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4.
Forensic Sci Med Pathol ; 15(4): 671-674, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31218657

RESUMO

A 65-year-old man was found lifeless in his apartment, laying in a peculiar head-down position. His head was on the floor and his neck was over-flexed, with his trunk flexed on his neck. Examination of the body showed intense violet lividity of the head, torso and limbs, according to the position of the body. Moreover, diffuse hemorrhagic spots on the shoulders, upper part of the back and upper arms, along with an intense arch-shaped purple area on the anterior neck were detected at external examination. Suspicions of neck injuries due to strangulation and death due to positional asphyxia arose, but a thorough examination of circumstantial data and autopsy findings enabled a correct identification of cause and manner of death, and excluded strangulation and positional asphyxia as the cause of death. This case raises several issues on differential diagnosis and underlines the importance of a correct combined analysis of the findings provided by on-scene investigation and autopsy.


Assuntos
Asfixia/etiologia , Postura , Púrpura/patologia , Idoso , Asfixia/patologia , Dorso/patologia , Humanos , Masculino , Pescoço/patologia , Extremidade Superior/patologia
5.
Turk J Med Sci ; 49(3): 710-714, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31203591

RESUMO

Background/aim: Verrucous epidermal nevi are cutaneous hamartomas with many clinical variants. Dermoscopic features of verrucous epidermal nevus have rarely been investigated. We aimed to identify dermoscopic findings of the entity which will facilitate the diagnostic process by reducing the use of invasive diagnostic methods. Materials and methods: The study included the patients with histopathologically approved verrucous epidermal nevus. Clinical, dermoscopic, and histopathological features of the patients were retrospectively reviewed and the findings identified were recorded. Dermoscopic examination was performed with a polarized-light handheld dermoscope with 10-fold magnification. Results: The most common dermoscopic features were thick brown circles, thick brown branched lines, and terminal hairs. The most common vessel pattern was dotted vessels. Branched thick brown lines, brown globules, brown dots forming lines, serpiginous brown dots, white and brown exophytic papillary structures, fine scale, thick adherent scale, and cerebriform structures were the other findings. Conclusion: We observed many vascular and nonvascular dermoscopic findings which were not described previously for the entity. Dermoscopic examination of the verrucous epidermal nevi may lead to more reliable clinical interpretation and thus may reduce the need for histopathological investigation.


Assuntos
Dermoscopia , Nevo Sebáceo de Jadassohn , Abdome/diagnóstico por imagem , Abdome/patologia , Adolescente , Adulto , Dorso/diagnóstico por imagem , Dorso/patologia , Criança , Feminino , Humanos , Masculino , Nevo Sebáceo de Jadassohn/diagnóstico por imagem , Nevo Sebáceo de Jadassohn/patologia , Estudos Retrospectivos , Pele/diagnóstico por imagem , Pele/patologia , Adulto Jovem
6.
Disabil Health J ; 12(3): 411-421, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31000498

RESUMO

BACKGROUND: Quantifying the number of people with and types of disabilities is helpful for medical, policy, and public health planning. OBJECTIVE/HYPOTHESIS: To update prior estimates on types, prevalence, and main causes of disability among U.S. adults using the Survey of Income and Program Participation (SIPP) data. METHODS: We used cross-sectional data from the SIPP 2008 Panel Wave 6 interviews collected May-August 2010. Analyses were restricted to non-institutionalized adults ages ≥18 years (n = 66,410). Disability was ascertained via five non-mutually exclusive components: 1) specific activity difficulties, 2) selected impairments, 3) use of an assistive aid, 4) household work limitations, and 5) paid work limitations. Prioritized main cause of disability was established for the 95% of respondents with a disability type eligible for health condition questions. We generated weighted population estimates (number and percentage, with 95% confidence intervals (CIs)), accounting for the complex sample survey design. RESULTS: 50 million U.S. adults (21.8%) experienced a disability in 2010. Mobility-related activity limitations were the most prevalent disabilities across all five components. The most common main causes of disability were arthritis/rheumatism, 9.1 million (19.2%, 95% CI = 18.4-20.0) and back or spine problems, 8.9 million (18.6%, 95% CI = 17.9-19.3). CONCLUSIONS: A growing population with disabilities has the potential to put considerable and unsustainable demand on medical, public health, and senior service systems. Strengthening clinical community linkages and expanding the availability of existing evidence-based public health interventions to prevent, delay, and mitigate the effects of disability could improve health and outcomes for people with disabilities.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite/epidemiologia , Dorso/patologia , Estudos Transversais , Pessoas com Deficiência/classificação , Emprego , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Prevalência , Doenças Reumáticas/epidemiologia , Coluna Vertebral/patologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Trabalho , Adulto Jovem
7.
Hautarzt ; 70(1): 44-46, 2019 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-29955917

RESUMO

Syringotropic mycosis fungoides (STMF) is an extremely rare form of cutaneous T­cell lymphoma with 51 published cases so far. Clinically STMF is manifested similarly to folliculotropic mycosis fungoides (MF), whereby the course of STMF is much milder. Histopathologically, it shows a prominent tropism of the T­cell lymphocytic infiltrate for the eccrine epithelium. We report the case of a 65-year-old woman with multiple small papules on the feet, shinbones and back.


Assuntos
Micose Fungoide , Neoplasias Cutâneas , Idoso , Dorso/patologia , Feminino , Pé/patologia , Humanos , Perna (Membro)/patologia , Micose Fungoide/diagnóstico , Micose Fungoide/fisiopatologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Linfócitos T/patologia
10.
J Bodyw Mov Ther ; 22(3): 693-699, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30100298

RESUMO

BACKGROUND AND DESIGN: Chronic nonspecific low back pain (CNSLBP) has major socioeconomic as well as personal impact in many industrialized and developing countries. Physiotherapy is a common intervention for this group of patients and using anti-pain physical modalities is a common part of the physical therapy. In a randomized controlled trial we investigated the immediate effect of the Diadynamic current in comparison to TENS on reducing the pain in patients suffering from non specific chronic low back pain. METHODS: Thirty patients were randomized into the Diadynamic current and TENS groups. Electrical stimulation was applied for 10 min in the Diadynamic group and for 15 min in the TENS group for one session. Pain, on a 100 mm Visual Analog Scale, and Pressure Pain Threshold (PPT), using an Algometer, was measured before the treatment, after the current application, 20 min later and after 48 h. RESULTS: Pain was decreased significantly after 20 min following the current application only in the TENS group, with no improvement at all measurement points in the group receiving Diadynamic current. PPT was increased immediately after current application in both groups but did not last until later measurements. CONCLUSION: Diadynamic current had no positive effect on prompt relief of pain in patients suffering from recurrent CNSLBP.


Assuntos
Dor Lombar/terapia , Medição da Dor/métodos , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Dorso/patologia , Terapia por Estimulação Elétrica/métodos , Eletricidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limiar da Dor , Modalidades de Fisioterapia , Resultado do Tratamento , Escala Visual Analógica
17.
BMJ Open ; 8(2): e017091, 2018 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29444776

RESUMO

OBJECTIVES: Characteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain (LBP) and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients' self-rated score of disability. DESIGN AND SETTING: This is a case-control study with 15 patients with mechanical LBP without radicular symptoms. Patients were recruited from the orthopaedic clinic at Charing Cross Hospital. Ten healthy adults were recruited from the staff working in the hospital and associated university. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and bilateral EMG activity was obtained from erector spinae at vertebral levels L4 and T12. Subjects performed three brief maximal voluntary isometric contractions (MVICs) of the back extensors and the torque was measured using a dynamometer. CWT was applied to the EMG signals of each muscle in a 200 ms window centred around the peak torque obtained during the MVICs. The ratio (low/high frequencies) of the energy, the peak power and the frequency of the peak power were calculated for each recording site, averaged and correlated with the individual's RMDQ score. RESULTS: Patients had lower peak power (T12 and L4) and lower frequency of the peak power (at T12) than the healthy adults. Additionally, RMDQ positively correlated to the average ratio of energy at T12 (r=0.63; p=0.012), that is, greater self-rated disability corresponded to a dominant distribution of energy in the lower frequencies. CONCLUSION: The current findings reveal alterations in EMG profile and its association with self-related back pain disability, suggesting that spectral characteristics of EMG reflect muscle function.


Assuntos
Dorso , Dor Lombar/fisiopatologia , Movimento/fisiologia , Contração Muscular/fisiologia , Força Muscular/fisiologia , Músculos Paraespinais/fisiopatologia , Coluna Vertebral/patologia , Adulto , Dorso/patologia , Dorso/fisiopatologia , Estudos de Casos e Controles , Estudos de Coortes , Autoavaliação Diagnóstica , Eletromiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Torque
19.
J Cutan Med Surg ; 22(2): 229-231, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28922948

RESUMO

INTRODUCTION: Porokeratosis is a benign hyperkeratotic skin tumour due to a clonal proliferation of keratinocytes and is characterised by a telltale annular threadlike configuration along the border of a skin-colored to erythematous papule that can expand centrifugally. CASE PRESENTATION: We are presenting a clinical and dermoscopic case of pigmented disseminated superficial actinic porokeratosis (DSAP) limited to the upper trunk of a white man with sun-damaged skin. Literature Review and Conclusion: A thorough review of PubMed failed to identify any previous reports on the dermoscopic appearance of pigmented porokeratosis. On dermoscopy, the presence of black dots limited to the periphery of the lesions is due to pigment incontinence and melanophages within the superficial papillary dermis limited to the area below the cornoid lamella. Pigmented DSAP is a unique morphological presentation of porokeratosis, and it is essential to be familiar with its clinical and dermoscopic presentation.


Assuntos
Poroceratose , Idoso , Dorso/patologia , Biópsia , Dermoscopia , Humanos , Queratinócitos/citologia , Masculino , Poroceratose/diagnóstico , Poroceratose/patologia , Pele/patologia , Luz Solar/efeitos adversos
20.
Dermatol Online J ; 24(12)2018 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-30677796

RESUMO

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus of unclear etiology that predominantly affects patients of skin types III to VI. We report a case of LPP of two years duration in a 67-year-old man involving upper extremities, chest, abdomen, and upper back.


Assuntos
Líquen Plano/patologia , Transtornos da Pigmentação/patologia , Abdome/patologia , Idoso , Dorso/patologia , Dermoscopia , Humanos , Líquen Plano/diagnóstico , Masculino , Transtornos da Pigmentação/diagnóstico , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/patologia , Pigmentação da Pele , Tórax/patologia
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