sua doença e depois a uma avaliação clínica pelo dermatologista e reumatologista. Casos suspeitos de artrite foram encaminhados para realização de investigação complementar e foram classificados quanto à presença ou não de artrite psoriásica segundo critérios de CASPAR. RESULTADOS: O número de pacientes com Artrite Psoriásica foi de 47 pacientes (35% ) sendo 17 desses casos novos. Não houve diferença entre os grupos quanto ao tipo de psoríase, envolvimento ungueal e de couro cabeludo e presença de artrite psoriásica. Pacientes com artrite psoriásica apresentaram mais entesites e dactilite (46,7%) do que os sem artrite. CONCLUSÕES: Apesar da alta prevalência de artrite encontrada como sabemos que resultados de estudos epidemiológicos são variáveis levando a limitação em seu uso e interpretação concluímos que mais estudos são necessários para se traçar um perfil de manifestações reumatológicas em nossa população de pacientes psoriásicos.


Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Artritis Psoriásica/epidemiología , Artritis Psoriásica/diagnóstico , Brasil/epidemiología , Estudios Transversales , Hospitales Universitarios , Prevalencia , Psoriasis/epidemiología
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