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RESUMO As Diretrizes Brasileiras para Reabilitação do AVC são fruto de um esforço conjunto do Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia com o objetivo de orientar os profissionais envolvidos no processo de reabilitação para a redução da incapacidade funcional e aumento da autonomia dos indivíduos. Membros do grupo acima participaram de fóruns de discussão na web com pré-temas, seguidos de reuniões por videoconferência em que as controvérsias foram discutidas, levando a um consenso. Essas diretrizes, divididas em duas partes, focam as implicações de recentes ensaios clínicos, revisões sistemáticas e metanálises sobre reabilitação do AVC. O objetivo principal é servir de orientação a médicos, fisioterapeutas, fonoaudiólogos, terapeutas ocupacionais, enfermeiros, nutricionistas e demais profissionais envolvidos no cuidado pós-AVC. As recomendações e níveis de evidência foram adaptados de acordo com a literatura disponível atualmente. Aqui é apresentada a Parte I sobre tópicos de reabilitação na fase aguda, prevenção e tratamento de doenças e comorbidades frequentes após o AVC.

ABSTRACT The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature. The main objective was to guide physicians, physiotherapists, speech therapists, occupational therapists, nurses, nutritionists, and other professionals involved in post-stroke care. Recommendations and levels of evidence were adapted according to the currently available literature. Part I discusses topics on rehabilitation in the acute phase, as well as prevention and management of frequent conditions and comorbidities after stroke.

https://doi.org/10.1590/0004-282x-anp-2021-0354

Trauma-induced acquired reactive perforating collagenosis
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Gontijo, João Renato Vianna

; Fernandes Júnior, Florentino

; Pereira, Luciana Baptista

; Pedrosa, Moisés Salgado

Anais Brasileiros de Dermatologia

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jun 2021, Volume 96 N. 3 Pages 392 - 393

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.abd.2020.06.022 57 downloads

Do you know this syndrome? Ichthyosis associated with neurological condition and alteration of hairs
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Pereira, Luciana Baptista

; Valente, Neusa Yuriko Sakai

; Rocha, Vanessa Barreto

Anais Brasileiros de Dermatologia

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feb 2018, Volume 93 N. 1 Pages 135 - 137

Abstract: En | Text: En | PDF: En

Abstract: Trichothiodystrophy refers to a heterogeneous group of rare genetic diseases that affects neuroectodermal-derived tissues with multisystem involvement. The hallmark of these syndromes is the deficiency of sulfur in hair matrix proteins, leading to short and brittle hair. Few cases of this rare disorder have been published. The authors report a case of trichothiodystrophy in a male infant with ichthyosis, photosensitivity, spastic paraparesis, short stature, and neurologic and psychomotor retardation. Diagnosis was based on clinical and microscopic features of hair samples.

https://doi.org/10.1590/abd1806-4841.20187727 1211 downloads

Role of magnetic resonance imaging in the planning of breast cancer treatment strategies: comparison with conventional imaging techniques
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França, Luciana Karla Lira

; Bitencourt, Almir Galvão Vieira

; Paiva, Hugo Lamartine Souza

; Silva, Caroline Baptista

; Pereira, Nara Pacheco

; Paludo, Jociana

; Graziano, Luciana

; Guatelli, Camila Souza

; Souza, Juliana Alves de

; Marques, Elvira Ferreira

Radiologia Brasileira

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apr 2017, Volume 50 N. 2 Pages 76 - 81

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Avaliar o papel da ressonância magnética (RM) no planejamento terapêutico de pacientes com câncer de mama. Materiais e Métodos: Foram avaliadas 160 mulheres com diagnóstico de câncer de mama submetidas a RM para estadiamento préoperatório. O tamanho do tumor principal avaliado pela RM e pelos exames convencionais (mamografia e ultrassonografia) foi comparado com o exame anatomopatológico (padrão ouro), utilizando o coeficiente de correlação de Pearson (r). Foi avaliada, ainda, a presença de lesões adicionais não identificadas nos exames prévios e sua influência no planejamento terapêutico. Resultados: A idade média das pacientes foi 52,2 anos (variação: 30-81 anos) e o tipo histológico mais comum foi o carcinoma ductal invasivo (60,6%). A medida do tumor na RM teve melhor correlação com o tamanho no exame anatomopatológico, quando comparado com a mamografia (r: 0,872 × 0,710) e com a ultrassonografia (r: 0,836 × 0,704). A RM identificou lesões adicionais em 53 pacientes (33,1%), sendo 20 malignas (12,5%), e modificou o planejamento terapêutico em 23 pacientes (14,4%). Conclusão: A RM das mamas demonstrou ser mais acurada que os exames convencionais na avaliação das dimensões do tumor principal e foi capaz de identificar lesões adicionais não identificadas pelos outros métodos, que alteraram o planejamento terapêutico em um percentual importante dos casos.

Abstract Objective: To assess the role of magnetic resonance imaging (MRI) in the planning of breast cancer treatment strategies. Materials and Methods: The study included 160 women diagnosed with breast cancer, who underwent breast MRI for preoperative staging. Using Pearson's correlation coefficient (r), we compared the size of the primary tumor, as determined by MRI, by conventional imaging (mammography and ultrasound), and in the pathological examination (gold standard). The identification of lesions not identified in previous examinations was also evaluated, as was its influence on treatment planning. Results: The mean age of the patients was 52.2 years (range, 30-81 years), and the most common histological type was invasive ductal carcinoma (in 60.6% of the patients). In terms of the tumor size determined, MRI correlated better with the pathological examination than did mammography (r = 0.872 vs. 0.710) or ultrasound (r = 0.836 vs. 0.704). MRI identified additional lesions in 53 patients (33.1%), including malignant lesions in 20 (12.5%), which led to change in the therapeutic planning in 23 patients (14.4%). Conclusion: Breast MRI proved to be more accurate than conventional imaging in determining the dimensions of the main tumor and was able to identify lesions not identified by other methods evaluated, which altered the therapeutic planning in a significant proportion of cases.

https://doi.org/10.1590/0100-3984.2015.0124 4997 downloads

Neurofibromatosis: part 2 – clinical management
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Batista, Pollyanna Barros

; Bertollo, Eny Maria Goloni

; Costa, Danielle de Souza

; Eliam, Lucas

; Cunha, Karin Soares Gonçalves

; Cunha-Melo, José Renan

; Darrigo Junior, Luiz Guilherme

; Geller, Mauro

; Gianordoli-Nascimento, Ingrid Faria

; Madeira, Luciana Gonçalves

; Mendes, Hérika Martins

; Miranda, Débora Marques de

; Mata-Machado, Nikolas Andre

; Morato, Eric Grossi

; Pavarino, Érika Cristina

; Pereira, Luciana Baptista

; Rezende, Nilton Alves de

; Rodrigues, Luíza de Oliveira

; Sette, Jorge Bezerra Cavalcanti

; Silva, Carla Menezes da

; Souza, Juliana Ferreira de

; Souza, Márcio Leandro Ribeiro de

; Martins, Aline Stangherlin

; Valadares, Eugênia Ribeiro

; Vidigal, Paula Vieira Teixeira

; Waisberg, Vanessa

; Waisberg, Yehuda

; Rodrigues, Luiz Oswaldo Carneiro

Arquivos de Neuro-Psiquiatria

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jun 2015, Volume 73 N. 6 Pages 531 - 543

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A primeira parte desta diretriz abordou o diagnóstico diferencial das neurofibromatoses (NF): neurofibromatose do tipo 1 (NF1), neurofibromatose do tipo 2 (NF2) e schwannomatose (SCH). As NF compartilham algumas características, como a origem neural dos tumores e sinais cutâneos, e afetam cerca de 80 mil brasileiros. O aumento do conhecimento científico sobre as NF tem permitido melhor manejo clínico e redução da morbidade das complicações, resultando em melhor qualidade de vida para os pacientes com NF. A maioria dos médicos é capaz de realizar o diagnóstico das NF, mas a variedade de manifestações clínicas e a dificuldade de se prever o surgimento e a gravidade de complicações, torna o manejo da NF um desafio para o clínico e envolve diferentes especialistas para o tratamento adequado e aconselhamento genético, especialmente a NF2 e a SCH. O presente texto sugere algumas orientações para o acompanhamento dos portadores de NF, com ênfase na NF1.

Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.

https://doi.org/10.1590/0004-282X20150042 13090 downloads

ENTEROPATHOGENS DETECTED IN A DAYCARE CENTER, SOUTHEASTERN BRAZIL: BACTERIA, VIRUS, AND PARASITE RESEARCH
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Castro, Edna Donizetti Rossi

; Germini, Marcela Cristina Braga Yassaka

; Mascarenhas, Joana D'Arc Pereira

; Gabbay, Yvone Benchimol

; Lima, Ian Carlos Gomes de

; Lobo, Patrícia dos Santos

; Fraga, Valéria Daltibari

; Conceição, Luciana Moran

; Machado, Ricardo Luiz Dantas

; Rossit, Andréa Regina Baptista

Revista do Instituto de Medicina Tropical de São Paulo

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feb 2015, Volume 57 N. 1 Pages 27 - 32

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Introdução: O objetivo deste estudo foi determinar a prevalência e o perfil etiológico de enteropatógenos em crianças de uma creche. Métodos: No período de outubro de 2010 a fevereiro de 2011 foram coletadas e analisadas amostras de fezes de 100 crianças matriculadas em creche do governo no município de São José do Rio Preto, Estado de São Paulo. Resultados: Um total de 246 bactérias foram isoladas em 99% das amostras de fezes; 129 eram diarreicas e 117 não-diarreicas. Foram isoladas setenta e três cepas de Escherichia coli, 19 de Enterobacter, uma de Alcaligenes e uma de Proteus. Foram detectados 14 casos de colonização mista com Enterobacter e de E. coli. Norovírus e Astrovirus foram detectados em crianças com sinais clínicos sugestivos de diarréia. Estes vírus foram detectados exclusivamente entre as crianças residentes em áreas urbanas. Todas as amostras fecais foram negativas para a presença das espécies de rotavírus A e C. Foi observada a presença de Giardia lamblia, Entamoeba coli, Endolimax nana e ancilostomídeos. Foi encontrada associação significativa entre o consumo de alimentos fora do centro da casa e creche e a presença de parasitos intestinais. Conclusões: Para as crianças desta creche, a infecção intestinal por patógenos não parece ter contribuido para a ocorrência de diarreia ou outros sintomas intestinais. As diferenças observadas podem ser atribuídas à grande diversidade de características geográficas, sociais e econômicas e o clima do Brasil, as quais tem sido relatadas como fatores críticos para a modulação da frequência de diferentes enteropatógenos

Introduction: The objective of this study was to determine the prevalence and etiological profile of enteropathogens in children from a daycare center. Methods: From October 2010 to February 2011 stool samples from 100 children enrolled in a government daycare center in the municipality of São José do Rio Preto, in the state of São Paulo, were collected and analyzed. Results: A total of 246 bacteria were isolated in 99% of the fecal samples; 129 were in the diarrheal group and 117 in the non-diarrheal group. Seventy-three strains of Escherichia coli were isolated, 19 of Enterobacter, one of Alcaligenes and one of Proteus. There were 14 cases of mixed colonization with Enterobacter and E. coli. Norovirus and Astrovirus were detected in children with clinical signs suggestive of diarrhea. These viruses were detected exclusively among children residing in urban areas. All fecal samples were negative for the presence of the rotavirus species A and C. The presence of Giardia lamblia, Entamoeba coli, Endolimax nana and hookworm was observed. A significant association was found between food consumption outside home and daycare center and the presence of intestinal parasites. Conclusions: For children of this daycare center, intestinal infection due to pathogens does not seem to have contributed to the occurrence of diarrhea or other intestinal symptoms. The observed differences may be due to the wide diversity of geographical, social and economic characteristics and the climate of Brazil, all of which have been reported as critical factors in the modulation of the frequency of different enteropathogens.

https://doi.org/10.1590/S0036-46652015000100004 3351 downloads

From one side to the other: what is essential? Perception of oncology patients and their caregivers in the beginning of oncology treatment and in palliative care
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Munhoz, Bruna Antenussi

; Paiva, Henrique Soares

; Abdalla, Beatrice Martinez Zugaib

; Zaremba, Guilherme

; Rodrigues, Andressa Macedo Paiva

; Carretti, Mayra Ribeiro

; Monteiro, Camila Ribeiro de Arruda

; Zara, Aline

; Silva, Jussara Oliveira

; Assis, Widner Baptista

; Auresco, Luciana Campi

; Pereira, Leonardo Lopes

; Giglio, Adriana Braz del

; Lepori, Ana Claudia de Oliveira

; Trufelli, Damila Cristina

; Giglio, Auro del

einstein (São Paulo)

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dec 2014, Volume 12 N. 4 Pages 485 - 491

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo Avaliar a percepção dos pacientes oncológicos e de seus cuidadores no início da abordagem diagnóstica e terapêutica, e durante os cuidados paliativos.Métodos Estudo transversal, realizado nos ambulatórios de oncologia e cuidados paliativos vinculados a Faculdade de Medicina do ABC. Foram coletados dados clínicos e demográficos de pacientes e de seus cuidadores, e aplicados questionários referentes aos elementos a serem elencados como importantes em relação ao tratamento.Resultados Foram incluídos 32 pacientes e 23 cuidadores que iniciavam o tratamento nos ambulatórios de oncologia, bem como 20 pacientes e 20 cuidadores nos ambulatórios de cuidados paliativos. Em relação aos pacientes do ambulatório de oncologia, os itens considerados mais importantes foram: médico disponível para discutir a doença e responder dúvidas (84%), confiança nos médicos (81%) e médico com linguagem acessível (81%). Para seus cuidadores, os seguintes aspectos foram considerados extremamente importantes: confiança nos médicos que cuidam do paciente (96%) e mesma equipe médica cuidando do seu familiar (87%). Para pacientes do ambulatório de cuidados paliativos, foram considerados extremamente importantes: confiança nos médicos (83%), estar com pessoas consideradas importantes (78%) e ser tratado de modo que preservasse sua dignidade (72%). Para seus cuidadores, foram considerados extremamente importantes: receber informação adequada sobre a doença e os riscos e benefícios do tratamento (84%), e sinceridade na comunicação das informações a respeito da doença (79%).Conclusão Confiança mediada por uma boa comunicação e a constância do cuidado foram valores tidos como fundamentais para a satisfação de cuidadores e de pacientes com câncer durante toda a evolução da doença.

Objective To evaluate the perception of oncology patients and their caregivers upon diagnosis and beginning of the therapy and during palliative care.Methods A cross-sectional study at the oncology and palliative care outpatients clinics of the Faculdade de Medicina do ABC. Clinical and demographic data from patients and their caregivers were collected and questionnaires regarding the elements considered important in relation to the treatment were applied.Results We enrolled 32 patients and 23 caregivers that were initiating treatment at the oncology outpatient clinic, as well as 20 patients and 20 caregivers at the palliative care clinic. Regarding the patients treated at the oncology clinic, the issues considered most important were a physician available to discuss the disease and answer questions (84%), trust in the physician (81%), and a physician with accessible language (81%). For their caregivers, the following issues were considered extremely important: trust in the medical team that treats the patients (96%), and the same medical team taking care of their relatives (87%). As to patients treated at the palliative care clinic, trust in the physician (83%), to be with people considered important to them (78%), and to be treated preserving their dignity (72%) were considered extremely important. For their caregivers, to receive adequate information about the disease and the treatment’s risks and benefits (84%), and sincere communication of information about the disease (79%) were considered extremely relevant.Conclusion Confidence through good communication and consistency in care were fundamental values to achieve satisfaction among caregivers and patients with cancer during all the course of disease development.

https://doi.org/10.1590/S1679-45082014RC3091 5486 downloads

10.

Impetigo - review
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Pereira, Luciana Baptista

Anais Brasileiros de Dermatologia

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apr 2014, Volume 89 N. 2 Pages 293 - 299

Abstract: En | Text: En | PDF: En

Impetigo is a common cutaneous infection that is especially prevalent in children. Historically, impetigo is caused by either group A β-hemolytic streptococci or Staphylococcus aureus. Currently, the most frequently isolated pathogen is S. aureus. This article discusses the microbiologic and virulence factors of group A β-hemolytic streptococci and Staphylococcus aureus, clinical characteristics, complications, as well as the approach to diagnosis and management of impetigo. Topical agents for impetigo therapy are reviewed.

https://doi.org/10.1590/abd1806-4841.20142283 33708 downloads

11.

Impetigo
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Pereira, Luciana Baptista

Anais Brasileiros de Dermatologia

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oct 2012, Volume 87 N. 5 Pages 804 - 804

Abstract: En | Text: En | PDF: En

5569 downloads

12.

Vertical growth control during maxillary expansion using a bonded Hyrax appliance
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Pinto, Francisco Marcelo Paranhos

; Abi-Ramia, Luciana Baptista Pereira

; Stuani, Andrea Sasso

; Stuani, Maria Bernadete Sasso

; Artese, Flavia

Dental Press Journal of Orthodontics

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feb 2012, Volume 17 N. 1 Pages 101 - 107

Abstract: En | Text: En | PDF: En

INTRODUCTION: Rapid maxillary expansion (RME) for the treatment of maxillary deficiency and posterior crossbite may induce changes in the vertical dimension. Expanders with occlusal splints have been developed to minimize unwanted vertical effects. OBJECTIVE: This preliminary study used cephalometri radiographs to evaluate the vertical effects of RME using a Hyrax appliance in children with maxillary deficiency. METHOD: Twenty-six patients (11 boys; mean age = 8 years and 5 months) with maxillary deficiency and posterior crossbite were treated using a Hyrax appliance with an acrylic occlusal splint. Radiographs and cephalometric studies were performed before the beginning of the treatment (T1) and after RME active time (T2), at a mean interval of 7 months. Results were compared with normative values. RESULTS AND CONCLUSIONS: At the end of treatment, there were no statistically significant changes, and measurements were similar to the normative values. Data showed that there were no significant effects on vertical growth, which suggests that appliances with occlusal splints may be used to correct transverse deficiencies regardless of the patient's growth pattern.

11153 downloads

13.

Apresentação cutânea inicial de linfomas na infância
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Oliveira, Maria Christina Lopes Araujo de

; Pereira, Luciana Baptista

; Rodrigues, Priscila Cezarino

; Sampaio, Keyla Cunha

; Oliveira, Benigna Maria de

; Viana, Marcos Borato

Anais Brasileiros de Dermatologia

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aug 2011, Volume 86 N. 4 Pages 799 - 802

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os linfomas cutâneos compreendem um grupo heterogêneo de desordens linfoproliferativas que envolvem a pele e são classificados como um subgrupo dos linfomas não Hodgkin. No período de 1981 a 2007, 100 casos de linfomas em crianças foram admitidos no Serviço de Hematologia, do Hospital das Clínicas da Universidade Federal de Minas Gerais, sendo que nove apresentaram manifestação cutânea inicial. Três pacientes foram classificados como linfoma cutâneo primário e seis como sistêmicos. Sete pacientes apresentaram linfoma de células T, um, linfoma linfoblástico B e um, imunofenótipo indefinido. Nenhum óbito ocorreu nos pacientes com linfoma cutâneo primário

Cutaneous lymphomas comprise a heterogeneous group of lymphoproliferative disorders with skin involvement and are classified as a subgroup of non-Hodgkin lymphomas. From 1981 to 2007, 100 children with non-Hodgkin lymphomas were admitted to the Hematology Unit of the Federal University of Minas Gerais Teaching Hospital. In nine of these children, the skin was involved at the onset of the disease. Three patients were classified as having primary cutaneous lymphoma, while in six the disease was systemic with cutaneous involvement. In seven patients, the immunophenotype was T-cell, in one it was B-cell, and in the remaining case the immunophenotype was indefinable. No deaths occurred in any of the children with primary cutaneous lymphoma

7430 downloads

14.

Você conhece esta síndrome?
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Baeta, Isabela Guimarães Ribeiro

; Pereira, Ana Carolina Figueiredo

; Guedes, Antônio Carlos Martins

; Pereira, Luciana Baptista

Anais Brasileiros de Dermatologia

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jun 2011, Volume 86 N. 3 Pages 605 - 607

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A síndrome KLICK é uma genodermatose rara, autossômica recessiva, caracterizada pela associação de queratodermia palmo-plantar difusa e transgressiva, com esclerodactilia, placas hiperqueratóticas lineares localizadas preferencialmente em flexuras e ictiose congênita. Não há alterações em fâneros ou mucosas, assim como sintomas sistêmicos associados. O tratamento consiste no uso de queratolíticos tópicos e retinóides orais

Keratosis linearis with ichthyosis congenita and sclerosing keratoderma (KLICK) syndrome is a rare autosomal recessive skin disorder characterized by the association of diffuse, transgressive palmoplantar keratoderma with sclerodactyly, linear hyperkeratotic plaques generally located in flexures, and congenital ichthyosis. The patient is physically and mentally healthy and has no history of any problems related to teeth, nails, hair or mucous membranes. Treatment is based on the use of topical keratolytics and oral retinoids

6288 downloads

15.

Discussão sobre a existência da forma unilesional de micose fungóide
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Pereira, Luciana Baptista

Anais Brasileiros de Dermatologia

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apr 2011, Volume 86 N. 2 Pages 404 - 404

Abstract: Pt | Text: Pt | PDF: Pt

1935 downloads

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