ABSTRACT
A vigilância epidemiológica é considerada uma forma tradicional de utilização da epidemiologia nos serviços de saúde, que gera informações pertinentes e promove o seu uso, com o propósito de facilitar a realização de medidas para a melhoria da saúde pública. Quando está relacionada à hanseníase deve ser organizada em todos os níveis e propiciar o acompanhamento rotineiro das principais ações estratégicas para a eliminação da doença enquanto problema de saúde pública.
ABSTRACT
O comprometimento do sistema nervoso periférico, decorrente da Hanseníase, pode gerar alterações sensitivas, motoras e autonômicas que evoluem com tipos e graus variados de incapacidade física, interferindo na qualidade de vida desses pacientes. Uma das formas de incapacidade é representada pela úlcera plantar, que também recebe a denominação de mal perfurante plantar. Objetivos: Elucidar a fisiopatologia e descrever quais são as principais formas de prevenção e tratamento da úlcera plantar em pacientes portadores de Hanseníase.
ABSTRACT
A Hanseníase é uma patologia infecciosa crônica causada pelo Mycobacterium leprae, que afeta a pele, o sistema nervoso periférico e eventualmente outros órgãos e sistemas. A reação hansênica do tipo 1 ou reação reversa é um episódio inflamatório agudo que ocorre devido a uma reação de hipersensibilidade do tipo IV de Gell e Coombs. Estes fenômenos inflamatórios podem surgir antes, durante ou após o tratamento específico para a Hanseníase, constituindo um dos maiores problemas relacionados a esta doença, pois são responsáveis por perda funcional de nervos periféricos e agravantes das incapacidades físicas.
ABSTRACT
The human orosomucoid 1 gene (ORM1) codes an alpha-1-acid glycoprotein that has been classified as an acute-phase reactive protein, and a major drug-binding serum component, as well as an immunomodulatory protein with genetic polymorphisms. Evaluation of ORM variation through isoelectric focusing and immunobloting has revealed a world-wide distribution of the ORM1 F and ORM1 S alleles. We evaluated and examined the genetic characteristicsof two Mexican populations that have different anthropological and cultural antecedents, examining two ORM1 genotypes (exon 1 - A/G (Gln20Arg) and exon 5 G/A (Val156Met)) in 145 individuals, using nested polymerase chain reaction, sequencing, and restrited fragment length polymorphism. Mexican Mestizos had higher frequencies of the exon 1 A allele (P = 0.020) and AA genotype(P = 0.018) and lower frequency of the G allele (P = 0.020) when compared to Teenek Amerindians. When we examined exon 5 G/A (Val156Met) polymorphisms, we found significantly higher frequencies of the G allele (P = 0.0007) and the GG genotype (P = 0.0003) in the Mexican Mestizo population. The Teenek population had a significantly higher frequency of the A allele than has been reported for Chinese and African (P < 0.05) populations, and the G/A genotype was more frequently found in this Mexican population than in Chinese, African and European populations (P < 0.05).
Subject(s)
Humans , Exons/genetics , Genetics, Population , Indians, North American/genetics , Orosomucoid/genetics , Polymorphism, Genetic , Alleles , DNA , Gene Frequency , Genetic Variation , Mexico , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Sequence Analysis, DNA , Statistics as TopicABSTRACT
BACKGROUND: Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EPC) are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibility tests are necessary to predict a therapeutic failure. Etest is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A). AIM: To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB) and Fluconazole (Flu) using Etest. MATERIAL AND METHODS: Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar. RESULTS: All studied strains showed minimal inhibitory concentrations (MICs) < 1 mg/mL for AmB. A highly resistant strain to Flu (> 256 mg/mL) was isolated from a patient previously treated with Flu. CONCLUSIONS: In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest is a reliable alternative in these cases, for laboratories that cannot use the reference method.
Subject(s)
Humans , Male , Female , Antifungal Agents , Candida albicans/drug effects , Candidiasis/drug therapy , Esophageal Diseases/mortality , AIDS-Related Opportunistic Infections/drug therapy , Antifungal Agents , Amphotericin B/pharmacology , Amphotericin B/therapeutic use , Candida albicans/isolation & purification , Candidiasis, Oral/drug therapy , Pharyngeal Diseases/drug therapy , Esophageal Diseases/complications , Esophageal Diseases/drug therapy , Fluconazole/pharmacology , Fluconazole/therapeutic use , AIDS-Related Opportunistic Infections/microbiology , Drug Resistance, Fungal , Microbial Sensitivity Tests/methodsABSTRACT
BACKGROUND: Kaposi sarcoma is the most common tumor in HIV infected patients. AIM: To describe a cohort of patients with Kaposi sarcoma. MATERIAL AND METHODS: Retrospective review of HIV patients with Kaposi sarcoma seen at a public hospital and at a HIV clinic. Detailed description of patients subjected to antiretroviral treatment and chemotherapy. RESULTS: Between 1995 and 2002, 1127 HIV infected patients were seen. Of these, 78 had Kaposi sarcoma, 15 were treated with high activity antiretroviral therapy (HAART) and 17 with HAART and chemotherapy. These 32 patients were male, and their mean age was 33 +/- 6 years. The initial CD4 count in 27 of these was 95 +/- 105 cells/ml. The initial viral load in 18 of these was 370,246 +/- 768,693 RNA copies/ml. Of the 15 patients treated with HAART, eight had a complete remission, one had a partial response, one remained stationary and five died. Of the 17 patients treated with HAART and chemotherapy, seven had complete remission, five had a partial response, 2 remained stationary and three died. The lapse of complete remission was 272 days for those treated with HAART and 292 days for those treated with HAART and chemotherapy. CONCLUSIONS: In HIV patients with Kaposi sarcoma, high activity antiretroviral therapy, associated or not to chemotherapy, induces complete remission in 46 per cent of patients and partial remission in 16 per cent.