São Paulo medical journal = Revista paulista de medicina
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Patients with low back pain frequently undergo a variety of diagnostic and therapeutic interventions, but some of these have uncertain effectiveness. This highlights the importance of the association of healthcare services and therapeutic measures relating to disability. ⋯ Occurrence of the combined of consultations and medication use was correlated with higher chance of severe disability among these elderly people with nonspecific low back pain. This suggested that overuse and "crowding-in" effects were present in medical services for elderly people.
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Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. ⋯ CRD42019125501.
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Healthcare institutions are confronted with large numbers of patient admissions during large-scale or long-term public health emergencies like pandemics. Appropriate and effective triage is needed for effective resource use. ⋯ CURB-65, STSS and PMEWS scores are useful for predicting mortality, ICU admission and MV need among patients diagnosed with COVID-19 pneumonia. Advanced age, increased respiratory rate, low SpO2 and prolonged ED length of stay may increase mortality. Further studies are needed for developing the triage scoring systems, to ensure effective long-term use of healthcare service capacity during pandemics.
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Case Reports
A case of COVID-19 with papulovesicular rash that progressed to retiform purpura, accompanied by cherry angiomas.
Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology of these lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. ⋯ The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.
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Stroke is the second leading cause of death in Brazil and the main cause of disability. Inability to identify alarm signals causes delays in seeking emergency services, thereby leading to a worse prognosis. ⋯ Despite the severity and prevalence of stroke, the population still has little information on this disease. In this context, the importance of mounting campaigns to improve prevention and treatment and to contribute to healthcare policies becomes evident.