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1.
J R Nav Med Serv ; 96(2): 92-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21073092

RESUMO

We present the case of a 26 year old Indian base worker who attended the Role 2 enhanced hospital in Iraq with a case of leprosy. The patient presented four times over a 12 month period with non-specific pain in the right hand and forearm combined with a large lesion of dry skin and reduced sensation in the forearm. A clinical diagnosis of leprosy was made, which was subsequently confirmed as paucibacillary leprosy by skin smears sent to the UK. It was not possible to treat the patient locally and a recommendation made to the patient's employer that the patient return to India to commence treatment.


Assuntos
Hanseníase , Adulto , Humanos , Índia , Iraque , Hanseníase/diagnóstico , Hanseníase/terapia , Masculino
2.
s.l; s.n; Jan. 2003. 3 p. ilus.
Não convencional em Inglês | SES-SP, HANSEN, HANSENIASE, SESSP-ILSLACERVO, SES-SP | ID: biblio-1240837

RESUMO

Two months after starting highly active antiretroviral treatment (HAART), an individual with human immunodeficiency virus type 1 (HIV-1) infection and profound CD4+ T lymphocytopenia developed several erythematous plaques on his face, which were due to borderline tuberculoid leprosy with reversal reaction. The temporal association between the development of these lesions and changes in blood CD4+ lymphocyte count and plasma HIV-1 load observed during HAART strongly suggests that the presentation of leprosy resulted from immune reconstitution.


Assuntos
Masculino , Humanos , Adulto , Fármacos Anti-HIV/uso terapêutico , Hanseníase Tuberculoide/etiologia , Hanseníase Tuberculoide/imunologia , Imunidade , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções por HIV/complicações , Infecções por HIV/imunologia , Infecções por HIV/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade/efeitos adversos
3.
Clin Infect Dis ; 36(1): e5-6, 2003 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-12491222

RESUMO

Two months after starting highly active antiretroviral treatment (HAART), an individual with human immunodeficiency virus type 1 (HIV-1) infection and profound CD4+ T lymphocytopenia developed several erythematous plaques on his face, which were due to borderline tuberculoid leprosy with reversal reaction. The temporal association between the development of these lesions and changes in blood CD4+ lymphocyte count and plasma HIV-1 load observed during HAART strongly suggests that the presentation of leprosy resulted from immune reconstitution.


Assuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Infecções por HIV/imunologia , Hanseníase Tuberculoide/etiologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Imunidade/efeitos dos fármacos , Hanseníase Tuberculoide/imunologia , Masculino
4.
Soc Sci Med ; 29(7): 799-811, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2799423

RESUMO

In Pakistan approx. 30% of the 18,000 known leprosy patients have dropped out of their treatment programs. To investigate reasons for such widespread noncompliance, 128 diagnosed leprosy patients--59 outpatients and 69 inpatients--were interviewed in Karachi. More than half of the 'noncompliant' outpatients denied having the disease. Denial was found to be an understandable coping mechanism in view of the severe stigma associated with leprosy. The presence of close-knit extended families, in which joint decision-making was the norm and in which such a dread diagnosis could spell the end of job and marriage prospects for even distant relatives, contributed to the likelihood of denial. In such a setting, the very term 'noncompliant' appeared to be an oversimplification since it covered so many different types of culturally-constrained behavior. In addition, many of the patients who initially seemed most 'compliant' by virtue of being long-term hospital inpatients in fact owed their hospitalization to the fact that they had been markedly noncompliant in the past. Thus the usual view that adherence to a biomedical treatment regimen constitutes 'compliance' and that nonadherence to such a regimen constitutes 'noncompliance' proved inadequate for understanding the health behavior of these Third World leprosy victims. The study also showed that many patients had initially consulted traditional healers, inadequately-trained physicians, and/or untrained medical practitioners for treatment of their symptoms, which resulted in lengthy delays before they were correctly diagnosed. Further, even after the diagnosis was made and appropriate medications were prescribed by trained personnel, most patients were not told what had caused their leprosy and how the drug regimen worked to combat it: when questioned, only 4% of the 128 respondents attributed the disease to infectious organisms. In addition, patients were usually not warned in advance of the possibility of undesirable side effects from their leprosy medications, which led to further 'compliance' problems. The findings of this study emphasize the need for better training of physicians and other health care providers in early diagnosis of leprosy and better health education of diagnosed patients. To be truly effective, the treatment of leprosy must include counseling of extended families and education of the public at large as well as enhanced communication with the patients themselves.


Assuntos
Atitude Frente a Saúde , Hanseníase/psicologia , Cooperação do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Características Culturais , Negação em Psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Educação de Pacientes como Assunto , Valores Sociais
5.
Am J Clin Pathol ; 83(4): 524-7, 1985 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2984921

RESUMO

A 54-year-old immunosuppressed cardiac transplant recipient with a six-month history of progressive swelling of the hand, with nodules and linear lymph node chain enlargement, diagnosed as a sporotrichoid Mycobacterium avium-intracellulare pseudotumor is described. The microscopic features closely resembled the previously described histoid variety of lepromatous leprosy. Routine hematoxylin and eosin staining suggested a spindle cell neoplasm rather than an infectious or inflammatory process. An infectious etiology was pursued on the basis of the clinical setting.


Assuntos
Infecções por Mycobacterium não Tuberculosas/patologia , Infecções por Mycobacterium/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Diferencial , Fibroma/patologia , Fibrossarcoma/patologia , Humanos , Leiomioma/patologia , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/complicações , Neoplasias de Tecido Nervoso/patologia , Neoplasias Cutâneas/etiologia
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