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1.
J Drugs Dermatol ; 20(4): 374-378, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852237

RESUMO

BACKGROUND: Recent reports have surfaced from the United States Food and Drug Administration hearings in December 2020 regarding the COVID-19 vaccines and study participants who developed facial and/or lip swelling after receiving the newly developed drug. Despite an incidence rate of 0.02% in the vaccine arm of the Moderna mRNA-1273 trial, concerns have been expressed about the association of adverse reactions following soft tissue filler injections and the COVID-19 vaccines. The International Society for Dermatologic and Aesthetic Surgery (ISDS) understands these concerns and has designed the following study. METHODS: A global survey was designed to capture the incidence of adverse events related to: (1) previous soft tissue filler injections, (2) soft tissue filler injections during positive testing for COVID-19, and (3) soft tissue filler injections during and after receiving any of the COVID-19 vaccines globally available. RESULTS: The information of 106 survey participants from 18 different countries was analyzed. 80.2% (n=85) never experienced any adverse reaction following their soft tissue filler injection whereas 15.1% (n=16) experienced swelling and 4.7% (n=5) experienced pain that lasted longer than two days. Of those who received at least one dose of the COVID-19 vaccine (n=78), 94.9% reported not to have experienced any adverse reaction related to their previous soft tissue filler injection, whereas 5.1% (n=4) reported to have perceived pain that lasted longer than two days. CONCLUSION: The data collected does not support the concern for an increased risk of developing adverse reactions following soft tissue filler injections associated with the COVID-19 vaccines compared to that risk associated with other previously described triggers or the default risk following soft tissue filler injections. J Drugs Dermatol. 20(4):374-378. doi:10.36849/JDD.2021.6041.


Assuntos
Materiais Biocompatíveis/efeitos adversos , /uso terapêutico , Dermatologia/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Edema/epidemiologia , Edema/etiologia , Face , Feminino , Humanos , Incidência , Lábio/patologia , Masculino , Pessoa de Meia-Idade , Cirurgia Plástica , Inquéritos e Questionários , Adulto Jovem
2.
Med Oral Patol Oral Cir Bucal ; 26(3): e269-e275, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33772570

RESUMO

BACKGROUND: The extraction of impacted third molar teeth is a common procedure in maxillofacial surgery. The aim of this study was to compare of piezoelectric surgical technique with the one with conventional rotary instruments in terms of edema, trismus and pain, in mandibular third molar surgery. MATERIAL AND METHODS: 20 individuals with symmetrically impacted lower mandibular third molars and 40 teeth were included in the study. Third molars on the left side of each patient were removed with piezosurgery, while the counterparts on the right side were removed with conventional rotary instruments. Postoperatively, the same antibiotic, analgesic, and mouthwash were recommended to both groups. Ultrasound, edema, trismus measurements were performed before surgery, postoperative, postoperative day 2 and postoperative day 7. VAS scale was used to evaluate the pain. RESULTS: The average age of 20 individuals included in the study was found to be 21.85 ± 3.08 years. The operation time of the individuals who underwent the surgery with conventional rotary instruments was found to be 12 minutes 31.70 ± 167.03 seconds, and the operation time in the Piezosurgery group was 19 minutes 10.60 ± 306.59 seconds. There was no significant difference between the two groups in terms of trismus, edema, and pain. CONCLUSIONS: Piezosurgery is a safe method that can be used in molar removal, but in this split-mouth study, it is not found advantageous in terms of postoperative morbidity due to the longer working time compared to the one performed with conventional rotary instruments.


Assuntos
Dente Serotino , Dente Impactado , Adulto , Edema/epidemiologia , Edema/etiologia , Humanos , Mandíbula/cirurgia , Dente Molar , Dente Serotino/cirurgia , Morbidade , Boca , Dor Pós-Operatória/etiologia , Extração Dentária , Dente Impactado/cirurgia , Trismo/epidemiologia , Trismo/etiologia , Adulto Jovem
3.
J Pregnancy ; 2020: 6153146, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33062334

RESUMO

Introduction: Obstetric danger signs are those signs that a pregnant woman will see or those symptoms that she will feel which indicate that something is going wrong with her or with the pregnancy. Evidence on the prevalence of obstetric danger signs and contributing factors were crucial in designing programs in the global target of reducing maternal morbidity and mortality. Objective: To assess the prevalence of obstetric danger signs during pregnancy and associated factors among mothers in a Shashemene rural district, South Ethiopia. Methods: A community-based cross-sectional study design was conducted among 395 randomly selected women who gave birth in the last six months. A pretested interviewer-administered questionnaire was utilized. Data were cleaned, coded, and entered into Epi data manager version 4.1 and then exported to SPSS version 20. Bivariable and multivariable logistic regression analyses were employed to assess the association between independent variables with the outcome variable. Statistical significance was declared at p < 0.05. Result: One hundred sixty-three (41.3%) of women had a history of obstetric danger signs during pregnancy. The most prevalent obstetric danger signs were vaginal bleeding (15.4%) followed by swelling of the body 12.7% and severe vomiting 5.3%. Women who have less than four times antenatal care visits were 6.7 times more likely to experience obstetric danger signs (AOR 6.7 (95% CI 3.05, 14.85)) compared to those who had antenatal care visit four times and above. Women who have inadequate knowledge of obstetric danger signs were 2.5 times more likely to experience obstetric danger signs during pregnancy (AOR 2.5 (95% CI 1.34, 4.71)), and primigravida women were 6.3 times more likely to have obstetric danger signs during pregnancy (AOR 6.3 (95% CI 2.61, 15.09)) compared to multiparous women. Conclusion: About half of the pregnant mothers have experienced at least one obstetric danger signs. Public health interventions on maternal health should give priority to the prevalent causes of obstetric danger signs, strengthening completion of four antenatal care visits and health education on obstetric danger signs for pregnant mothers at community level especially for primgravid women.


Assuntos
Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Edema/epidemiologia , Edema/etiologia , Edema/prevenção & controle , Etiópia/epidemiologia , Feminino , Número de Gestações , Educação em Saúde , Humanos , Conhecimento , Mortalidade Materna , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Inquéritos e Questionários , Hemorragia Uterina/epidemiologia , Hemorragia Uterina/etiologia , Hemorragia Uterina/prevenção & controle , Vômito/epidemiologia , Vômito/etiologia , Vômito/prevenção & controle , Adulto Jovem
4.
Niger J Clin Pract ; 23(10): 1407-1413, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33047698

RESUMO

Aims: In this study, using Beck depression inventory (BDI), we aimed to determine alterations in the emotional state of patients who had impacted third molars (M3) extracted owing to postoperative pain, edema, and trismus.In this prospective clinical trial, which was conducted at Tokat Gaziosmanpasa University, Faculty of Dentistry, Department of Maxillofacial Surgery Clinic, we studied 60 patients (30 males and 30 females), who were 18-47 years old (the mean of 25.6 years of age). The patients with M3 with moderate preoperative pain intensities, edema, and maximal mouth opening (MMO) data were recorded, and BDI was applied to determine their emotional states. The patients were re-evaluated using BDI to detect alterations in their emotional state owing to pain intensity, edema, and trismus on postoperative second and seventh day. Subjects and Methods: Descriptive statistical analysis, Chi-square, and independent t-test were utilized to interpret the obtained data. Results: According to our findings, a statistically significant relationship was observed between BDI scores and gender on the second postoperative day (P = 0.004), and between MMO and BDI scores on the second and seventh postoperative day (P = 0.012, P = 0.045). Pain intensity scores on the postoperative sixth hour and seventh day were significantly correlated with BDI scores on the postoperative second and seventh day (P = 0.000/ P = 0.000/P = 0.002/P = 0.004/P = 0.010/P = 0.017/P = 0.001/P = 0.000). Conclusions: Our results suggest that the pain and trismus owing to the M3 surgery were significantly correlated with an increase in the postoperative BDI scores.


Assuntos
Depressão/diagnóstico , Edema/psicologia , Dente Serotino/cirurgia , Dor Pós-Operatória/psicologia , Extração Dentária/psicologia , Adolescente , Adulto , Cárie Dentária/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Edema/epidemiologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Extração Dentária/métodos , Extração Dentária/estatística & dados numéricos , Trismo/epidemiologia , Trismo/psicologia , Turquia/epidemiologia , Adulto Jovem
5.
Niger J Clin Pract ; 23(9): 1260-1265, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913166

RESUMO

Backgound: There are many methods used to alleviate edema, trismus, and pain after impacted third molar (3M) removal, one of which is Kinesio Taping (KT). Aims: This study aimed to evaluate the effectiveness of Kinesio Taping with Web Strip technique on postoperative morbidity after impacted mandibular 3M extraction. Methods: The study employed a split-mouth and controlled randomized clinical trial design. A total of 60 patients were scheduled for surgical extractions of bilateral lower 3Ms. They were randomly divided into two groups, and KT was applied to one group while the others was determined as a control group without KT application. Tape was applied directly after surgery and maintained for postoperative (post-op) 7 days. Pain intensity was recorded subjectively using a Visual Analogue Scale (VAS). Pain and analgesic usage were recorded on the post-op 1st, 2nd, 3rd, and 7th days. Trismus was evaluated before the surgery and on the post-op 2nd and 7th days. Facial edema was analyzed on the post-op 2nd and 7th days by VAS and by measuring the lengths of three lines using a flexible plastic tape measure. Results: VAS pain scores were statistically lower in the KT group on the post-op 1st, 3rd and 7th days. Total analgesic usage was also significantly lower in the KT group. On the post-op 2nd day, measurement of the lengths of three lines showed a statistically less edema in the KT group. Similar results were obtained from the measurement of edema using VAS. Maximum mouth opening was statistically higher in the KT group on the post-op 2nd and 7th day. Conclusion: KT with the web strip technique should be considered more economic and less traumatic than other approaches, as it is free from systemic side effects and is a simple method to carry out to decrease morbidity.


Assuntos
Fita Atlética/estatística & dados numéricos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Dor Pós-Operatória/reabilitação , Trismo/reabilitação , Adolescente , Adulto , Edema/epidemiologia , Edema/etiologia , Edema/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Procedimentos Cirúrgicos Bucais/métodos , Medição da Dor , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/reabilitação , Período Pós-Operatório , Resultado do Tratamento , Trismo/epidemiologia , Trismo/etiologia , Escala Visual Analógica , Adulto Jovem
6.
Toxicon ; 187: 10-18, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32846146

RESUMO

Snakebite accidents are considered serious public health problems. They are often neglected, and individuals who have received insufficient treatment are subjected to various disabling alterations. Snake venoms are secretions composed of biologically active molecules capable of triggering local and systemic effects in envenomation victims. Bothropic snakes are responsible for most of the ophidian accidents in Brazil; their venoms are mainly related to local manifestations, due to a composition that is especially rich in proteases and phospholipases A2. The most common local damages are inflammation, with consequent cellular activation and release of inflammatory mediators, hemorrhage, edema, pain and (myo)necrosis, which may lead to amputation of the affected areas. Antivenom therapy is the main treatment for snakebites. However, the efficiency is mainly due to the neutralization of the toxins responsible for the systemic alterations. Thus, the local damages can evolve to markedly compromise the tissue. The complexity of these local effects associated with the toxicity of the snake venom components of the genus Bothrops, arouse interest in the study of the biochemical and pathophysiological mechanisms involved with the actions caused by toxins of the venom. Therefore, this review aims to analyze the edematogenic, hyperalgesic and myotoxic effects caused by Brazilian bothropic venoms in order to contribute to the study and elucidation of the mechanisms of action of its components and, consequently, enable discoveries of more effective combined therapies in the treatment of local damages resulting from envenoming.


Assuntos
Mordeduras de Serpentes/epidemiologia , Animais , Bothrops , Brasil/epidemiologia , Venenos de Crotalídeos/toxicidade , Edema/epidemiologia , Humanos , Hiperalgesia/epidemiologia , Doenças Musculares/epidemiologia , Necrose/epidemiologia
7.
Ann Rheum Dis ; 79(7): 929-934, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32299794

RESUMO

OBJECTIVES: Bone marrow oedema (BMO) on MRI of sacroiliac joints (SIJs) represents a hallmark of axial spondyloarthritis (SpA), yet such lesions may also occur under augmented mechanical stress in healthy subjects. We therefore sought to delineate the relationship between pregnancy/delivery and pelvic stress through a prospective study with repeated MRI. Results were matched with maternal, child and birth characteristics. METHODS: Thirty-five women underwent a baseline MRI-SIJ within the first 10 days after giving birth. MRI was repeated after 6 months and, if positive for sacroiliitis according to the Assessment of SpondyloArthritis International Society (ASAS) definition, after 12 months. BMO and structural lesions were scored by three trained readers using the Spondyloarthritis Research Consortium of Canada (SPARCC) method. RESULTS: Seventy-seven per cent of the subjects (27/35) displayed sacroiliac BMO immediately postpartum, 60% fulfilled the ASAS definition of a positive MRI. After 6 months, 46% of the subjects (15/33) still showed BMO, representing 15% (5/33) with a positive MRI. After 12 months, MRI was still positive in 12% of the subjects (4/33). Few structural lesions were detected. Intriguingly, in this study, the presence of BMO was related to a shorter duration of labour and lack of epidural anaesthesia. CONCLUSION: A surprisingly high prevalence of sacroiliac BMO occurs in women immediately postpartum. Our data reveal a need for a waiting period of at least 6 months to perform an MRI-SIJ in postpartum women with back pain. This study also underscores the importance of interpreting MRI-SIJ findings in the appropriate clinical context.


Assuntos
Parto Obstétrico/efeitos adversos , Imagem por Ressonância Magnética/métodos , Transtornos Puerperais/epidemiologia , Sacroileíte/epidemiologia , Adulto , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/epidemiologia , Doenças da Medula Óssea/etiologia , Canadá/epidemiologia , Diagnóstico Diferencial , Edema/diagnóstico por imagem , Edema/epidemiologia , Edema/etiologia , Feminino , Humanos , Parto/fisiologia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/fisiopatologia , Período Pós-Parto , Gravidez , Prevalência , Estudos Prospectivos , Transtornos Puerperais/diagnóstico por imagem , Transtornos Puerperais/etiologia , Sacroileíte/diagnóstico por imagem , Sacroileíte/etiologia , Estresse Fisiológico
8.
Int J Infect Dis ; 95: 44-49, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32088340

RESUMO

OBJECTIVES: Visceral leishmaniasis (VL) is a public health threat for several tropical countries, including Brazil. Therapy failures and relapses aggravate VL morbidity and mortality. Our study aimed at identifying predictors of relapse and thus contributes to directing therapeutic options and patient follow-up. METHODS: A nonconcurrent cohort of 571 subjects who completed successful therapy for VL in the city of Bauru, São Paulo State, Brazil, was followed for 24 months in order to identify the incidence and predictors of relapse. Extensive review of medical charts and laboratory files was conducted. Univariate and multivariable Cox regression models were used to identify predictors for the outcome of interest. A hierarchical strategy was used for variable selection in multivariable models. RESULTS: Relapses occurred in 6.8% of treated subjects, after a median of 6 months (interquartile range, 4-9). In a comprehensive multivariable model, relapse was associated with: HIV-coinfection (hazard ratio [HR], 7.47; 95% confidence interval [CI], 2.58-21.55); the presence of lower limb edema (HR, 6.06; 95%CI, 1.38-26.77) and low platelet count upon admission (HR for platelet count × 1000, 0.99; 95%CI, 0.98-0.99) ; and secondary pneumonia (HR, 5.49; 95%CI, 1.49-20.18). On the other hand, therapy with Liposomal Amphotericin (as opposed to Antimoniate) was not independently associated with relapse (HR, 5.97; 95%CI, 0.63-56.29). CONCLUSION: Besides reinforcing the impact of HIV coinfection on the outcome of VL, our study points to clinical and laboratory findings that characterize patients who were more likely to relapse. Those groups should be more closely followed, and possibly could benefit from novel therapeutic options.


Assuntos
Leishmaniose Visceral/tratamento farmacológico , Adolescente , Adulto , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Coinfecção , Edema/epidemiologia , Feminino , Infecções por HIV/complicações , Humanos , Lactente , Recém-Nascido , Leishmaniose Visceral/complicações , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Recidiva , Resultado do Tratamento
9.
Sci Rep ; 10(1): 2159, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32034272

RESUMO

This nationwide retrospective case-control study was aimed at elucidating the risk from cataract surgery in end-stage renal disease (ESRD) patients. Cataract surgery patients were identified using the diagnostic and procedural codes for International Classification of Diseases, 9th Revision, Clinical Modification from Taiwan's National Health Insurance Research Database. ESRD patients were selected as cases, while propensity scores for age, sex, comorbidities and year-of-surgery-matched patients without chronic kidney disease constituted the controls. Patients who had undergone eye surgery within 3 years before cataract surgery were excluded. The main outcome measures were target cataract surgery-related complications within 3 months after surgery. A total of 352 cases and 1,760 controls were analysed. Patients with ESRD had a 5.06-fold (95% CI: 2.36-10.87; p < 0.001) risk of vitreous haemorrhage and a 2.74-fold (95% CI: 1.20-6.27; p = 0.017) risk of re-operation for dropped nucleus or vitreous complications. Non-diabetic ESRD patients had a 3.49-fold (95% CI: 1.36-8.91; p = 0.009) risk of corneal oedema. In conclusion, ESRD patients have a higher risk of vitreous haemorrhage, re-operation for dropped nucleus or vitreous complications and corneal oedema (non-diabetic patients) after cataract surgery. Pre-surgery corneal examination, surgery procedure and medication adjustment, closer and longer post-surgery follow-up may lower the risk and improve the visual outcome.


Assuntos
Extração de Catarata/efeitos adversos , Catarata/complicações , Edema/epidemiologia , Falência Renal Crônica/complicações , Hemorragia Pós-Operatória/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Córnea/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Corpo Vítreo/patologia
10.
Plast Reconstr Surg ; 145(3): 661-667, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32097303

RESUMO

BACKGROUND: Nonsurgical rhinoplasty with injectable dermal fillers has become an increasingly popular alternative to surgical procedures, in view of its relative low cost, convenience and rapid recovery, and low risk profile. The safety and efficacy of nonsurgical rhinoplasty remains a relatively contentious and ambiguous matter, given that there are few large-scale series reporting results or complications. This study reports the experience of a single clinician performing nonsurgical rhinoplasty in the largest cohort to date. METHODS: Patient demographics, indications, treatment details, and outcomes of patients treated between March of 2016 and January of 2019 were reviewed. The nonsurgical rhinoplasty technique described previously by Harb was used using hyaluronic acid dermal filler. RESULTS: Nonsurgical rhinoplasty was performed in 5000 patients. The commonest indication was dorsal hump (44 percent). Swelling and erythema were self-limiting side effects encountered in approximately half of patients. Infection was seen in two patients, and localized skin necrosis was observed in three patients. CONCLUSIONS: Nonsurgical rhinoplasty is a safe procedure with positive aesthetic results when performed by an experienced clinician. Knowledge of nasal anatomy, comprehensive training, and use of appropriate materials are key in ensuring safety and results. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Nariz/anatomia & histologia , Rinoplastia/métodos , Adolescente , Adulto , Idoso , Preenchedores Dérmicos/efeitos adversos , Edema/induzido quimicamente , Edema/epidemiologia , Eritema/induzido quimicamente , Eritema/epidemiologia , Estética , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/efeitos adversos , Masculino , Pessoa de Meia-Idade , Necrose/induzido quimicamente , Necrose/epidemiologia , Satisfação do Paciente , Estudos Retrospectivos , Rinoplastia/efeitos adversos , Pele/efeitos dos fármacos , Pele/patologia , Resultado do Tratamento , Adulto Jovem
11.
Int J Pediatr Otorhinolaryngol ; 131: 109869, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31972384

RESUMO

OBJECTIVES: To evaluate the suitability, benefits, and limitations of sialendoscopy for pediatric patients. METHODS: We performed a retrospective analysis of all pediatric sialendoscopy patients (aged 16 years or younger) in our tertiary care institution between September 2007 and October 2018. We characterized patient data, procedure-related factors, complications, and outcomes. RESULTS: In total, 55 sialendoscopies were performed on 42 patients. Among these, 36 were diagnostic endoscopies and 19 were interventional. Five endoscopies were performed under local anesthesia. We identified 16 sialolithiasis patients, where removal of a sialolith was possible in 11 (69%) cases; one case required a second endoscopy. We removed two sialoliths under local anesthesia. Among recurrent juvenile parotitis (RJP) patients, 18/20 (90%) were symptom-free after a single sialendoscopy, and all after a second endoscopy. The median follow-up time was 70 months. We achieved a 95% success rate in sialendoscopies, with a failure-to-treat rate of 15%. The complication rate for the study cohort was 2%, with prolonged parotid swelling the only complication encountered. CONCLUSIONS: Sialendoscopy represented a safe and effective method to treat pediatric patients. Local anesthesia was successful in selected cases, even for sialolith removal. Sialendoscopy had a soothing effect on RJP and the majority of sialoliths were suitable for endoscopic removal.


Assuntos
Anestesia Local , Edema/epidemiologia , Endoscopia , Complicações Pós-Operatórias/epidemiologia , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/cirurgia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do Tratamento
12.
Mod Rheumatol ; 30(4): 703-707, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31500483

RESUMO

Objectives: To analyze the association among remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, diabetes mellitus (DM), and antidiabetic drugs.Methods: We retrospectively analyzed the clinical and serologic manifestations of patients who had RS3PE syndrome with and without pre-existing DM. Then we performed a subanalysis in which patients with pre-existing DM were classified into two groups according to whether they were or were not taking a dipeptidyl peptidase 4 inhibitor (DPP4i), an antidiabetic drug that was suggested to have an association with the pathogenesis of RS3PE syndrome.Results: Pre-existing DM was found in 13 (35.1%) of 37 patients with RS3PE syndrome. No significant differences in age, gender, physical manifestations, and laboratory findings were observed between the patients with DM and those without DM. DPP4i had been administered to 6 of 13 patients with RS3PE and pre-existing DM. We observed no significant differences in manifestations of RS3PE syndrome before treatment; however, one relapse occurred in a patient with poorly controlled DM who had been continuing DPP4i therapy.Conclusion: This study revealed no evidence suggesting an association among RS3PE syndrome, DM, and antidiabetic drugs. DPP4i would be safe for use by most of patients with RS3PE syndrome. However, elderly patients and patients with poorly controlled DM might require careful observation.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Edema/epidemiologia , Hipoglicemiantes/efeitos adversos , Sinovite/epidemiologia , Idoso , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Pessoa de Meia-Idade
13.
J Cosmet Dermatol ; 19(1): 55-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31034761

RESUMO

BACKGROUND: Many therapeutic options are today available for neck aging, but little evidence exists about the efficacy of combining such procedures. Nonsurgical treatment of neck laxities and wrinkles is often preferred by patients, and combined strategies are nowadays emerging as the standard of care. Both plasma exeresis and hyaluronic acid (HA) injection are two emerging techniques in this setting. AIMS: To investigate the synergic effect of plasma exeresis and non-cross-linked HA injection, in stabilized hybrid complex of low and high molecular weight, in terms of both tolerability (assessed using VAS scale of pain) and improvement of neck skin laxities, according to the GAIS score assigned by patients and clinicians. PATIENTS/METHODS: Ten consecutive patients with signs of neck skin laxities (≥ type 3 according to the Glogau wrinkle scale) aged between 35 and 65 years were enrolled in our study. Two treatment sessions were performed. During the first session, both plasma exeresis and HA injection were performed. Patients were re-evauated after 30 days, and HA injection in the wrinkles of the neck was repeated. After 30 days from the second treatment session, a follow-up visit was performed to assess global efficacy of the two-step combined treatment and to monitor eventual long-term side effects. RESULTS: A GAIS score of 1 or 2 was present in 90% of the treated cases, according to both patients and clinicians. Mean VAS value for pain was 2.4/10. Minor side effects such as erythema and/or edema were transient and completely resolved. No major adverse events were observed. CONCLUSIONS: We strongly encourage the combined treatment with plasma exeresis and non-cross-linked HA injection for its promising remodeling effects in the field of neck rejuvenation.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Gases em Plasma/uso terapêutico , Rejuvenescimento , Terapia Combinada/efeitos adversos , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Técnicas Cosméticas/efeitos adversos , Técnicas Cosméticas/instrumentação , Preenchedores Dérmicos/efeitos adversos , Edema/epidemiologia , Edema/etiologia , Eritema/epidemiologia , Eritema/etiologia , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Pessoa de Meia-Idade , Pescoço , Satisfação do Paciente , Gases em Plasma/efeitos adversos , Pele/efeitos dos fármacos , Envelhecimento da Pele/efeitos dos fármacos , Resultado do Tratamento
14.
BMC Pregnancy Childbirth ; 19(1): 522, 2019 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-31878905

RESUMO

INTRODUCTION: Pregnancy management in women with Wilson disease (WD) remains an important clinical problem. This research was conducted to investigate how to avoid worsening of WD symptoms during pregnancy and increase pregnancy success in women with WD by identifying the best pregnancy management approaches in these patients. PATIENTS AND METHODS: The clinical data of 117 pregnancies among 75 women with WD were retrospectively analyzed. Related information of the fetus was also recorded and analyzed. At the same time, regression analysis was performed for data of 22 pregnant women without WD, as normal controls. RESULTS: Of a total of 117 pregnancies among the 75 women with WD and 31 pregnancies among the 22 control womenincluded in this study, there were 108 successful pregnancies and 9 spontaneous abortions. Among the 108 successful pregnancies, 97 women a history of copper chelation therapy before pregnancy; all 97 women stopped anti-copper therapy during pregnancy. The nine women with spontaneous abortion had no pre-pregnancy history of copper displacement therapy. The incidence of lower limb edema was higher in the WD group than in normal controls (P = 0.036). Compared with the control group, there was a higher proportion in the WD group of male infants (P = 0.022) and lower average infant birth weight (t = 3.514, P = 0.001). CONCLUSION: It is relatively safe for women with WD patients to become pregnant. The best management method for pregnancy in women with WD may be intensive pre-pregnancy copper chelation therapy and no anti-copper treatment during pregnancy.


Assuntos
Terapia por Quelação/métodos , Degeneração Hepatolenticular/terapia , Cuidado Pré-Concepcional/métodos , Complicações na Gravidez/terapia , Aborto Espontâneo/epidemiologia , Adulto , Peso ao Nascer , Estudos de Casos e Controles , Quelantes/uso terapêutico , Gerenciamento Clínico , Edema/epidemiologia , Feminino , Humanos , Incidência , Extremidade Inferior , Gravidez , Complicações na Gravidez/epidemiologia , Transtornos Puerperais/epidemiologia , Estudos Retrospectivos , Adulto Jovem
15.
BMC Musculoskelet Disord ; 20(1): 590, 2019 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-31810455

RESUMO

BACKGROUND: The purpose of this study is to determine the incidence of bone marrow oedema (BME) at magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ) in a non- rheumatological population, and to explore whether patient-reported outcome measures are suitable for predicting BME at the SIJ at referral. Furthermore, to investigate the final clinical diagnoses three months after initial SIJ MRI. METHODS: This study was a retrospective cohort study consisting of patients 18-45 years of age that were referred for a SIJ MRI between 1 July 2016 to 30 June 2017 at the Department of Radiology in Lillebaelt Hospital, Denmark. The SIJ MRI radiological reports were evaluated for signs of BME. Principal and secondary diagnoses according to the 10th version of International Classification of Diseases (ICD-10)-three months after the initial MRI-were identified in the electronic patient record system. For a subgroup of patients, patient- reported outcome measures, such as the 23-item Roland Morris Disability Questionnaire, quality of life and pain intensity in the back and leg were included from the local SpineData database. RESULTS: In total, 333 patients were included, and 187 (56.2%) of those patients received a final diagnosis within three months after the SIJ MRI. BME was detected in 63 (18.9%) patients; 17 (9.1%) patients had both BME at SIJ MRI and were diagnosed with spondyloarthritis (M45/M46). There was no statistically significant difference between patients with and without BME regarding demographics, quality of life, pain descriptions or function. CONCLUSIONS: The incidence of BME in the cohort correlates well to previous studies regarding the incidence of SIJ MRI changes in non-rheumatological populations in Denmark. Patient-reported outcome measures do not seem to contribute to identifying patients with early-phase BME in a non-rheumatological population.


Assuntos
Doenças da Medula Óssea/epidemiologia , Edema/epidemiologia , Articulação Sacroilíaca/patologia , Espondilartrite/epidemiologia , Adolescente , Adulto , Doenças da Medula Óssea/diagnóstico , Doenças da Medula Óssea/patologia , Dinamarca/epidemiologia , Edema/diagnóstico , Edema/patologia , Feminino , Humanos , Incidência , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Estudos Retrospectivos , Articulação Sacroilíaca/diagnóstico por imagem , Espondilartrite/diagnóstico , Espondilartrite/patologia , Adulto Jovem
16.
PLoS One ; 14(11): e0219875, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31765379

RESUMO

BACKGROUND: Chronic edema (CO) is a progressive, physically disfiguring and currently incurable condition. A multifaceted program has been recommended to manage the swelling. However, there is little evidence investigating patients' perspectives following the program, particularly for those who have poor adherence and/or are disengaged. AIM: To investigate the perceived challenges faced by disengaged participants with lower limb CO by identifying their enablers and barriers to participating in a Physiotherapy CO program. METHOD: An exploratory qualitative approach was used. A purposive sampling strategy was adopted to recruit participants. Those with more than three months swelling and who had low adherence and/or attendance (disengaged) to the CO program were invited to participate. Semi-structured interviews with six participants from a CO clinic in a tertiary hospital were conducted. Data were thematically analyzed and findings in terms of enablers and barriers were subsequently reflected in the light of a theoretical framework. RESULTS: All six participants were morbidly obese (BMI 47 ± 4 kg/m2) with multiple chronic comorbidities. Enablers and barriers detected included physical, psychological and social factors that interplay to present multidimensional challenges that influence the participants' adjustment to managing their CO. For the disengaged participants in this study, their under-managed lower limb CO was a progression towards being housebound and having a gradually increasing level of disability. CONCLUSION: This study has identified the multidimensional challenges faced by low adherent and/or disengaged participants with lower limb CO to participating in a hospital-based CO program. Perceived enablers and barriers included physical, psychological and social factors. These were mapped using a health behavior change theoretical framework. Understanding these challenges has implications for developing a multidisciplinary approach aimed at enhancing patient engagement and participation in the physiotherapy CO program.


Assuntos
Edema/psicologia , Edema/terapia , Idoso , Doença Crônica , Estudos de Coortes , Comorbidade , Gerenciamento Clínico , Edema/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Cooperação do Paciente/psicologia , Participação do Paciente/psicologia , Modalidades de Fisioterapia/psicologia , Projetos Piloto , Pesquisa Qualitativa
17.
Pan Afr Med J ; 33: 236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692655

RESUMO

Introduction: Acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors. Methods: An observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI. Results: Mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively. Conclusion: The study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery.


Assuntos
Lesão Renal Aguda/fisiopatologia , Edema/epidemiologia , Febre/epidemiologia , Edema Pulmonar/epidemiologia , Lesão Renal Aguda/diagnóstico , Adulto , Edema/etiologia , Feminino , Febre/etiologia , Gana , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Edema Pulmonar/etiologia , Recuperação de Função Fisiológica , Sódio/sangue , Centros de Atenção Terciária , Adulto Jovem
18.
Eur J Obstet Gynecol Reprod Biol ; 243: 7-11, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31675633

RESUMO

OBJECTIVE: Postpartum urinary retention (PUR) is an uncommon complication of vaginal delivery, defined as a failure to void spontaneously in the six hours following vaginal birth. The objective of this study was to identify risk factors for PUR in order to provide prompt management. STUDY DESIGN: A retrospective, comparative, case-control study, including two groups of 96 patients who delivered vaginally, was conducted at the Women and Children's University Hospital in Lyon, France. Patients were selected based on data extraction from the medical records of the obstetrics and gynecology department. The first group included patients with postpartum urinary retention and the second group, without PUR, was selected randomly, respecting 1:1 matching criteria, paired according to the year of delivery and patient's age at delivery. RESULTS: Logistic regression analysis found that instrumental delivery (OR 13.42, 95%CI [3.34;53.86], p = 0.0002), absence of spontaneous voiding before leaving the delivery room (OR 6.14, 95%CI [2.56;14.73], p < 0.0001), no intact perineum (OR 3.29, 95%CI [1.10;9.90], p = 0.03) and vulvar edema or perineal hematoma (OR 8.05, 95%CI [1.59;40.67], p = 0.01) were independent risk factors associated with PUR. CONCLUSION: The present study identified risk factors for PUR that should be taken into consideration as soon as delivery is over in order to implement appropriate management. Future studies are needed to assess the contribution of early systematic bladder scanning in patients with risk factors for early diagnosis of PUR.


Assuntos
Edema/epidemiologia , Episiotomia/estatística & dados numéricos , Extração Obstétrica/estatística & dados numéricos , Hematoma/epidemiologia , Transtornos Puerperais/epidemiologia , Retenção Urinária/epidemiologia , Doenças da Vulva/epidemiologia , Adulto , Estudos de Casos e Controles , Parto Obstétrico , Feminino , Humanos , Períneo/lesões , Gravidez , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
19.
Audiol Neurootol ; 24(6): 279-284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31665723

RESUMO

BACKGROUND: Cochlear implantation (CI) is an effective treatment option for patients with severe-to-profound hearing loss. When CI first started, it was recommended to wait until at least 4 weeks after the CI surgery for the initial activation because of possible complications. Advances in the surgical techniques and experiences in fitting have made initial activation possible within 24 h. OBJECTIVES: To compare the complaints and complications after early activation between behind-the-ear (BTE) and off-the-ear (OTE) sound processors and to show the impact of early activation on the electrode impedance values. METHOD: CI surgeries performed between March 2013 and July 2018 were retrospectively analyzed from the database. In total, 294 CI users were included in the present study. The impedance measurements were analyzed postoperatively at the initial activation prior to the stimulation, and 4 weeks after the initial activation in the first-month follow-up visit. A customized questionnaire was administered in the first-month follow-up fitting session to caregivers and/or patients who were using CI at least for 6 months. Medical records were also reviewed to identify any postoperative complications. RESULTS: In the early activation group, impedance values were significantly lower than in the control group (p < 0.05) at first fitting. At the first-month follow-up, no significant difference was found between the groups (p > 0.05). The most common side effects were reported to be edema (6.1%) and pain (5.7%) in the early activation group. In patients with OTE sound processors, the rate of side effects such as skin infection, wound swelling, skin hyperemia, and pain was higher than in patients with BTE sound processors; however, a statistical significance was only observed in wound swelling (p = 0.005). Selecting the appropriate magnet was defined as a problem for the OTE sound processors during the initial activation. CONCLUSION: This study revealed that early activation of CI was clinically safe and feasible in patients with BTE sound processors. When using OTE sound processors, the audiologists should be careful during the activation period and inform patients of possible side effects. The first fitting should be delayed for 4 weeks after CI for OTE sound processors. This current study is the first to report this finding with 5 years of experience in a large cohort.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Surdez/reabilitação , Ajuste de Prótese/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Edema/epidemiologia , Feminino , Humanos , Hiperemia/epidemiologia , Lactente , Masculino , Pessoa de Meia-Idade , Ruído , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Processamento de Sinais Assistido por Computador , Percepção da Fala , Infecção da Ferida Cirúrgica , Inquéritos e Questionários , Adulto Jovem
20.
Rev Esc Enferm USP ; 53: e03493, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389488

RESUMO

OBJECTIVE: To evaluate the predictive clinical factors for ocular dryness and for the nursing diagnosis Risk for dry eye in the ocular surface of hospitalized adult patients in an intensive care unit. METHOD: A cross-sectional study was conducted between January and July 2016, with 206 patients (412 eyes). An inference about the presence of the diagnosis in the evaluated patients was performed by diagnostic nurses. The descriptive and inferential statistics subsidized the data analysis. RESULTS: 47.6% of the patients presented Risk for dry eye, and 52.4% were already diagnosed with ocular dryness. Statistical differences between the ocular dryness diagnosis in the right eye with hyperemia, mucous secretion, eyelid edema and lagophthalmia were identified. In addition, statistical differences were observed between hyperemia and eyelid edema with Risk for dry eye in the left eye and with the nursing diagnosis Risk for dry eye. CONCLUSION: Hyperemia, mucous secretion, eyelid edema and lagophthalmia are the predictive clinical factors for the nursing diagnosis Risk for dry eye and also of ocular dryness in the intensive care unit environment which deserve special attention in the preventive evaluation.


Assuntos
Síndromes do Olho Seco/epidemiologia , Unidades de Terapia Intensiva , Diagnóstico de Enfermagem , Adulto , Idoso , Estudos Transversais , Síndromes do Olho Seco/diagnóstico , Edema/epidemiologia , Doenças Palpebrais/epidemiologia , Feminino , Humanos , Hiperemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
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