ABSTRACT
Leprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions...
Subject(s)
Humans , Male , Female , Biopsy , Granuloma , Leprosy , Mycobacterium leprae , PathologyABSTRACT
The record of the first cases of leprosy in Rio de Janeiro dates from the seventeenth century. The first local host of leprosy patients was created from 1741, and the first colonies hospitals were built in the early twentieth century, in order to avoid contagion of the population. The first structures dedicated to research also date from this time: the Leprosy International Institute, the Leprology Institute, and the Leprosy Laboratory of the Oswaldo Cruz Foundation, where the most prestigious leprologists of Rio de Janeiro worked. Currently, investigations are focused on the Oswaldo Cruz Foundation; additionally, leprosy patients are treated at municipal health centers and state hospitals, and former colony hospitals only accept patients with severe disabilities.
Subject(s)
Hospitals, Isolation/history , Hospitals/history , Leprosy/history , Brazil , History, 18th Century , History, 19th Century , History, 20th Century , HumansABSTRACT
The record of the first cases of leprosy in Rio de Janeiro dates from the seventeenth century. The first local host of leprosy patients was created from 1741, and the first colonies hospitals were built in the early twentieth century, in order to avoid contagion of the population. The first structures dedicated to research also date from this time: the Leprosy International Institute, the Leprology Institute, and the Leprosy Laboratory of the Oswaldo Cruz Foundation, where the most prestigious leprologists of Rio de Janeiro worked. Currently, investigations are focused on the Oswaldo Cruz Foundation; additionally, leprosy patients are treated at municipal health centers and state hospitals, and former colony hospitals only accept patients with severe disabilities.
Subject(s)
Humans , History, 18th Century , History, 19th Century , History, 20th Century , Hospitals, Isolation/history , Hospitals/history , Leprosy/history , BrazilABSTRACT
BACKGROUND: Leprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions. OBJECTIVES: To investigate the differences between a type 1 leprosy (reversal) reaction and relapse on using histopathology. METHODS: The histopathological changes in 167 biopsies from 66 leprosy patients were studied. The patients were selected when their sequential biopsies demonstrated either different patterns or maintained the same pattern of granulomatous reaction over more than two years during or after the treatment of leprosy. RESULTS: In 57 of the patients studied, a reactivation was seen which coincided with a decrease in the bacteriological index (BI), suggesting that this reactivation (reversal reaction or type 1 leprosy reaction) coincides with an effective capacity for bacteriological clearance. In nine patients, an increase of the bacteriologic index (IB) or persistence of solid bacilli occurred during the reactivation, indicating proliferative activity, suggestive of a relapse. The histopathological aspects of the granulomas were similar in both groups. CONCLUSION: Bacterioscopy provided the only means to differentiate a reversal reaction from a relapse in patients with granulomatous reactivation. The type 1 leprosy reaction may be considered as a part effective immune reconstitution (reversal, upgrading reaction) or as a mere hypersensitivity reaction (downgrading reaction) in a relapse.
Subject(s)
Granuloma/microbiology , Granuloma/pathology , Leprosy/microbiology , Leprosy/pathology , Mycobacterium leprae/isolation & purification , Adult , Aged , Aged, 80 and over , Biopsy , Female , Granuloma/immunology , Histocytochemistry , Humans , Immune Reconstitution Inflammatory Syndrome/microbiology , Immune Reconstitution Inflammatory Syndrome/pathology , Leprosy/immunology , Male , Microscopy , Middle Aged , Mycobacterium leprae/immunology , RecurrenceABSTRACT
The present study evaluate efficacy of twelve doses of multidrug therapy, as suggested by World Health Organization, in ten lepromatous leprosy patients with bacilloscopic index equal or higher than 4. The patients have taken the doses in twelve month-doses regularly. At the end od treatment a specimen was collected by punch biopsy and inoculated into mouse hind footpad acoording to Shepard's technique. Persistence of viable bacilli was demonstrated in three patients. In spite of the small number of patients, same results have been found by other authors, showing that in highly bacilliferous leprosy patients, at the beginning of treatment more doses may be required to prevent relapses.
Subject(s)
Leprosy/microbiology , Leprosy/drug therapy , Microbiology , Mycobacterium leprae , Serial Passage/methods , Serial PassageABSTRACT
Trabalho de investigacao, com o obejtivo de avaliar a eficacia do tratamento de doze doses com o esquema poliquimioterapico proposto pela Organizacao Mundial da Saude em 10 pacientes de hanseniase virchoviana em indice baciloscopico igual ou maior que 4. Os pacientes foram submetidos ao tratamento por 12 meses, regularmente. Apos o final do tratamento, foi feita retirada de material e inoculacao em coxim plantar de camundongos, conforme a tecnica de Shepard. Os resultados mostraram persistencia de bacilos viaveis em tres pacientes. Os autores, apesar da amostra pequena, observam que os mesmos resultados tem sido encontrados por outros autores surgerindo que talves seja necessario tratar os pacientes com altos indices baciloscopico no inicio do tratamento, por mais tempo, na tentativa de evitar possiveis recidivas.
