RESUMO
Cutaneous leishmaniasis (CL) is often considered a 'great imitator' and is the most common form of leishmaniasis. The Leishmania species responsible for CL varies among countries, as these species exhibit specific distribution patterns. The increased mobility of people across countries has resulted in the imported incidences of leishmaniasis caused by non-endemic species of Leishmania. During 2023, we confirmed three CL cases caused by L. major from Kerala, India, and upon detailed investigation, these were identified to be imported from the Middle East and Kazakhstan regions. This is the first report of CL caused by L. major from Kerala. The lesion morphology, detection of anti-rK 39 antibody and Leishmania parasite DNA from the blood samples were the unique observations of these cases. Kerala, being an emerging endemic zone of visceral leishmaniasis (VL) and CL, the imported incidences of leishmaniasis by non-endemic species can pose a significant threat, potentially initiating new transmission cycles of leishmaniasis caused by non-endemic species.
Assuntos
Leishmania major , Leishmaniose Cutânea , Índia/epidemiologia , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/diagnóstico , Humanos , Masculino , Leishmania major/isolamento & purificação , Leishmania major/genética , Adulto , Feminino , Doenças Transmissíveis Importadas/parasitologia , Doenças Transmissíveis Importadas/epidemiologia , Pessoa de Meia-Idade , DNA de Protozoário/genética , Anticorpos Antiprotozoários/sangueRESUMO
Sexual abuse of children is a problem that can present to any physician at any time. This article provides basic information about child sexual abuse and instructs physicians how to respond to abuse victims in a professionally responsible way that assures that the child is supported and protected. Legal definitions, prevalence, epidemiology, evaluation approaches, psychological problems, interviewing, the physical examination, sexually transmitted diseases, and management issues are discussed with emphasis on the physician's role. Finally, prevention is mentioned as the only real solution to this problem.
Assuntos
Abuso Sexual na Infância/diagnóstico , Relações Médico-Paciente , Adolescente , Cuidadores/psicologia , Criança , Abuso Sexual na Infância/legislação & jurisprudência , Abuso Sexual na Infância/psicologia , Pré-Escolar , Feminino , Humanos , Entrevista Psicológica , Masculino , Equipe de Assistência ao Paciente/legislação & jurisprudência , Desenvolvimento da Personalidade , Exame FísicoRESUMO
The records of 944 children who had been examined by one pediatrician for alleged sexual abuse were analyzed. Sixty-four percent of the females and 34 percent of the males had positive findings suggestive of ano-genital injury. The data indicated that in girls with no evidence of injury, the hymenal opening diameter varied directly with age, but in those with evidence of injury, the opening size could not be correlated with age.
