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Texto completo SciELO Cuba
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Id: lil-672126
Autor: Martín González, Miguel Ángel; Fuentes Valdés, Edelberto; Placeres, Augusto Zoilo; Pérez Palenzuela, Javier; Corona Mancebo, Sixto.
Título: Resultado de la timectomía en los tumores epiteliales / Result of thymectomy in epithelial tumors
Fonte: Rev. cuba. cir;52(1):25-32, ene.-mar. 2013.
Idioma: es.
Resumo: Introducción: el timoma describe las neoplasias que no presentan atipia manifiesta del componente epitelial, cuando se exhibe claramente atipia citológica se le conoce como carcinoma tímico, y la cirugía es el tratamiento de elección. Nuestro objetivo es evaluar la eficacia de la timectomía en los enfermos con tumores epiteliales del timo (timoma, carcinoma tímico). Métodos: se estudiaron 26 enfermos entre enero 2007 a enero 2012 que, con este diagnostico, fueron operados en nuestro centro. Resultados: la miastenia gravis estuvo presente en 16 (61,5 por ciento) pacientes, de ellos en el posoperatorio se extubaron 11 (68,7 por ciento) después de 12 horas. La esternotomía total fue el abordaje principal 13 (50 por ciento), cuando la lesión era superior a los 7 centímetros fue más probable la ampliación a un hemitórax. Cuando se necesitó resección de pulmón, pericardio o ambos, el tiempo quirúrgico fue superior a los 120 minutos. Se complicaron 7 (29,6 por ciento), de ellos 5 (71,4 por ciento) de causa respiratoria. En 19 (73,9 por ciento) los tumores se clasificaron como estadio I de Masaoka y en 6 (23,1 por ciento) hubo carcinoma tímico.Tuvimos 1 fallecido (3,8 por ciento). Todos los miasténicos tuvieron remisión completa o farmacológica, en 2 hubo recidiva local y en ninguno fallecimiento durante el seguimiento. Conclusiones: la timectomía transesternal es el tratamiento de elección, y se necesita ampliar a un hemitórax cuando la lesión es más de 7 cm con resección de pericardio, pulmón o ambos. En este caso, se obtendrán resultados favorables en los miasténicos y en el control del tumor durante el seguimiento(AU)

Introduction: Thymomea describes the neoplasias that do not present evident atypia of the epithelial component; the clear cytological atypia indicated thymic carcinoma and surgery is the treatment of choice. The objective of this paper was to evaluate the efficacy of thymectomy aimed at patients with epithelial tumors in the thymus (thymoma, thymic carcinoma). Methods: Twenty six patients under study from January 2007 to January 2012, they were operated on after this diagnosis. Results: Myasthenia gravis was present in 16 patients (61.5 percent), 11 of them (68.7 percent) were removed their intubation after 12 hours of surgery. Total sternotomy was the main approach in 13 patients (50 percent); in case of an over 7cm long injure, the approach was extended to hemithorax. Resection of lung, pericardium or both required more than 120min surgical time. Seven patients (29.6 percent) suffered complications, 5 of them (71.4 percent) respiratory complications. Nineteen patients (73.9 percent) had Masaoka's staging I tumors whereas 6 (23.1 percent) had thymic carcinoma. One patient died (3.8 percent). All these patients with myasthenia gravis showed complete or pharmacological remission, 2 experienced local relapse and no patient died in the follow-up period. Conclusions: Transsternal thymectomy is the treatment of choice. It is required to extend it to hemithorax when there is an over 7 cm long injure, with resection of the pericardium, the lung or both. In this case, the favorable results will be achieved in myasthenic patients and in the tumor control during the follow-up phase(AU)
Descritores: Neoplasias do Timo/cirurgia
Timectomia/métodos
Timoma/cirurgia
-Estudos Prospectivos
Miastenia Gravis/cirurgia
Resultado do Tratamento
Limites: Seres Humanos
Idoso de 80 Anos ou mais
Responsável: CU1.1 - Biblioteca Médica Nacional


  2 / 9100 LILACS  
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Id: biblio-887007
Autor: Oliveira, Mariele Gobo de; Abbade, Luciana Patricia Fernandes; Miot, Hélio Amante; Ferreira, Rosana Rossi; Deffune, Elenice.
Título: Pilot study of homologous platelet gel in venous ulcers
Fonte: An. bras. dermatol;92(4):499-504, July-Aug. 2017. tab, graf.
Idioma: en.
Projeto: FAPESP.
Resumo: Abstract: Background: Venous ulcers represent 70% of the lower limb ulcers. They are difficult to heal, requiring a correct diagnostic and therapeutic approach. Many products have been developed to healing, such as homologous platelet gel obtained from the platelet concentrate exceeding from blood transfusion. Objective: To evaluate the safety and efficacy of homologous platelet gel in venous ulcers compared with hydrocolloid dressing. Method: A pilot randomized clinical trial in patients with venous ulcers. Randomized groups (homologous platelet gel and hydrocolloid groups) were followed for 90 days and were assessed through the evolution of ulcerated area, qualitative analysis of vascularization and adverse events. Both groups used elastic compression. Results: We included 16 participants, with a total of 21 venous ulcers. Both treatments promoted a reduction of the areas of the ulcers in 90 days (mean 69%), there was significant difference between the groups concerning the gradual reduction of the ulcers areas, favorably to the hydrocolloid (70% vs 64%; p <0.01). There were some mild adverse events in both groups. Study limitations: Single-center study with a small number of patients, preventing more accurate assessment of the effects of platelet gel. Conclusion: The homologous platelet gel associated with the elastic compression can be an alternative to the venous ulcer treatment and is safe due to the occurrence of a few mild local adverse events and no serious adverse events. Clinical trials with larger numbers of patients must be performed to maintain the indication of this treatment for venous ulcer.
Descritores: Úlcera Varicosa/terapia
Cicatrização/fisiologia
Curativos Hidrocoloides
Plasma Rico em Plaquetas
-Cicatrização/efeitos dos fármacos
Projetos Piloto
Estudos Prospectivos
Resultado do Tratamento
Curativos Hidrocoloides/efeitos adversos
Curativos Hidrocoloides/normas
Géis
Limites: Seres Humanos
Adolescente
Adulto
Meia-Idade
Adulto Jovem
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


  3 / 9100 LILACS  
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Id: biblio-887001
Autor: Han, Tong; Lin, De-Feng; Jiang, Hua.
Título: Wound natural healing in treatment of tumor-like hypertrophic scar
Fonte: An. bras. dermatol;92(4):474-477, July-Aug. 2017. tab, graf.
Idioma: en.
Resumo: Abstract: Background: Surgical sutures, wound tension, additional skin incisions and other factors may result in recurrence of tumor-like scar. Objective: To investigate the role of wound natural healing therapy in tumor-like hypertrophic scar. Methods: In this study, tumor-like hypertrophic scars of 47 cases were excised completely and the residual wounds were treated with natural healing. The short-term and long-term effects of treatment were evaluated. Results: All cases were successfully cured by natural healing therapy. The healing time of the maximum wound (80mm × 20mm) and the minimal wound (5mm× 5mm) was 25 days and 7 days respectively. The size of new skin scars ranged from 3mm to 11 mm. Clinical followed-up was performed in 34 cases for 36 months. Among them, no recurrence happened in 31 cases and new scar size ranged from 2mm to 8mm, while local recurrence happened in 3 cases whose scar size were less than 5 mm. Study Limitations: The cure rate of the therapy was 91.2%. Conclusion: The wound natural healing therapy is effective in treating tumor-like hypertrophic scar, which can prevent recurrence and has good cosmetic results.
Descritores: Cicatrização/fisiologia
Cicatriz Hipertrófica/cirurgia
Técnicas de Fechamento de Ferimentos
-Período Pós-Operatório
Recidiva
Infecção da Ferida Cirúrgica/etiologia
Suturas/efeitos adversos
Técnicas de Sutura/efeitos adversos
Resultado do Tratamento
Cicatriz Hipertrófica/patologia
Cicatriz Hipertrófica/prevenção & controle
Período Pré-Operatório
Limites: Masculino
Feminino
Criança
Adolescente
Adulto
Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME


  4 / 9100 LILACS  
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Id: biblio-886974
Autor: Ramos, Mariana Gontijo; Ramos, Daniel Gontijo; Ramos, Camila Gontijo.
Título: Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo
Fonte: An. bras. dermatol;92(3):312-318, May-June 2017. tab, graf.
Idioma: en.
Resumo: Abstract Background: Vitiligo is a chronic disease characterized by the appearance of achromic macules caused by melanocyte destruction. Surgical treatments with melanocyte transplantation can be used for stable vitiligo cases. Objectives: To evaluate treatment response to the autologous transplantation of noncultured epidermal cell suspension in patients with stable vitiligo. Methods: Case series study in patients with stable vitiligo submitted to noncultured epidermal cell suspension transplantation and evaluated at least once, between 3 and 6 months after the procedure, to observe repigmentation and possible adverse effects. The maximum follow-up period for some patients was 24 months. Results: Of the 20 patients who underwent 24 procedures, 25% showed an excellent rate of repigmentation, 50% good repigmentation, 15% regular, and 10% poor response. The best results were observed in face and neck lesions, while the worst in extremity lesions (88% and 33% of satisfactory responses, respectively). Patients with segmental vitiligo had a better response (84%) compared to non-segmental ones (63%). As side effects were observed hyperpigmentation of the treated area and the appearance of Koebner phenomenon in the donor area. Study limitations: Some limitations of the study included the small number of patients, a subjective evaluation, and the lack of long-term follow-up on the results. CONCLUSION: Noncultured epidermal cell suspension transplantation is efficient and well tolerated for stable vitiligo treatment, especially for segmental vitiligo on the face and neck.
Descritores: Vitiligo/cirurgia
Queratinócitos/transplante
Melanócitos/transplante
-Transplante Autólogo
Resultado do Tratamento
Limites: Seres Humanos
Masculino
Feminino
Adolescente
Adulto
Meia-Idade
Responsável: BR1.1 - BIREME


  5 / 9100 LILACS  
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Id: biblio-886948
Autor: Wang, Qian; Jiang, Can; Liu, Wei; Chen, Jin; Lin, Xinyu; Huang, Xiangning; Duan, Xiling.
Título: A new optical intra-tissue fiber irradiation ALA-PDT in the treatment of acne vulgaris in rabbit model: improved safety and tolerability
Fonte: An. bras. dermatol;92(3):350-355, May-June 2017. tab, graf.
Idioma: en.
Resumo: Abstract Background: Photodynamic therapy with topical aminolevulinic acid (ALA-PDT) has been suggested to be effective in treatment of acne vulgaris. However, adverse events occur during and after treatment. Objectives: To compare the efficacy and tolerability of optical intra-tissue fiber irradiation (OFI) ALA-PDT versus traditional ALA-PDT in treatment of acne vulgaris in rabbit models. Methods: Twenty-five rabbits of clean grade were used. Twenty rabbits were randomly selected to establish acne model and the other five were used as control. Rabbits in model group (40 ears) were further divided into four groups (10 ears/group): I, OFI-ALA-PDT with the head of optical fiber inserted into the target lesion (intra-tissue); II, traditional ALA-PDT group; III, OFI group; IV, blank control group without any treatment. Uncomfortable symptoms, adverse events, and effectiveness rates were recorded on post-treatment day 14, 30, and 45. Results: On post-treatment day 14, the effectiveness rate in OFI-ALA-PDT group was obviously higher than that of the other three groups (P<0.05). However, no improved effects were observed in OFI-ALA-PDT group on day 30 and 45. During the period of treatment, the frequencies of uncomfortable symptoms in ALA-PDT group were obviously higher than those in the other three groups (P<0.05). The adverse event rate in OFI-ALA-PDT group was obviously lower than that of the ALA-PDT group (P<0.05) Study limitations: The unblindness of the study and temporary animal models of acne induced may hamper the assessment and monitoring of the results, and future studies are still needed to clarify it further. Conclusion: The OFI-ALA-PDT group (intra-tissue irradiation) showed no improved efficacy on treating rabbit ear acne but had higher safety and better tolerability.
Descritores: Fotoquimioterapia/métodos
Fármacos Fotossensibilizantes/administração & dosagem
Acne Vulgar/terapia
Ácido Aminolevulínico/administração & dosagem
-Fotoquimioterapia/efeitos adversos
Distribuição Aleatória
Resultado do Tratamento
Fármacos Fotossensibilizantes/efeitos adversos
Modelos Animais de Doenças
Ácido Aminolevulínico/efeitos adversos
Limites: Animais
Coelhos
Responsável: BR1.1 - BIREME


  6 / 9100 LILACS  
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Id: biblio-838068
Autor: Al-Talib, Hassanain; Al-khateeb, Alyaa; Hameed, Ayad; Murugaiah, Chandrika.
Título: Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris
Fonte: An. bras. dermatol;92(2):212-216, Mar.-Apr. 2017. tab.
Idioma: en.
Resumo: Abstract: Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid
Descritores: Abrasão Química/métodos
Acne Vulgar/terapia
Ácido Salicílico/uso terapêutico
Glicolatos/uso terapêutico
Ceratolíticos/uso terapêutico
-Abrasão Química/efeitos adversos
Salicilatos
Resultado do Tratamento
Eritema/etiologia
Limites: Seres Humanos
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


  7 / 9100 LILACS  
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Id: biblio-838052
Autor: Campaner, Adriana Bittencourt; Cardoso, Fernanda de Araujo; Fernandes, Gustavo Leme; Veasey, John Verrinder.
Título: Verrucous carcinoma of the vulva: diagnosis and treatment
Fonte: An. bras. dermatol;92(2):243-245, Mar.-Apr. 2017. graf.
Idioma: en.
Resumo: Abstract: Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Lesions present in the form of a verrucous, ulcerated, and bleeding tumor that can reach large dimensions. This type of tumor can be mistaken for condylomata, both macroscopically and microscopically. We report the case of an 81-year-old patient with a large vulvar tumor presented for eight years, initially considered as a Buschke-Löwenstein tumor. The patient underwent radical vulvectomy with a V-Y advancement flap technique. This type of tumor should be considered by clinicians dealing with condylomatous ulcerative lesions that do not respond to the usual treatment.
Descritores: Neoplasias Vulvares/patologia
Carcinoma de Células Escamosas/patologia
Carcinoma Verrucoso/patologia
Tumor de Buschke-Lowenstein/patologia
-Retalhos Cirúrgicos
Vulva/patologia
Neoplasias Vulvares/cirurgia
Carcinoma de Células Escamosas/cirurgia
Resultado do Tratamento
Carcinoma Verrucoso/cirurgia
Diagnóstico Diferencial
Limites: Seres Humanos
Feminino
Idoso de 80 Anos ou mais
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


  8 / 9100 LILACS  
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Silva, Ester da
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Id: lil-767067
Autor: Tamburus, Nayara Y; Paula, Roberta F. L; Kunz, Vandeni C; César, Marcelo C; Moreno, Marlene A; Silva, Ester da.
Título: Interval training based on ventilatory anaerobic threshold increases cardiac vagal modulation and decreases high-sensitivity c-reative protein: randomized clinical trial in coronary artery disease
Fonte: Braz. j. phys. ther. (Impr.) = Rev. bras. fisioter;19(6):441-450, Nov.-Dec. 2015. tab, graf.
Idioma: en.
Projeto: Conselho Nacional de Desenvolvimento Científico e Tecnológico; . Conselho Nacional de Desenvolvimento Científico e Tecnológico; . Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Resumo: Background: Autonomic dysfunction and inflammatory activity are involved in the development and progression of coronary artery disease (CAD), and exercise training has been shown to confer a cardiovascular benefit. Objective: To evaluate the effects that interval training (IT) based on ventilatory anaerobic threshold (VAT) has on heart rate variability (HRV) and high-sensitivity C-reactive protein (hs-CRP) levels, as well as the relationship between both levels, in patients with CAD and/or cardiovascular risk factors (RF). Method: Forty-two men (aged 57.88±6.20 years) were divided into two training groups, CAD-T (n= 12) and RF-T (n= 10), and two control groups, CAD-C (n= 10) and RF-C (n=10). Heart rate and RR intervals in the supine position, cardiopulmonary exercise tests, and hs-CRP levels were measured before and after IT. HRV was analyzed by spectral and symbolic analysis. The CAD-T and RF-T underwent a 16-week IT program of three weekly sessions at training intensities based on the VAT. Results: In the RF-T, cardiac sympathetic modulation index and hs-CRP decreased (p<0.02), while cardiac parasympathetic modulation index increased (p<0.02). In the CAD-T, cardiac parasympathetic modulation index increased, while hs-CRP, systolic, and diastolic blood pressures decreased (p<0.02). Both control groups showed increase in hs-CRP parameters (p<0.02). There was a strong and significant association between parasympathetic and sympathetic modulations with hs-CRP. Conclusion: The IT program based on the VAT promoted a decrease in hs-CRP associated with improvement in cardiac autonomic modulation.
Descritores: Nervo Vago/fisiopatologia
Pressão Sanguínea/fisiologia
Doença da Artéria Coronariana/reabilitação
Proteína C-Reativa/metabolismo
Limiar Anaeróbio
Doenças Cardiovasculares/fisiopatologia
Frequência Cardíaca/fisiologia
-Doença da Artéria Coronariana/fisiopatologia
Doença da Artéria Coronariana/metabolismo
Proteína C-Reativa/química
Resultado do Tratamento
Estimulação do Nervo Vago
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


  9 / 9100 LILACS  
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Id: lil-767063
Autor: Phadke, Vandana; Makhija, Meena; Singh, Harpreet.
Título: The use of evidence-based practices for the management of shoulder impingement syndrome among Indian physical therapists: a cross-sectional survey
Fonte: Braz. j. phys. ther. (Impr.) = Rev. bras. fisioter;19(6):473-481, Nov.-Dec. 2015. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS). Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75%) believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2%) and dyskinesis, especially in women (24.2%). Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.
Descritores: Modalidades de Fisioterapia
Síndrome de Colisão do Ombro
Índia
-Resultado do Tratamento
Fisioterapeutas
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


  10 / 9100 LILACS  
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Id: biblio-1050354
Autor: Costa, Osvaldo Rodolfo; Alonso, M. I; Piazza, M. B.
Título: Cirugía mínimamente invasiva: implante inmediato con carga inmediata / Minimally invasive surgery: immediate implant with immediate load
Fonte: Rev. Fundac. Juan Jose Carraro;23(43):26-30, 2019. ilus.
Idioma: es.
Resumo: El presente trabajo tiene como objetivo el remplazo de piezas dentarias con indicación de extracción por implantes dentales de titanio, con la finalidad de devolver función y estética en forma inmediata respetando los tejidos periodontales y adaptando al máximo la clínica a las necesidades y requerimientos del paciente (AU)
Descritores: Procedimentos Cirúrgicos Minimamente Invasivos
Implantes Dentários para Um Único Dente
Carga Imediata em Implante Dentário
-Planejamento de Assistência ao Paciente
Extração Dentária
Cicatrização
Biotipologia
Resultado do Tratamento
Gengivectomia
Limites: Seres Humanos
Masculino
Meia-Idade
Responsável: AR29.1 - Biblioteca



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