RESUMO
Scholars around the world have dedicated themselves to developing an effective vaccine against SARS-CoV-2. However, vaccines have produced adverse effects in some patients. We report the case of a 44-year-old man who developed a pruritic papulosquamous rash on the trunk with a characteristic pattern known as Christmas tree after receiving the first dose of the Oxford-AstraZeneca COVID-19 vaccine, similar to pityriasis rosea (PR). He had no previous symptoms of viral infection and tested negative for neutralizing antibodies (enzyme immunoassay) against COVID-19. There are few reports in the literature about the relationship between the onset of cutaneous adverse reactions and the Oxford-AstraZeneca vaccine, therefore, the dissemination of this case is of paramount importance.
Assuntos
Humanos , Masculino , Adulto , Pitiríase Rósea/diagnóstico , Vacinas contra COVID-19/efeitos adversos , ChAdOx1 nCoV-19/efeitos adversos , SARS-CoV-2 , COVID-19/patologiaRESUMO
Abstract: Background: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. Objectives: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. Methods: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. Results: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). Study limitations: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. Conclusions: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Psoríase/diagnóstico , Psoríase/classificação , Traduções , Índice de Gravidade de Doença , Brasil , Valor Preditivo dos Testes , Inquéritos e Questionários , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Características Culturais , IdiomaRESUMO
BACKGROUND: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. OBJECTIVES: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. METHODS: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. RESULTS: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). STUDY LIMITATIONS: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. CONCLUSIONS: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.
Assuntos
Psoríase/diagnóstico , Adulto , Brasil , Características Culturais , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Psoríase/classificação , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Inquéritos e Questionários , TraduçõesRESUMO
Soft tissue augmentation is a common procedure, and a wide variety of injectable fillers are used. Liquid injectable silicone (LIS) was the first highly popularized injectable filler. LIS is a permanent filler and can be used in the correction of facial furrows and wrinkles. Some complications are inherent to the procedure and can resolve spontaneously, such as redness, swelling, and immediate hypersensitivity reactions. Unintended reactions, such as granulomas, infections, vascular occlusion, can also follow the treatment with LIS and may appear several years after the injections. These can be difficult to manage, show little or no tendency to spontaneous resolutions, and rarely resolve completely. Injecting physicians must be aware of these potential complications caused by LIS because early medical care and treatment, including psychological support for these patients, can minimize the consequences for patients and physicians, and may also help obtaining better outcomes when treating complications.
Assuntos
Materiais Biocompatíveis/efeitos adversos , Dermatoses Faciais/terapia , Granuloma/terapia , Silicones/efeitos adversos , Técnicas Cosméticas , Hipersensibilidade a Drogas/etiologia , Dermatoses Faciais/induzido quimicamente , Granuloma/induzido quimicamente , Humanos , Falha de Prótese , Dermatopatias Bacterianas/induzido quimicamente , Dermatopatias Bacterianas/terapia , Dermatopatias Vasculares/induzido quimicamente , Dermatopatias Vasculares/terapiaRESUMO
Phaeohyphomycosis is a disease caused by dematiaceous fungi with a worldwide geographic distribution and broad spectrum. It is most commonly found in adult individuals of both genders and all races. We report the case of a 57-year-old woman with phaeohyphomycosis in the ungual apparatus.
Assuntos
Doenças da Unha/microbiologia , Feoifomicose/microbiologia , Pele/microbiologia , Antifúngicos/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Doenças da Unha/tratamento farmacológico , Doenças da Unha/patologia , Feoifomicose/tratamento farmacológico , Feoifomicose/patologia , Pele/patologia , Resultado do TratamentoRESUMO
Phaeohyphomycosis is a disease caused by dematiaceous fungi with a worldwide geographic distribution and broad spectrum. It is most commonly found in adult individuals of both genders and all races. We report the case of a 57-year-old woman with phaeohyphomycosis in the ungual apparatus.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Doenças da Unha/microbiologia , Feoifomicose/microbiologia , Pele/microbiologia , Antifúngicos/uso terapêutico , Doenças da Unha/tratamento farmacológico , Doenças da Unha/patologia , Feoifomicose/tratamento farmacológico , Feoifomicose/patologia , Pele/patologia , Resultado do TratamentoRESUMO
Psoriasis is a chronic inflammatory disease that directly affects the quality of life. Biologics are prescribed for patients unresponsive to conventional treatments and with severe forms of the disease. Ustekinumab is a fully human monoclonal antibody against the p40 subunit of interleukins 12/23 that is being used with satisfactory responses, achieving an improvement in the baseline Psoriasis Area and Severity Index of approximately 75% after 12 weeks of treatment. It has few side effects, including grater susceptibility to infections and development of reactions to the drug. Our report discusses a case of a cutaneous reaction to the use of ustekinumab in a 27 year-old male patient after the third dose of the medication. No similar case has been reported in the literature.
RESUMO
OBJECTIVE: To test the hypothesis that the aortic isthmus flow index (IFI) is lower in fetuses of diabetic mothers than in fetuses of nondiabetic mothers. STUDY DESIGN: We performed a cross-sectional observational study to assess the IFI in fetuses, with (n = 13) and without (n = 37) myocardial hypertrophy, of mothers with diabetes mellitus and in fetuses of nondiabetic mothers (n = 23). Analysis of variance and Tukey test were used to assess differences among the groups. RESULTS: There were no differences in maternal or gestational age among the groups. In fetuses of diabetic mothers, the mean IFI in fetuses with myocardial hypertrophy was 1.19 ± 0.06, and in fetuses without it was 1.18 ± 0.09. The mean IFI in fetuses of nondiabetic mothers was 1.32 ± 0.07 (P < 0.001). CONCLUSIONS: The IFI in fetuses of diabetic mothers is lower than in fetuses of nondiabetic mothers, possibly as a result of a decreased left ventricular compliance.
Assuntos
Aorta/fisiologia , Diabetes Gestacional/fisiopatologia , Gravidez em Diabéticas/fisiopatologia , Fluxo Sanguíneo Regional , Adulto , Cardiomegalia/fisiopatologia , Estudos Transversais , Feminino , Doenças Fetais/fisiopatologia , Humanos , Gravidez , Adulto JovemRESUMO
OBJECTIVE: To test the hypothesis that fetal pulmonary venous flow pulsatility index is lower during fetal respiratory movements than in apnea. DESIGN: Case control. SETTINGS/PATIENTS: Twenty-two normal fetuses of mothers without systemic disease were examined in apnea (controls) and in the presence of fetal respiratory movements (cases). Fetuses were examined by prenatal Doppler echocardiography with color flow mapping. The pulsatility index of the pulmonary vein was obtained by placing the pulsed Doppler sample volume over the right upper or left lower pulmonary vein, and calculating the ratio (maximum velocity [systolic or diastolic]-presystolic velocity/mean velocity). RESULTS: Mean gestational age was 28.9 +/- 2.9 weeks. During fetal apnea, mean systolic, diastolic, and presystolic velocities were, respectively, 0.35 +/- 0.08 m/s, 0.26 +/- 0.07 m/s, and 0.09 +/- 0.03 m/s. In the presence of fetal respiratory movements, mean systolic, diastolic, and presystolic velocities were, respectively, 0.33 +/- 0.1 m/s, 0.28 +/- 0.08 m/s, and 0.11 +/- 0.04 m/s. Pulsatility index pulmonary vein in apnea was 1.25 +/- 0.23 (1.69 to 0.82), and during fetal respiratory movements it was 0.97 +/- 0.2 (1.53 to 0.61). CONCLUSION: We showed a significant reduction in impedance of pulmonary venous flow, represented by pulmonary vein pulsatility index, during fetal respiratory movements, reflecting modifications of the left atrial dynamics and enhancement of left ventricular compliance.