International Archives of Medicine (E-Journal)
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Leprosy: demographic and clinical characteristics of patients of endemic area in Amazon Region
No full textIntroduction: The hyperendemicity of leprosy in the northern region permeates regional aspects, including its large territorial extension and waterways, which make it difficult to access health and, consequently, control the disease. So that, the objective of this project is to describe the demographic and clinical profile of patients with leprosy and to evaluate their intradomiciliary contacts.
Methods and findings: Observational, descriptive study, type of case series, through interview and complementary analysis of the medical records of patients undergoing specific treatment and / or treatment of leprosy reactions followed at the Dermatology outpatient clinic of the University of the State of Pará, in the city of Belém-PA, from January 2015 to December 2017. With convenience sampling, we interviewed 83 patients that met the inclusion criteria and collected socioeconomic and demographic variables, as well as clinical aspects based on the Madrid classification. Descriptive and inferential statistical methods were applied as: tables, graphs and statistical measures of position and Test G, with alpha significance = 0,05 and reliability of 95%. The predominance of males was observed (60.24%), the most affected age group was between 30 and 44 years old and the majority with incomplete secondary education. The predominant family income was up to 1 minimum wage. The most frequent clinical type was Virchowian (38 patients). Most of the patients did not present leprosy reaction and those who presented, the type 1 reaction was the most frequent and the nerve most affected was ulnar.
Conclusion: Prevalence of multibacillary cases is a reflex of late diagnosis. It is important that there be intensification of actions and monitoring and active search for new cases
Unusual dyspnea in a hemodialysis patient: A case report
Get PDFThe typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy
How does the ZIKA infection is higher among black women?
Get PDFIntroduction: ZIKA is a single-stranded RNA, from the Flaviviridae family. The infection of this virus became extremely visible during its epidemic in 2015 at South America, after the outbreak many speculations that includes newborns with central nervous system malformations and neurological disorders.
Objective: determine the epidemiological profile of the Brazilian female population afflicted with Zika virus, by means of database research of 2017.
Results: the higher incidence shows the social inequality of those affected by arboviruses: young, poor, black and brown women, the majority of population in the Northeast and North of Brazil.
Conclusion: Brazilian epidemiology of Zika virus and Congenital Zika Virus is concentrated in the black and poor female population due to the historical and cultural Brazilian history of colonization, as it is concentrated in the same region where the Aedes mosquito has an easy procreation due to a wet and hot summer leading to propagation of arboviruses
An unusual case of diffuse ST elevation mimicking acute myocardial infarction: A challenge of emergent percutaneous coronary intervention?
No full textCoronary artery disease combined sepsis associated myocardial ischemia resulting in diffuse ST elevation on electrocardiogram has rarely been reported. We reported a rare case of diffuse ST elevation precipitated by septic shock and preexisting severe atherosclerosis heart disease. In clinical scenario, it is imperative for physicians to be aware of non-ischemic ST elevation etiologies and avoid inappropriate activation of the percutaneous coronary intervention (PCI) protocol, while not missing ST elevation myocardial infarction
Sports Rehabilitation and Interprofessional Collaboration
Get PDFBackground: The demand for interprofessional collaboration continues to grow due to changing priorities of the health care system. The benefits of interprofessional collaboration are well documented; however, the methods of collaboration are often unclear and often difficult to put into practice. While there is a growing number of studies on the impact of interprofessional collaboration in settings such as inpatient, intensive care units, and acute care, there are limited documented cases regarding the interprofessional management of a physical therapy patient in the outpatient orthopedic private practice setting.
Purpose: The purpose of this paper is to describe the reflections of a physical therapist and an athletic trainer in their experience with interprofessional collaboration, describe the barriers they have experienced that make interprofessional collaboration challenging, and to offer solutions to these barriers. The barriers discussed in the paper include limited knowledge of and respect for other professionals’ skill set, high-productivity work environments, medical hierarchy, overlapping bodies of knowledge, discrepancy between professional reasoning, territorial behavior, and ineffective communication.
Discussion: It appears that contextual factors, such as community in which the professionals practice, the healthcare setting, and the practice environment, have a far less important impact to successful collaboration than the professionals’ attitudes and investment in the collaborative efforts.
Conclusion: Collaboration between a PT and an AT can lead to power struggles and suboptimal patient care if these barriers are not overcome and collaboration may be necessary to provide the highest quality of patient care
Control Actions on Leprosy in Primary Health Care in a Brazilian Capital: Profile of Professionals and Users
Get PDFObjective: analyze profile of users of primary health care services affected by leprosy, as well as the medical professionals and nurses responsible for the follow - up of these patients.
Methods: This is a field study that surveyed the socioeconomic and clinical profile of 26 patients affected by leprosy, attended at the municipal health units of the urban area of Teresina-PI, as well as the professional profile and clinical practices of 15 physicians and 19 nurses responsible for the follow-up of these patients.
Results: It was observed a profile of people affected by leprosy, characterized by: individuals aged 50 years or more; predominantly male; with low schooling and income. The clinical characteristics reveal a high prevalence of multibacillary cases of leprosy and with a significant diagnosis of some degree of physical disability. Regarding the profile of the professionals and their clinical behaviors, it was verified that the majority had post-graduation and a long time of experience in primary health care and leprosy control actions, however, it has been shown that they do not always put into practice all actions necessary for the diagnosis and treatment of the disease.
Conclusions: The profile of patients with leprosy treated at the municipal health units in the urban area of Teresina was similar to that found in other Brazilian territories, thus evidencing the need to implement public social support policies and more effective diagnostic and therapeutic follow-up practices by reduce the high rates of endemicity of the disease
Dohi's Reticulated Acropigmentation: a Case Report
No full textBackground: Dohi's Reticulated Acropigmentation is a rare autosomal dominant genodermatosis with high penetrance, characterized by small, irregular, hypo and hyperpigmented macules on the dorsal surface of the distal extremities.
Case: The authors report a case of Dohi’s Reticulated Acropigmentation in a 61 years old female patient. The patient complained of spots on hands, feet and posteriorly face involvement since she was 7 years old.
Conclusion: Dohi's Reticulated Acropigmentation is a rare clinical condition, which usually appear in childhood and commonly interrupt their onset before adolescence. The diagnosis is based on clinical data, physical examination and histopathological findings. The treatment is unsatisfactory and still no therapy is proposed
Atelectasis as a Complication of Tuberculosis: a Case Report
No full textBackground: Tuberculosis is an infectious disease caused by a bacillus called Mycobacterium tuberculosis or Koch's Bacillus (BK). It is associated with various long-term lung complications, including: lung scarring (fibrosis), bronchiectasis, Chronic Pulmonary Aspergillosis, and more rarely, atelectasis. There is however very limited data in literature on the full spectrum of these complications, and relies mostly on case reports and small case series.
Case: The authors report a case of atelectasis in a patient with previous diagnosis of Tuberculosis. Normal laboratory tests and imaging test presenting right lung atelectasis. Went under respiratory therapy, presented improve and is under clinical control.
Conclusion: There is a huge importance of knowing the various methods to diagnose this disease and treat it well. Thus, it enables an improvement in the patient and a reduction in the spread of bacteria
Clinical and Epidemiological Study of Vitiligo Patients at a Dermatology Service in Northern Brazil
Get PDFBackground: Vitiligo is an acquired hypomelanosis that affects between 0.5% and 4% of the world population, characterized by distinct acromic macules of various shapes and sizes, and may appear in any region of the skin. Worldwide, there are few publications on vitiligo that address epidemiological characteristics. Thus, the objective was to describe the clinical and epidemiological profile of patients with this condition at the State University of Pará’s Dermatology Clinic, in the city of Belém, Northern of Brazil.
Methods and Findings: A cross-sectional descriptive study was performed, in which 180 medical records of patients treated at the State University of Pará’s Dermatology Clinic, from July 2000 to July 2014, were analyzed using a protocol consisting of variables related to the disease. The information obtained was organized in a database and submitted to descriptive and inferential statistical analysis. The study was approved by the ethics and research committee under the number 923.213. A predominance of the female gender (72.2%), of the adult age group (55%) was observed; without relation to family history (46.7%); without progression (58.3%); with a predominant clinical form of vitiligo of the generalized type (67.2%), being the common generalized one with the highest prevalence (57%). The most affected sites were head and neck (27.5%), and upper limbs (25.3%).
Conclusions: This study revealed the characteristics of the vitiligo patient residing in the Amazon region, and patients were found to have a generalized clinical form, most of the patients achieved improvement of the lesions with the proposed treatment, and only a minority presented progression of the disease. It is concluded that vitiligo is a disease with great therapeutic difficulty, and it is emphasized the importance of an early diagnosis, since in the early stages is easier to resolve the disease
Evaluation Of Risk Factors In Cardiovascular Patients With Diagnosis Of Systemic Lupus Erythematosus (SLE)
No full textTitle: Evaluation of risk factors in cardiovascular patients with diagnosis of Systemic Lupus Erythematosus (SLE).
Background: prevalence of cardiovascular risk factors in lupic patients.This study aimed to evaluate the presence of cardiovascular risk factors in patients diagnosed with SLE in a Rheumatology Ambulatory, comparing groups with and without SLE nephritis.
Methods: a quantitative, observational and cross-sectional study was carried out during the period from November 2016 to June 2017. 86 patients were interviewed using specific protocol.
Conclusions: among the cardiovascular risk factors evaluated, systemic hypertension was more frequent in SLE patients (33.7%), followed by smoking (17.4%) and diabetes mellitus (5.8%). There was, however, no difference between the frequency of these comorbidities in the groups with and without lupus nephritis