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Sepsis after Administering an Intramuscular Iron Injection in the Arm of an Elder Patient with Multiple Comorbidities: A Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 158-165页

作者： Michele Paula dos santos Taís Michele Werle Mariana Martins Dantas santos Carolina Boeira Soares Carlos Augusto Treviso Italo Trois Maestri Stella Duarte Pinto Carolina Hack Alves Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Guilherme Boeira Soares Gabriel Lorentz Trein Aline Porto Bárbara Adelmann de Lima Fernanda Bercht Merten Luane Pereira Gomes Rafaela Siviero Caron-Lienert Miriam viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of Medicine and Health Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and Health Education Porto Alegre Brazil

Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.

关键词： Critical Care Education Continuing Injectables Septicemia Soft Tissue Infections Suppuration

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Use of the Scar Acceleration Method/Método de Aceleração Cicatricial—MAC®—in the Treatment of Capsular Contracture: Case Report

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Open Journal of Therapy and Rehabilitation 2020年第4期8卷 131-142页

作者： Carolina Macedo Alves Moreira Carolina Gonçalves Pinheiro Aline Ronis Sampaio Michele Paula dos santos Andres Felipe Mantilla Santamaria Miriam viviane Baron Cristine Brandenburg Nathália Ken Pereira Iketani Mara Alessandra Porto dos Reis Oliveira Alexandre Sancho Esteban Fortuny Felice Picariello Marcus Vinicius de Mello Pinto Dr. Daniel Thomaz Clinic Uberlandia Minas Gerais Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FMABC) The Vale do Salgado Faculty (FVS) Ceará Brazil Celulare Institute Petrópolis Rio de Janeiro Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of Medicine of the Industrial University of Santander (UIS) Bucaramanga Colombia School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Por-to Alegre Brazil Brazilian Education of the Federal University of Ceará (UFC) Fortaleza Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Clínica Instituto de Cirurgia Plástica Vênus Barreiras Bahia Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae and CEO of Diagnostra Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Ph.D. and Creator of the MAC® Method CEO and Researcher of the Celulare Institute Petrópolis Rio de Janeiro Brazil

Capsular contracture is a frequent complication in the postoperative period of breast implantation. It usually accompanies the appearance of a firm breast that can progress to pain, distortion, and asymmetry of the breasts, requiring surgical revision. The present study is a case report. A 58-year-old woman with a medical diagnosis of capsular contracture of the right breast evidenced by ultrasound. She was referred to the physiotherapy clinic in October 2019 with an initial complaint of pain on palpation, swelling, and stiffness in her right breast. The patient was evaluated and the MACò method was used to treat capsular contracture. For this, 12 sessions of photodynamic therapy were carried out. The treatment included the use of LED by doping: red (300 s), violet (60 s) and blue (120 s), with the use of 1% methylene blue in target areas, three times a week. The patient had the beginning of symptoms’ remission in the fourth visit and total remission in the 12th visit. It was concluded that the use of photodynamic therapy using the MAC

关键词： Breast Implants Fibroses Methylene Blue Semiconductor Diode Laser Photodynamic Therapy

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Advanced Stage Stuck Gland Adenocarcinoma:Case Report

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Modern Research in Inflammation 2020年第1期9卷 1-7页

作者： Miriam viviane Baron Michele Paula dos santos Gabriela Di Lorenzo Garcia Scherer Luis Manuel Ley Dominguez Vitoria Pereira Itaquy Natalia Cardoso Nascimento Fernanda Nerys Tais Michele Werle Carolina Paz Mohamad Isa Carina Marangoni Mariana Martins Dantas santos Marcus Vinicius de Mello Pinto Janine Koepp Daiana Klein Weber Carissimi Joice Nedel Ott Carolina Goncalves Pinheiro Nathália Ken Pereira Iketani Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil Improvement of Higher Education Personnel Brazil(CAPES)Distrito FederalBrazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil School of Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil Celulare Institute PetrópolisRio de JaneiroBrazil Undergraduate Nursing Course of the University of Santa Cruz do Sul(UNISC) Santa Cruz do SulBrazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC(FMABC) Sao PauloBrazil Undergraduate Physiotherapy Course of the Vale do Salgado Faculty(FVS) CearáBrazil Physiotherapy of the Hospital Beneficiente Portuguesa of Belém ParáBrazil

Parotid gland adenocarcinoma is commonly a tumor of low malignancy and low incidence worldwide. The reported case shows the rapid progression of this tumor in an elderly patient and infrequent effects, such as a presentation of facial edema not commonly described in the medical literature. Patient was admitted to hospital in November 2019 with secretion and partial hearing loss in the right ear and infiltrative and stone lesion with initial skin ulceration in the right cervical region. After 42 days, he returned and was admitted to the intensive care unit with significant swelling of the face, hardened and hyperemic neck, difficulty in speech and inability to open the eye. He presented changes in the mobility of the speech and hearing organs, reduced laryngeal mobility, vocal changes, speech with altered articulation and severe oropharyngeal dysphagia with risk of bronchoaspiration. The patient was diagnosed in September 2019 with a parotid tumor (salivary gland adenocarcinoma T4). The medical team requested computed tomography, computed tomography angiography of the chest and cervical vessels and computed tomography of the neck, in addition to evaluation by the head and neck surgery service and general surgery. After analyzing the results, the medical team suggested a hypothesis of tumor invasion that could result in obstruction of local lymphatic drainage, something unusual in the evolution of this type of tumor. In addition, it was not possible to adhere to radiotherapy treatment due to the extent of the lesion and there was also no confirmation of metastases. The reported case shows us that parotid gland adenocarcinoma, when diagnosed in an advanced stage, can limit the approach to treatment. It was chosen in agreement with the family to proceed with palliative care without invasive measures. Palliative care may be the best option for cases like this, bringing some comfort to the patient and his family.

关键词： Parotid Neoplasms Cancer of the Parotid Palliative Care Critical Care

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Study about Top-Down and Bottom-Up Controls in Regulating the Phytoplankton Biomassin a Eutrophic Reservoir in Northeastern Brazil

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Journal of Water Resource and Protection（水资源与保护） 2012年第8期

作者： Juliana dos santos Severiano Ariadne do Nascimento Moura Enaide Marinho de Melo Magalh？es viviane Lúcia dos santos Almeida

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A Study of Laser Effectiveness in Injured Tissues Regeneration

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Journal of Biosciences and Medicines 2021年第3期9卷 55-63页

作者： Marcus Vinicius de Mello Pinto Aline Ronis Sampaio Miriam viviane Baron Carolina Macedo Alves Moreira Carolina Gonçalves Pinheiro Michele Paula dos santos Andres Felipe Mantilla Santamaria Cristine Brandenburg Nathália Ken Pereira Iketani Mara Alessandra Porto dos Reis Oliveira Alexandre Sancho Felice Picariello Esteban Fortuny Juliano Tibola Nilton Petrone Vilardi Junior Celulare Institute Petrópolis Rio de Janeiro Brazil School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Dr. Daniel Thomaz Clinic Uberlandia Minas Gerais Brazil Faculty of Medicine of ABC (FMABC) Santo André Brazil Vale do Salgado Faculty (FVS) Ceará Brazil School of Medicine Industrial University of Santander (UIS) Bucaramanga Colombia Federal University of Ceará (UFC) Fortaleza Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Clínica Instituto de Cirurgia Plástica Vênus Barreiras Bahia Brazil Unigranrio Rio de Janeiro Brazil da Universita Federico II di Napoli Italia e Pesquisador do Internacional Research Group Rio Grande do Norte Brazil Universidad Finis Terrae Santiago Chile UDESC Florianopolis SC Brazil Fluminense Football Club Rio de Janeiro RJ Brazil

This study aimed to understand the use of low level laser in the regeneration of injured tissues. Also to design our own opinion on the subject, as chemists. Laser is nothing more than a light with very special characteristics that grant it therapeutic properties. We can observe the existence of three different types of laser, being one of them the therapeutic laser, which is used in substitution for medications or along with them. Another type of laser is the surgical one and, in addition to these, there is a diagnostic type. A great advantage is that, instead of taking the medicine, the patient’s own body can be activated by the laser to produce certain substances that can often replace the drugs. This is a literature review emphasizing the use of low level laser. Thus, the reflections from this study can contribute to the amplification of the production of knowledge that aims at the resignification of the use of laser in therapy. Greater attention was given to two types of laser radiation: He-Ne and As-Ga, both presenting a high therapeutic potential in superficial and deep injures. However, the He-Ne laser excels in superficial lesions, whereas the As-Ga laser does so in deep injures, such as articular, muscular, etc.

关键词： Laser Injury Regeneration

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Opportunistic Infections in Late Kidney Transplantation with Death Outcome: Case Report

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Open Journal of Nephrology 2021年第2期11卷 171-182页

作者： Miriam viviane Baron Carina Marangoni Michele Paula dos santos Célia Regina Martins Korzenieski Vitória Pereira Itaquy Tais Michele Werle Gabriela Di Lorenzo Garcia Scherer Joice Nedel Ott Marcus Vinicius de Mello Pinto Janine Koepp Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Cristine Brandenburg Aline Ronis Sampaio Alexandre Sancho Danielle de Mello Florentino Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Coordination for the Improvement of Higher Education Personnel Brazilia Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Schoolof Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil CelulareInstitute Rio de Janeiro Brazil University of Santa Cruz do Sul (UNISC) Santa Cruz do Sul Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FMABC) S&atilde o Paulo Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Dom José Institute of Education and Culture/University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Unigranrio University Rio de Janeiro Brazil Uniredentor University Rio de Janeiro Brazil

Cytomegalovirus (CMV) and Pneumocystis jirovecii fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus® and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or Pneumocystis jirovecii. Treatment with Ganciclovir® and Bactrim® was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and Pneumocystis jirovecii. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and Pneumocystis jirovecii. Adjusting the doses of immunos

关键词： Renal Transplantation Infections Opportunistic Immunosuppressive Agent Cytomegalovirus Pneumocystis

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Pulmonary Tuberculosis Associated with Socioeconomic Vulnerability and Ineffective Support Network: Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 151-157页

作者： Michele Paula dos santos Gabriela Di Lorenzo Garcia Scherer Carolina Hack Alves Italo Trois Maestri Carolina Boeira Soares Carlos Augusto Treviso Stella Duarte Pinto Ana Paula Wagner Steinmetz Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Gabriel Lorentz Trein Guilherme Boeira Soares Aline Porto Brendda Pereira Gomes Fernanda Bercht Merten Luane Pereira Gomes Bárbara Adelmann de Lima Rafaela Siviero Caron-Lienert Miriam viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and Health Education Porto Alegre Brazil

Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequent complication. Due to these symptoms, many patients with tuberculosis require admission to the Intensive Care Unit, where they usually are placed on mechanical ventilation. Tuberculosis is more prevalent in the population in situations of social and economic vulnerability. The main factors that interfere with adherence to treatment and the prognosis of these patients are the patient’s support network and their socioeconomic status. We present the following report of a long-time smoker patient, with chronic kidney disease and previous treatment for tuberculosis, who was brought to the emergency room due to lowering of the sensorium, and was immediately placed on mechanical ventilation. The tests suggested sepsis with a respiratory focus, so a search for Alcohol-Acid-Resistant Bacillus was carried out, with a positive result. The patient was transferred to the Intensive Care Unit due to tachycardia and acute respiratory failure. The patient was a smoker with a high tobacco load, chronic kidney disease, in addition to precarious economic, educational and self-care conditions. This report shows that patients with tuberculosis and its complications can be stabilized through known pharmacological treatment. However, the most effective measure to interrupt the transmission of the disease remains the early diagnosis and the provision of adequate treatment, with guidelines aimed at the cessation of harmful habits, such as smoking.

关键词： Smoking Kidney Disease Sepsis Respiratory Failure

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Early Hepatic Encephalopathy after a Transjugular Intrahepatic Portosystemic Shunt Procedure: Case Report

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Open Journal of Gastroenterology 2021年第6期11卷 81-88页

作者： Miriam viviane Baron Gabriela Di Lorenzo Garcia Scherer Michele Paula dos santos Andres Felipe Mantilla Santamaria Cristine Brandenburg Isabel Cristina Reinheimer Marcus Vinicius de Mello Pinto Aline Ronis Sampaio Alexandre Gomes Sancho Alexandre Gomes Sancho Esteban Fortuny Pacheco Felice Picariello Danielle de Mello Florentino Joice Nedel Ott Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Sonia Carvalho Patrícia Froes Meyer Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil Industrial University of Santander (UIS) Bucaramanga Colombia University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Celulare Institute Rio de Janeiro Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Uniredentor University Rio de Janeiro Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FABC) S&#227o Paulo Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Rigshospital Copenhagen East K&#248benhavn Denmark Centro Universitário do Rio Grande do Norte Natal Brazil

Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt. Male, elderly, and ex-alcoholic, diagnosed with liver cirrhosis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital after 24 hours with agitation and mental confusion. He had a bowel movement stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hypophosphatemia. He underwent a new procedure to occlude the transjugular intrahepatic portosystemic shunt, showing improvement of the mental status and ascites. However, continued with decompensation and hydro-electrolytic disorders. He evolved with worsening of the ventilatory pattern, and neurological and renal function, with a fatal outcome. Esophageal varices due to portal hypertension can be corrected with the transjugular intrahepatic portosystemic shunt. However, complications such as hypernatremia, hepatic hydrothorax, and hepatic encephalopathy may occur. Therefore, there is a need for reintervention to shunt or reduce its caliber. Thus, for patients with advanced age and decompensated cirrhosis, the potential risks and benefits of this procedure should be carefully evaluated due to the risk of complications and death.

关键词： Ascites Hypernatremia Portasystemic Shunt Transjugular Intrahepatic Hepatic Encephalopathy

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Role of Cognitive Behavioral Therapy in Fibromyalgia: A Systematic Review

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第4期11卷 169-187页

作者： Heloisa Lima Heller Aline Rizzo Borges Luís Otávio Amarante Franco João Pedro De Oliveira Aucelio Marcos Igor Albanaz Vargas Rebeca Naoum Lorga Mirella Bastos Sales Natália Vargas Do Nascimento Gabriela Furlan Ribeiro Barbosa Netto Beatriz Carneiro Passos Beatriz Pires Paes Beatriz Toledo Mendes Bruna De Paula Gonçalves Sousa Lyra Ciro Moisés Oliveira Vieira Dos santos Gustavo Araújo Do Nascimento santos Maria Luiza Pimentel De Oliveira Matheus Macêdo Da Silva Maurício Silva De Jesus Paulo Ricardo Guimaraes Rocha Storni Tamires Martinelli De Oliveira Ferraz viviane Cristina Uliana Peterle Ana Paula Monteiro Gomides Reis Centro Universitário de Brasília Brasília Brazil Universidade Católica de Brasília Brasília Brazil Centro Universitário Euro Americano Brasília Brazil

A literature search of articles from 2002-2019 was performed using Medline, Embase, Cochrane, LILACS, IBECS, CRD, and Epistemonikos databases, to analyze the effects of Cognitive-Behavioral Therapy (CBT) in the treatment of fibromyalgia. Twenty-seven articles were selected in which CBT was performed exclusively by specialist physicians, associated or not with conventional pharmacological treatment and/or physical exercise. In most articles, CBT worked with self-knowledge and cognitive restructuring, attempting to reduce pain perception, and it showed a general improvement in daily activities by decreasing patient’s limitations, such as morning stiffness. The literature showed significant correlations of CBT in pain processing over time. When CBT was compared to conventional pharmacological therapy, a certain superiority of CBT could be observed concerning the quality of life, catastrophizing, and acceptance of pain. However, when they were simultaneously applied, this improvement in quality of life was not observed.

关键词： Cognitive Behavioral Therapy Fibromyalgia Pain

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Lipid Accumulation Product: Reliable Marker for Cardiovascular Risk Detection?

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Open Journal of Epidemiology（流行病学期刊） 2021年第3期

作者： Lidiane Aparecida Vila Pires Ricardo José Tofano Sandra Maria Barbalho Claudia Rucco Penteado Detregiachi Marcelo Dib Bechara viviane Alessandra Capelluppi Tofano Jesselina Francisco dos santos Haber Eduardo Federighi Baisi Chagas Ana Maria Gonçalvez Milla Karina Quesada

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