RESUMEN
Wade's histoid leprosy (HL) is a rare variant of multibacillary leprosy, with characteristic clinical, immunologic, histopathologic, and bacteriologic features. It is associated with resistance to sulfa drugs or polychemotherapy and is rarely observed in patients who have not undergone prior treatment. Clinically, HL resembles keloid or dermatofibroma. Furthermore, HL is rare in children and is difficult to diagnose even by experts. This report describes a case of HL in a 14-year-old Brazilian boy, who presented with multiple nodular and tumor-like lesions, simulating keloids. He had not undergone prior treatment with anti-leprosy drugs, which accentuates the relevance of this case report.
Asunto(s)
Lepra Multibacilar/diagnóstico , Adolescente , Diagnóstico Diferencial , Humanos , Lepra Multibacilar/patología , Masculino , Piel/patologíaRESUMEN
Abstract Wade's histoid leprosy (HL) is a rare variant of multibacillary leprosy, with characteristic clinical, immunologic, histopathologic, and bacteriologic features. It is associated with resistance to sulfa drugs or polychemotherapy and is rarely observed in patients who have not undergone prior treatment. Clinically, HL resembles keloid or dermatofibroma. Furthermore, HL is rare in children and is difficult to diagnose even by experts. This report describes a case of HL in a 14-year-old Brazilian boy, who presented with multiple nodular and tumor-like lesions, simulating keloids. He had not undergone prior treatment with anti-leprosy drugs, which accentuates the relevance of this case report.
Asunto(s)
Humanos , Lepra Multibacilar/patología , Piel/patología , Diagnóstico Diferencial , Lepra Multibacilar/diagnósticoAsunto(s)
Enfermedades Desmielinizantes/inducido químicamente , Fármacos Dermatológicos/efectos adversos , Infliximab/efectos adversos , Trastornos Motores/inducido químicamente , Psoriasis/tratamiento farmacológico , Trastornos de la Sensación/inducido químicamente , Adulto , Humanos , Masculino , Síndrome , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresAsunto(s)
Humanos , Masculino , Adulto , Psoriasis/tratamiento farmacológico , Enfermedades Desmielinizantes/inducido químicamente , Trastornos de la Sensación/inducido químicamente , Fármacos Dermatológicos/efectos adversos , Infliximab/efectos adversos , Trastornos Motores/inducido químicamente , Síndrome , Linfotoxina-alfa/antagonistas & inhibidoresRESUMEN
Abstract We report an unprecedented case of ectopic thymoma in a young adult. A 33-year-old male presented with a 10-day history of non-productive cough and fever. Investigation revealed mediastinal widening without pulmonary involvement. Computed tomography showed a large mass-14.8 × 10.8 × 8.4 cm-in the mid-posterior mediastinum, and a biopsy obtained by video-assisted thoracoscopy indicated that the mass was a tumor. Immunohistochemistry showed combined thymoma type AB1. Because of the considerable proportions of the tumor and its close proximity to major structures, the patient was treated with chemotherapy.
Resumo Apresentamos caso inédito de volumoso timoma ectópico em adulto jovem. Homem de 33 anos de idade, encaminhado com tosse seca e febre diária havia 10 dias. Durante investigação observou-se alargamento mediastinal sem comprometimento pulmonar. Um tumor mediastinal medioposterior, medindo 14,8 × 10,8 × 8,4 cm, foi diagnosticado após tomografia computadorizada e biópsia videotoracoscópica. A imuno-histoquímica revelou timoma misto AB1. Devido à íntima relação com estruturas nobres e grandes proporções, optou-se pela quimioterapia.
RESUMEN
We report an unprecedented case of ectopic thymoma in a young adult. A 33-year-old male presented with a 10-day history of non-productive cough and fever. Investigation revealed mediastinal widening without pulmonary involvement. Computed tomography showed a large mass-14.8 × 10.8 × 8.4 cm-in the mid-posterior mediastinum, and a biopsy obtained by video-assisted thoracoscopy indicated that the mass was a tumor. Immunohistochemistry showed combined thymoma type AB1. Because of the considerable proportions of the tumor and its close proximity to major structures, the patient was treated with chemotherapy.
Apresentamos caso inédito de volumoso timoma ectópico em adulto jovem. Homem de 33 anos de idade, encaminhado com tosse seca e febre diária havia 10 dias. Durante investigação observou-se alargamento mediastinal sem comprometimento pulmonar. Um tumor mediastinal medioposterior, medindo 14,8 × 10,8 × 8,4 cm, foi diagnosticado após tomografia computadorizada e biópsia videotoracoscópica. A imuno-histoquímica revelou timoma misto AB1. Devido à íntima relação com estruturas nobres e grandes proporções, optou-se pela quimioterapia.
RESUMEN
O objetivo do estudo foi avaliar o grau de dependência dos idosos internados, conforme o sistema de classificação de pacientes; e identificar fatores relacionados à dependência dos pacientes para o cuidado de enfermagem. Delineamento transversal, com amostra de 161 pacientes idosos avaliados no início, meio e final da hospitalização, pela escala de classificação de pacientes. Identificou-se prevalência na classificação intermediária (52,2%); associação estatística significativa da faixa etária de 80 a 100 anos com as classes intermediária e semi-intensiva; 40% dos classificados com cuidados semi-intensivos tiveram o óbito como desfecho. O processo de envelhecimento deve determinar cuidados de enfermagem específicos para esse grupo populacional, garantindo a qualidade da assistência.
The study aimed to evaluate the degree of dependency of elderly inpatients, according to the classification system of patients, and to identify factors related to patient dependency to nursing care. Cross-sectional study with a sample of 161 elderly patients evaluated at the beginning, middle and end of hospitalization, according to the patient classification scale. It was identified a prevalence in the intermediate rating (52.2%); statistically significant association between the ages of 80 to 100 years with the middle and semi-intensive classes; 40% of the elderly classified to the semi-intensive care had death as the outcome. The aging process must determine specific nursing care for this population group, ensuring the quality of care.
El objetivo del estudio fue evaluar el grado de dependencia de los ancianos hospitalizados, de acuerdo con el sistema de clasificación de pacientes, e identificar los factores relacionados con la dependencia del paciente a la atención de enfermería. Estudio transversal con una muestra de 161 pacientes de edad avanzada evaluados al inicio, mitad y final de la hospitalización, con la escala de clasificación de pacientes. Fue identificada prevalencia en la clasificación intermedia (52,2%); se encontró asociación estadísticamente significativa entre las edades de 80 a 100 años y las clases medias y semi-intensivo; y 40% de los ancianos clasificados como de atención semi-intensiva tuvieran la muerte como resultado. El proceso de envejecimiento debe determinar los cuidados de enfermería específicos para este grupo de población, asegurando la calidad de la atención.
Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Actividades Cotidianas , Evaluación Geriátrica , Hospitalización , Pacientes/clasificación , Estudios TransversalesRESUMEN
The study aimed to evaluate the degree of dependency of elderly inpatients, according to the classification system of patients, and to identify factors related to patient dependency to nursing care. Cross-sectional study with a sample of 161 elderly patients evaluated at the beginning, middle and end of hospitalization, according to the patient classification scale. It was identified a prevalence in the intermediate rating (52.2%); statistically significant association between the ages of 80 to 100 years with the middle and semi-intensive classes; 40% of the elderly classified to the semi-intensive care had death as the outcome. The aging process must determine specific nursing care for this population group, ensuring the quality of care.
