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Diagnóstico diferencial de primeiro episódio psicótico: importância da abordagem otimizada nas emergências psiquiátricas; Differential diagnosis of first episode psychosis: importance of optimal approach in psychiatric emergencies

DEL-BEN, Cristina Marta; RUFINO, Armanda Carla Teixeira Brandão Fragata; AZEVEDO-MARQUES, João Mazzoncini de; MENEZES, Paulo Rossi
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: Revisar dados da literatura relativos ao diagnóstico de primeiro episódio psicótico no contexto das emergências psiquiátricas. MÉTODO: Revisão de artigos empíricos e de revisão selecionados por meio de busca eletrônica no indexador PubMed. RESULTADOS: Características específicas de atendimento de emergência - avaliação única e breve, em corte transversal e com poucas informações disponíveis - podem dificultar o processo diagnóstico. Essas limitações podem ser contornadas por meio da aplicação adequada de critérios diagnósticos operacionais, do uso de escalas e entrevistas diagnósticas padronizadas e de um tempo mínimo de observação de 24 a 72 horas. Diagnósticosdetranstornobipolar,esquizofrenia,depressãopsicóticaetranstorno delirante elaborados em contexto de emergência apresentam boa estabilidade temporal, não ocorrendo o mesmo com diagnósticos de transtorno psicótico breve, transtorno esquizofreniforme e transtorno esquizoafetivo. Primeiro episódio psicótico pode ocorrer na vigência do uso de substâncias psicoativas, sendo relativamente frequente a manutenção do quadro psicótico mesmo após cessação do uso. A utilização racional de exames complementares pode ajudar no diagnóstico diferencial com episódios psicóticos devido a condições médicas gerais. CONCLUSÃO: Diagnósticos de primeiro episódio psicótico podem ser adequadamente realizados durante emergências psiquiátricas...

Biópsia com agulha grossa guiada por ultrassonografia para o diagnóstico dos tumores fibroepiteliais da mama; Ultrasound-guided core needle biopsy for the diagnosis of fibroepithelial breast tumors

RICCI, Marcos Desidério; AMARAL, Paulo Gustavo Tenório do; AOKI, Denis Seiiti; OLIVEIRA FILHO, Hélio Rubens de; PINHEIRO, Walter da Silva; FILASSI, José Roberto; BARACAT, Edmund Chada
Fonte: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Publicador: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: avaliar a taxa de concordância da biópsia percutânea com agulha grossa guiada por ultrassom seguida pela biópsia excisional em nódulos de mama palpáveis, sugestivos de tumores fibroepiteliais. MÉTODO: estudo retrospectivo que selecionou 70 biópsias com diagnóstico histológico de tumor fibroepitelial em 67 dentre 531 pacientes com lesões mamárias submetidas à biópsia percutânea com agulha grossa guiada por ultrassonografia, com transdutor linear de alta frequência (7.5 MHz), utilizando pistola automática Bard-Magnum e agulha 14 gauge. Foram incluídos os casos com diagnóstico de tumor fibroepitelial na biópsia percutânea ou biópsia excisional. Biópsias com diagnóstico histopatológico de fibroesclerose também foram incluídas no estudo. A força da concordância entre o resultado da biópsia percutânea e da biópsia excisional foi medida pelo coeficiente de Kappa. RESULTADOS: a biópsia excisional revelou 40 casos de fibroadenoma (57,1%), 19 de tumor filoide (27,2%) e 11 de fibroesclerose (15,7%). A taxa de concordância para o fibroadenoma foi substancial (k = 0,68; IC95% = 0,45 - 0,91), quase perfeita para o tumor filoide (k = 0,81; IC95% = 0,57 - 1,0) e moderada para a fibroesclerose (k = 0,58; IC95% = 0...

Potentially malignant epithelial oral lesions: Discrepancies between clinical and histological diagnosis

Onofre, M. A.; Sposto, M. R.; Navarro, C. M.; Motta, M. E S F M; Turatti, E.; Almeida, R. T.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 148-152
ENG
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OBJECTIVE: To evaluate the discrepancy index between the clinical and histological diagnosis and the prevalence of epithelial dysplasia and carcinoma in 45 patients with potentially malignant epithelial oral lesions (PMEL). PATIENTS AND METHODS: We submitted 45 patients with PMEL to clinical examination and obtained a biopsy from each. The results of histological diagnosis were compared to the clinical diagnosis. RESULTS: Clinical diagnosis showed that the most common PMEL was leukoplakia followed by lichen planus and by actinic cheilitis associated with leukoplakia. The most common site was the buccal mucosa. Histological diagnosis revealed that 46.7% of the PMEL were lichen planus. The discrepancy index between clinical and histological diagnosis was 24.4%. The higher discrepancy index occurred among leukoplakias. The prevalence of epithelial dysplasia and carcinoma was 17.8%. CONCLUSIONS: We conclude that all PMEL should be submitted to a microscopic analysis because the discrepancy between clinical and histological diagnosis was present in a quarter of these lesions. Otherwise, the epithelial dysplasia and carcinoma were more frequent in the leukoplakias.

Cytologic diagnosis of vaginal metastasis from renal cell carcinoma: A case report

Queiroz, Conceição; Bacchi, Carlos Eduardo; Oliveira, Cassimiro; Carvalho, Marione; Santos, Délia Rabelo
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 1098-1100
ENG
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BACKGROUND: Metastasis of renal cell carcinoma to the vagina is rare, although it may be the first evidence of the existence of the primary tumor. CASE: A metastatic deposit of renal cell carcinoma in the vagina was diagnosed by cytology as clear cell adenocarcinoma, which was confirmed by biopsy. Radiographic and ultrasound examinations confirmed the renal site of origin, which was corroborated by immunohistochemistry of the biopsy specimen. CONCLUSION: When a cytologic diagnosis of vaginal clear cell adenocarcinoma is made, metastasis of renal cell carcinoma should be considered in the differential diagnosis.

Immunohistochemistry as a fundamental tool for the differential diagnosis of polymorphous low-grade adenocarcinoma

De Vasconcellos, Luana Marotta Reis; Silveira, Vanessa Ávila Sarmento; Rosa, Luiz Eduardo Blumer; Cavalvante, Ana Sueli Rodrigues; Carvalho, Yasmin Rodarte
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 565-573
ENG
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Polymorphous low-grade adenocarcinoma (PLGA) is a subtype of salivary gland carcinoma with a marked predilection for the minor salivary glands. The diagnosis of this lesion can be a challenge in incisional biopsies because of its similarity to other salivary neoplasms and the difficulty of analyzing its infiltrative nature and neurotropism. Diagnosis can be facilitated, however, by immunohistochemistry, a technique that has become a fundamental tool to the pathologist. The purpose of this study was analyze the immunohistochemical aspects of 4 cases that were examined in the São José dos Campos School of Dentistry. The patients included 4 women, ages 32 to 57 years (mean, 50 years), who reported an intraoral painless lesion, ranging in size from 1 to 3 cm (mean, 1.75 cm) with a variable evolution period. Histologically, the lesions showed similar aspects, characterized by polymorphous growth pattern, including solid, cribriform, trabecular, papillary, and single-file arrays. The tumors showed positivity to cytokeratins (Cks) 7 and 8 and vimentin, variable expression for Ck 14, and a negative reaction to Cks 13 and 19 and muscle-specific actin. PLGA is a tumor of the salivary gland that must be distinguished from other neoplasms for therapeutic and prognostic considerations...

Oral lichen planus versus oral lichenoid reaction: Difficulties in the diagnosis

Prado, Renata Falchete do; Marocchio, Luciana Sassa; Felipini, Renata Callestini
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 361-364
ENG
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Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.

Use of the histopathology in the differential diagnosis of drowning in fresh and salty water: an experimental model establishment in rats

Locali,Rafael Fagionato; Almeida,Marcos de; Oliveira-Júnior,Itamar Souza de
Fonte: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia Publicador: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2006 EN
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PURPOSE: To develop a method of differential diagnosis to drowning, due to analysis of the alveolar macrophages quantitative, in rats submitted to induced drowning in fresh water and salty water. METHODS: Were used 15 male adult rats Wistar EPM-1, weight 360g (SD=21,3), randomized in three groups: G1- Control; G2- Fresh water; G3- Salty water, each one with n=5. The animals have been anesthetized and tracheostomized to insert a cannula inside the trachea, for drowning induction. The lungs have been removed, weighed, prepared for histology and colored by immunohistochemistry. The macrophages have been counted in both lungs (right and left) of each animal. The statistical test used was ANOVA (SPSS.10) with p<0,05. RESULTS: The amount of macrophages was G3>G2>G1 with p=0,0001 in each comparison. The weight of lungs of G3 and G2 was higher than G1, with p>0,0001, however G3 and G2 do not possess difference statistics in the weight of lungs. CONCLUSION: The developed diagnostic method was efficient in rats. The results, if expanded, will be able to assist the Forensic Pathology for technique of low cost and high trustworthiness.

Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

Levitan,Michelle Nigri; Chagas,Marcos H.; Linares,Ila M.; Crippa,José A.; Terra,Mauro B.; Giglio,Alcir T.; Cordeiro,Joana L.C.; Garcia,Giovana J.; Hasan,Rosa; Andrada,Nathalia C.; Nardi,Antonio E.
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
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Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed), Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”). Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

Differential diagnosis between post-polio syndrome symptoms and temporomandibular disorder: clinical case

Barbosa,Gustavo Augusto Seabra; Morais,Maria Helena de Siqueira Torres
Fonte: Faculdade de Odontologia de Piracicaba - UNICAMP Publicador: Faculdade de Odontologia de Piracicaba - UNICAMP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2013 EN
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Post-poliomyelitis syndrome (PPS) is characterized by the delayed appearance of new neuromuscular symptoms in patients several years after their acute poliomyelitis paralysis. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. The diagnosis is essentially clinical after excluding other neurological, orthopedic or rheumatologic problems. Temporomandibular disorders (TMD) are usually diagnosed by means of comprehensive review of patient history and clinical examination and the symptoms are pain/ discomfort in the jaw, mainly in the region of the temporomandibular joints (TMJs) and/or masticatory muscles, limitation of mandibular function and/or TMJ sounds. In the same way as PPS, the diagnosis of TMD is challenging. This study reports the case of a patient that presented the symptoms of both conditions in the stomatognathic system, and discusses how to achieve the differential diagnosis for proper management of the cases.

The differential diagnosis of localised amelanotic limbal lesions: a review of 162 consecutive excisions

Rudkin, A.; Dodd, T.; Muecke, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
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Aims: To report the distribution of histopathological diagnoses in patients who underwent excision of localised limbal lesions that were clinically suspected to be squamous neoplasia (intra-epithelial neoplasia or squamous cell carcinoma). Methods: 162 consecutive patients of a single ocular oncologist underwent an excisional biopsy between 1998 and 2009 for suspected squamous neoplasia. Histopathological reports were retrospectively reviewed. Results: The population comprised 122 males and 40 females. The mean age was 63.4±15.8 (range: 27–90). 138 (85.2%) lesions were identified as intraepithelial neoplasia (CIN), of which 34 (21.0%) were CIN I, 32 (19.8%) were CIN II and 72 (44.4%) were CIN III or squamous cell carcinoma in situ. In seven (4.3%) cases, the lesion was invasive squamous cell carcinoma. In two (1.2%) cases, the lesion was amelanotic malignant melanoma. In 16 (9.9%) cases, histopathology revealed a benign entity including lesions described as squamous papilloma, solar elastosis and epithelial hyperplasia, keratosis or reactive atypia. Conclusions: In this population, for an experienced ocular oncologist, the misdiagnosis of localised limbal squamous neoplasia occurred in 10.5% of cases, with 5.5% of cases being malignant. This study highlights the importance of acquiring a clinical diagnosis before administering a topical chemotherapeutic agent.; Adam K Rudkin...

Follicular mucinosis: an important differential diagnosis of leprosy in an endemic area

Westphal,Danielle Cristine; Pennini,Silmara Navarro; Souza,Petra Pereira de; Maquiné,Gustavo Ávila; Schettini,Antônio Pedro Mendes; Santos,Mônica
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
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AbstractPrimary follicular mucinosis is a rare dermatosis characterized by the accumulation of mucin in the follicular epithelium and sebaceous glands. Clinically, it is characterized by the presence of papules or well-circumscribed and infiltrated plaques. In this paper, we report the case of a female patient, seven years old, evolving for three months with an asymptomatic, erythematous and infiltrated plaque located in the chin region. The research of thermal, pain and tactile sensitivity was inconclusive. Histological findings confirmed the diagnosis of follicular mucinosis. There was regression of the lesion with the use of medium potency topical corticosteroids for 20 days. The pathogenesis of follicular mucinosis remains unknown, being in some cases associated with lymphoproliferative disorders. In endemic areas of leprosy, isolated and infiltrated follicular mucinosis lesions should be further differentiated from leprosy.

“Apple Jelly” Sign: Diascopy in Cutaneous Sarcoidosis; Sinal “Apple Jelly”: Diascopia na Sarcoidose Cutânea

Matos, Diogo; Serviço de Dermatovenereologia. Hospital Garcia de Orta. Almada. Portugal.; Coelho, Ricardo; Serviço de Dermatovenereologia. Hospital Garcia de Orta. Almada. Portugal.
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; other; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 30/06/2015 ENG
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Keywords: Diagnosis, Differential; Sarcoidosis; Skin Diseases.; Palavras-chave: Diagnóstico Diferencial; Doenças da Pele; Sarcoidose.

Malignant fibrous histiocytoma of the eyelid: Differential diagnosis and management

Khong, J.; Chen, C.; James, C.; Huilgol, S.; O'Donnell, B.; Sullivan, T.; Selva-Nayagam, D.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
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PURPOSE: Malignant fibrous histiocytoma (MFH) is a pleomorphic soft tissue sarcoma that occurs rarely in the periocular region. The purpose of this study was to present a case series of periocular MFH and to discuss the differential diagnosis and management. METHODS: This is a retrospective case review of patients diagnosed with periocular MFH from tertiary hospitals and private practices. RESULTS: Four patients, two women and two men with periocular MFH, had a mean age of 81 years (range, 72 to 85 years). All tumors were <5 cm in diameter and of storiform pleomorphic histologic subtype. One was located deep and 3 presented superficially. The initial diagnoses were sarcomatoid carcinoma, atypical fibroxanthoma, and leiomyosarcoma that were subsequently reclassified as MFH. One patient had a frozen section, 1 had fast track paraffin section margin control, and 2 had no frozen section margins at the initial excisions. Histology showed 2 negative margins, 1 close margin, and 1 positive margin that were cleared with wide local excision. Local recurrence occurred in 3 cases, and of these, 1 required orbital exenteration. Adjuvant radiotherapy was given to 3 patients. One had regional node metastases. There were no distant metastases or tumor-related deaths. Mean follow-up period was 36 +/- 35 months (median...

Diretrizes da Associação Médica Brasileira para o diagnóstico e diagnóstico diferencial do transtorno de ansiedade social; Guidelines of the Brazilian Medical Association for the diagnosis and differential diagnosis of social anxiety disorder

CHAGAS, Marcos Hortes N.; NARDI, Antonio E.; MANFRO, Gisele G.; HETEM, Luiz Alberto B.; ANDRADA, Nathalia C.; LEVITAN, Michelle N.; SALUM, Giovanni A.; ISOLAN, Luciano; FERRARI, Maria Cecília Freitas; CRIPPA, José Alexandre S.
Fonte: Associação Brasileira de Psiquiatria - ABP Publicador: Associação Brasileira de Psiquiatria - ABP
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
46.06%
OBJETIVO: O transtorno de ansiedade social é o transtorno de ansiedade mais comum, apresenta curso crônico, frequentemente sem remissões, sendo comumente associado com importante prejuízo funcional e comprometimento psicossocial. A Associação Médica Brasileira, por meio do projeto "Diretrizes", busca desenvolver consensos de diagnóstico e tratamento para as doenças mais comuns. O objetivo deste trabalho é apresentar os achados mais relevantes das diretrizes da Associação Médica Brasileira relativas ao diagnóstico e diagnóstico diferencial do transtorno de ansiedade social. MÉTODO: O método utilizado foi o proposto pela Associação Médica Brasileira para o projeto Diretrizes. A busca foi realizada nas bases de dados do Medline (PubMed), Scopus, Web of Science e Lilacs, sem limite de tempo. A estratégia utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (acrônimo das iniciais "paciente ou população"; "intervenção, indicador ou exposição"; "controle ou comparação" e; "outcome ou desfecho"). RESULTADOS: São apresentados dados relativos a manifestações clínicas, prejuízos e implicações, diferenças entre os subtipos generalizado e circunscrito, e impacto com depressão, abuso e dependência de drogas e outros transtornos de ansiedade. Além disso...

Desenvolvimento e avaliação de um software de controle de atendimentos e apoio à decisão, para diagnóstico diferencial de disfunções do trato urinário inferior, baseado em lógica fuzzy; Development and evaluation of a software control and decision support calls for differential diagnosis lower urinary tract dysfunction, based on fuzzy logic

Anna Carolina Faleiros Martins
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 01/07/2011 PT
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Introdução: O uso de ferramentas de informática é visto como facilitador dos processos de compilação, registro e análise de dados. Na competência do enfermeiro, auxilia o Processo de Enfermagem proporcionando cuidado individualizando ao paciente. Além disso, o emprego de sistemas especialistas de apoio à decisão podem auxiliar profissionais generalistas ou sem experiência na área a determinar o diagnóstico diferencial em condições mais específicas como é o caso das alterações da eliminação urinária. Objetivos: Desenvolver um software de apoio à decisão, baseado em lógica fuzzy, para o diagnóstico diferencial de disfunções do trato urinário inferior, utilizando a terminologia de consenso da ICS, como parte integrante de um sistema informatizado de atendimento que incluísse o processo de enfermagem, e questionários de avaliação da qualidade de vida. Tiveram-se como objetivos específicos: realizar uma revisão de literatura sobre a informatização do processo de enfermagem e aceitação dos profissionais; desenvolver e validar quanto ao conteúdo, os instrumentos de avaliação de qualidade interna, externa e em uso; desenvolver um software, de apoio à decisão baseado em lógica fuzzy para o diagnóstico de disfunções do trato urinário inferior...

Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

Alves,Rodrigo Andrade; Miszputen,Sender Jankiel; Figueiredo,Maria Stella
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
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CONTEXT AND OBJECTIVES: Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables. DESIGN AND SETTING: Cross-sectional at a federal university. METHODS: 44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated. RESULTS: Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis...

HANSENÍASE: FORMAS CLÍNICAS E DIAGNÓSTICO DIFERENCIAL; LEPROSY: CLINICAL FORMS AND DIFFERENTIAL DIAGNOSIS

Souza, Cacilda Silva
Fonte: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto Publicador: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 30/09/1997 POR
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Este artigo se propõe a realizar uma abordagem centrada nos diversos aspectos clínicodermatológicos da hanseníase, destacando as variações de suas formas clínicas e de seus diagnósticos diferenciais.; The objective of the present review was to approach the different clinical-dermatologic aspects of leprosy, with emphasis on the variations of the clinical forms and differential diagnosis of the disease.

Importance of presumptive diagnosis of encefalic abscess in central nervous system; Importância do diagnóstico presuntivo de abscessos encefálicos no sistema nervoso central

Lucena, Adson Freitas de; Tibúrcio, Rachel Vasconcelos; Cavalcante, Herberth Duarte; Furtado, Luís Edmundo Teixeira de Arruda; Paiva Neto, Cícero Silvério de; Moreira, Cláudio Henrique; Cristino Filho, Gerardo
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 17/06/2011 POR
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45.87%
Introdução: Abscessos cerebrais são caracterizados por uma coleção de exsudato no parênquima encefálico capazes de acometer indivíduos de qualquer idade, raça e sexo. Atenção especial deve ser dada a esses casos, pois sua apresentação clínica pode simular outros agravos, tornando importante ampliar o raciocínio para diversos diagnósticos diferenciais. O presente estudo visa o relato de caso de uma paciente admitida na Santa Casa de Misericórdia de Sobral com quadro sugestivo de cefaléia secundária. Material e Métodos: MEMA, 22 anos, universitária, evoluiu em 11 dias com cefaléia unilateral em região frontal esquerda e pulsátil. Essa cefaléia tinha caráter habitual, apresentava intensidade progressiva, associava-se a náuseas, melhorava com repouso e analgésicos, não havendo relato de fator desencadeante. Resultados: O exame neurológico evidenciou alteração no estado mental, com déficit de memória imediata e recente, compreensão e nomeação; além de desorientação temporo-espacial. Observou-se na Tomografia Computadorizada de Crânio (TCC) uma imagem hipodensa temporal esquerda, com halo hiperdenso de reforço após administração de contraste. Conclusão: A mortalidade nos pacientes com abscesso cerebral pode variar entre 10-40%...

Molecular aspects of craniosynostoses: implications in diagnosis and genetic counseling; Aspectos moleculares das craniossinostoses: implicações no diagnóstico e aconselhamento genético

Passos-Bueno, Maria Rita; Jehee, Fernanda Sarquis; Armelin, Lúcia Maria Libório
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 03/03/2001 POR
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Craniosynostosis is characterized by the premature closure of one or more cranial sutures. It is a highly heterogeneous group, with an incidence of 1 per 2000-3000 births. Both environmental and genetic factors play a role in its etiology. In the last decade, it has been shown that mutations i0 4 genes (FGFR1, FGFR2, FGFR3, TWIST) may cause very well known craniosynostotic syndromes: Apert, Pfeiffer, Crouzon, Jackson-Weiss, Beare-Stevenson and Saethre-Chotzen. Two new conditions associated with the molecular defect have also been elucidated: Muenke's syndrome and Boston type of craniosynostosis. The variability of the phenotype of these two conditions is particularly wide, including patients with only craniosynostosis, classified as non syndromic cases, or those with cloverleaf skull. A precise phenotype and genotype correlationhas not always been possible because of the great clinical overlap and genetic heterogeneity in this group of disorders. A11 the above syndromes present an autossomal dominant pattern of inheritance, and therefore a patient has a 50% chance of having an affected child. Other patterns of inheritance for craniosynostosis have also been described and therefore it is important to perform a careful examination of each case and family. We present two cases seen at our laborato% one with Crouzon and other with Saethre-Chotzen syndrome...

Differential diagnosis between post-polio syndrome symptoms and temporomandibular disorder – Clinical case

Barbosa, Gustavo Augusto Seabra; Morais, Maria Helena de Siqueira Torres
Fonte: UNICAMP/FOP Publicador: UNICAMP/FOP
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ;
Publicado em 19/10/2015 POR
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45.99%
Post-poliomyelitis syndrome (PPS) is characterized by the delayed appearance of new neuromuscular symptoms in patients several years after their acute poliomyelitis paralysis. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. The diagnosis is essentially clinical after excluding other neurological, orthopedic or rheumatologic problems. Temporomandibular disorders (TMD) are usually diagnosed by means of comprehensive review of patient history and clinical examination and the symptoms are pain/ discomfort in the jaw, mainly in the region of the temporomandibular joints (TMJs) and/or masticatory muscles, limitation of mandibular function and/or TMJ sounds. In the same way as PPS, the diagnosis of TMD is challenging. This study reports the case of a patient that presented the symptoms of both conditions in the stomatognathic system, and discusses how to achieve the differential diagnosis for proper management of the cases.