ABSTRACT
Abstract Varicella is a common viral infection in childhood and usually has a benign evolution. However, the evolution can be severe in immunosuppressed children. Vaccination can prevent its occurrence and especially the development of severe and/or complicated cases. Methotrexate is a systemic therapeutic option for many inflammatory diseases, and its immunosuppressive action exposes its users to a higher susceptibility to infection. The present report describes a case of severe varicella infection in a child immunosuppressed with methotrexate.
ABSTRACT
Varicella is a common viral infection in childhood and usually has a benign evolution. However, the evolution can be severe in immunosuppressed children. Vaccination can prevent its occurrence and especially the development of severe and/or complicated cases. Methotrexate is a systemic therapeutic option for many inflammatory diseases, and its immunosuppressive action exposes its users to a higher susceptibility to infection. The present report describes a case of severe varicella infection in a child immunosuppressed with methotrexate.
Subject(s)
Chickenpox , Methotrexate , Chickenpox/drug therapy , Child , Herpesvirus 3, Human , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Methotrexate/adverse effectsSubject(s)
Antibodies, Monoclonal/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Psoriatic/drug therapy , Biosimilar Pharmaceuticals/supply & distribution , Infliximab/therapeutic use , Psoriasis/drug therapy , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Treatment OutcomeSubject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Arthritis, Psoriatic/drug therapy , Antirheumatic Agents/therapeutic use , Biosimilar Pharmaceuticals/supply & distribution , Infliximab/therapeutic use , Antibodies, Monoclonal/therapeutic use , Psoriasis/drug therapy , Follow-Up Studies , Treatment OutcomeABSTRACT
PURPOSE: Data on chronic plaque psoriasis severity and its potential clinical and lifestyle implications in the Brazilian population are limited. The primary aim of this study was to assess the clinical severity of plaque psoriasis in Brazil. Further objectives included evaluating potential associations between disease severity and demographic, lifestyle, and clinical characteristics, health-related quality of life (HRQOL), and work productivity. MATERIALS AND METHODS: This observational (non-interventional) cross-sectional study was conducted in 26 dermatologic clinics across 11 Brazilian states. Psoriasis severity was assessed using investigator judgment and Finlay's Rule of Tens: a Psoriasis Area and Severity Index (PASI) score >10, a Body Surface Area (BSA) > 10%, or a Dermatology Life Quality Index (DLQI) score >10. RESULTS: Among 1125 patients, 205 (18.2%) had moderate-to-severe disease. On multiple regression analyses, psoriasis severity was significantly (directly) associated with the presence of physical inactivity and comorbid pain, anxiety, and depression; and significantly (inversely) associated with HRQOL and work productivity. LIMITATIONS: Cross-sectional studies cannot assess temporal trends, and observational studies cannot conclusively determine causality or exclude biases and confounding due to unmeasured variables. CONCLUSIONS: Among Brazilian patients with moderate-to-severe psoriasis, disease severity had far-reaching adverse impacts on lifestyle, comorbidities, HRQOL, and work productivity.
Subject(s)
Psoriasis/complications , Psoriasis/pathology , Adult , Aged , Ambulatory Care Facilities , Brazil , Cross-Sectional Studies , Depression/etiology , Female , Humans , Male , Middle Aged , Psoriasis/psychology , Quality of Life , Regression Analysis , Severity of Illness IndexABSTRACT
Foram utilizados 182 camundongos machos, isogênicos, da linhagem C57BL/6 inoculados na orelha direita com 3,0 x 10(6) formas promastigotas da cepa MHOM/BR/PH8 de Leishmania (Leishmania) amazonensis. Os animais foram separados em três grupos: 1) 52 animais tratados com mefloquina (16mg/kg/dia/l0 dias), 2) 52 animais tratados com aminosidina [Paramomicina ©] (20mg/kg/dia/20 dias), 3) 78 animais controles, näo manipulados. Vinte e seis animais de cada grupo tratado foram sacrificados nove e quinze semanas após a inoculaçäo. Animais do grupo controle foram sacrificados na sexta, nona e décima quinta semanas após a inoculaçäo. Ao final do tratamento, em relaçäo à curva de peso da orelhas, somente nos animais tratados com aminosidina, houve nítida reduçäo do peso em comparaçäo com grupo controle. Na histopatologia verificou-se: a) näo houve diferença entre o grupo tratado com mefloquina e o grupo controle; o grupo tratado com aminosidina, ao final do tratamento, teve menor infiltraçäo por macrófagos vacuolizados; b) as avaliaçöes da extensäo das áreas de necrcose e do nível da fibrose tecidual näo mostraram diferenças entre os grupos tratados. Os animais do grupo controle apresentaram fibrose mais acentuada, seis semanas após o fim do tratamento. Pode-se concluir que ocorreu efeito terapêutico reduzido com a mefloquina e houve significativa melhora com a aminosidina. Entretanto, em todos os grupos as lesöes näo chegaram a curar
