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2.
Indian J Pathol Microbiol ; 62(3): 470-472, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361244

RESUMO

A rare complication of chronic lymphedema is development of cutaneous malignant tumors particularly cutaneous lymphomas. We report a case of primary cutaneous diffuse large B-cell lymphoma, leg type, associated with chronic lymphedema of the lower limbs. A literature review identified 12 additional cases of primary cutaneous lymphomas associated with chronic lymphedema. Chronic lymphatic stasis may cause a local dysfunction of the immune system that predisposes to the induction of neoplasia, cutaneous lymphomas in particular.


Assuntos
Linfedema/complicações , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico , Biópsia , Doença Crônica , Feminino , Humanos , Imuno-Histoquímica , Perna (Membro)/patologia , Linfedema/imunologia , Linfoma Difuso de Grandes Células B/patologia , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia
3.
BMC Health Serv Res ; 19(1): 406, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226997

RESUMO

BACKGROUND: There is limited research on the economic burden of low back-related leg pain, including sciatica. The aim of this study was to describe healthcare resource utilisation and factors associated with cost and health outcomes in primary care patients consulting with symptoms of low back-related leg pain including sciatica. METHODS: This study is a prospective cohort of 609 adults visiting their family doctor with low back-related leg pain, with or without sciatica in a United Kingdom (UK) Setting. Participants completed questionnaires, underwent clinical assessments, received an MRI scan, and were followed-up for 12-months. The economic analysis outcome was the quality-adjusted life year (QALY) calculated from the EQ-5D-3 L data obtained at baseline, 4 and 12-months. Costs were measured based on patient self-reported information on resource use due to back-related leg pain and results are presented from a UK National Health Service (NHS) and Societal perspective. Factors associated with costs and outcomes were obtained using a generalised linear model. RESULTS: Base-case results showed improved health outcomes over 12-months for the whole cohort and slightly higher QALYs for patients in the sciatica group. NHS resource use was highest for physiotherapy and GP visits, and work-related productivity loss highest from a societal perspective. The sciatica group was associated with significantly higher work-related productivity costs. Cost was significantly associated with factors such as self-rated general health and care received as part of the study, while quality of life was significantly predicted by self-rated general health, and pain intensity, depression, and disability scores. CONCLUSIONS: Our results contribute to understanding the economics of low back- related leg pain and sciatica and may provide guidance for future actions on cost reduction and health care improvement strategies. TRIAL REGISTRATION: 13/09/2011 Retrospectively registered; ISRCTN62880786 .


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Perna (Membro)/patologia , Dor Lombar/economia , Dor/economia , Atenção Primária à Saúde/economia , Ciática/economia , Adulto , Feminino , Humanos , Dor Lombar/complicações , Dor Lombar/terapia , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Manejo da Dor , Estudos Prospectivos , Anos de Vida Ajustados por Qualidade de Vida , Ciática/etiologia , Ciática/terapia , Resultado do Tratamento , Reino Unido
4.
Spine (Phila Pa 1976) ; 44(13): E774-E781, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31205173

RESUMO

STUDY DESIGN: A prospective observational study with translation and psychometric analyses of a questionnaire. OBJECTIVE: Cross-cultural adaptation of the Short-Form McGill Pain Questionnaire-2 into Norwegian. SUMMARY OF BACKGROUND DATA: The different versions of the McGill Pain Questionnaire (MPQ) have been important and influential tools for pain assessment. To more reliably assess qualities of both neuropathic and non-neuropathic pain, the Short-Form MPQ was revised in 2009 (SF-MPQ-2), including seven additional descriptors. No Norwegian adaptation of the SF-MPQ-2 has been performed. METHODS: A translation of the SF-MPQ-2 was performed based on established guidelines. Forward-translations were compared and discussed in an expert workgroup. A synthesis was achieved by consensus. A backward translation was reviewed and consolidated with the forward translations to confirm linguistic equivalence. A prefinal version was tested in eight patients, who were interviewed to evaluate acceptability and comprehension of the questionnaire. Minor changes were implemented. The questionnaire was externally proofread. The final Norwegian version (NSF-MPQ-2) was tested for content and construct validity and internal consistency reliability in a population with low back-related leg pain. RESULTS: The backward translation was in good accordance with the original version. The prefinal version showed excellent acceptability and comprehension in initial patient-testing. The NSF-MPQ-2 showed satisfactory content and construct validity, including responsiveness to change, and acceptable internal consistency reliability as measured by Cronbach's alpha. A confirmatory factor analysis showed poor fit for the established four-factor structure, especially regarding the neuropathic subscale. CONCLUSION: The NSF-MPQ-2 showed excellent acceptability and comprehension, satisfactory content and construct validity, including responsiveness to change, and internal consistency reliability as measured by Cronbach's alpha. However, a confirmatory factor analysis raised concerns regarding the factor-structure in the present population. Until more evidence emerges for the four-factor solution we suggest the NSF-MPQ-2 should be used as a single measure. LEVEL OF EVIDENCE: 3.


Assuntos
Comparação Transcultural , Dor Lombar/diagnóstico , Dor Lombar/etnologia , Medição da Dor/normas , Inquéritos e Questionários/normas , Traduções , Adulto , Feminino , Seguimentos , Humanos , Perna (Membro)/patologia , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Noruega/etnologia , Medição da Dor/métodos , Estudos Prospectivos , Psicometria/normas , Reprodutibilidade dos Testes
7.
BMC Musculoskelet Disord ; 20(1): 161, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30967135

RESUMO

BACKGROUND: Post-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation. The aim of this pilot study was to evaluate the effect of compression stockings versus no compression on post-operative swelling and pain in the early post-operative phase. METHODS: A single-centre, randomised controlled trial was performed. Patients who underwent minor knee arthroscopy were randomised to wear class II compression stockings (23-32 mmHg) (CS) or no compression stockings (NCS) immediately post-operatively for ten days. All patients received low molecular weight heparin (LMWH) at prophylactic dosage. The primary outcome variable was post-operative swelling of the limb, quantified by using an optical 3D measurement system (Bodytronic© 600). Pain was rated on a visual analogue scale (VAS). From a total of 76 patients assessed, 19 patients were eligible for final analysis. The trial followed the CONSORT criteria, was registered at clinicaltrial.gov and approved by the local ethics committee. RESULTS: The circumference at the middle thigh (cF) was significantly different between groups at day 10 (p = 0.032; circumference - 1.35 ± 2.15% (CS) and + 0.79 ± 3.71% (NCS)). Significant differences were also noted around the knee (cD) at day 10 (p = 0.026) and a significant trend at cD and at the mid lower leg (cB1) at day 4. The volume of the thigh was also different with marked difference between days 1 and 4 between the two groups (p = 0.021; volume + 0.54 ± 2.03% (CS) and + 4.17 ± 4.67 (NCS)). Pain was lower in compression group (not statistically significant). CONCLUSIONS: Post-operative limb swelling can be reduced significantly by wearing compression stockings in the early post-operative phase when compared to not wearing stockings. This may improve the rehabilitation process after arthroscopic surgery. The optimal duration of compression therapy seems to be between three and ten days. TRIAL REGISTRATION: clinicaltrials.gov ( NCT02096562 , date of registration 11.11.2013).


Assuntos
Artroscopia/tendências , Edema/prevenção & controle , Perna (Membro)/patologia , Complicações Pós-Operatórias/prevenção & controle , Meias de Compressão/tendências , Adulto , Idoso , Artroscopia/efeitos adversos , Edema/diagnóstico , Edema/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Método Simples-Cego , Resultado do Tratamento
8.
Wounds ; 31(5 Suppl): S29-S44, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31033453

RESUMO

As the population ages and more people live with diabetes, obesity, and vascular disease, chronic wounds have become more prevalent. Increasingly, wound care falls into the hands of clinicians who may be new to the specialty. To facilitate a better understanding of wounds and to ensure all integral items for best outcomes are considered, an interprofessional panel of wound care experts developed a checklist to aid in lower extremity wound identification, assessment, evaluation, and potential complication recognition. This checklist focuses on an evidence-based approach to obtaining a medical history, evaluating the wound, determining the etiology, and assessing perfusion, edema, infection, and neurologic status. The goal of this fundamental evaluation tool is to help the clinician move towards the next steps in optimizing patient care. Evidence-based support for each item on the checklist is reviewed and detailed for clinician reference.


Assuntos
Lista de Checagem , Pé Diabético/diagnóstico , Úlcera da Perna/diagnóstico , Perna (Membro)/patologia , Obesidade/complicações , Doença Crônica , Pé Diabético/patologia , Pé Diabético/terapia , Humanos , Perna (Membro)/irrigação sanguínea , Perna (Membro)/fisiopatologia , Úlcera da Perna/patologia , Úlcera da Perna/terapia , Obesidade/patologia , Obesidade/fisiopatologia
10.
Dtsch Med Wochenschr ; 144(6): 398-410, 2019 03.
Artigo em Alemão | MEDLINE | ID: mdl-30870871

RESUMO

In case of an acute leg swelling a deep leg vein thrombosis needs to be excluded. In order to do this, compression sonography and the D-dimer-test are applied in the framework of an established diagnostic algorithm. The ensuing therapy consists in anticoagulation and compression.In case of a chronic leg swelling anamnesis and a clinical check-up often lead to a differential diagnosis. Chronic venous insufficiency is a generic term for a disturbed venous backflow. It is caused by an obstruction or an antegrade or retrograde flow insufficiency. Most common diseases in this context are varicosis or a post-thrombotic syndrome. Sonography and special function tests provide a diagnosis. The basic therapy consists in regular exercise, normalization of weight and compression therapy. In case of a hemodynamically relevant varicose vein surgery or endovascular treatment is advisable. The post-thrombotic syndrome must be treated consistently with the basic therapy.A lymphedema may be hereditary or acquired. In a first step diseases like neoplasia need to be excluded. The initial therapy consists in manual lymph drainage in combination with special compression bandages. Flat knit stockings should be prescribed. Surgical treatment is reserved for special circumstances.A lipedema is clinically diagnosed. It is characterized by lipohypertrophia, pressure sensitivity of the tissue and susceptibility to hematomas. Treatment options include weight reduction, regular exercise, lymph drainage and compression therapy, in some cases liposuction.


Assuntos
Edema , Perna (Membro) , Linfedema , Doenças Vasculares , Diagnóstico Diferencial , Edema/diagnóstico , Edema/etiologia , Edema/patologia , Edema/fisiopatologia , Humanos , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/patologia , Perna (Membro)/fisiopatologia , Linfedema/complicações , Linfedema/diagnóstico , Linfedema/patologia , Linfedema/fisiopatologia , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Doenças Vasculares/patologia , Doenças Vasculares/fisiopatologia
11.
Trop Med Int Health ; 24(4): 463-476, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30706585

RESUMO

OBJECTIVES: This longitudinal comparative study investigated the effect of preventive chemotherapy (PC) on covert tissue changes associated with lymphatic filariasis (LF) among young people living in an LF-endemic area in Myanmar. METHODS: Tissue compressibility and extracellular free fluid in the lower limbs of people aged 10-21 years were measured using indurometry and bioimpedance spectroscopy (BIS). Baseline measures were taken in October 2014, annual mass drug administration (MDA) of PC was delivered in December, and in March 2015 further PC was offered to LF-positive cases who had missed MDA. Follow-up measures were taken in February and June 2015. RESULTS: A total of 50 antigen-positive cases and 46 antigen-negative controls were included. Self-reported PC consumption was 60.1% during 2014 MDA and 66.2% overall. At second follow-up, 24 of 34 cases and 27 of 43 controls had consumed PC. Significant and clinically relevant between-group differences at baseline were not found post-PC. Bayesian linear mixed models showed a significant change in indurometer scores at both calves for antigen-positive cases who consumed any PC (dominant calf: -0.30 [95% CI -0.52, -0.07], P < 0.05 and non-dominant calf: -0.35 [95% CI -0.58, -0.12], P < 0.01). Changes in antigen-negative participants or those not consuming PC were not significant. CONCLUSION: This study is the first attempt to use simple field-friendly tools to track fluid and tissue changes after treatment of asymptomatic people infected with LF. Results suggested that PC alone is sufficient to reverse covert lymphatic disturbance. Longer follow-up of larger cohorts is required to confirm these improvements and whether they persist over time. These findings should prompt increased efforts to overcome low PC coverage, which misses many infected young people, particularly males, who are unaware of their infection status, unmotivated to take PC and at risk of developing lymphoedema. Indurometry and BIS should be considered in assessment of lymphatic filariasis-related lymphedema.


Assuntos
Quimioprevenção/métodos , Filariose Linfática/tratamento farmacológico , Filaricidas/uso terapêutico , Perna (Membro)/patologia , Adolescente , Adulto , Antígenos , Teorema de Bayes , Estudos de Casos e Controles , Criança , Impedância Elétrica , Filariose Linfática/patologia , Líquido Extracelular , Feminino , Humanos , Estudos Longitudinais , Linfedema , Masculino , Mianmar , Adulto Jovem
12.
Lasers Med Sci ; 34(7): 1325-1332, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30707327

RESUMO

Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.


Assuntos
Lasers de Estado Sólido , Perna (Membro)/patologia , Polidocanol/administração & dosagem , Polidocanol/uso terapêutico , Varizes/tratamento farmacológico , Varizes/cirurgia , Terapia Combinada , Feminino , Humanos , Lasers de Estado Sólido/efeitos adversos , Pessoa de Meia-Idade , Satisfação do Paciente , Polidocanol/efeitos adversos , Soluções Esclerosantes/uso terapêutico , Escleroterapia/efeitos adversos , Resultado do Tratamento
13.
J Med Case Rep ; 13(1): 13, 2019 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-30646927

RESUMO

BACKGROUND: Panitumumab is the first human combinatorial antibody for the treatment of metastatic colorectal carcinoma. Dermatologic toxicity of all grades occurs in more than 90% of patients. However, there are few reports of purpura induced by anti-epidermal growth factor receptor antibody. Renal failure is also uncommon as an adverse event of anti-epidermal growth factor receptor antibody. CASE PRESENTATION: A 67-year-old Japanese man with advanced colon cancer received monotherapy with panitumumab. General malaise, bilateral edema of his legs, and bilateral purpura of his forearms developed 2 days after the second cycle of panitumumab. A skin biopsy was performed to evaluate the purpuric lesions on his left leg and leukocytoclastic vasculitis was diagnosed. Blood tests showed grade III acute renal failure with a blood urea nitrogen level of 33.8 mg/dL and a creatinine level of 3.10 mg/dL. CONCLUSIONS: This is the first reported case of leukocytoclastic vasculitis followed by purpura and acute renal failure associated with panitumumab.


Assuntos
Lesão Renal Aguda/patologia , Neoplasias do Colo/tratamento farmacológico , Perna (Membro)/patologia , Neoplasias Hepáticas/tratamento farmacológico , Panitumumabe/uso terapêutico , Púrpura/patologia , Vasculite Leucocitoclástica Cutânea/patologia , Lesão Renal Aguda/induzido quimicamente , Idoso , Neoplasias do Colo/patologia , Progressão da Doença , Evolução Fatal , Humanos , Neoplasias Hepáticas/secundário , Masculino , Panitumumabe/efeitos adversos , Púrpura/induzido quimicamente , Vasculite Leucocitoclástica Cutânea/induzido quimicamente
14.
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
15.
Am J Clin Oncol ; 42(1): 1-5, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29782358

RESUMO

OBJECTIVES: Patients with large, high-grade extremity soft tissue sarcoma (STS) are at high risk for both local and distant recurrence. RTOG 95-14, using a regimen of neoadjuvant interdigitated chemoradiotherapy with mesna, doxorubicin, ifosfamide, and dacarbazine followed by surgery and 3 cycles of adjuvant mesna, doxorubicin, ifosfamide, and dacarbazine, demonstrated high rates of disease control at the cost of significant toxicity (83% grade 4, 5% grade 5). As such, this regimen has not been widely adopted. Herein, we report our institutional outcomes utilizing a modified interdigitated chemoradiotherapy regimen, without dacarbazine, and current radiotherapy planning and delivery techniques for high-risk STS. MATERIALS AND METHODS: Adults with large (≥5 cm; median, 12.9 cm), grade 3 extremity STS who were prospectively treated as part of our institutional standard of care from 2008 to 2016 are included. Neoadjuvant chemoradiotherapy consisted of 3 cycles of mesna, doxorubicin, and ifosfamide (MAI) and 44 Gy (22 Gy in 11 fractions between cycles of MAI) after which patients underwent surgical resection and received 3 additional cycles of MAI. RESULTS: Twenty-six patients received the MAI treatment protocol. At a median follow-up of 47.3 months, 23 (88.5%) patients are still alive. Three year locoregional recurrence-free survival, disease-free survival, and overall survival are 95.0%, 64.0%, and 95.0%, respectively. There have been no therapy-related deaths or secondary malignancies. The nonhematologic grade 4 toxicity rate was 7.7%. CONCLUSIONS: Neoadjuvant interdigitated MAI radiotherapy followed by resection and 3 cycles of adjuvant MAI has resulted in acceptable and manageable toxicity and highly favorable survival in patients at greatest risk for treatment failure.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Quimiorradioterapia/efeitos adversos , Sarcoma/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Braço/patologia , Quimiorradioterapia/métodos , Doxorrubicina/administração & dosagem , Feminino , Humanos , Ifosfamida/administração & dosagem , Perna (Membro)/patologia , Masculino , Mesna/administração & dosagem , Pessoa de Meia-Idade , Terapia Neoadjuvante , Tratamentos com Preservação do Órgão , Estudos Retrospectivos , Sarcoma/mortalidade , Sarcoma/patologia , Resultado do Tratamento
16.
Mycopathologia ; 184(1): 115-119, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29974323

RESUMO

BACKGROUND: Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by different melanized fungi. The disease occurs worldwide, particularly in tropical and subtropical regions but not reported in Vietnam. A 47-year-old women was admitted to hospital 103, Hanoi, Vietnam, with a 10-year lasting lesion on backside of her right shank. Diagnosis of chromoblastomycosis was made after discovery of a muriform cell in histopathological examination. A black, slow-growth fungus was isolated and identified as Fonsecaea pedrosoi after molecular analysis. After 1-month treatment with itraconazole, the lesion has significant improvement. CONCLUSION: This is the first case of chromoblastomycosis caused by Fonsecaea pedrosoi reported in Vietnam.


Assuntos
Ascomicetos/isolamento & purificação , Cromoblastomicose/diagnóstico , Cromoblastomicose/patologia , Perna (Membro)/patologia , Antifúngicos/administração & dosagem , Ascomicetos/crescimento & desenvolvimento , Cromoblastomicose/tratamento farmacológico , Cromoblastomicose/microbiologia , Feminino , Histocitoquímica , Humanos , Itraconazol/administração & dosagem , Técnicas Microbiológicas , Microscopia , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Resultado do Tratamento , Vietnã
18.
Clin Exp Dermatol ; 44(2): 190-193, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29947025

RESUMO

Lichen planus pigmentosus (LPP) is a rare disease characterized by persistent and asymptomatic slate-grey pigmentation, which mostly affects patients with skin types IV-VI. The face and neck are the most commonly involved sites, followed by the trunk and extremities. LPP is believed to spare the palms, soles and nails. In this report, we describe palmoplantar involvement in 10 (4.65%, 10/215) patients with LPP, and compare its clinicodemographic features with those of classic LPP. LPP lesions on the palms and soles present as asymptomatic, well-circumscribed, hyperpigmented, brown-black patches without any history of prior lichen planus lesions. They are mostly observed in young patients with rapidly spreading active disease, who often require systemic treatment to control the disease activity. Strikingly, palmoplantar involvement is frequently associated with other atypical LPP variants. It is important to identify palmoplantar involvement in LPP, as it has a different clinical course and associations compared with classic LPP.


Assuntos
, Mãos , Líquen Plano/patologia , Adolescente , Adulto , Braço/patologia , Criança , Face/patologia , Feminino , Pé/patologia , Mãos/patologia , Humanos , Perna (Membro)/patologia , Masculino , Pessoa de Meia-Idade , Pescoço/patologia , Estudos Retrospectivos , Pele/patologia , Tórax/patologia , Adulto Jovem
19.
Ned Tijdschr Geneeskd ; 1632018 12 05.
Artigo em Holandês | MEDLINE | ID: mdl-30570923

RESUMO

A 31-year-old woman presented at the fertility department with primary subfertility since one year. Last year she had had progressive dysmenorrhea and pain in her right leg and groin during her menstrual period. MRI showed extensive pelvic endometriosis with a lesion in the right round ligament in the inguinal canal.


Assuntos
Endometriose/diagnóstico , Virilha/patologia , Canal Inguinal/patologia , Perna (Membro)/patologia , Dor/diagnóstico , Ligamento Redondo do Útero/patologia , Adulto , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Infertilidade Feminina , Imagem por Ressonância Magnética/métodos , Ciclo Menstrual , Dor/etiologia
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