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Id: biblio-833862
Autor: Santos, Marco Antonnio Rocha dos; Olmi, Marina Plain; Oliveira, Eduardo Anton; Martin, Kelin Cristine; Bianchin, Marino Muxfeldt.
Título: Faringo-cérvico-braquial: variante rara do espectro da síndrome de Guillain-Barré / Pharyngeal-cervical-brachial: a rare variant of the Guillain-Barré syndrome spectrum
Fuente: Rev. AMRIGS;59(3):229-229, jul.-set. 2015.
Idioma: pt.
Resumen: A Síndrome de Guillain-Barré (SGB) é uma polineuropatia autolimitada, na maioria das vezes de mecanismo autoimune pós-infeccioso. Este caso tem por objetivo relatar uma variante rara do espectro da SGB. O método utilizado foi o acompanhamento clínico do paciente e revisão de prontuário. Conclui-se que conhecimento acerca da FCB e alto grau de suspeição são importantes para o diagnóstico diferencial de pacientes que apresentam sintomas bulbares e fraqueza de membros superiores, principalmente pela gama de diagnósticos diferenciais que os sintomas podem sugerir (AU)

Guillain-Barré syndrome (GBS) is a self-limited polyneuropathy, most often by a post-infectious autoimmune mechanism. This case aims at reporting a rare variant of the GBS spectrum. The method used was clinical monitoring of the patient and medical record review. It was concluded that knowledge of the pharyngeal-cervical-brachial variant and high degree of suspicion are important for the differential diagnosis of patients with bulbar symptoms and weakness of the upper limbs, particularly because of the range of differential diagnoses the symptoms may suggest (AU)
Responsable: BR18.1 - Biblioteca FAMED/HCPA


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Id: lil-774033
Autor: Swaiin, James; Bush, Kenneth W.
Título: Diagnóstico por imagem para fisioterapeutas / Diagnostic imaging for physical therapists.
Fuente: São Paulo; Cia. dos Livros; 2011. 342 p. ilus, tab, graf.
Idioma: pt.
Responsable: BR75.1 - Biblioteca - Documentação Científica


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Id: lil-771850
Autor: Zhang, Yi; Xu, Hua; Wang, Tao; He, Jinguang; Wei, Jiao; Wang, Tingliang; Dong, Jiasheng.
Título: Remote limb ischemic post-conditioning attenuates ischemia-reperfusion injury in rat skin flapby limiting oxidative stress
Fuente: Acta cir. bras;31(1):15-21, Jan. 2016. tab, graf.
Idioma: en.
Resumen: PURPOSE: To investigate the effect of remote ischemic post-conditioning (RIPoC) against ischemia-reperfusion (I/R) injury on flaps of rats. METHODS: Sprague-Dawley rats were randomized into the Sham, Control, RIPoC1 and RIPoC2 groups. All the animals were submitted to a 5×4 cm superficial inferior epigastric artery flap. Eight hours of flap ischemia was induced and two protocols of limb RIPoC were applied. Tissue MDA level and SOD activity in 24-h reperfusion were assessed. Flap survival was assessed 7 days postoperatively. RESULTS: Compared to the Control group, the RIPoC1 group showed statistically decreased MDA level at 6-, 12-, and 24-h reperfusion (P = 0.01, P < 0.01 and P < 0.01, respectively), and statistically increased SOD activity at 12- and 24-h reperfusion (P < 0.05 and P < 0.01, respectively). Flap survival rate on the 7th day was significantly higher in the RIPoC1 group than the control group (47.9 ± 6.4 vs . 29.4 ± 7.1 %, P < 0.01). CONCLUSION: Three cycles of 5-min Limb remote ischemic post-conditioning rather than a single cycle of 15-min limb RIPoC has protective effect on flaps against ischemia-reperfusion injury by attenuating oxidative stress.
Responsable: BR1.1 - BIREME


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Id: lil-768402
Autor: Neira, M. Florencia; López Di Noto, Ada Laura; Weintraub, Laura; Sánchez, Graciela F; Merola, Gladys.
Título: Lentiginosis unilateral parcial / Unilateral partial lentiginosis
Fuente: Arch. argent. dermatol;61(2):53-59, mar.2011. ilus.
Idioma: es.
Resumen: La lentiginosis unilateral parcial (LUP) es un raro desorden pigmentario caracterizado por numerosos lentigos, dispuestos en grupo, que se presentan durante la infancia, asintomáticos, y comprometen de manera unilateral un segmento del cuerpo: cabeza, cuello, tronco, extremidades, etc. Pocas veces sobrepasan la línea media, permaneciendo estables en el tiempo. Presentamos cinco casos clínicos y una breve revisión del tema...

Partial Unilateral Lentiginosis (PUL) is a rare pigmentarydisorder characterized by numerous asymptomatic andstable lentigines confined to one side of the body.It begins in childhood, affecting different body segmentsincluding the head, neck, trunk and extremities.Lentigines rarely surpass the midline.We present five cases and briefly review the subject...
Responsable: AR144.1 - CIBCHACO - Centro de Información Biomedica del Chaco


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Id: lil-751061
Autor: Spencer, Ranyell Matheus Sobreira Batista.
Título: Avaliação da expressão imunoistoquímica de proteínas da via de sinalização mediada por TGFβ como preditores de resposta à quimioterapia pré-operatória em adultos portadores de sarcoma de partes moles de alto grau em extremidades / Protein expression evaluation of protein of genes belonging to the TGFβ pathway as predictors of response to preoperative chemotherapy with doxorubicin and ifosfamide in adult patients with high grade soft tissue sarcomas located in extremities.
Fuente: São Paulo; s.n; 2013. 111 p. ilus, tab.
Idioma: pt.
Tesis: Presentada en Fundação Antônio Prudente para obtención del grado de Doutor.
Resumen: Introdução: Sarcomas de partes moles (SPM) constituem um grupo de neoplasias raras de comportamentos distintos. O tratamento para os tumores de alto grau, não passiveis de ressecção adequada, é feito por cirurgia, radioterapia (RT) e quimioterapia (QT). Apesar disso, 50% dos pacientes com tumores localizados ao diagnóstico morrem da doença metastática. A QT pré-operatória para o tratamento de tumores localizados, apesar de não ser considerada como padrão, é uma opção promissora. A escassez de preditores biológicos de resposta, e achados de que a superexpressão de genes pertencentes à via mediada por TGFβ estaria relacionada à resistência à QT nos levaram à tentativa de estabelecer a relação entre a expressão de FST, SMAD4, TGFβ e Id com resposta patológica. Objetivos: Avaliar por imunoistoquímica (IQ) a expressão das proteínas produzidas a partir dos genes TGFB, FST, Id1 e SMAD4 da via mediada por TGFβ, correlacionando com a resposta patológica; expandir os resultados clínicos do esquema de QT pré-operatória com doxorrubicina e ifosfamida em vigência no Hospital A.C. Camargo; determinar as taxas de toxicidade e avaliar um método de análise patológica que quantifique a percentagem de células tumorais viáveis em peça operatória. Pacientes e Métodos: 42 pacientes com SPM de alto grau localizados em extremidades, tratados com doxorrubicina e ifosfamida pré-operatória, foram observados de forma prospectiva, desde janeiro de 2005 a agosto de 2012. Amostras das biópsias e das peças operatórias foram obtidas e submetidas à pesquisa da expressão das proteínas já referidas por IQ. Resultados: A expressão das proteínas estudadas não teve correlação estatisticamente significativa com a resposta patológica...

Backgraund: Soft Tissue Sarcomas (STS) are rare neoplasms with many histological subtypes, behaviors and response to different treatments. The treatment of these tumors involves surgery, radiation and chemotherapy. Despite that 50% of patients with localized tumors will develop metastatic disease. Preoperative chemotherapy (CT) although not standard is considered a promising therapeutic option. The lack of biological predictors of response, led us to study the relationship between the expression of FST, SMAD4, TGFβ and Id (TGFβ superfamily genes) in patients submitted to preoperative CT. Objectives: To evaluate the protein expression. Produced by genes belonging to the TGFβ pathway by IH and correlate it with pathologic response; expand the preliminary results of a previous phase II trial testing a schedule of preoperative CT with doxorubicin and ifosfamide in Hospital A.C. Camargo; determine the rate of toxicity and evaluate a method of assessing pathological analysis that quantifies the percentage of viable tumor cells in surgical specimens. Patients and Methods: 42 patients with high grade STS located in extremities treated with preoperative doxorubicin and ifosfamide CT were observed prospectively, on a non controlled fashion since January 2005 to august 2012. Biopsies and surgical specimens were obtained to enable the analysis of TGFβ, FST, SMAD4 and Id protein expressional by immunohistochemistry (IH). Results: The expression of the proteins studied had no significant association with pathological response. The objective response rates of the primary tumor were 17.5% for clinical response and 15% for pathologic complete response. Only 7.5% patients had a limb amputated. The rate of surgical contraindication was 4.7%. Grade 3-4 toxicity occurred in 45.2% of cases. Conclusion: The method of pathological response analysis was considered easily applicable. TGFβ-mediated pathway proteins studied did not correlate with pathological response...
Responsable: BR30.1 - Biblioteca


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Id: lil-750492
Autor: Pinal-Fernández, Iago; Garrigasait Vilaseca, Vanesa; Fernández-Codina, Andreu; Aranda Rodríguez, Santiago.
Título: Variante faringo-cérvico-braquial del síndrome de Guillain-Barré
Fuente: Medicina (B.Aires);74(6):474-475, dic. 2014.
Idioma: es.
Resumen: El síndrome de Guillain-Barré es una polineuropatía desmielinizante inflamatoria aguda, existiendo variantes locorregionales poco frecuentes como la faringo-cérvico-braquial. Presentamos el caso de un varón de 63 años de edad que acudió a urgencias por debilidad de extremidades superiores y a nivel cervical, con incapacidad para deglutir y masticar, y una insuficiencia respiratoria aguda rápidamente progresiva por debilidad de músculos respiratorios, todo ello secundario a la variante faringo-cérvico-braquial del síndrome de Guillain-Barré. Esta variante, aunque poco frecuente, presenta un patrón clínico y unos criterios diagnósticos bien definidos, importantes de reconocer para poder así iniciar de forma precoz el tratamiento y mejorar el pronóstico, no siempre favorable, de estos pacientes.

Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.
Responsable: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Leonardi, Dilmar Francisco
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Id: lil-750373
Autor: Leonardi, Dilmar Francisco; Laporte, Gustavo Andreazza; Tostes, Francisco Moreira.
Título: Amputação de membro por queimadura elétrica de alta voltagem / Limb amputation due to high-tension electrical burn
Fuente: Rev. bras. queimaduras;10(1):27-29, jan.-mar. 2011. ilus.
Idioma: pt.
Responsable: BR30.1 - Biblioteca


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Id: lil-742331
Autor: Kizlansky, Viviana; Clerico Mosina, Paola; Casas, Gabriel; Escarrá, Florencia.
Título: Paniculitis lipoatrófica y alteración del cromosoma 10 / Lipoatrophic panniculitis and alteration of chromosome 10
Fuente: Dermatol. pediátr. latinoam. (En línea);10(2):68-71, jul. 2012. ilus.
Idioma: es.
Resumen: La paniculitis lipoatrófica (PL) es una enfermedad rara que afecta principalmente a mujeres y niños. Su forma de presentación consiste en múltiples placas eritematosas en las extremidades, que resuelven con atrofia subcutánea. Frecuentemente el cuadro se asocia con fiebre y trastornos autoinmunes. Presentamos una paciente de sexo femenino, de 8 años de edad, con síndrome febril de un mes de evolución asociado a atrofia y pigmentación en el dorso de las manos y piernas, edema semiduro simétrico del dorso de los pies pies y cara posterior del tercio distal de las piernas, nódulos en la cara posterior de las piernas, parestesias y limitación a la deambulación. Estudios complementarios: enzimas hepáticas, eritrosedimentación, proteína C reactiva, fibrinógeno y ferritina elevadas y FAN positivo; en la ecografía de partes blandas (pies, piernas y dorso de manos) presencia de múltiples imágenes pseudonodulares compatibles con focos de fibrosis; en la biopsia de piel (lesión nodular) hallazgos de paniculitis lobular; cariotipo 46XX, con anomalía estructural y deleción del brazo largo del cromosoma 10. Presentamos este caso, por tratarse de una patología infrecuente, con un sólo caso descripto en la literatura asociado a alteraciones del cromosoma 10, y por el desafío diagnóstico que ocasionó al plantel médico.

Lipoatrophic panniculitis is a rare disease affecting mostly women and children. It presents as multiple erythematous plaques on the extremities resolving with subcutaneous atrophy. Affected patients are often febrile and may have associated autoimmune phenomena. We report an 8-year-old girl, with 30-day history of fever, with atrophy and pigmentation on the back of the hand and legs, semi-hard symmetrical edema in the back of feet and distal posterior third of legs, and nodules on the back of the legs, paresthesia, and impaired deambulation. Complementary studies revealed elevated liver enzymes, fibrinogen, ferritin, VSG and CRP; positive ANA; multiple pseudonodular images compatible with focal areas of fibrosis in ultrasound of feet, limbs and back of the hands; skin biopsy (performed on a nodule) showed a lobular panniculitis; the chariotype was 46XX with structural anomaly and deletion of long arm of chromosome 10. We report this case because of its infrequent nature, with only one case reported in medical literature associated to chromosome 10 anomalies, and the diagnostic challenges that it represented to medical staff.
Responsable: AR338.1 - Biblioteca


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Id: lil-729788
Autor: Rosario, Pedro Weslley; Calsolari, Maria Regina.
Título: Screening for acromegaly in adult patients not reporting enlargement of the extremities, but with arterial hypertension associated with another comorbidity of the disease / Rastreamento de acromegalia em pacientes adultos não relatando crescimento de extremidades, mas com hipertensão arterial associada a outra comorbidade da doença
Fuente: Arq. bras. endocrinol. metab;58(8):807-811, 11/2014. tab, graf.
Idioma: en.
Resumen: Objective To determine the value of acromegaly screening in adult patients not reporting enlargement of the extremities, but who present arterial hypertension associated with at least one other comorbidity of the disease. Subjects and methods Patients seen by general practitioners at primary health care units were evaluated. Among the patients without extremity enlargement, those with recently diagnosed arterial hypertension associated with at least one other comorbidity were selected. Results A total of 1,209 patients were submitted to laboratory investigation. Elevated IGF‐1 was observed in 22 patients. Eighteen patients had adequate suppression of growth hormone (GH). No GH suppression was observed in four women with confirmed elevated IGF‐1. In the latter, IGF‐1 and nadir GH were only slightly elevated, magnetic resonance showed a normal pituitary, and chest and abdominal computed tomography revealed no tumor, and no intervention was performed. Conclusion In patients with arterial hypertension without known pituitary disease, acromegaly is unlikely in the absence of enlargement of the extremities. .

Objetivo Determinar o valor do rastreamento de acromegalia em pacientes adultos sem aumento de extremidades, mas com hipertensão arterial associada a pelo menos uma outra comorbidade da doença. Sujeitos e métodos Pacientes vistos por clínicos em unidades primárias de saúde foram avaliados. Entre pacientes sem aumento de extremidades, aqueles com hipertensão arterial diagnosticada recentemente e associada a pelo menos uma outra comorbidade foram selecionados. Resultados Um total de 1.209 pacientes foi submetido à investigação laboratorial. IGF‐1 foi elevado em 22 pacientes. Dezoito pacientes apresentavam supressão adequada do hormônio do crescimento (GH). Ausência de supressão do GH foi vista em quatro mulheres com IGF‐1 repetidamente elevado. Nestas, IGF‐1 e nadir do GH foram apenas discretamente aumentados, ressonância magnética revelou hipófise normal, tomografia computadorizada de tórax e abdome não revelaram tumor, e nenhuma intervenção foi realizada. Conclusão Em pacientes com hipertensão arterial sem doença hipofisária conhecida, acromegalia é improvável na ausência de aumento de extremidades. .
Responsable: BR1.1 - BIREME


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Id: lil-725406
Autor: Hanasilo, Carlos E.H.; Casadei, Marcelo S.; Auletta, Leandro; Amstalden, Eliane M.I.; Matte, Silvia R.F.; Etchebehere, Mauricio.
Título: Comparative study of planned and unplanned excisions for the treatment of soft tissue sarcoma of the extremities
Fuente: Clinics;69(9):579-584, 9/2014. tab, graf.
Idioma: en.
Resumen: OBJECTIVE: Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities. METHODS: In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared. RESULTS: Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables. CONCLUSIONS: There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group. .
Responsable: BR1.1 - BIREME



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