Effect of a light-darkness cycle on the body weight gain of preterm infants admitted to the neonatal intensive care unit.

The Continuous bright light conditions to which premature infants are subjected while hospitalized in Neonatal Intensive Care Units (NICU) can have deleterious effects in terms of growth and development. This study evaluates the benefits of a light/darkness cycle (LDC) in weight and early hospital discharge from the NICU. Subjects were recruited from three participating institutions in Mexico. Eligible patients (n = 294) were premature infants who were hospitalized in the low-risk and high-risk neonatal units classified as stable. The subjects randomized to the experimental group (n = 150) were allocated to LDC conditions are as follows: light from 07:00 to 19:00 and darkness (25 lx) from 19:00 to 07:00. The control group (n = 144) was kept under normal room light conditions (CBL) 24 h a day. Main outcome was weight gain and the effect of reducing the intensity of nocturnal light in development of premature infants. Infants to the LDC gained weight earlier, compared with those randomized to CBL, and had a significant reduction in length of hospital stay. These results highlight those premature infants subjected to a LDC exhibit improvements in physiological development, favoring earlier weight gain and consequently a decrease in hospital stays. ClinicalTrials.gov; 02/09/2020 ID: NCT05230706.

Quality of tuberculosis information systems after record linkage.

OBJECTIVE: to analyze the quality of a tuberculosis notification information system after record linkage and spatial and temporal distribution of tuberculosis in a Brazilian state. METHOD: an ecological study carried between 2006 and 2016 in Sergipe, Brazil. A deterministic linkage was performed with Notifiable Diseases Information System and Mortality Information System, recording 7,873 cases and 483 deaths. The temporal trend of tuberculosis incidence was calculated. RESULTS: there was an increase among men (2.75%), > 60 years (6.29%), higher education (4.34%) and indigenous (4.76%). A total of 190 new cases (2.9%) was found. There was an increasing trend in tuberculosis incidence with a concentration of deaths in the metropolitan region. CONCLUSION: the quality of the information system showed fragility in identifying cases and deaths in Sergipe. Temporal distribution showed an increasing trend in tuberculosis incidence, and spatial distribution identified higher incidences in southeastern Brazil.

Atypical clinical presentation of distal renal tubular acidosis: a case report registered in Amazonas, Brazil / Apresentação clínica atípica da acidose tubular renal distal: relato de caso registrado no Amazonas, Brasil

ABSTRACT We report an unusual case of a 24-year-old girl with a history of recurrent hypokalemic paralysis episodes and skin lesions on the lower limbs and buttocks, both of which had an acute evolution. In subsequent investigations, the patient also had nephrocalcinosis, nephrolithiasis, hyperchloremic metabolic acidosis and persistent alkaline urinary pH. The findings were consistent with distal renal tubular acidosis as the cause of hypokalemic paralysis. Clinical findings, immunological tests and the result of skin biopsy suggested primary Sjögren's syndrome as an underlying cause. The patient developed azotemia due to obstructive nephrolithiasis. All the features presented in this case are an unusual manifestation of distal renal tubular acidosis; so far, we are not aware of a similar report in the literature.

RESUMO Relatamos um caso incomum de uma jovem de 24 anos com história de episódios recorrentes de paralisia hipocalêmica e lesões cutâneas em membros inferiores e nádegas, ambas de evolução aguda. Em investigações subsequentes, verificou-se que a paciente apresentava nefrocalcinose, nefrolitíase, acidose metabólica hiperclorêmica e pH urinário persistentemente alcalino. Os achados foram consistentes com acidose tubular renal distal como causa da paralisia hipocalêmica. Achados clínicos, exames imunológicos e o resultado da biópsia de pele foram compatíveis com a síndrome de Sjögren primária como causa subjacente. A paciente evoluiu com azotemia em decorrência da nefrolitíase obstrutiva. Todas as características apresentadas nesse caso são uma manifestação incomum de acidose tubular renal distal; até o momento, não temos conhecimento de um relato semelhante na literatura.

Atypical clinical presentation of distal renal tubular acidosis: a case report registered in Amazonas, Brazil.

We report an unusual case of a 24-year-old girl with a history of recurrent hypokalemic paralysis episodes and skin lesions on the lower limbs and buttocks, both of which had an acute evolution. In subsequent investigations, the patient also had nephrocalcinosis, nephrolithiasis, hyperchloremic metabolic acidosis and persistent alkaline urinary pH. The findings were consistent with distal renal tubular acidosis as the cause of hypokalemic paralysis. Clinical findings, immunological tests and the result of skin biopsy suggested primary Sjögren's syndrome as an underlying cause. The patient developed azotemia due to obstructive nephrolithiasis. All the features presented in this case are an unusual manifestation of distal renal tubular acidosis; so far, we are not aware of a similar report in the literature.

Quality of tuberculosis information systems after record linkage / Calidad de los sistemas de información sobre tuberculosis después de la vinculación de bases de datos / Qualidade dos sistemas de informação da tuberculose após linkage das bases de dados

ABSTRACT Objective: to analyze the quality of a tuberculosis notification information system after record linkage and spatial and temporal distribution of tuberculosis in a Brazilian state. Method: an ecological study carried between 2006 and 2016 in Sergipe, Brazil. A deterministic linkage was performed with Notifiable Diseases Information System and Mortality Information System, recording 7,873 cases and 483 deaths. The temporal trend of tuberculosis incidence was calculated. Results: there was an increase among men (2.75%), > 60 years (6.29%), higher education (4.34%) and indigenous (4.76%). A total of 190 new cases (2.9%) was found. There was an increasing trend in tuberculosis incidence with a concentration of deaths in the metropolitan region. Conclusion: the quality of the information system showed fragility in identifying cases and deaths in Sergipe. Temporal distribution showed an increasing trend in tuberculosis incidence, and spatial distribution identified higher incidences in southeastern Brazil.

RESUMEN Objetivo: analizar la calidad del sistema de información sobre tuberculosis después de la vinculación de registros y la distribución espacial y temporal de la tuberculosis en el estado brasileño. Método: estudio ecológico realizado entre 2006 y 2016 en Sergipe, Brasil. Se realizó la vinculación determinística con las bases de datos del Sistema de Información de Enfermedades de Notificación y del Sistema de Información de Mortalidad, registrando 7873 casos y 483 defunciones. Se calculó la tendencia temporal de la incidencia de tuberculosis. Resultados: hubo un aumento entre los hombres (2,75%), > 60 años (6,29%), educación superior (4,34%) e indígenas (4,76%). Se encontraron 190 casos nuevos (2,9%). Hubo una tendencia creciente en la incidencia de tuberculosis con una concentración de muertes en la región metropolitana. Conclusión: la calidad del sistema de información mostró debilidad en la identificación de casos y muertes en Sergipe. La distribución temporal mostró una tendencia creciente en la incidencia de tuberculosis, y la distribución espacial identificó mayores incidencias en la Región Sudeste.

RESUMO Objetivo: analisar a qualidade do sistema de informação da tuberculose após linkage de registros e a distribuição espacial e temporal da tuberculose em estado brasileiro. Método: estudo ecológico realizado entre 2006 e 2016 em Sergipe, Brasil. Foi realizado o linkage determinístico com as bases de dados do Sistema de Informação de Agravos de Notificação e do Sistema de Informação sobre Mortalidade, registrando 7.873 casos e 483 óbitos. A tendência temporal da incidência por tuberculose foi calculada. Resultados: houve incremento entre homens (2,75%), > 60 anos (6,29%), ensino superior (4,34%) e indígenas (4,76%). Foram encontrados 190 casos novos (2,9%). Observou-se tendência crescente da incidência de tuberculose com concentração de óbitos na região metropolitana. Conclusão: a qualidade do sistema de informação mostrou fragilidade na identificação de casos e óbitos em Sergipe. A distribuição temporal mostrou tendência crescente da incidência de tuberculose, e a distribuição espacial identificou maiores incidências na Região Sudeste.

Assessment of the antinociceptive and anti-inflammatory activities of the stem methanol extract of Diplotropis purpurea.

Context: Since there is still a great need to search for plant species with antinociceptive and anti-inflammatory activities, Diploptropis purpurea (Rich.) Amshoff (Fabaceae) is studied for the first time. Objective: This evaluates the analgesic and anti-inflammatory activities of the stem methanol extract of Diplotropis purpurea (MEDP). Material and methods: The anti-inflammatory and analgesic effects of MEDP of D. purpurea were evaluated in vivo. The antinociceptive activity was assessed in CD1 male mice were treated by oral gavage with 500 mg/kg of MEDP 30 min before submitting to acetic acid-induced abdominal writhing, hot-plate, and formalin tests. Paws oedema induced by carrageenan, histamine or serotonin were performed in male Sprague-Dawley rats to determinate the anti-inflammatory activity. Results: Oral administration of MEDP produced significant antinociceptive effects on the inflammatory phase in the formalin test [12.0 s versus 72.5 s in carboxymethyl cellulose (CMC) control group]. MEDP produced an analgesic effect in the hot-plate model, although the effect was modest compared to tramadol (40 and 60%, respectively). The oral administration of MEDP in a dose of 500 mg/kg showed maximum inhibition (75.1%) after 0.5 h in carrageenan-induced oedema, but it did not modify histamine or serotonin-induced oedemas. Discussion and conclusion: In the peripheral nociception model, acetic acid-induced abdominal writhing, the MEDP did not show a protective effect, but its analgesic effects were evident in the inflammatory phase of the formalin test and in the hot-plate model. These results show that the anti-inflammatory effect was accompanied by a reduction in the perception of painful stimuli.

Expression analysis of ST3GAL4 transcripts in cervical cancer cells.

ST3GAL4 gene expression is altered in different cancer types, including cervical cancer. Several mRNA transcripts have been reported for this gene; however, their expression levels in cervical cancer have not been analyzed. ST3GAL4 encodes for ß­galactosidase α­2,3­sialyltransferase 4, involved in the biosynthesis of the tumour antigens sLe(x) and sulfo­sLe(x). The present study evaluated the presence of three mRNA variants (V1, V2 and V3) in cervical cancer cell lines, detecting the three variants. Additionally, the expression level of the V1 transcript of the ST3GAL4 gene was determined by reverse transcription­quantitative polymerase chain reaction in cervical cell lines and in normal, premalignant and cervical cancer tissue. The V1 transcript of the ST3GAL4 demonstrated significant decreased expression in premalignant and malignant cervical tissues. The results suggested that deregulation of this gene could occur prior to the presence of cancer and demonstrated the importance of evaluating the expression level of V1, and its association with disease progression.

A transcultural study of hoarding disorder: Insights from the United Kingdom, Spain, Japan, and Brazil.

Though problematic hoarding is believed to be a universal human behavior, investigations of clinically-defined hoarding disorder (HD) have been confined almost exclusively to Western countries. The current investigation sought to describe and directly compare the features of individuals meeting diagnostic criteria for HD across four distinct cultural settings. Participants were 82 individuals meeting DSM-5 diagnostic criteria for HD, recruited and assessed by trained clinicians at one of four project sites: London, Barcelona, Fukuoka, and Rio de Janeiro. A series of semi-structured interviews and self-report scales were administered, including assessments of socio-demographic characteristics, psychiatric comorbidity, and severity of hoarding and related features. Results indicate that the severity and core features of HD, as well as the cognitions and behaviors commonly associated with this condition, are largely stable across cultures. However, some differences in patient demographics-in particular age, marital status, and clinical expression-as well as comorbid psychiatric features also emerged. These findings confirm that HD, as defined in DSM-5, exists and presents with similar phenomenology across the studied cultures. Future, more fine-grained, research will be needed to study the features of the disorder in additional cultures (e.g., non-industrialized nations) and to evaluate the impact of these cultural aspects on the design of interventions for the disorder.

Cancer-Related Fatigue and Muscle Quality in Hodgkin's Lymphoma Survivors.

The purpose of this study was to compare fatigue, strength, body composition, muscle thickness, and muscle quality between Hodgkin's lymphoma survivors (HLS) and apparently healthy subjects matched by age, gender, and physical activity levels (CON). Twelve HLS (32.16 ± 8.06) and 36 CON (32.42 ± 7.64) were enrolled in the study. Fatigue was assessed using the 20-item Multidimensional Fatigue Inventory, muscle strength using an isokinetic dynamometer, body composition using dual-energy X-ray absorptiometry, and thickness and muscle quality using B-mode ultrasound. Differences between HLS and CON were analyzed using independent samples t tests. No significant differences were observed between groups for any demographic characteristics: age ( P = .922), weight ( P = .943), height ( P = .511), body mass index ( P = .796), fat mass ( P = .688), fat-free mass ( P = .520), and percent body fat ( P = .446). No significant differences were observed for strength (peak torque; P = .552), relative peak torque ( P = .200), muscle thickness ( P > .05) and muscle quality ( P > .05). However, self-perceived fatigue was significantly higher in HLS than in CON ( P = .009). It appears that when HLS are matched by age and physical activity levels to CON, no significant difference in body composition, muscle thickness, muscle quality, or strength is observed. Self-perceived fatigue, as predicted, is higher in HLS, which may have implications and should be considered when prescribing exercise training to this cancer population.

Caracterização do comportamento sexual entre adolescentes / Characteristics of teenage sexual behavior / Características de la conducta sexual entre adolescentes

Objetivo: descrever o comportamento sexual dos adolescentes das escolas estaduais do município de Senhor do Bomfim, Bahia. Método: estudo quantitativo descritivo. Foram pesquisados 185 adolescentes de 16 a 19 anos. Para coleta de dados utilizou-se um questionário estruturado. A análise de dados foi descritiva a partir do cálculo de frequências simples e respectivas proporções. Projeto de pesquisa aprovado em comitê de ética com CAAE nº 26849914.3.0000.0057. Resultados: a maioria dos adolescentes já teve a primeira relação sexual, aproximadamente um terço não utilizou método contraceptivo na primeira relação e parcela significativa já esteve grávida ou parceira engravidou. Apenas metade dos jovens referiu fazer uso de contraceptivo em todas as relações e o mais utilizado foi o preservativo. Conclusão: observa-se a vulnerabilidade dos jovens em relação às infecções sexualmente transmissíveis e gestação precoce, pois é elevada a frequência daqueles que tem relações sexuais desprotegidas, mostrando a necessidade de ações de promoção e prevenção.

Objective: to describe the sexual behavior of adolescents at state schools in the municipality of Senhor do Bomfim, Bahia. Method: in this descriptive, quantitative study of 185 adolescents aged 16 to 19 years, data were collected by semi-structured questionnaire and analyzed descriptively by calculating simple frequencies and their proportions. Research project approved by ethics committee (CAAE No. 26849914.3.0000.0057). Results: most of the adolescents had had their first sexual intercourse, approximately one third used no contraception in the first relation, and a significant number of them (or their partners) were now pregnant. Only half the young people reported using contraception in all relationships, and the method most used was the condom. Conclusion: the young people were observed to be vulnerable to sexually transmitted infections and early pregnancy, since the frequency of those having unprotected sex was high, showing the need for promotion and prevention actions.

Objetivo: describir la conducta sexual de los adolescentes de las escuelas estatales del municipio de Senhor do Bomfim, Bahía. Método: estudio cuantitativo descriptivo. Se investigaron 185 adolescentes cuya edad variaba de 16 a 19 años. Para la recolección de datos se utilizó un cuestionario semiestructurado. El análisis de datos fue descriptivo utilizando el cálculo de frecuencias simples y respectivas proporciones. Proyecto de investigación aprobado en comité de ética con CAAE nº 26849914.3.0000.0057. Resultados: la mayoría de los adolescentes ya tuvieron la primera relación sexual, cerca de un tercio no utilizó método anticonceptivo en la primera relación y una parte significativa ya estuvo embarazada o su pareja lo estuvo. Sólo la mitad comentó hacer uso de anticonceptivos en todas las relaciones y el más utilizado fue el preservativo. Conclusión: se observa la vulnerabilidad de los jóvenes respecto a las Infecciones Sexualmente Transmisibles y el embarazo precoz, pues es elevada la frecuencia de relaciones sexuales desprotegidas, mostrando la necesidad de acciones de promoción y prevención.

Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis.

OBJECTIVE: To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly. DATA SOURCES: An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials. REVIEW METHOD: Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias. RESULTS: A total of 28 studies met the inclusion criteria and were appraised ( n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3-6 and 8-12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. CONCLUSION: Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.

Avaliação antropométrica e percentual de gordura em idosos sem doença crônica não transmissível e não acamados, internados no hospital regional de Itabaiana / Anthropometric evaluation and percentage of fat in no elderly chronic disease not and do not transmissible bedridden, hospitalized in hospital regional Itabaiana

A Organização Mundial de Saúde considera idosos, nos países em desenvolvimento, os indivíduos com mais de 60 anos. A antropometria é uma ferramenta importante para uma avaliação clínica adequada a qual mede o tamanho corporal e suas proporções. O Objetivo do trabalho foi determinar o estado nutricional de idosos sem doença crônica não transmissível e não acamados, internados no Hospital Regional de Itabaiana, de acordo com o Índice de Massa Corporal (IMC) e medir o percentual de gordura corporal e perda de massa magra. Foi realizada uma pesquisa científica/sistemática, na instituição hospitalar, Hospital Dr. Pedro Garcia Moreno Filho (Hospital Regional de Itabaiana-SE), incluindo idosos não portadores de doença crônica transmissível e não acamados. Foram realizadas as medidas antropométricas- peso, altura, IMC, circunferência da panturrilha e dobra cutânea triciptal (DCT) para se avaliar a prevalência de desnutrição através do baixo peso e adiposidade, além do recolhimento do perfil social (idade e sexo) no período de permanência no Hospital. Foram entrevistados 30 idosos, com média de idade de 74 anos. Desse total, a porcentagem de idosos que apresentaram IMC e DCT abaixo da média foi de 43,3% e 53,3%, respectivamente. Em relação à panturrilha, a maior parte dos idosos apresentou-se com a massa magra preservada. Sabe-se que após os 60 anos, o ser humano tende a perder massa magra e o peso tende a diminuir. Conclui-se que a maior parte dos idosos apresentou-se com baixo peso e baixo percentual de gordura e depleção de massa magra dentro da normalidade.

Padrão de aleitamento e estado nutricional de crianças até os seis meses de idade / Feeding patterns and nutritional status of children under six months of age

O aleitamento materno é fundamental na alimentação das crianças menores de dois anos de idade. O leite materno reúne componentes nutricionais ideais, com balanceamento adequado de nutrientes, proteções imunológica e psicológicas, importantes na diminuição da morbidade e mortalidade infantil. A introdução de alimentos complementares na dieta da criança só deve ocorrer após os seis meses de idade. Sendo assim, este trabalho objetivou comparar o estado nutricional entre crianças em aleitamento materno exclusivo e misto até o sexto mês. Trata-se de um estudo observacional transversal e descritivo, realizado em um ambulatório de aleitamento materno situado em uma maternidade filantrópica e clínica privada, localizados no município de Itabaiana, Sergipe. Os dados foram coletados em três momentos distintos (2º, 4º, 6º mês de vida) por meio de entrevista estruturada aplicada às mães e da aferição de medidas antropométricas: peso, estatura, IMC. Para a análise estatística dos dados foi utilizado o programa SPSS, versão 20.0. A amostra foi composta por 80 crianças, 40 sob aleitamento exclusivo e 40 sob aleitamento misto, sendo 15 meninos e 25 meninas. Percebeu-se que ao longo dos seis meses as crianças sob aleitamento exclusivo tiveram um melhor estado nutricional, com um maior número de crianças com IMC adequado para idade, menor classificação para baixo peso e nenhuma com obesidade. É importante incentivar o aleitamento exclusivo até o sexto mês de vida para promoção de um crescimento e desenvolvimento adequados das crianças e prevenção de doenças infecciosas, gastrointestinais e carências nutricionais.

Formation of multiple pulmonary nodules during treatment with leflunomide.

Pulmonary involvement is one of the extra-articular manifestations of rheumatoid arthritis and can be due to the disease itself or secondary to the medications used in order to treat it. We report the case of a 60-year-old woman who had been diagnosed with rheumatoid arthritis and developed multiple pulmonary nodules during treatment with leflunomide.

Formation of multiple pulmonary nodules during treatment with leflunomide / Formação de múltiplos nódulos pulmonares durante tratamento com leflunomida

Pulmonary involvement is one of the extra-articular manifestations of rheumatoid arthritis and can be due to the disease itself or secondary to the medications used in order to treat it. We report the case of a 60-year-old woman who had been diagnosed with rheumatoid arthritis and developed multiple pulmonary nodules during treatment with leflunomide.

O comprometimento pulmonar é uma das manifestações extra-articulares da artrite reumatóide e pode ser devido à própria doença ou secundário às medicações utilizadas para seu tratamento. Este trabalho relata um caso de uma paciente de 60 anos de idade com diagnóstico de artrite reumatoide que evoluiu com múltiplos nódulos pulmonares durante o tratamento com leflunomida.

Cobertura estimada da triagem auditiva neonatal para usuários do Sistema Único de Saúde, Brasil, 2008-2011 / Estimated coverage of newborn hearing screening among users of the Brazilian National Health System, 2008-2011

Estimar e descrever a cobertura da triagem auditiva neonatal (TAN) para os usuários do Sistema Único de Saúde (SUS) no Brasil, entre 2008 e 2011. Métodos: estudo ecológico de séries temporais utilizando-se dados do Sistema de Informação Ambulatorial do SUS (SIA-SUS), Sistema de Informações sobre Nascidos Vivos (SINASC), Rede Interagencial de Informações para a Saúde (RIPSA) e Sistema de Informações de Beneficiários (SIB) da Agência Nacional de Saúde Suplementar (ANS). A cobertura foi estimada considerando-se os procedimentos para TAN autorizados pelo SUS e os nascidos vivos usuários do SUS, para cada ano e Unidade da Federação. Resultados: a cobertura nacional da TAN para usuários do SUS foi estimada em 7,1 por cento em 2008, e alcançou 21,8 por cento em 2011, com evidências de desigualdades inter e intrarregionais. Maiores coberturas foram observadas no Rio Grande do Sul (60,1 por cento) e no Paraná (59,4 por cento), enquanto Rondônia, Espírito Santo e Pernambuco apresentaram cobertura inferior a 5 por cento. Conclusões: no país, mais de dois terços dos neonatos usuários do SUS não foram submetidos à triagem auditiva, mesmo em 2011, ano seguinte à promulgação da lei nacional que estabeleceu a obrigatoriedade do procedimento. Embora o cenário seja de avanço, a meta é a cobertura universal...

To estimate and describe the coverage of newborn hearing screening (NHS) among users of the Brazilian National Health System (SUS) between 2008 and 2011. Methods: an ecological study of time series was conducted using data from the SUS’s Outpatients Information System (SIA-SUS), the Live Births Information System (SINASC), the Interagency Health Information Network (RIPSA) and the Beneficiaries Information System (SIB) of the National Supplementary Health Agency (ANS). Coverage was estimated based on the NHS procedures authorized by the SUS and the live newborns are users of SUS, for every year for each federal unit. Results: national NHS coverage among SUS users was estimated to have been 7.1 percent in 2008, and rose to 21.8 percent in 2011, with evidence disparities between and within regions. More extensive coverage was found in the states of Rio Grande do Sul (60.1 percent) and Paraná (59.4 percent), while, in the states of Rondônia, Espírito Santo and Pernambuco, coverage was less than 5 percent. Conclusions: in Brazil, more than two thirds of newborns who are users of the SUS did not undergo hearing screening, even in 2011, the following year the passing of a law making the procedure obligatory. Although there has been progress, the goal should be universal coverage...

Esclerodermia generalizada: apresentaçäo de um caso e revisäo da literatura / Generalized scleroderma: case report

A esclerodermia generalizada é uma patologia rara, limitada à pele, sem etioliogia definida, com influência de fatores imunológicos. Estuda-se uma paciente do sexo feminino, de quarenta anos de idade, com quadro clínico de Esclerodermia generalizada, cujo diagnóstico foi confirmado através da histopatologia e exames laboratoriais. Discutem-se os principais aspectos dessa entidade, ressaltando-se a raridade e a exuberância das lesões clïnicas