ABSTRACT
The treatment effect against psoriasis of an antigen (delipidated, deglycolipidated form of M. vaccae-PVAC) was investigated. One hundred and sixty-five patients were enrolled in three arms (50 or 15 microg or placebo), each receiving a total of two intradermal injections (days 0 and 21). At week 12, a 75% decrease in psoriasis area and severity index was similar among the studied groups (13, 9 and 18%, p=0.429). The overall incidence of adverse events was significantly higher in the PVAC treated groups when compared to placebo (98.2, 87.3 and 70.9%; p<0.001) largely due to local reactions that were limited for the most part to grades 1 and 2 in severity and were self-limiting. Despite its overall safety, PVAC was not clearly indicated to be superior to placebo in the treatment of psoriasis in this study.
Subject(s)
Bacterial Vaccines/therapeutic use , Immunotherapy, Active , Mycobacterium/immunology , Psoriasis/drug therapy , Adolescent , Adult , Aged , Antigens, Bacterial/genetics , Antigens, Bacterial/therapeutic use , Bacterial Vaccines/adverse effects , Female , Humans , Male , Middle Aged , Mycobacterium/genetics , Placebos , Vaccines, Inactivated/adverse effects , Vaccines, Inactivated/therapeutic useABSTRACT
Infective dermatitis associated with HTLV-I (IDH) is a chronic, infected childhood eczema. Two adult-onset cases of IDH were studied, one of which was associated with HAM/TSP. The patients were submitted to dermatological, neurological and pathological examination. Immunohistochemical studies were made using CD3, CD4, CD8, CD20, CD79a, and CD57 antibodies. Cytotoxic granules were investigated using granzyme B, perforin, and TIA. The patients presented infected erythematous, scaly lesions with mild itching and a good response to sulfamethoxazole/ trimethoprim. A differential diagnosis with atopic dermatitis (AD) and seborrheic dermatitis (SD) was made, based on: the distinctive morphology and distribution of the lesions, presence of exudative and infected lesions, and mild pruritus. The inflammatory infiltrate was composed predominantly of CD8+ lymphocytes that did not present cytotoxic granules. We concluded that IDH can begin in adulthood and may be associated with HAM/TSP. The immunohistochemical findings were different from those observed in AD and SD.
Subject(s)
HTLV-I Infections/pathology , Human T-lymphotropic virus 1/isolation & purification , Skin Diseases, Viral/pathology , Adult , Biopsy, Needle , Brazil , Female , Follow-Up Studies , HTLV-I Infections/drug therapy , Humans , Immunohistochemistry , Middle Aged , Severity of Illness Index , Skin Diseases, Viral/drug therapy , Treatment Outcome , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
BACKGROUND: Infective dermatitis associated with human T cell lymphotropic virus type I (HTLV-I) infection is a chronic, relapsing eczema of childhood. METHODS: Children, their mothers, and their siblings underwent serological testing for HTLV-I. Epidemiological data were collected from all seropositive children and their family members, and clinical and dermatological examinations were performed. Laboratory studies, including skin culture, and histopathological analyses were also performed. The diagnosis of infective dermatitis associated with HTLV-I (IDH) was made according to previously established criteria. RESULTS: All of the patients with cases that demonstrated clinical aspects of IDH were positive for HTLV-I. The median age of the children at the time of the first visit was 8.0 years (range, 2-14 years). The median duration of breastfeeding for 19 children was 22.5 months (range, 1-48 months). The lesions were erythematous, scaly, exudative, and crusted in all cases. The scalp, retroauricular areas, neck, and groin were the regions that were commonly affected. Cultures were positive for Staphylococcus aureus for 95% of the patients. The children were followed-up for a median of 3.0 years (range, 0.1-7 years), and 5 children developed HTLV-I-associated myelopathy/tropical spastic paraparesis. All of the children except 1 were treated with sulfamethoxazole-trimethoprim, and their lesions either improved greatly or completely disappeared. CONCLUSIONS: The present study demonstrates the severity of IDH in Bahia and confirms that its diagnosis is based almost exclusively on clinical aspects of the disease. Serological testing for HTLV-I and careful follow-up is recommended for all children with chronic, relapsing, severe eczema in regions where HTLV-I is endemic.
Subject(s)
Dermatitis/virology , Human T-lymphotropic virus 1/isolation & purification , Adolescent , Adult , Brazil/epidemiology , Child , Child, Preschool , Dermatitis/drug therapy , Dermatitis/epidemiology , Dermatitis/pathology , Humans , Infant , Skin/pathologyABSTRACT
A Associação Brasileira de Enfermagem - ABEn "75" Anos de existência, berço de outras organizações profissionais e núcleo propulsor do desenvolvimento da profissão de enfermagem no país. A criação, implantação e desenvolvimento dos Conselhos de Enfermagem como empreendimento de destaque da ABEn, 28 anos de luta para a aprovação da Lei n§ 5.905, de 12 de julho de 1973 que criou os Conselhos de Enfermagem, Implantação do Conselho Federal de Enfermagem - COFEN e dos CORENs sob a liderança da ABEn. Participação da ABEn no processo de desenvolvimento dos Conselhos Federal e Regionais de Enfermagem. Situação atual do relacionamento da ABEn com outras entidades de classe e em particular com os Conselhos de Enfermagem