São Paulo medical journal = Revista paulista de medicina
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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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Spreader and super-spreader are terms that refer to people who have greater potential for disease transmission, to infect other people. ⋯ The scientific community needs greater depth of evaluation and understanding of how these patients physiologically develop the ability to propagate COVID-19 more intensely. A simpler way of tracking them is also necessary, given that many infected people are asymptomatic. Many patients also have mild symptoms, suggesting that these individuals could also be classified as possible COVID-19 spreaders.PROSPERO Number: ID 217874 (submitted for publication and is being assessed by the editorial team).
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Observational Study
Functional outcomes among stroke patients in Alagoas, Brazil: observational study.
Stroke is the principal cause of disability around the world and the ensuing functional dependence (FD) can be correlated with different factors. ⋯ We found a FD rate four times greater than in another Brazilian study. Lower stroke severity and fewer depressive symptoms were associated with achieving functional independence. Less than half of the patients were referred to a rehabilitation service at hospital discharge and few had access to multidisciplinary treatment.
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High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. ⋯ The participants' low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.
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The fragility of healthcare systems worldwide had not been exposed by any pandemic until now. The lack of integrated methods for bed capacity planning compromises the effectiveness of public and private hospitals' services. ⋯ The proposed approach provides valuable information to help hospital managers anticipate actions for improving healthcare system capacity.