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2.
Echocardiography ; 36(6): 1179-1180, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31087401

RESUMO

A 39-year-old male commercial diver developed cutis marmorata after a dive. He had a full recovery after therapy in a hyperbaric oxygen chamber. Transthoracic echocardiography revealed an atrial septal aneurysm and a large shunt during normal respirations. This form of decompression sickness may progress to type II DCS, thus is important to identify and treat. Cutis marmorata as a result of diving is highly associated with an atrial septal defect or a large patent foramen ovale. It is particularly important to assess these patients for a right-to-left shunt as part of a medical evaluation prior to returning to diving.


Assuntos
Doença da Descompressão/complicações , Mergulho , Ecocardiografia/métodos , Forame Oval Patente/complicações , Dermatopatias Vasculares/diagnóstico por imagem , Dermatopatias Vasculares/etiologia , Adulto , Humanos , Oxigenoterapia Hiperbárica , Masculino , Dermatopatias Vasculares/terapia
4.
Am J Emerg Med ; 33(3): 363-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25636518

RESUMO

PURPOSE: The aim of this study is to investigate factors associated with residual symptoms after hyperbaric oxygen therapy (HBOT) in type I decompression sickness (DCS). BASIC PROCEDURES: An HBOT registry, which includes patients with type I DCS, was analyzed retrospectively. We divided enrolled patients into two groups; complete resolution group and residual symptom (RS) group after a single HBOT session. We investigated factors associated with residual symptoms at discharge with univariable and multivariable analyses. Restrictive cubic spline curve and a test for trend analysis were used to show the trend of therapeutic response after HBOT based on time from symptom onset to HBOT. MAIN FINDINGS: In a total of 195 patients, 131 (67.2%) patients were included in the RS group after single HBOT. Prolonged time from symptom onset to recompression was independently associated with residual symptoms (P = .004). When patients who underwent recompression within 24 hours from symptom were included in the reference group, the adjusted odds ratios (AOR) (95% confidence interval) of residual symptoms after HBOT were the following: 24 to 96 hours, 2.24 (0.75-6.65); 96 to 240 hours, 3.31 (1.08-10.13); more than 240 hours, 22.83 (2.45-231.43). In terms of sort of diving, commercial and recreational divers had higher probability of residual symptoms than military divers (AOR, 4.78 and 33.36, respectively). PRINCIPAL CONCLUSIONS: Early HBOT is associated with rapid symptom elimination after treatment in type I DCS. Military divers showed a more immediate response after recompression in comparison with commercial and recreational divers.


Assuntos
Doença da Descompressão/terapia , Mergulho/estatística & dados numéricos , Oxigenoterapia Hiperbárica , Dor Musculoesquelética/terapia , Doenças Profissionais/terapia , Dermatopatias Vasculares/terapia , Tempo para o Tratamento/estatística & dados numéricos , Adulto , Doença da Descompressão/complicações , Feminino , Humanos , Masculino , Militares , Análise Multivariada , Dor Musculoesquelética/etiologia , Recreação , Estudos Retrospectivos , Fatores de Risco , Dermatopatias Vasculares/etiologia , Resultado do Tratamento
5.
Diving Hyperb Med ; 44(1): 45-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24687485

RESUMO

A probable case of decompression illness with associated cutis marmorata is presented, which regressed over a few hours with oxygen breathing and after intravenous methylprednisolone and fluid resuscitation without recompression. He was eventually transferred for hyperbaric treatment some 10 hours post dive. Cutaneous decompression illness is not associated with high mortality per se, but prompt and accurate recognition is warranted, as it may represent a prodromal feature of potentially life-threatening complications. However, in this case, as differential diagnosis, an allergic reaction remains possible.


Assuntos
Doença da Descompressão/etiologia , Mergulho/efeitos adversos , Dermatopatias Vasculares/etiologia , Glucocorticoides/administração & dosagem , Humanos , Oxigenoterapia Hiperbárica , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Dermatopatias Vasculares/terapia
6.
Int J Dermatol ; 52(1): 41-5, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23113694

RESUMO

BACKGROUND: Eruptive pseudoangiomatosis (EP) is a rare, benign, spontaneously regressing exanthema of unknown etiology, characterized by an eruption of distinctive erythematous papules. This study was performed to evaluate the etiologic, clinical, and histopathologic characteristics of EP in Koreans. METHODS: Patients diagnosed with EP during 2005-2010 were included in a retrospective study. Diagnoses were based on clinical findings and confirmed by histology. Biopsies were re-examined. Patient gender, age at onset, disease duration, lesion location, season of occurrence, concomitant diseases, occupation, previous related events, disease course, responses to treatment, and laboratory findings were analyzed. RESULTS: A total of 32 patients were identified. Mean age at onset was 50.06 ± 17.12 years. Two patients developed lesions after outdoor activities. Two patients presented with simultaneous occurrences in family members. One patient reported having taken herbal medicine. One subject experienced systemic contact dermatitis caused by eating a lacquer chicken dish just before the lesions developed. All patients had typical erythematous papules measuring 2-5 mm. Lesions were usually located on exposed sites. No prodromal or systemic symptoms were observed. Routine laboratory tests were within normal ranges, except in one patient with known hyperlipidemia. Most patients were treated with oral antihistamine and topical steroid, or oral prednisolone. Eight patients did not receive any treatment. Mean disease duration was 1.64 ± 1.41 months in the treatment group and 1.20 ± 1.24 months in the no-treatment group (P > 0.05). CONCLUSIONS: Any clear relationship between EP and exposure to allergens or insect bites has yet to be elucidated. In patients in whom EP occurs on non-exposed sites, drugs and food should be considered as possible causative agents. Intravascular neutrophil infiltration on histology can be helpful in diagnosing EP.


Assuntos
Angiomatose/patologia , Dermatopatias Vasculares/patologia , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Angiomatose/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Estudos Retrospectivos , Dermatopatias Vasculares/etiologia , Adulto Jovem
7.
Rev. chil. dermatol ; 27(3): 335-339, 2011. ilus
Artigo em Espanhol | LILACS | ID: lil-654659

RESUMO

Se presenta el caso de una mujer de 36 años que consultó por lesiones vasculíticas en extremidades inferiores que aparecieron con relación al uso de un producto oral comercializado para la caída del pelo que contiene prosilium, vitaminas B6, B5, B8, hierro, zinc y vitamina E. Algunos elementos evolucionaron hacia la necrosis, especialmente en la pierna derecha. Los análisis de laboratorio permitieron excluir otras patologías asociadas con vasculitis, diagnosticándose una vasculitis cutánea de vaso pequeño posiblemente asociado a alguno de los componentes de dicho producto.


A 36 year old woman went for a consultation because of vasculitic lesions in her lower extremities that appeared after the use of a commercial oral product for hair loss which contains prosilium, vitamin B6, B5, B8, E, iron, and zinc. Some elements evolved towards necrosis, especially in the right leg. Laboratory analysis excluded other causes of vasculitis. The final diagnosis was a cutaneous vasculitis possible associated with some of the components of the hair loss product.


Assuntos
Humanos , Feminino , Adulto , Alopecia , Dermatopatias Vasculares/etiologia , Terapias Complementares/efeitos adversos , Vasculite Leucocitoclástica Cutânea/etiologia
11.
J Surg Oncol ; 93(1): 24-9, 2006 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-16353193

RESUMO

BACKGROUND: The objective of this study was to analyze factors that may have an impact on the failure rate of the surgical implantation technique for totally implantable access ports (TIAP) and to assess whether morbidity rates differ between a primarily successful surgical and a secondary Seldinger approach. METHODS: Four hundred consecutive patients receiving a primary TIAP in local anesthesia were included into this retrospective cohort study. A logistic regression-model was used to evaluate reasons for failure of the TIAP method. RESULTS: Three hundred eighteen (79.5%) patients had a successful TIAP procedure, 82 patients were intraoperatively converted to a Seldinger technique. Reasons for failure were: correct positioning impossible n = 54, no or only an undersized vessel for insertion available n = 17, other reasons n = 11. Logistic regression analysis did not reveal any significant factor for failure of the primary surgical approach. In the group with primarily successful TIAP, 8 of 318 patients (3%) developed complications compared to 7 of 82 patients (9%) converted to a Seldinger technique. CONCLUSION: Failure of the surgical approach for implanting totally implantable access ports is related to insertion and positioning. Conversion to a Seldinger technique results in a higher complication rate. A modified approach for surgical port placement should be considered in order to reduce complications.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/normas , Bombas de Infusão Implantáveis , Neoplasias/tratamento farmacológico , Complicações Pós-Operatórias , Idoso , Anestesia Local , Neuropatias do Plexo Braquial/etiologia , Cateterismo Venoso Central/estatística & dados numéricos , Cateteres de Demora/efeitos adversos , Estudos de Coortes , Falha de Equipamento , Feminino , Hematoma/etiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pneumotórax/etiologia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Dermatopatias Vasculares/etiologia , Venostomia
13.
Int J Dermatol ; 43(12): 922-4, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15569020

RESUMO

Telangiectasia macularis eruptiva perstans (TMEP) is a cutaneous form of mastocytosis. It has been rarely associated with an underlying myeloproliferative disorder. We report the case of a patient, while receiving treatment for thrombocytosis, with both platelet production and function inhibitors presented with TMEP. TMEP is often refractory to therapy; however, our patient responded to treatment with PUVA.


Assuntos
Dermatoses da Perna/etiologia , Mastocitose Cutânea/etiologia , Dermatopatias Vasculares/etiologia , Telangiectasia/etiologia , Trombocitose/complicações , Feminino , Humanos , Dermatoses da Perna/tratamento farmacológico , Mastocitose Cutânea/tratamento farmacológico , Pessoa de Meia-Idade , Terapia PUVA , Policitemia Vera/complicações , Dermatopatias Vasculares/tratamento farmacológico , Telangiectasia/tratamento farmacológico
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