Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 41
Filtrar
1.
Haemophilia ; 25(5): 821-830, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322311

RESUMO

AIM: To compare subjective and objective measures of adherence to prophylaxis in haemophilia. METHODS: In this cross-sectional study, we compared participants' self-perceived adherence and their estimate of the number of clotting factor concentrates (CFCs) that had been missed over the last period of CFC dispensation with an objective measure of adherence based on counts of CFC vials returned by participants. RESULTS: We included 29 out of 31 eligible patients in the study. There was no significant correlation between self-perceived degree of adherence and the objective classification of adherence (Rho: 0.10, 95% CI: -028 to 0.46, P: 0.61) and between the classification of adherence based on the proportion of missed CFC doses assessed by participants' self-report and objectively (Rho: 0.32, 95% CI: -0.01 to 0.59, P: 0.11). Conversely, we found evidence of moderate correlation between the proportion of missed CFC doses as assessed by participants' self-report and objectively (Rho: 0.56, 95% CI: 0.24 to 0.77, P: 0.003). Participants' self-perceived adherence was 3 times more likely to be rated as very good or good than it was for the objective assessment to be classified as adherent or suboptimally adherent. CONCLUSION: Our results showed significant discrepancies between subjective and objective measures of adherence, which likely reflect the influence of social desirability bias in self-reported measures and different concepts of adherence between patients/caregivers and haemophilia experts. Additionally, our results allow us to hypothesize that studies on adherence to prophylaxis in haemophilia relying exclusively on information from self-reports and questionnaires may substantially overestimate adherence levels.

4.
Rev. bras. promoç. saúde (Impr.) ; 31(2): 1-7, 22/06/2018.
Artigo em Inglês, Português | LILACS | ID: biblio-907009

RESUMO

Objetivo: Revisar na literatura a descrição dos conceitos e o emprego das evidências científicas no âmbito da Saúde Coletiva (SC). Métodos: Realizou-se uma revisão narrativa utilizando e combinando as palavras-chave "Saúde Pública" OR "Saúde Coletiva"; "Medicina baseada em evidências" e "Política informada por evidências" por meio da consulta as bases de dados Lilacs, SciELO e MedLine. As buscas foram limitadas ao período entre janeiro de 1990 a dezembro de 2016, no idioma português e/ou inglês. A seleção dos estudos foi realizada por dois autores, de modo independente, por meio da leitura do título, resumo e texto completo. Para o processo de síntese, as temáticas encontradas foram agrupadas em três grandes eixos norteadores: as evidências e a prática em saúde, as evidências em SC, e os avanços e desafios da Saúde Coletiva Informada pelas Evidências (SCIE). Resultados: Os achados desta revisão apontam que as tomadas de decisão na SC são mais complexas do que as decisões clínicas individuais, pois envolvem avaliações de impactos orçamentários e políticos, reforçando a relevância da adoção de práticas informadas pelas evidências neste campo. Conclusão: Os meios de apropriação e emprego das evidências no campo da SC são complexos, pois envolvem pressupostos de plausibilidade e adequação nem sempre observados em intervenções individuais. Ainda assim, o campo beneficia-se da aproximação observada na SCIE e, em particular, na tomada de decisões em saúde. (AU)


Objective: To review the literature about the description of concepts and the use of scientific evidence in Public Health (PH). Methods: A narrative review was carried out using and combining the keywords "Public Health" OR "Collective Health"; "Evidence-based medicine" and "Evidence-informed policy" to consult the Lilacs, SciELO and MedLine databases. The searches were limited to articles published between January 1990 and December 2016 in Portuguese and/or English. The studies were selected by two independent authors who read the title, abstract and full text. For the synthesis process, the themes found were grouped into three main guiding axes: health evidence and practice, PH evidence, and the advances and challenges of Evidence-Informed Public Health (EIPH). Results: The findings of this review point out that decision making in PH is more complex than individual clinical decisions as it involves assessment of budgetary and political impacts, thus reinforcing the relevance of adopting evidence-informed practice in this field. Conclusion: The means of appropriation and use of evidence in the PH field are complex because they involve assumptions of plausibility and adequacy that are not always observed in individual interventions. Yet, the field benefits from the approach observed in EIPH and, particularly, in health decision making. (AU)


Objetivo: Revisar en la literatura la descripción de los conceptos y el empleo de las evidencias científicas en el ámbito de la Salud Colectiva (SC). Métodos: Se realizó una revisión narrativa utilizando y mesclando las palabras-clave "Salud Pública" OR "Salud Colectiva"; "Medicina basada en la evidencia" AND "Política informada por evidencias" a través de la consulta en las bases de datos LILACS, SciELO y MEDLINE. Las búsquedas se han limitado al período entre enero de 1990 y diciembre de 2016 en los idiomas portugués y/o inglés. La selección de los estudios se dio por dos autores de modo independiente a través de la lectura del título, resumen y texto completo. Para el proceso de síntesis se han unido las temáticas encontradas en tres grandes ejes norteadores: las evidencias y la práctica en salud, las evidencias en SC y los avances y desafíos de la Salud Colectiva Informada por las Evidencias (SCIE). Resultados: Los hallazgos de esta revisión apuntan que las tomas de decisiones de la SC son más complejas que las decisiones clínicas individuales pues implican evaluaciones de impactos políticos y de presupuesto con refuerzo para la importancia de prácticas informadas por las evidencias en este campo. Conclusión: Los medios de apropiación y empleo de las evidencias para el campo de la SC son complejos pues implican presupuestos de plausibilidad y adecuación no observados en intervenciones individuales. Aun así, el campo se beneficia de la aproximación observada en la SCIE y, en particular, de las tomas de decisiones en salud. (AU)


Assuntos
Saúde Pública , Medicina Baseada em Evidências , Tomada de Decisões
5.
Age Ageing ; 2018 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-29415116

RESUMO

Background: infectious diseases in older people are associated with higher mortality rates and probiotics have been hypothesised to reduce the occurrence of infection. Objectives: to assess the effectiveness and safety of probiotics in the occurrence of infections in older adults in comparison to placebo. Methods: a systematic review and meta-analysis of randomised placebo-controlled trials were conducted on 30 December 2016 using Medline, Embase, CENTRAL, Web of Science and LILACS databases. Efficacy outcomes were: occurrence of infection, quality of life, mortality and mean duration of infection per episode. Safety outcomes were adverse events. Data were analysed using relative risk ratios with 95% confidence intervals. Relative risk ratios were pooled where more than three estimates were available. Results: fifteen articles were included, with a total of 5,916 participants with a mean age of 75.21 years. The effect of probiotics was not significantly different from that reported for placebo on the occurrence of infection, adverse events, mortality or mean duration of infection episodes (relative risk (RR) 0.90, 95% confidence interval (CI) 0.76 to 1.08; RR 1.01, 95% CI 0.91 to 1.12; RR 1.09, 95% CI 0.70 to 1.72; MD -0.35, 95% CI -1.57 to 0.87, respectively). Conclusion: the current low-quality evidence does not support the use of probiotics for the reduction in the occurrence of infection in older adults, however, the safety outcomes were similar between probiotics and placebo. Further research is required to confirm these findings. PROSPERO: CRD42014013707.

6.
An Bras Dermatol ; 92(4): 580-582, 2017 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28954121

RESUMO

Leprosy in children under 15 years of age is a serious public health problem. In this retrospective case series conducted in a Brazilian reference center (2004-2012), we found 18 cases with a mean age of 10.0±3.6 years of age and 16.6% between 0-5 years of age. Almost 56% of the cases were female, with a median time between the first symptoms and diagnosis of 11 months (4-24); 77.8% reported household contact with leprosy patients. Upon hospital admission, 66.7% presented mostly skin symptoms, while 27.8% presented a degree 2 disability. Most were classified as multibacillary (66.7%). Half of the sample developed a reaction (predominantly type 1) during the follow-up period, while 22.2% developed a late disability.


Assuntos
Hanseníase/epidemiologia , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Avaliação da Deficiência , Feminino , Humanos , Lactente , Recém-Nascido , Hanseníase/diagnóstico , Masculino , Encaminhamento e Consulta , Estudos Retrospectivos
7.
An. bras. dermatol ; 92(4): 580-582, July-Aug. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1038253

RESUMO

Abstract: Leprosy in children under 15 years of age is a serious public health problem. In this retrospective case series conducted in a Brazilian reference center (2004-2012), we found 18 cases with a mean age of 10.0±3.6 years of age and 16.6% between 0-5 years of age. Almost 56% of the cases were female, with a median time between the first symptoms and diagnosis of 11 months (4-24); 77.8% reported household contact with leprosy patients. Upon hospital admission, 66.7% presented mostly skin symptoms, while 27.8% presented a degree 2 disability. Most were classified as multibacillary (66.7%). Half of the sample developed a reaction (predominantly type 1) during the follow-up period, while 22.2% developed a late disability.

8.
Geriatr., Gerontol. Aging (Impr.) ; 11(2): 95-98, abr.-jun. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-849286

RESUMO

Background: Melanoma is often misdiagnosed in older people. Some clinical and histopathological features seem to differ according to age. Objectives: This case series aimed to identify clinicopathological differences of melanoma between older and younger patients. Methods: We identified all incident melanomas diagnosed in a dermatology outpatients unit from January/2007 to December/2014. Data were collected from medical records and pathology registries. RESULTS: We included 62 patients (mean age of 62.1 ± 4.2 years), with a median Breslow thickness of 4 mm (1.2 − 6.5). While men were majority in the older group, women prevailed between younger counterparts (p = 0.02). Multivariate analysis identified history of chronic sun exposure, multiple naevi, skin phototypes 1 and 2, in situ melanoma and the presence of another skin tumour to be correlated with age. In a logistic regression model, the presence of chronic sun exposure and nodular subtype were found to influence age. Major limitations include those inherent to cross ­sectional design, including selection and information biases, the lack of confounding factors analysis (including survival and prognosis), and the sample size. Conclusions: On this case series, melanoma seems to be more frequent in older men and in elders with chronic sun exposure; age was found to be significantly related to nodular subtype and chronic sun exposure.


Introdução: O melanoma é frequentemente diagnosticado de modo tardio em pessoas idosas. Algumas características clínicas e histopatológicas parecem diferir de acordo com a idade. Objetivos: Este estudo de série de casos tem por objetivo identificar as diferenças clínico­patológicas do melanoma entre pacientes idosos e jovens. Métodos: Identificaram­se todos os casos incidentes de melanoma diagnosticados em uma unidade ambulatorial de dermatologia de janeiro de 2007 a dezembro de 2014. Os dados foram coletados a partir da revisão dos prontuários médicos e registros do laboratório de patologia. Resultados: Foram incluídos 62 pacientes, com uma média etária de 62,1 ± 4,2 anos, e tumores com mediana de espessura de Breslow de 4 mm (1,2 − 6,5). Enquanto os homens foram maioria no grupo idoso, as mulheres prevaleceram entre os pacientes jovens (p = 0,02). Análise multivariada identificou que a exposição crônica ao sol, presença de múltiplos nevos, fototipos baixos, melanoma in situ e antecedentes de neoplasias cutâneas correlacionaram­se com a idade. Modelo de regressão múltipla confirmou que a exposição ao sol e o tipo nodular influenciam a idade. Conclusões: O melanoma foi mais frequente nesta amostra em homens idosos com exposição crônica ao sol; a idade correlacionou­se significativamente com o tipo nodular e exposição ao sol.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Idoso , Idoso , Melanoma/epidemiologia
9.
An Bras Dermatol ; 92(2): 281-282, 2017 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28538902

RESUMO

Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.


Assuntos
Aminas/uso terapêutico , Amitriptilina/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doxepina/uso terapêutico , Prurido/tratamento farmacológico , Ácido gama-Aminobutírico/uso terapêutico , Antidepressivos Tricíclicos/classificação , Antipsicóticos/uso terapêutico , Estudos Transversais , Quimioterapia Combinada , Feminino , Gabapentina , Humanos , Masculino , Pessoa de Meia-Idade
10.
An. bras. dermatol ; 92(2): 281-282, Mar.-Apr. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1038248

RESUMO

Abstract: Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.

11.
An Bras Dermatol ; 91(4): 549-51, 2016 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27579762

RESUMO

This is a cross-sectional study, conducted from May to November/2014, in a dermatology reference unit, through review of medical records and interviews. In a sample of 49 patients with brachioradial pruritus, we observed higher prevalence of Caucasian (81.6%) and women (73.5 %), with a mean age of 56.1 years. Pruritus occurred in the topography of brachioradialis muscle in 87.8% of cases; 59.2% of the sample reported worsening of pruritus with sun exposure; the mean intensity of this symptom before treatment was 8.63. Therapy effectiveness was described as "very good/good" in 79.2% of cases, and for 55.3% relapses were categorized as "uncommon".


Assuntos
Neurodermatite/tratamento farmacológico , Neurodermatite/epidemiologia , Prurido/tratamento farmacológico , Prurido/epidemiologia , Idoso , Anticonvulsivantes/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Antipsicóticos/uso terapêutico , Brasil/epidemiologia , Estudos Transversais , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Resultado do Tratamento
12.
Acta sci., Health sci ; 38(1): 57-63, jan.-jun. 2016. tab
Artigo em Inglês | LILACS | ID: biblio-831612

RESUMO

Previous studies have reported a controversial relationship between inadequate blood pressure control and predictor variables. Current prospective cohort study analyzes the interference of age, gender, diabetes and medication adherence in the control of blood pressure of hypertensive outpatients. Patients were interviewed under blind conditions to determine medication adherence, and clinical variables assessment were standardized. Univariate analysis of variance identified the variables correlated to blood pressure control at the end of the follow-up period. Missing data were excluded from analysis. After adjusting for confounders with univariate analysis, the association between the outcome (BP control rate) with significant factors and the calculated adjusted odds ratios (OR) and their 95% CI was analyzed by logistic regression. No interference by age or medication adherence in blood pressure control was reported. In fact, the higher the number of medications in use, the greater were the chances of having blood pressure control in disorder. Females are associated with a 3.1 increase in odds ratio of poor blood pressure control. Compared with non-diabetic hypertensive patients, hypertensive diabetic ones had a lower chance of poor blood pressure control.


Estudos anteriores encontraram relações controversas entre o inadequado controle da pressão arterial e variáveis preditoras. Nesta coorte prospectiva, objetivamos analisar a interferência da idade, do gênero, da presença de diabetes e da adesão à medicação no controle da pressão arterial em pacientes hipertensos ambulatoriais. Os pacientes foram entrevistados sob condições de cegamento dos avaliadores na mensuração da adesão à medicação, e a metodologia de avaliação das variáveis clínicas foi padronizada. Uma análise univariada identificou quais variáveis correlacionaram-se com o controle da pressão arterial ao final do período de seguimento. Dados faltantes foram excluídos da análise. Após ajuste para variáveis de confusão por meio da análise univariada, analisamos as associações entre o desfecho (controle da pressão arterial) e variáveis preditoras, e calculamos o odds ratio ajustado e seu intervalo de confiança de 95%, utilizando regressão logística. Não encontramos interferência da idade ou aderência aos medicamentos no controle tensional. Constatamos que, quanto maior o número de medicamentos em uso, maiores as chances de apresentar controle tensional fora das metas. O gênero feminino associou-se com o aumento de 3,1 vezes na chance de mau controle da pressão arterial. Comparados com pacientes hipertensos não diabéticos, os hipertensos diabéticos tiveram menores chances de apresentar mau controle tensional.


Assuntos
Humanos , Masculino , Feminino , Estratégia Saúde da Família , Hipertensão , Adesão à Medicação , Cooperação do Paciente
13.
J Cutan Med Surg ; 20(3): 249-51, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26627593

RESUMO

BACKGROUND: Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM) that rarely causes skin infections. The correct identification of the specific RGM infecting the skin will enhance therapeutic success. OBJECTIVE: To highlight the importance of rapid and precise identification of the Mycobacterium involved in skin infections in order to enhance therapeutic success. METHODS: We describe an RGM skin infection in an immunocompetent patient. RESULTS: Classic methods (biochemical tests and culture) of RGM identification are time-consuming, and the histopathological features are not specific. Some molecular methods are reliable but expensive. The PRAhsp-65 is a simple procedure that is helpful in identifying the specific agent of an RGM. CONCLUSION: Although skin infections caused by M peregrinum are rare, they represent a substantial clinical challenge. Specific and more effective treatment options depend on the development of precise and rapid methods for identifying mycobacterial species.


Assuntos
Infecções por Micobactéria não Tuberculosa/diagnóstico , Infecções por Micobactéria não Tuberculosa/microbiologia , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade
14.
Rev Soc Bras Med Trop ; 48(2): 228-30, 2015 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25992943

RESUMO

Exacerbation of the immune response against Mycobacterium leprae can lead to neuritis, which is commonly treated via immunosuppression with corticosteroids. Early neurolysis may be performed concurrently, especially in young patients with a risk of functional sequelae. We report the case of a young patient experienced intense pain in the left elbow one year after the treatment of tuberculoid-tuberculoid leprosy. The pain was associated with paresthesias in the ulnar edge and left ulnar claw. After evaluation, the diagnosis was changed to borderline tuberculoid leprosy accompanied with neuritis of the left ulnar nerve. Early neurolysis resulted in rapid reduction of the pain and recovery of motor function.


Assuntos
Hanseníase Paucibacilar/complicações , Neurite (Inflamação)/cirurgia , Adolescente , Humanos , Masculino , Bloqueio Nervoso , Neurite (Inflamação)/etiologia , Resultado do Tratamento
15.
An Bras Dermatol ; 90(2): 273-5, 2015 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25831006

RESUMO

We conducted a transversal retrospective study with secondary data collection from 25 cases of sporotrichosis, treated at a teaching unit in inner São Paulo (Brazil), between the years 2003-2013. We found that the prevalence was higher in men (72%), rural workers (44%) and those living in rural areas (60%), with an average age of 42.48 years. The median between the onset of lesions and diagnosis was six weeks. Lesions predominated in the upper limbs (92%), and were classified as lymphocutaneous (80%) and fixed cutaneous (20%) forms. Clinical cure was observed in 62.5% of the cases treated with potassium iodide and 100% of cases treated with itraconazole.


Assuntos
Esporotricose/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Itraconazol/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Esporotricose/tratamento farmacológico , Esporotricose/patologia , Estatísticas não Paramétricas , Adulto Jovem
16.
Rev. Soc. Bras. Med. Trop ; 48(2): 228-230, mar-apr/2015. graf
Artigo em Inglês | LILACS | ID: lil-746221

RESUMO

Exacerbation of the immune response against Mycobacterium leprae can lead to neuritis, which is commonly treated via immunosuppression with corticosteroids. Early neurolysis may be performed concurrently, especially in young patients with a risk of functional sequelae. We report the case of a young patient experienced intense pain in the left elbow one year after the treatment of tuberculoid-tuberculoid leprosy. The pain was associated with paresthesias in the ulnar edge and left ulnar claw. After evaluation, the diagnosis was changed to borderline tuberculoid leprosy accompanied with neuritis of the left ulnar nerve. Early neurolysis resulted in rapid reduction of the pain and recovery of motor function.


Assuntos
Adolescente , Humanos , Masculino , Hanseníase Paucibacilar/complicações , Neurite (Inflamação)/cirurgia , Bloqueio Nervoso , Neurite (Inflamação)/etiologia , Resultado do Tratamento
17.
Artigo em Inglês | MEDLINE | ID: mdl-25806076

RESUMO

The infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group.

18.
An Bras Dermatol ; 90(1): 140-2, 2015 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25672318

RESUMO

Chromoblastomycosis is one of the most frequent deep mycoses found in rural populations. This cross-sectional, retrospective and descriptive study was conducted with cases of chromoblastomycosis diagnosed throughout 20 years. A higher prevalence was observed among White male rural workers, with an average age of 59.69 years. Median time between onset of symptoms and diagnosis was 156 months. Lesions were predominantly located on the lower limbs; 34% of cases reported previous trauma. The most common associated symptoms were itching, pain and burning sensation. Mycological examination was positive in 91% of cases and Fonsecaea pedrosoi was the most prevalent etiologic agent.


Assuntos
Cromoblastomicose/epidemiologia , Adulto , Distribuição por Idade , Idoso , Doenças dos Trabalhadores Agrícolas/epidemiologia , Ascomicetos/isolamento & purificação , Brasil/epidemiologia , Cromoblastomicose/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , População Rural , Distribuição por Sexo
19.
Surg. cosmet. dermatol. (Impr.) ; 7(3): 258-262, Jul-Set. 2015. ilus
Artigo em Inglês, Português | LILACS-Express | ID: biblio-607

RESUMO

Os hansenomas originam-se da infiltração cutânea acentuada por bacilos do Mycobacterium leprae em hansênicos virchowianos. Tendem a involuir com tratamento, mas podem desenvolver reações queloidianas. Descrevem-se alternativas na abordagem de hansenomas em regressão disseminados em orelhas, face, membros superiores e tronco em paciente virchowiano já tratado. Realizou-se exérese da lesão em orelha esquerda seguida de infiltrações de triancinolona na cicatriz cirúrgica, apenas infiltrações nas outras lesões em áreas expostas e conduta expectante nas demais. Observaram-se bom resultado estético na lesão excisada e redução nas lesões infiltradas com corticoide. Os procedimentos são de fácil execução, baixo custo e boa resposta estética.


Hansenomas originate from the intense cutaneous infiltration by Mycobacterium leprae bacilli in Virchowian hansenic patients who tend to improve with treatment,however can develop keloid reactions. Alternative approaches are described for the treatment of disseminated receding hansenomas in the ears, face, upper limbs, and trunk in already treated virchowian patients. The exeresis of the lesion in the left ear was carried out and followed by injections of triamcinolone in the surgical scar, combined with simple injections in other lesions in exposed areas and an expectant approach in other areas. A good cosmetic result was observed in the excised lesion, in addition to a reduction in the lesions injected with corticosteroids. These procedures are easy to perform and cost effective, yielding good aesthetic outcomes.

20.
Artigo em Inglês | LILACS-Express | ID: biblio-954736

RESUMO

AbstractThe infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA