Characterization of the profession/occupation of individuals affected by leprosy and the relationship with limitations in professional activities.

People who had leprosy stay away from work and have difficulty of employability and to perform their functions or retire early. This study aimed at determining whether there is a relationship between profession/occupation and limitations in activities. This was a cross-sectional study that used the SALSA scale (Screening of Activity Limitation and Safety Awareness) to assess limitations and to classify professions/occupations as low, medium or high risk. Of the 277 people surveyed, 50.2% were men, the mean age was 53.8 years (SD = 16.3), 62.7% had multibacillary, 59.7% had family incomes of 3 minimum wages or less, 58.5% had up to 6 years schooling and 57% did not have paid jobs. As for occupations, 45.8% were considered low, 39.7% medium and 12.3% high risk. Of thetotal, 49.1% had mild/moderate, 8.7% severe/very severe and 42.2% did not have any limitations. The relationship between limitations in activities and occupational risk indicated that people with severe limitations tend to have low risk occupations (p value < 0.05). The limitations associated with employability showed that most active individuals have no limitations (p value < 0.05). Hence, most people who had leprosy have low risk professions/occupations; the limitations favor a shift from high-risk activities and interfere with employability.

Comparison of the safety and efficacy of cyclosporine minimization versus cyclosporine elimination in de novo renal allograft patients receiving sirolimus.

The safety and efficacy of concentration-controlled use of sirolimus (SRL) and cyclosporine (CsA) followed by CsA minimization (CsAm) or elimination (CsAe) beginning at week 13 was compared in a phase 4, open-label, randomized (1:1) trial of renal transplant recipients enrolled between March 2004 and November 2005. The primary endpoint was renal function, measured at 12 months using the Nankivell formula, in patients remaining on therapy. Though a total enrollment of 140 patients in each group was planned to provide an 80% power to detect a difference in means, only 207 subjects were enrolled in this study. Demographic characteristics were similar between groups, with 98.1% recipients of first grafts, 69.1% from living donors, and 7.2% diabetics. At 12 months, there were no differences in renal function (61.08 vs 65.24 mL/min, P = .132); incidence of biopsy-confirmed acute rejection (14.3% vs 22.5%, P = .152); and patient (89.5% vs 92.2%, P = .632), graft (87.6% vs 88.2%, P = .999), and death-censored graft (98.1% vs 94.1%, P = .166) survivals between CsAm and CsAe groups, respectively. There were no differences in the overall rate of study-drug discontinuation (32.4% vs 36.3%, P = .562) but more patients discontinued because of lack of efficacy/graft loss in the CsAe group (4.8% vs 14.7%, P = .018). This study was underpowered to demonstrate the superiority of one regimen over the other. In summary, SRL immunotherapy combined with CsA minimization or elimination showed comparative safety and efficacy. Both regimens offer potential treatment options for de novo renal allograft recipients.