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article
Use of 5% lidocaine patch in the management of post-traumatic localized neuropathic pain. Case reports
(2023) LIGGIERI, André; MINSON, Fabíola
ABSTRACT BACKGROUND AND OBJECTIVES: Neuropathic pain is defined as a pain caused by a lesion or condition that affects the somatosensory nervous system. Taking its prevalence into account, in particular post-traumatic localized neuropathic pain, and to discuss ways to manage patients with this condition, considering efficacy and tolerability of proposed treatments, this report presents three clinical cases of patients with post-traumatic localized neuropathic pain treated with 5% lidocaine transdermal patch in both monotherapy and polytherapy. CASE REPORTS: This study reports the cases of three female patients aged between 29 and 81 years with complaints of pain due to trauma, who were managed with 5% lidocaine transdermal patch in prolonged treatment, with a significant improvement in pain. CONCLUSION: According to scientific evidence, the use of 5% lidocaine transdermal patch in post-traumatic localized neuropathic pain as shown efficacy with favorable safety and tolerance. Moreover, it was possible to demonstrate that a 5% lidocaine transdermal patch in a polytherapy format has contributed to improved outcomes with no effect in treatment tolerability.
article
Dermatofibrossarcoma na glabela: Uma localização incomum
(2023) BALDINI, CARLOS EDUARDO; CASTRO, MARIO AUGUSTO FERRARI DE; DEDIVITIS, ROGéRIO APARECIDO
ABSTRACT Dermatofibrosarcoma is a rare cancer with a slow growth pattern and aggressive tissue invasion. The treatment for this condition involves surgical intervention to achieve clear margins. In this particular case, we have a 60-year-old man who had a mass in the glabella area that was excised twice under local anesthesia at a different facility. The results of both biopsies indicated dermatofibroma. However, the patient experienced a new recurrence, and during the immunohistochemistry analysis of the initial excision, it was revealed to be dermatofibrosarcoma. As a result, a broad excision was performed until negative margins were obtained based on frozen sections. Additionally, a frontal flap was employed to reconstruct the surgical defect. The outcome of the treatment was deemed successful, without complications.
article
Lidocaine 5% patch in the treatment of localized neuropathic pain due to nerve compression. Case reports
(2023) LIGGIERI, André; PALLADINI, Mariana
ABSTRACT BACKGROUND AND OBJECTIVES: Neuropathic pain is a chronic condition with a significant burden for patients, society, and healthcare systems. Due to neuropathic complexity, its management must be different than the one for nociceptive pain. First-line systemic treatments may be associated with dose-dependent adverse events and drug-drug interactions. On the other hand, topical treatments have less systemic adverse events, with the 5% lidocaine transdermal patch being recommended for firstor second line of treatment for neuropathic pain according to various international guidelines. The aim of this study is to present three cases of localized neuropathic pain due to nerve compression managed with 5% lidocaine transdermal patch. CASE REPORTS: The cases of three adult patients (>40 years old) with pain or tingling for a long period of time and their outcomes with treatment with 5% lidocaine transdermal patch for a prolonged duration were investigated. All three cases report a significant improvement in pain. CONCLUSION: The results of the reported cases revealed that a 5% lidocaine transdermal patch represents an effective, safe and tolerable and noninvasive option for the management of localized neuropathic pain due to peripheric nerve compression.
article
Tapentadol extended-release as a therapeutic strategy for pain control in cases of osteoarthritis. Case reports
(2023) MORAES, Frederico Barra de; LIGGIERI, André Cicone; SADIGURSKY, David
ABSTRACT BACKGROUND AND OBJECTIVES: Osteoarthritis affects many individuals worldwide and is caused by multiple factors that lead to joint wear and tear, inflammation and, consequently, chronic pain that is difficult to treat. It is predominant in seniors, but not restricted to older age groups. Pain reduction is prioritized when facing crises, so that rehabilitation work and postural corrections can be applied later. The present study aimed to evaluate the analgesic potential of tapentadol extended-release (ER) in three patients with osteoarthritis who had undergone numerous previous treatments and had a history of moderate to severe chronic pain. CASE REPORTS: Three women, aged 49, 75 and 86 years old, diagnosed with osteoarthritis, with complaints of severe pain and who had undergone numerous therapies including drug use, without significant pain control were included in the study. The use of tapentadol ER was recommended and adjusted to each patient according to the intensity of pain. All of them responded satisfactorily and returned to their daily activities. One of them presented nausea after two days of tapentadol use, which was controlled with an antiemetic drug only during the two days of nausea CONCLUSION: Tapentadol ER was effective in controlling pain from osteoarthritis in the three cases evaluated, without serious adverse effects. The period and dosage of tapentadol ER must be in accordance with the clinical evolution of each patient.
article
“Star of Bethlehem sign” in the analysis of the evolution of brain lesions during and after treatment for neuroparacoccidioidomycosis
(2023) SANTANA, Larissa M.; PEÇANHA, Paulo Mendes; FALQUETO, Aloísio; KRUSCHEWSKY, Wdson L. M.; GRÃO-VELLOSO, Tânia Regina; GONÇALVES, Sarah Santos; ROSA-JÚNIOR, Marcos
Abstract Objective: To describe the clinical and radiological evolution of lesions during and after treatment in patients diagnosed with neuroparacoccidioidomycosis (NPCM). Materials and Methods: This was a retrospective study of the medical records, computed tomography scans, and magnetic resonance imaging (MRI) scans of patients with NPCM treated between September 2013 and January 2022. Results: Of 36 cases of NPCM, eight were included in the study. One patient presented only with pachymeningeal and skull involvement, and seven presented with pseudotumors in the brain. Collectively, the eight patients presented with 52 lesions, of which 46 (88.5%) were supratentorial. There were 32 lesions with a diameter ≤ 1.2 cm, of which 27 (84.4%) disappeared during the treatment. In three cases, there were lesions > 1.2 cm that showed a characteristic pattern of evolution on MRI: an eccentric gadolinium contrast-enhanced nodule, with a subsequent decreased in the size and degree of contrast enhancement of the lesions. Conclusion: In NPCM, supratentorial lesions seem to predominate. Lesions ≤ 1.2 cm tend to disappear completely during treatment. Lesions > 1.2 cm tend to present with a similar pattern, designated the “Star of Bethlehem sign”, throughout treatment.
article
Pedagogical concerns of physical therapist professors and their perceptions of the COVID-19 pandemic
(2023) ARAUJO, Cintia Pereira de; OLIVO, Clarice Rosa
ABSTRACT In health professions education, professors usually face some difficulties and concerns. The COVID-19 pandemic has further amplified these challenges, leading to changes in teaching methods and new concerns. This study aimed to identify undergraduate physical therapy professors’ concerns (PC) about the learning environment during the COVID-19 pandemic. Physical therapists who served as undergraduate physical therapy professors in Brazil answered a questionnaire on PC (Teacher Concerns Questionnaire - TCQ), a sociodemographic profile questionnaire, and an open-ended question on the perception of changes in PC during the pandemic. A total of 187 physical therapist professors completed the questionary and had moderate PC (TCQ 49.6±10.5), with no association with the stage of their teaching career, age, and length of professional training. Participants in continuing education activities had higher PC. Of the participants, 94.1% reported changes in PC resulting from the pandemic. Therefore, professors who participate in continuing education activities are more concerned about the impact of their practice than those who do not participate. At the same time, these concerns seem to have changed during the pandemic.
article
The generation of innovative ophthalmologists
(2023) KARA-JÚNIOR, Newton
article
Cognitive profile of patients with and without speech impairment in Parkinson's disease
(2023) SOUSA, Nariana Mattos Figueiredo; DINIZ, Juliana de Fátima Garcia; GALVÃO, Ana Paula; BRUCKI, Sonia Maria Dozzi
ABSTRACT. Cognitive functions have been the subject of studies evaluating the pathophysiological mechanism of speech control. Objective: To compare the groups of patients with and without speech disorders with cognitive assessment, demographic, and clinical data (disease duration, functionality, and motor symptoms). Methods: Retrospective, cross-sectional study. Patients were evaluated using the Addenbrooke's Cognitive Examination III and neuropsychological tests. The following speech subsystems were analyzed: articulation, phonation, resonance, and prosody, through auditory-perceptual evaluation (based on the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson's Disease — PADAF Protocol tests), observing aspects of speech programming and execution. The patients were distributed into three subgroups (normal cognition, mild cognitive impairment, and dementia). After speech evaluation, they were divided into two subgroups (with and without speech disorders). Results: A total of 150 patients participated in this study, 104 men and 46 women, 63.58 (8.81) years of age, 11.03 (4.00) years of schooling, 6.61 (4.69) years of disease progression, and with the highest proportion of individuals in stage I–II of the Hoehn & Yarh (H&Y) scale (86, or 57.33%). Statistically significant differences were observed between subgroups with and without speech alteration. Worse performance was verified in the Trail Making Test (TMT) TMT-Δ and a tendency of difference in the TMT-B of the subgroup with speech disorders, in addition to worse severity of motor symptoms (H&Y) and cognitive complaints. Conclusion: Individuals with speech disorders brought more frequent cognitive complaints and impairment below expected in tests assessing executive functions. Future studies, with stratification by type of speech disorder, are necessary to contribute to and validate these results.
article
Difração e o olho humano
(2023) HELENE, Otaviano; FERNANDES, Ícaro Salerno; MARTINS, Thiago Gonçalves dos Santos
This work presents some aspects of diffraction in the human eye, which occurs in the pupil, in the cells of the lens, and in structures within it. An Appendix presents the calculations necessary to understand the phenomenon of diffraction. To complement the understanding of optical phenomena, some physiological aspects of the eye, especially the retina, are examined. The purpose of the paper is to provide teachers and students with examples that can help in the study of optics and motivate students to take a closer look at diffraction, including numerical calculations. Examples include the visibility of structures like the Great Wall of China when viewed from long distances, the dots of the letters i and j from the drug information leaflet the shape of floaters, and why we see stars as pointy objects. This article targets physicists, physics students, and professionals from other areas related to human vision, such as ophthalmologists, opticians, and optometrists.
article
The presence of depressive symptoms and cognitive performance among older individuals with and without self-reported chronic diseases
(2023) SILVA, Thaís Bento Lima da; ORDONEZ, Tiago Nascimento; SILVA, Guilherme Alves da; SOUZA, Maria Antônia Antunes de; SILVA, Sabrina Aparecida da; SANTOS, Gabriela dos; GUTIERREZ, Beatriz Aparecida Ozello; MOREIRA, Ana Paula Bagli; COSTA, Laydiane Alves; MORAES, Luiz Carlos de; LESSA, Patrícia Prata; CARDOSO, Neide Pereira; SAKAGUCHI, Mitsuru; SILVA, Henrique Salmazo da; BRUCKI, Sonia Maria Dozzi
ABSTRACT. Dementias secondary to cardiovascular diseases are the second cause of neurogenerative diseases. These conditions can be prevented by controlling risk factors, and it is necessary to observe the relationship between chronic diseases. Objective: to know the influence of chronic non-communicable diseases on cognition and depressive symptoms in the elderly, amid the COVID-19 pandemic. Methods: 578 older adults were evaluated using a sociodemographic questionnaire, the Brazilian Telephone version of the Mini Mental State Examination (Braztel-MMSE), the Geriatric Depression Scale (GDS-15) and an open questionnaire related to NCDs. Results: the association of Non-Communicable Diseases (NCD) with age, depressive symptoms and schooling was confirmed. Conclusion: no association with cognitive decline was evident due to the relationship of high schooling of participants and control of NCDs.
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