Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 928
Filter
1.
Nursing (Ed. bras., Impr.) ; 26(303): 9867-9875, set.2023. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1511825

ABSTRACT

Objetivo: Avaliar a qualidade de vida de pacientes durante e após o tratamento de hanseníase. Método: Estudo descritivo, exploratório e quantitativo. Realizado através da escala de qualidade de vida WHOQOL-bref. CAAE: 58389422.0.0000.5587. Resultados: Participaram 33 (100%) pacientes que tiveram diagnóstico de Hanseníase, a amostra foi tabulada separando entre dois grupos, 13 (100%) em tratamento ativo e 20 (100%) com tratamento finalizado. Para os pacientes ainda em tratamento: no domínio físico 31% referem boa qualidade de vida e 23% referem ruim, já no meio ambiente, psicológico e relações sociais 08% referem boa qualidade de vida e 23% ruim, respectivamente. Para os participantes com tratamento finalizado, o domínio físico, meio ambiente, psicológico e relações sociais obtiveram 40% com boa qualidade de vida e 05% ruim. Conclusão: os pacientes que finalizaram tratamento apresentam melhor qualidade de vida do que os pacientes em tratamento de hanseníase, demonstrando a importância de realizar o tratamento corretamente.(AU)


Objective: To evaluate the quality of life of patients during and after leprosy treatment. Method: Descriptive, exploratory and quantitative study. It was carried out using the WHOQOL-bref quality of life scale. CAAE: 58389422.0.0000.5587. Results: 33 (100%) patients diagnosed with leprosy took part in the study. The sample was divided into two groups: 13 (100%) in active treatment and 20 (100%) with treatment completed. For patients still undergoing treatment: in the physical domain 31% reported a good quality of life and 23% a poor one, while in the environmental, psychological and social relations domains 08% reported a good quality of life and 23% a poor one, respectively. For participants who had completed treatment, 40% reported good quality of life in the physical, environmental, psychological and social relations domains and 05% reported poor quality of life. Conclusion: Patients who have completed treatment have a better quality of life than patients undergoing leprosy treatment, demonstrating the importance of carrying out treatment correctly.(AU)


Objetivo: Evaluar la calidad de vida de los pacientes durante y después del tratamiento de la lepra. Método: Estudio descriptivo, exploratorio y cuantitativo. Se realizó utilizando la escala de calidad de vida WHOQOL-bref. CAAE: 58389422.0.0000.5587. Resultados: Participaron en el estudio 33 (100%) pacientes diagnosticados de lepra. La muestra se tabuló en dos grupos: 13 (100%) en tratamiento activo y 20 (100%) con tratamiento finalizado. Para los pacientes aún en tratamiento: en el dominio físico el 31% informó de una buena calidad de vida y el 23% de una mala, mientras que en los dominios ambiental, psicológico y de relaciones sociales el 08% informó de una buena calidad de vida y el 23% de una mala, respectivamente. En el caso de los participantes que habían completado el tratamiento, el 40% informó de una buena calidad de vida en los dominios físico, ambiental, psicológico y de relaciones sociales y el 05% informó de una mala calidad de vida. Conclusión: Los pacientes que han completado el tratamiento tienen una mejor calidad de vida que los pacientes en tratamiento contra la lepra, lo que demuestra la importancia de llevar a cabo el tratamiento correctamente.(AU)


Subject(s)
Humans , Indicators of Quality of Life , Leprosy , Mycobacterium leprae
2.
Rev. Ciênc. Méd. Biol. (Impr.) ; 22(2): 188-196, set 2023. fig
Article in English | LILACS | ID: biblio-1516244

ABSTRACT

Introduction: Hansen's disease, or leprosy is caused by Mycobacterium leprae (M. leprae), is a major public health problem in developing countries, and affecting the skin and peripheral nerves. However, M. leprae can also affect bone tissue, mucous membranes, liver, eyes, and testicles, producing a variety of clinical phenotypes. MicroRNAs (miRNAs) have been expressed in the various clinical forms of leprosy and could potentially be used for its diagnosis. Objective: in silico design of the molecular structure of miRNAs expressed in leprosy. Methodology: we performed a nucleotide sequence search of 17 miRNAs expressed in leprosy, designing in silico the molecular structure of the following miRNAs: miRNA-26a, miRNA-27a, miRNA-27b, miRNA-29c, miRNA-34c, miRNA-92a-1, miRNA- 99a-2, miRNA-101-1, miRNA-101-2, miRNA-125b-1, miRNA-196b, miRNA-425-5p, miRNA-452, miRNA-455, miRNA-502, miRNA-539, and miRNA-660. We extracted the nucleotides were from the GenBank of National Center for Biotechnology Information genetic sequence database. We aligned the extracted sequences with the RNA Folding Form, and the three-dimensional molecular structure design was performed with the RNAComposer. Results: we demonstrate the nucleotide sequences, and molecular structure projection of miRNAs expressed in leprosy, and produces a tutorial on the molecular model of the 17 miRNAs expressed in leprosy through in silico projection processing of their molecular structures. Conclusion: we demonstrate in silico design of selected molecular structures of 17 miRNAs expressed in leprosy through computational biology.


Introdução: a doença de Hansen, ou hanseníase é causada pelo Mycobacterium leprae (M. leprae), é um grande problema de saúde pública nos países em desenvolvimento e afeta, a pele e os nervos periféricos. Entretanto, o M. leprae também pode comprometer o tecido ósseo, membranas mucosas, fígado, olhos e testículos, produzindo uma variedade de fenótipos clínicos. MicroRNAs (miRNAs) têm sido expressos nas várias formas clínicas da hanseníase e podem ser potencialmente utilizados para seu diagnóstico. Objetivo: objetivou-se com esse experimento modelar computacionalmente a estrutura molecular dos miRNAs expressos na hanseníase. Metodologia: realizou-se como metodologia uma pesquisa das sequências nucleotídicas de 17 miRNAs expressos na hanseníase, desenhando em modelo computacional a estrutura molecular dos seguintes miRNAs: miRNA-26a, miRNA-27a, miRNA-27b, miRNA- 29c, miRNA-34c, miRNA-92a-1, miRNA-99a-2, miRNA-101-1, miRNA-101-2, miRNA-125b-1, miRNA-196b, miRNA-425-5p, miRNA-452, miRNA-455, miRNA-502, miRNA-539, e miRNA-660. Extraiu-se os nucleotídeos do banco de dados do GenBank of National Center for Biotechnology Information . Alinhou-se as sequências extraídas com o RNA Folding Form, e o projeto da estrutura molecular tridimensional foi realizado com o RNAComposer. Resultados: demonstrou-se como resultados as sequências dos nucleotídeos e a projeção da estrutura molecular dos miRNAs expressos na hanseníase, e produzimos um tutorial sobre o modelo molecular dos 17 miRNAs expressos em hanseníase através do processamento de suas estruturas moleculares em projeção computacional. Conclusão: foi demonstrado computacionalmente o projeto de estruturas moleculares selecionadas de 17 miRNAs expressos em hanseníase através da biologia computacional.


Subject(s)
Peripheral Nerves , Skin , Biomarkers , MicroRNAs , Leprosy , Mycobacterium leprae , Testis , Bone and Bones , Eye , Liver , Mucous Membrane
3.
Medisan ; 27(4)ago. 2023. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1514571

ABSTRACT

Se describe el caso clínico de un paciente infectado por el virus de la inmunodeficiencia humana en fase sintomática precoz, quien fue asistido en el Servicio de Dermatología del Hospital Clínico Quirúrgico Docente Dr. León Cuervo Rubio en Pinar del Río por presentar lesiones eritematosas infiltradas de tres meses de evolución en el miembro inferior derecho, con alteración de la sensibilidad térmica y dolorosa. Se le indicó baciloscopia y estudio histopatológico que confirmaron el diagnóstico de sospecha de lepra dimorfa tuberculoide, por lo que se comenzó a aplicar poliquimioterapia combinada con terapia antirretroviral, lo cual favoreció la evolución del paciente.


The case report of a patient infected by the human immunodeficiency virus in early symptomatic phase is described, who was seen at the Dermatology Service of the Dr. León Cuervo Rubio Teaching Clinical Surgical Hospital of Pinar del Río for presenting infiltrated erythematous lesions of three months of evolution in the right lower limb, with altered pain and thermal sensation. A basiloscopic and histopathologic study was indicated, which confirmed the presumptive diagnosis of borderline tuberculoid leprosy, and therefore polychemotherapy combined with antiretroviral therapy was started, which favored the patient's evolution.


Subject(s)
Mycobacterium leprae
4.
Rev. cuba. med ; 62(1)mar. 2023.
Article in Spanish | LILACS, CUMED | ID: biblio-1450013

ABSTRACT

La lepra o enfermedad de Hansen es una infección crónica causada por Mycobacterium leprae (M. leprae) o Mycobacterium lepromatosis (M. lepromatosis), es una enfermedad infecciosa curable que es endémica en más de 140 países de todo el mundo. La Organización Mundial de la Salud lo declaró eliminado como un problema mundial de salud pública en el año 2000, sin embargo, en 2017 se informaron aproximadamente 200 000 casos nuevos en todo el mundo. A pesar de la terapia farmacológica combinada disponible, continúa como un importante problema de salud pública, que conlleva un fuerte estigma. En Cuba, según el Anuario Estadístico de Salud de 2020, se reportaron durante ese año 116 casos, las provincias más afectadas fueron Santiago de Cuba con 25 nuevos casos y Guantánamo con 17 nuevos casos. La presentación de caso se trata de una joven de 20 años, en edad reproductiva, con manifestaciones generales de astenia, pérdida del cabello, adenopatías, poliartritis, lesiones cutáneas y fiebre, que hizo sospechar en una enfermedad del colágeno. En estos momentos con buena evolución y en seguimiento por atención primaria de salud de su provincia(AU)


Leprosy or Hansen's disease is a chronic infection caused by mycobacterium leprae (M. leprae) or mycobacterium lepromatosis (M. lepromatosis). It is a curable infectious disease, endemic in more than 140 countries around the world. Despite being declared eradicated as a global public health problem by the World Health Organization in 2000, approximately 200,000 new cases were reported worldwide in 2017. Despite available combination drug therapy, it remains a major public health problem, carrying strong stigma. In Cuba, according to 2020 health statistical yearbook, 116 cases were reported during that year. The most affected provinces were Santiago de Cuba (25 new cases) and Guantánamo (17 new cases). The case to be reported concerns a 20-year-old young woman of reproductive age, with general manifestations of asthenia, hair loss, adenopathies, polyarthritis, skin lesions, and fever; she suspected was a collagen disease. Currently, she is well and she is followed up by primary health care in her province(AU)


Subject(s)
Humans , Male , Female , Leprosy/epidemiology , Mycobacterium leprae , Cuba
5.
J. Health Biol. Sci. (Online) ; 11(1): 1-5, Jan. 2023. tab
Article in English | LILACS | ID: biblio-1442534

ABSTRACT

Objective: to evaluate leprosy bacilloscopy exam notifications in the Brazilian Unified Health System (SUS) from April 2018 to March 2022. Methods: an ecological study was carried out using open-access data from the SUS. Results: the temporal tendency of leprosy bacilloscopy was considered significantly decrease over time (p <0.05), as well as there was a significant decrease in the first and second pandemic years when compared to the control interval in all Brazilian regions (p <0.05). Conclusion: leprosy bacilloscopy exams remain negatively affected by the COVID-19 pandemic in the SUS.


Objetivo: avaliar o número de notificações de baciloscopia para hanseníase no Sistema Único de Saúde brasileiro (SUS) de abril de 2018 até março de 2022. Método: foi realizado um estudo ecológico com dados de acesso aberto do SUS. Resultados: a tendência temporal da baciloscopia da hanseníase foi considerada significativamente decrescente ao longo do tempo (p <0.05), bem como houve uma redução significativa no primeiro e segundo ano de pandemia quando comparado ao intervalo-controle em todas as regiões brasileiras (p <0.05). Conclusão: os exames de baciloscopia da hanseníase permanecem afetados negativamente pela pandemia de COVID-19 no SUS.


Subject(s)
Mycobacterium leprae , Unified Health System , COVID-19 , Leprosy
6.
Rev. chil. infectol ; 39(1): 80-85, feb. 2022. ilus, tab
Article in Spanish | LILACS | ID: biblio-1388336

ABSTRACT

Resumen La enfermedad de Hansen o lepra es una enfermedad infecciosa crónica causada por Mycobacterium leprae, y que afecta principalmente la piel y nervios periféricos. En los últimos años, se ha logrado un mejor control de la enfermedad en forma global. Sin embargo, en Chile la incidencia de la lepra ha ido en aumento. Presentamos el caso clínico de un paciente de 40 años, haitiano, con lesiones e histopatología compatibles con una lepra tuberculoide. Se discute la importancia en la educación sobre enfermedades menos prevalentes en Chile y se hace una revisión sobre la fisiopatología, clínica y clasificación de la enfermedad de Hansen.


Abstract Hansen's disease or leprosy is a chronic infectious disease caused by Mycobacterium leprae, mainly affecting the skin and peripheral nerves. In recent years, a better control of the disease has been achieved globally. However, in Chile the incidence of leprosy has continued to increase. We present a case of a 40-year-old patient Haitian nationality with lesions and histopathology compatible with tuberculoid leprosy. We discuss the importance of education on less prevalent diseases in Chile, in conjunction with a review of the pathophysiology, clinic, and classification of Hansen's disease.


Subject(s)
Humans , Male , Adult , Leprosy, Tuberculoid/diagnosis , Leprosy, Tuberculoid/drug therapy , Chile , Haiti , Leprosy , Mycobacterium leprae
7.
Hansen. int ; 47: 1-7, 2022. ilus
Article in Portuguese | LILACS, SES-SP, HANSEN, HANSENIASE, SESSP-ILSLACERVO, SES-SP | ID: biblio-1436168

ABSTRACT

Introdução: o diagnóstico clínico da hanseníase em crianças é particularmente difícil. Relato de Caso: crianças gêmeas bivitelinas, com três anos de idade, eram contactantes de pai com hanseníase Virchowiana. Os dois pacientes têm lesões cutâneas bem definidas e irregulares, anteriormente tratadas como micoses e uma cicatriz de BCG. Foram confirmados positivos para Mycobacterium por análise histopatológica da pele. Discussão: especialmente, com menos de cinco anos, os diagnósticos de hanseníase são raros e difíceis porque simulam outras doenças. Esses diagnósticos são alarmes epidemiológicos para áreas endêmicas e mostram a importância dos sintomas em crianças e o rastreamento nos contactantes dos pacientes.


Introduction: the clinical diagnosis of leprosy in children is particularly difficult. Case Report: fraternal twins, three years old, were in contact with a father with Virchowian leprosy. Both patients have well-defined and irregular skin lesions previously treated as mycoses and a BCG scar. They were confirmed positive for Mycobacterium by histopathological analysis of the skin. Discussion:especially, with less than five years, leprosy diagnoses are rare and difficult because they simulate other diseases. These diagnoses are epidemiological alarms for endemic areas and show the importance of symptoms in children and tracking of patients' contacts.


Subject(s)
Humans , Male , Female , Child, Preschool , Early Diagnosis , Leprosy/diagnosis , Leprosy/pathology , Leprosy/transmission , Contact Tracing , Diseases in Twins , Leprosy/microbiology , Leprosy/prevention & control , Mycobacterium leprae/isolation & purification
8.
An. bras. dermatol ; 96(5): 598-601, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345144

ABSTRACT

Abstract Histoid leprosy is considered a rare form of lepromatous leprosy. Its peculiar clinical picture makes its diagnosis a challenging one, which can delay starting treatment and perpetuate the disease as endemic. In addition to representing a reservoir of bacilli, and being an important means of contamination, these patients have greater resistance to standard treatment. This is a report of a typical case of this rare presentation, aiming to share the knowledge and favor earlier diagnosis of the disease.


Subject(s)
Humans , Leprosy, Lepromatous/diagnosis , Leprosy, Lepromatous/drug therapy , Leprosy , Mycobacterium leprae
9.
Rev. baiana saúde pública ; 45(2): 37-49, 20211010.
Article in Portuguese | LILACS | ID: biblio-1379618

ABSTRACT

A hanseníase é uma doença infecciosa crônica causada pelo Mycobacterium leprae, considerada um grave problema de saúde pública. A adesão à terapia farmacológica contribui para a qualidade de vida do paciente e para a interrupção da cadeia de transmissão da doença. Este trabalho objetivou analisar a adesão à poliquimioterapia em pacientes com hanseníase acompanhados em um serviço de atendimento especializado do município de Rondonópolis (MT). Trata-se de um estudo descritivo de abordagem quantitativa. Participaram da pesquisa 63 pacientes com diagnóstico de hanseníase, acompanhados no Serviço de Atendimento Especializado do Município de Rondonópolis. Para analisar a adesão, utilizou-se o teste de Morisky-Green. Foram classificados como aderentes ao tratamento 31 pacientes (49,2%) no total. As menores frequências de adesão foram observadas em mulheres, na faixa etária de 51 a 59 anos, de cor autodeclarada branca, renda familiar superior ou igual a dois salários mínimos, com até oito anos de estudo, sem companheiros e que possuíam rede de esgoto em suas residências. Observou-se diferença estatística para as variáveis sexo (p = 0,036), modo de detecção (p = 0,008) e forma clínica (p = 0,028). Os resultados indicaram baixa adesão à poliquimioterapia. Mulheres, pacientes com modo de detecção do tipo encaminhamento ou exames de coletividade, com forma clínica indeterminada, tuberculoide ou virchowiana são menos aderentes à poliquimioterapia. Os resultados indicam a necessidade de adoção de medidas que busquem promover melhor aceitação à terapia farmacológica entre os pacientes com hanseníase.


Hansen's disease, a chronic infectious disease caused by Mycobacterium leprae, is considered a major public health issue. Adherence to pharmacological therapy contributes to the patient's quality of life and to interrupting the disease transmission chain. Hence, this study analyzes adherence to multidrug therapy in patients with Hansen's disease treated at a specialized care service in Rondonópolis, Mato Grosso, Brazil. A quantitative, descriptive research was carried out with 63 patients diagnosed with Hansen's disease and treated at the Specialized Care Service of the municipality of Rondonópolis. Adherence was analyzed using the Morisky-Green test. A total of 31 (49.2%) patients were classified as adherent to treatment. The lowest frequency of adherence was observed in women, aged 51 to 59 years, white, family income ≥ 2 minimum wages, with up to eight years of schooling, without partners, and with a sewage system in their homes. Statistical difference was observed for the variables gender (p=0.036), detection mode (p=0.008), and clinical form (p=0.028). Results showed low adherence to multidrug therapy. Women, patients with referral detection or collective exams, with undetermined clinical form, tuberculoid or Lepromatous leprosy, are less adherent to polychemotherapy. The findings indicate the need to adopt measures that seek to promote better adherence to pharmacological therapy among patients with Hansen's disease.


La lepra es una enfermedad infecciosa crónica causada por Mycobacterium leprae y considerada un grave problema de salud pública. La adherencia a la terapia farmacológica contribuye a la calidad de vida del paciente y a la interrupción de la cadena de transmisión de la enfermedad. Este estudio tuvo como objetivo analizar la adherencia a la poliquimioterapia en pacientes con lepra seguidos en un servicio de atención especializado en la ciudad de Rondonópolis, en Mato Grosso (Brasil). Se trata de un estudio descriptivo, de tipo cuantitativo. Participaron en la investigación 63 pacientes diagnosticados de lepra, seguidos en el Servicio de Atención Especializado del Municipio de Rondonópolis. Para analizar la adherencia se utilizó la prueba de Morisky-Green. Un total de 31 (49,2%) pacientes fueron clasificados como adherentes al tratamiento. La menor frecuencia de adherencia se observó en mujeres, en el grupo de edad de entre 51 y 59 años, de color autodeclarado blanco, renta familiar mayor o igual a 2 salarios mínimos, con nivel de educación hasta ocho años, sin pareja y que tenían red de alcantarillado en sus hogares. Hubo diferencia estadística para la variable sexo (p = 0,036), modo de detección (p = 0,008) y forma clínica (p = 0,028). Los resultados indicaron una baja adherencia a la poliquimioterapia. Las mujeres, los pacientes con modo de detección por derivación o exámenes colectivos, con forma clínica indeterminada, tuberculoide o virchowiana fueron los menos adherentes a la poliquimioterapia. Los resultados indican la necesidad de adoptar medidas que busquen promover una mejor aceptación de la terapia farmacológica entre los pacientes con lepra.


Subject(s)
Humans , Answering Services , Drug Therapy , Drug Therapy, Combination , Leprosy , Mycobacterium leprae
12.
Arq. ciências saúde UNIPAR ; 25(1): 79-85, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151426

ABSTRACT

Introdução: O diagnóstico da hanseníase possui números significativos que causam preocupação à saúde pública. Os casos de resistência medicamentosa nessa doença se iniciaram em meados dos anos 60 e diante do problema, a Organização Mundial da Saúde instituiu em 1981 a poliquimioterapia, associação dos antibióticos rifampicina, dapsona e clofazimina, tratamento atual de escolha. A resistência aos fármacos na hanseníase é reportada pela literatura, desvelando um obstáculo à sua eliminação. Apresentamos nessa revisão os principais aspectos da resistência medicamentosa no tratamento para hanseníase e seus impactos. Metodologia: Revisão sistemática sobre os aspectos da resistência medicamentosa utilizando a pesquisa exploratória como metodologia de abordagem. Foram pesquisados os termos resistência medicamentosa, hanseníase, recidiva, alterações genéticas e os operadores booleanos "and" e "or" na busca. Resultados e discussão: A dificuldade de tomar a medicação corretamente foi um dos principais fatores que acarretaram resistência do bacilo Mycobacterium leprae aos fármacos. Homens de países norte e sul-americanos e asiáticos foram os mais atingidos por episódios de resistência. A resistência medicamentosa é uma das principais causas de recidivas em hanseníase. O principal fármaco causador de resistência medicamentosa descrito nos trabalhos foi a dapsona (46,6%) e a maioria das alterações genéticas encontradas estão no gene rpoB; 23,2% dos registros relatados foram de resistência secundária aos fármacos e, também, sete casos de resistência múltipla a esses medicamentos. Conclusão: Os principais aspectos da resistência medicamentosa na hanseníase são os equívocos ao ingerir os medicamentos e as alterações genéticas na bactéria. Os impactos causados estão na dificuldade de refazer o tratamento, a possibilidade de nova transmissão e o aparecimento de sintomas mais graves.


Introduction: The diagnosis of leprosy has significant numbers causing public health concern. Reports of drug resistance in this disease begun in the mid-1960s and due to this problem, the World Health Organization instituted a multidrug therapy with rifampicin, dapsone, and clofazimine antibiotic association in 1981, which is currently the first-choice treatment for leprosy. Cases of drug resistance have been reported in literature, revealing an obstacle to the eradication of the disease. This paper has the purpose of presenting the key aspects and impacts of drug resistance in the treatment for leprosy. Methods: Systematic review of the drug resistance aspects using exploratory research as an approach methodology. The authors searched the terms drug resistance, leprosy, recurrence, genetic alterations, and the Boolean operators "and" and "or" between them. Results and discussion: The difficulty in taking the medication correctly was one of the key factors that led to drug resistance for Mycobacterium leprae. Men from North and South American, as well as from Asian countries, were the most affected by episodes of resistance. Drug resistance is one of the main causes of leprosy recurrences. Dapsone was the most frequently identified drug resistance in the studies (46.6%), while most of the genetic alterations were found in the rpoB gene; 23.2% of the cases were from secondary resistance episodes, and seven cases of multiple resistance were reported. Conclusion: The misconceptions when taking the treatment and the Mycobacterium leprae genetic alterations have been described as the key aspects of drugs resistance in leprosy and the impacts caused are the difficulty in redoing the treatment, the possibility of new transmission, and the appearance of more severe symptoms.


Subject(s)
Drug Resistance/drug effects , Drug Resistance, Bacterial/drug effects , Mycobacterium leprae/drug effects , Rifampin/adverse effects , Bacteria/genetics , Pharmaceutical Preparations , Clofazimine/adverse effects , Fluoroquinolones/adverse effects , Dapsone/adverse effects , Drug Therapy, Combination/adverse effects , Leprosy/drug therapy , Anti-Bacterial Agents/adverse effects
13.
Medisan ; 25(1)ene.-feb. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1154843

ABSTRACT

Introducción: La lepra es una enfermedad infectocontagiosa crónica, producida por el Mycobacterium leprae, y constituye uno de los males más antiguos de la humanidad. Objetivo: Describir algunas características clínicas y epidemiológicas de los pacientes con lepra pertenecientes al Policlínico Docente Ramón López Peña de Santiago de Cuba. Métodos: Se realizó un estudio descriptivo y retrospectivo de los 11 pacientes diagnosticados con la enfermedad de Hansen en la mencionada área de salud en el período 2005-2019. Para el procesamiento de la información se creó una base de datos mediante el sistema SPSS, versión 11.5 para Windows, donde se tabularon los datos de las encuestas. El análisis de los resultados se expresó en números absolutos y porcentajes para su mejor interpretación. Resultados: Predominaron el grupo etario de 35-44 años (54,5 %), el sexo masculino (54,6 %) y la lepra dimorfa, en su forma clínica multibacilar. La mayoría de los pacientes fueron diagnosticados precozmente y solo se observó algún grado de discapacidad en los diagnósticos tardíos; asimismo, las condiciones higiénicas desfavorables y el hacinamiento fueron los factores de riesgo de mayor relevancia. Conclusiones: A pesar de la existencia de pacientes con lepra en dicha área de salud, se observó un período de silencio epidemiológico, que unido a los factores de riesgo presentes, aumenta la posibilidad de contagio y pone en peligro los objetivos establecidos para su erradicación.


Introduction: Leprosy is an infectious chronic disease, produced by the Mycobacterium leprae, and constitutes one of the oldest ills of humanity. Objective: To describe some clinical and epidemiological characteristics of the patients with leprosy belonging to Ramón López Peña Teaching Polyclinic in Santiago de Cuba. Methods: A descriptive and retrospective study of the 11 patients diagnosed with Hansen disease in the mentioned health area during 2005-2019 was carried out. A database was created by means of the SPSS system, version 11.5 for Windows, for processing the information, where the data of the surveys were tabulated. The analysis of the results was expressed in absolute numbers and percentages for its best interpretation. Results: There was a prevalence of the 35-44 age group (54.5 %), the male sex (54.6 %) and the borderline lepromatous leprosy, in its multibacilar clinical form. Most of the patients were early diagnosed and certain degree of disability was just observed in the late diagnoses; also, the unfavorable hygienic conditions and overcrowding were the risk factors of more relevance. Conclusions: In spite of the existence of patients with leprosy in this health area, a period of epidemiological silence was observed that along with the existing risk factors, increases the infection possibility and puts in danger the established objectives for its eradication.


Subject(s)
Communicable Diseases , Leprosy/epidemiology , Primary Health Care , Mycobacterium leprae
14.
An. bras. dermatol ; 96(1): 97-99, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152798

ABSTRACT

Abstract Leprosy is a chronic infectious disease caused by Mycobacterium leprae and, depending on the host immune status, presents different clinical forms. This report describes the case of a 46-year-old man who had hypoesthetic lesions in the infrahyoid region for 30 days. The bacilloscopy was negative. The anatomopathological examination showed alterations corresponding to the tuberculoid pole (epithelioid histiocytes) and virchowian pole (foamy histiocytes), compatible with borderline-virchowian leprosy (Ridley and Jopling classification). Rapid tests for HIV I, II, and syphilis were positive, with a CD4 count of 223. The patient started treatment with multibacillary multidrug therapy, antiretroviral therapy, and benzathine penicillin, with marked clinical improvement in two months.


Subject(s)
Humans , Male , Leprosy, Borderline/drug therapy , Leprosy/drug therapy , Drug Therapy, Combination , Leprostatic Agents/therapeutic use , Middle Aged , Mycobacterium leprae
15.
Rev. bras. oftalmol ; 80(1): 21-26, jan.-fev. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1251319

ABSTRACT

RESUMO Objetivo: O presente trabalho teve por objetivo caracterizar o perfil epidemiológico e clínico de pacientes com lagoftalmo associado à hanseníase, atendidos no ambulatório de oftalmologia da Fundação Alfredo da Matta, Manaus, Amazonas. Métodos: Trata-se de estudo retrospectivo realizado por meio da análise dos prontuários clínicos dos pacientes incluídos no estudo. Sexo, idade, forma clínica, grau de incapacidade no diagnóstico e desfecho foram obtidos dos prontuários. Início, tipo de comprometimento (unilateral ou bilateral), grau de intensidade do lagoftalmo e alterações oculares associadas também foram compilados. Resultados: Foram incluídos 65 pacientes; 66,1% eram do sexo masculino e 53,8% tinham idade superior a 60 anos. Em relação à classificação operacional da hanseníase, a maioria dos pacientes (81,5%) era multibacilar: 33,8% na forma de hanseníase borderline e 47% virchowiana. 36,9% casos apresentavam sequelas oculares associadas ao lagoftalmo: opacidade corneana, epífora, ceratopatia em faixa, e neovascularização corneana.41,6% evoluíram para a cegueira. O lagoftalmo foi conduzido de forma clínica em 23 pacientes e a abordagem cirúrgica foi indicada em 42. Em relação ao tratamento cirúrgico consistiu principalmente no implante de peso de ouro e na cantoplastia de Tessier. Discussão: O lagoftalmo nessa casuística acometeu mais homens idosos, esteve relacionado à forma multibacilar, com hanseníase do tipo virchowiano como relatado na literatura. O diagnóstico de lagoftalmo foi tardio na maioria dos casos, explicando o grande número de sequelas incluindo a cegueira. Conclusão: O presente estudo reforça a necessidade de acompanhamento oftalmológico precoce para que as potenciais e graves sequelas associadas a essa condição sejam evitadas.


ABSTRACT Objective: The present study aimed to characterize the epidemiological and clinical profile of patients with lagophthalmos associated with leprosy, seen at the ophthalmology outpatient clinic of Fundação Alfredo da Matta, Manaus, Amazonas. Methods: This is a retrospective study carried out by analyzing the medical records of the patients included in the study. Sex, age, clinical form, degree of disability in diagnosis and outcome were obtained from medical records. Onset, type of impairment (unilateral or bilateral), degree of intensity of lagophthalmos and associated eye changes were also compiled. Results: 65 patients were included; 66.1% were male and 53.8% were older than 60 years. Regarding the operational classification of leprosy, most patients (81.5%) were multibacillary: 33.8% in the form of borderline leprosy and 47% virchowian. 36.9% of cases had ocular sequelae associated with lagophthalmos: corneal opacity, epiphora, band keratopathy, and corneal neovascularization.41.6% progressed to blindness. Lagophthalmos was performed clinically in 23 patients and the surgical approach was indicated in 42. Regarding surgical treatment, it consisted mainly of gold weight implantation and Tessier's canthoplasty. Discussion: Lagophthalmos in this sample affected more elderly men, was related to the multibacillary form, with leprosy-like leprosy as reported in the literature. The diagnosis of lagophthalmos was delayed in most cases, explaining the large number of sequelae including blindness. Conclusion: The present study reinforces the need for early eye care so that the potential and serious sequelae associated with this condition are avoided.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Blindness/complications , Eye Diseases/epidemiology , Leprosy/epidemiology , Mycobacterium leprae , Oculomotor Muscles/abnormalities , Brazil , Epidemiology, Descriptive , Retrospective Studies
16.
J. venom. anim. toxins incl. trop. dis ; 27: e20200027, 2021. tab, graf
Article in English | VETINDEX, LILACS | ID: biblio-1287091

ABSTRACT

Mycobacterium leprae and Mycobacterium lepromatosis are gram-positive bacterial pathogens and the causative agents of leprosy in humans across the world. The elimination of leprosy cannot be achieved by multidrug therapy alone, and highlights the need for new tools and drugs to prevent the emergence of new resistant strains. Methods In this study, our contribution includes the prediction of vaccine targets and new putative drugs against leprosy, using reverse vaccinology and subtractive genomics. Six strains of Mycobacterium leprae and Mycobacterium lepromatosis (4 and 2 strains, respectively) were used for comparison taking Mycobacterium leprae strain TN as the reference genome. Briefly, we used a combined reverse vaccinology and subtractive genomics approach. Results As a result, we identified 12 common putative antigenic proteins as vaccine targets and three common drug targets against Mycobacterium leprae and Mycobacterium lepromatosis. Furthermore, the docking analysis using 28 natural compounds with three drug targets was done. Conclusions The bis-naphthoquinone compound Diospyrin (CID 308140) obtained from indigenous plant Diospyros spp. showed the most favored binding affinity against predicted drug targets, which can be a candidate therapeutic target in the future against leprosy.(AU)


Subject(s)
Gram-Positive Rods/pathogenicity , Vaccinology , Mycobacterium leprae/pathogenicity , Mycobacterium lepraemurium/pathogenicity
17.
Rev. bras. epidemiol ; 24: e210039, 2021. graf
Article in English, Portuguese | LILACS | ID: biblio-1280024

ABSTRACT

RESUMO Objetivo: Investigar os fatores de risco associados ao adoecimento por hanseníase em contatos de casos da doença. Métodos: Realizou-se uma revisão sistemática e metanálise com busca nas bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus e Web of Science até setembro de 2019. A seleção, a análise e a avaliação da qualidade dos estudos foram realizadas por quatro revisores. Utilizou-se modelo de efeitos aleatórios para calcular o risco relativo agrupado (RR) e intervalos de confiança de 95% (IC95%) quando na presença de heterogeneidade superior a 50%. Resultados: A busca resultou em 2.148 referências e foram incluídos 24 estudos. Estes, em sua maioria, foram realizados no Brasil e na Índia, com delineamento coorte, e incluíram contatos domiciliares, peridomiciliares e sociais. Mostraram-se associados ao adoecimento por hanseníase em contatos: o analfabetismo (RR = 1,48; IC95% 1,22 - 1,79), a convivência intradomiciliar (RR = 2,41; IC95% 1,87 - 3,10) com caso de hanseníase apresentando alta carga bacilar (RR = 2,40; IC95% 1,69 - 3,41), a soropositividade ao antígeno PGL-1(glicolipídeo fenólico-1) do Mycobacterium leprae (RR = 3,54; IC95% 2,21 - 5,67), presença do bacilo na corrente sanguínea (RR = 10,61; IC95% 4,74 - 23,77) e reação de Mitsuda negativa (RR = 2,68; IC95% 1,76 - 4,07). A imunização com bacilo Calmette-Guérin (BCG) teve efeito protetor contra o adoecimento (RR = 0,52; IC95% 0,34 - 0,78). Conclusão: O adoecimento por hanseníase em contatos perpassa pela determinação social, pela susceptibilidade individual e por fragilidades no acesso às ações de controle da doença; contudo, fatores de risco modificáveis são os principais determinantes do adoecimento nessa população.


ABSTRACT Objective: To investigate the risk factors associated with leprosy in contacts of patients. Method: We carried out a systematic review and meta-analysis by searching the databases MEDLINE, Embase, Cochrane Library, CINAHL, LILACS, Scopus, and Web of Science until September 2019. Four reviewers carried out the selection, analysis, and evaluation of quality of studies. The random effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (95% CI) when heterogeneity was greater than 50%. Results: The search resulted in 2,148 references and included 24 reports. Most of the studies had been conducted in Brazil and India, had a cohort design and included household, neighbors, and social contacts. The risk factors associated with illness due to leprosy in contacts were: illiteracy (RR = 1,48; 95%CI 1,22 - 1,79), living in the same house (RR = 2,41; 95%CI 1,87 - 3,10) of a case of leprosy with high bacillary load (RR = 2.40; 95%CI 1.69 - 3.41), seropositivity to the Mycobacterium leprae PGL-1 (phenolic glycolipid-1) antigen (RR = 3.54; 95%CI 2.21 - 5.67), presence of the bacillus in the bloodstream (RR = 10.61; 95%CI 4.74 - 23.77) and negative Mitsuda reaction (RR = 2,68; 95%CI 1,76 - 4,07). Immunization with BCG (bacillus Calmette-Guérin) vaccine had a protective effect against leprosy. Conclusion: Leprosy in contacts of patients involves social determination, individual susceptibility, and difficulties in access to disease control actions, but modifiable risk factors are the main determinants of illness in this population.


Subject(s)
Humans , Leprosy/epidemiology , Antigens, Bacterial , Brazil/epidemiology , Glycolipids , Mycobacterium leprae
18.
Ciênc. cuid. saúde ; 20: e58386, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356130

ABSTRACT

RESUMO Introdução: a hanseníase é uma doença infectocontagiosa que prevalece como problema de saúde pública no Brasil. Objetivo: descrever o perfil sociodemográfico, de tratamento e clínico de pacientes que concluíram o tratamento poliquimioterápico para a hanseníase. Método: estudo transversal, desenvolvido de novembro de 2017 a fevereiro de 2018 no município de Natal. A população-alvo foi constituída por 113 indivíduos cadastrados no Sistema de Informação de Agravos de Notificação e a amostra por 90, que foram notificados para a hanseníase e concluíram o tratamento poliquimioterápico, selecionados por sorteio. Os dados foram coletados por formulário, tabulados e analisados pelo SPSS 21. Quanto ao teste de Kolmogorov-Smirnov, não se observou uma distribuição de normalidade dos achados, optando-se por trabalhar com testes não paramétricos: qui-quadrado de Pearson (ou exato de Fisher) e o teste de Mann-Whitney. Resultados: predominaram indivíduos do sexo feminino, até 59 anos, com baixa renda, baixo grau de escolaridade, tratados nos centros de referência e classificados como paucibacilares. Conclusão: as condições de vulnerabilidade associada à predominância de casos tratados nos centros de referência reforçam a necessidade de organização da atenção básica para acompanhamento dos casos de hanseníase.


RESUMEN Introducción: la lepra es una enfermedad infectocontagiosa que prevalece como problema de salud pública en Brasil. Objetivo: describir el perfil sociodemográfico, de tratamiento y clínico de pacientes que concluyeron el tratamiento poliquimioterapéutico para la lepra. Método: estudio transversal, desarrollado de noviembre de 2017 a febrero de 2018 en el municipio de Natal. La población objetivo fue constituida por 113 individuos registrados en el Sistema de Información de Agravios de Notificación y la muestra por 90, que fueron notificados para la lepra y concluyeron el tratamiento poliquimioterapéutico, seleccionados por sorteo. Los datos fueron recogidos por formulario, tabulados y analizados por el SPSS 21. En cuanto a la prueba de Kolmogorov-Smirnov, no se observó una distribución de normalidad de los hallazgos, optándose por trabajar con pruebas no paramétricas: chi-cuadrado de Pearson (o exacta de Fisher) y la prueba de Mann-Whitney. Resultados: predominaron individuos del sexo femenino, hasta 59 años, con bajos ingresos, bajo grado de escolaridad, tratados en los centros de referencia y clasificados como paucibacilares. Conclusión: las condiciones de vulnerabilidad asociadas al predominio de casos tratados en los centros de referencia refuerzan la necesidad de organizar la atención básica para el seguimiento de los casos de lepra.


ABSTRACT Introduction: leprosy is an infectious and contagious disease that persists as a public health problem in Brazil. Objective: to describe the sociodemographic, treatment and clinical profile of patients who completed polychemotherapy treatment for leprosy. Method: cross-sectional study developed from November 2017 to February 2018 in the city of Natal. The target population consisted of 113 individuals registered in the Information System for Notifiable Diseases, and the sample consisted of 90, who were reported for leprosy and completed the multidrug therapy, selected by drawing lots. Data were collected using a form, tabulated and analyzed using SPSS 21. In the Kolmogorov-Smirnov test, non-normal distribution of the findings was found, and thus non-parametric tests were used, namely, Pearson's chi-square (or exact Fisher test) and the Mann-Whitney test. Results: there was a predominance of female individuals, up to 59 years old, with low income, low level of education, treated in reference centers and cases classified as paucibacillary. Conclusion: the conditions of vulnerability associated with the predominance of cases treated in reference centers reinforce the need to organize primary care in order to monitor leprosy cases.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patient Discharge/statistics & numerical data , Drug Therapy, Combination , Leprosy/nursing , Primary Health Care , Health Profile , Leprosy, Tuberculoid/nursing , Chronic Disease/drug therapy , Communicable Diseases/classification , Diagnosis , Health Services Needs and Demand , Mycobacterium leprae
19.
Braz. j. infect. dis ; 25(5): 101634, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350321

ABSTRACT

ABSTRACT Leprosy can be considered a dissimulated disease, mainly when presented as atypical cases leading to mistaken diagnosis at the emergency setting. Herein we report six patients referred to the emergence room with hypotheses of acute myocardial infarction and arterial and venous thrombosis, although with chronic neurological symptoms; the seventh patient was referred with a wrong suspicion of infected skin ulcer. Positive findings included hypo-anesthetic skin lesions and thickened nerves; 100% were negative for IgM anti-phenolic glycolipid-I, while 71.4%, 100% and 42.8% were positive for IgA, IgM and IgG Mce1A. RLEP-PCR was positive in all patients. Ultrasound of peripheral nerves showed asymmetric and focal multiple mononeuropathy for all patients. Unfortunately, in many patients leprosy is often misdiagnosed as other medical conditions for long periods thus delaying initiation of specific treatment. This paper is intended to increase physicians' awareness to recognize leprosy cases presented as both classical and unusual forms, including in emergency department.


Subject(s)
Humans , Leprosy , Glycolipids , Emergency Service, Hospital , Mycobacterium leprae
20.
Braz. arch. biol. technol ; 64: e21210030, 2021. graf
Article in English | LILACS | ID: biblio-1339317

ABSTRACT

Abstract Nowadays, a prompt and reliable diagnosis is one of the most critical measures for leprosy control. The current diagnostic is based on clinical exams by a health care professional, and it may not recognize early signs of the disease. Therefore, other leprosy diagnosis methods are needed that are sensitive, disease-specific, and easy to deliver to the end-user. This study describes the construction of an electrochemical DNA biosensor to detect PCR products of Mycobacterium leprae using methylene blue as an indicator of the hybridization. The capture probe was immobilized on the graphite electrode modified with poly(4-aminophenol). The electrode surface was morphologically characterized by atomic force microscopy. Linear voltammetry was used to monitor the concentration of methylene blue on the DNA biosensor, which indicated a limit detection of 1 x 10-10 mol/L. The biosensor showed selective when placed to hybridize with a non-complementary sequence. This study suggests that the electrochemical DNA biosensor developed is promising for detecting DNA of Mycobacterium leprae.


Subject(s)
Biosensing Techniques , Aminophenols , Methylene Blue , Mycobacterium leprae
SELECTION OF CITATIONS
SEARCH DETAIL