Comparative study between physical examination, electroneuromyography and ultrasonography in diagnosing carpal tunnel syndrome

AbstractObjectiveTo evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard.MethodsIn this cross-sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination.ResultsNocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7%–78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0%–100%); and electromyography, 98.6% (95% CI: 95.7%–100%). The presence of atrophy, abnormalities of the sense of touch and longer-duration symptoms increased the sensitivity of ultrasonography and physical examination.ConclusionThe sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination

Stigmas and prejudices experienced by people living with HIV/AIDS: A literature review

HIV is considered a public health problem in the world, especially in Brazil, where about 194,000 people have been infected with the virus in the last 10 years in the country. In addition to the physical problems that HIV infection imposes on HIV-positive individuals, social and institutional problems end up being a major barrier in the lives of these individuals, such as stigma and prejudice, which segregate and exclude them from social life. Objective: to make a critical analysis of the stigma and prejudice seen by people living with HIV in recent decades. Methodology: integrative literature review, with searches in lilacs, Bdenf and Scielo databases, based on the question "how prejudice interferes in the routine of people living with HIV/AIDS, and the stigmas that are carried by them". Eighteen (18) articles were selected in the respective databases, which followed the theme "HIV and prejudice". Results: Soon after the analysis of the articles, 03 thematic axes were constructed that helped to understand the data. Conclusion: It was noticed that prejudice and stigma are factors that transform, in a negative way, the life of those who have HIV/AIDS infection

Construção de instrumento para consulta ginecológica utilizando sistematização da assistência de enfermagem: relato de experiência / Construction of instrument for gynecological consultation using nursing care systematization: experience report

Introdução: A consulta ginecológica é uma ferramenta utilizada no cuidado à saúde da mulher, onde o enfermeiro pode investigar todo o processo saúde-doença da cliente. Objetivo: Relatar a experiência da construção de um instrumento para utilizar na consulta ginecológica de enfermagem. Método: Relato de experiência por enfermeira residente, no Hospital Universitário do Maranhão, durante o mês de fevereiro de 2021.  Resultados: criou-se um instrumento para ser utilizado nas consultas ginecológicas realizadas pelo enfermeiro, segundo a SAE para melhor estruturação do instrumento e qualidade no atendimento. Conclusões: reconheceu-se a importância de produzir um instrumento para nortear e planejar o cuidado

Construção De Instrumento Para Consulta Ginecológica Utilizando Sistematização Da Assistência De Enfermagem: Relato De Experiência / Construction Of Instrument For Gynecological Consultation Using Nursing Care Systematization: Experience Report

Introdução: A consulta ginecológica é uma ferramenta utilizada no cuidado à saúde da mulher, onde o enfermeiro pode investigar todo o processo saúde-doença da cliente. Objetivo: Relatar a experiência da construção de um instrumento para utilizar na consulta ginecológica de enfermagem. Método: Relato de experiência por enfermeira residente, no Hospital Universitário do Maranhão, durante o mês de fevereiro de 2021.  Resultados: criou-se um instrumento para ser utilizado nas consultas ginecológicas realizadas pelo enfermeiro, segundo a SAE para melhor estruturação do instrumento e qualidade no atendimento. Conclusões: reconheceu-se a importância de produzir um instrumento para nortear e planejar o cuidado.

Limb girdle muscular dystrophy type 2G with myopathic-neurogenic motor unit potentials and a novel muscle image pattern

Abstract\ud \ud Background\ud Limb girdle muscular dystrophy type 2G (LGMD2G) is a subtype of autosomal recessive muscular dystrophy caused by mutations in the telethonin gene. There are few LGMD2G patients worldwide reported, and this is the first description associated with early tibialis anterior sparing on muscle image and myopathic-neurogenic motor unit potentials.\ud \ud \ud Case presentation\ud Here we report a 31 years old caucasian male patient with progressive gait disturbance, and severe lower limb proximal weakness since the age of 20 years, associated with subtle facial muscle weakness. Computed tomography demonstrated soleus, medial gastrocnemius, and diffuse thigh muscles involvement with tibialis anterior sparing. Electromyography disclosed both neurogenic and myopathic motor unit potentials. Muscle biopsy demonstrated large groups of atrophic and hypertrophic fibers, frequent fibers with intracytoplasmic rimmed vacuoles full of autophagic membrane and sarcoplasmic debris, and a total deficiency of telethonin. Molecular investigation identified the common homozygous c.157C > T in the TCAP gene.\ud \ud \ud Conclusion\ud This report expands the phenotypic variability of telethoninopathy/ LGMD2G, including: 1) mixed neurogenic and myopathic motor unit potentials, 2) facial weakness, and 3) tibialis anterior sparing. Appropriate diagnosis in these cases is important for genetic counseling and prognosis.We wish to thank the patient for participation in this study. We acknowledge\ud Cleides Campos de Oliveira, Leticia Nogueira and Simone Ferreira do\ud Nascimento for technical assistance. MV, LUY and CFA are supported by\ud FAPESP-CEPID, and INCT-CNPq, Capes- COFECUB

Muscle Phenotypic Variability in Limb Girdle Muscular Dystrophy 2 G

Abstract Limb girdle muscular dystrophy type 2 G (LGMD2G) is caused by mutations in the telethonin gene. Only few families were described presenting this disease, and they are mainly Brazilians. Here, we identified one additional case carrying the same common c.157C > T mutation in the telethonin gene but with an atypical histopathological muscle pattern. In a female patient with a long duration of symptoms (46 years), muscle biopsy showed, in addition to telethonin deficiency, the presence of nemaline rods, type 1 fiber predominance, nuclear internalization, lobulated fibers, and mitochondrial paracrystalline inclusions. Her first clinical signs were identified at 8 years old, which include tiptoe walking, left lower limb deformity, and frequent falls. Ambulation loss occurred at 41 years old, and now, at 54 years old, she presented pelvic girdle atrophy, winging scapula, foot deformity with incapacity to perform ankle dorsiflexion, and absent tendon reflexes. The presence of nemaline bodies could be a secondary phenomenon, possibly associated with focal Z-line abnormalities of a long-standing disease. However, these new histopathological findings, characteristic of congenital myopathies, expand muscle phenotypic variability of telethoninopathy

Osteoma osteoide no osso ilíaco: relato de dois casos Osteoid osteoma in the iliac bone: report on two cases

O osteoma osteoide é um tumor benigno do osso que se apresenta geralmente com dor noturna em adultos jovens, aliviada por repouso e salicilatos. Pode acometer qualquer osso, mas sua ocorrência no ilíaco é infrequente. Os autores descrevem dois casos de osteoma osteoide intramedular, localizado junto à articulação sacroilíaca, com sintomas que simulavam dor ciática e cujo diagnóstico se deu de forma tardia, apesar de o exame radiológico inicial mostrar lesão esclerótica em ambos os casos. O diagnóstico foi ratificado por tomografia computadorizada e o tratamento proposto foi a ressecção em bloco da lesão, com excisão do nidus. O diagnóstico definitivo foi confirmado pelo exame histopatológico. No seguimento de longo prazo, ambos estão assintomáticos e observou-se completa remodelação óssea no sítio cirúrgico. Os autores enfatizam as características típicas do tumor, a localização não usual, o diagnóstico diferencial e o tratamento.<br>Osteoid osteoma is a benign bone tumor that generally presents with nighttime pain among young adults and is relieved by rest and salicylates. It can affect any bone, but occurrences in the iliac are unusual. The authors describe two cases of intramedullary osteoid osteoma next to the sacroiliac joint, with symptoms that simulated sciatic pain. The cases were diagnosed late, although the initial radiographs showed sclerotic lesions in both cases. The diagnosis was confirmed by means of CT scan and the nidus was excised surgically through en bloc resection. The definitive diagnosis was given by means of histopathological examination. Over long-term follow-up, both cases remained asymptomatic and complete bone remodeling at the surgical site was observed. The authors highlight the typical characteristics of the tumor, the unusual location, the differential diagnosis and the treatment