Hanseníase: poliquimioterapia e monoterapia, Araraquara, Säo Paulo - 1990-1993 / Leprosy polichemotherapy and new therapeutics in Araraquara, Säo Paulo -1990-1993

Com o objetivo de conhecer os resultados da nova terapêutica da hanseníase por poliquimioterapia estudamos sua aplicaçäo em pacientes em Araraquara-SP no período de 1990 a 1993, do Serviço Especial de Saúde de Araraquara. Como o tratamento é de longa duraçäo, somente a partir de 1993 começamos a observar a eficiência dos resultados em relaçäo a monoterapia. Obtivemos alta por cura em 65 por cento para multibacilares e 48,5 por cento para paucibacilares e sem recidiva, enquanto para os pacientes tratados com a terapia anterior, a cura foi de 35,4 por cento. Baseado nestes resultados concluímos que é importante a poliquimioterapia na cura da hanseníase.

Adelantos terapéuticos en lepra / Progress in leprosy therapeutic

Se comentan los recientes aportes terapéuticos, dividiéndose el trabajo en los siguientes capítulos: I)Resistencia bacteriana a los diversos fármacos, en especial a la D.D.S. en su forma secundaria, así como la primaria. Dosis a emplear con la monoterapia. Causas de aparición de la resistencia (tratamiento irregular y/o bajas dosis). II) Asociación medicamentosa: sus ventajas y los principales esquemas en enfermos vírgenes y en casos de resistencia a las sulfonas. III) Tratamiento de la reacción leprosa. IV) Inmunoterapia en lepra: sus objetivos, los medios más comúnmente empleados, sus riesgos y efectos colaterales

Adelantos terapéuticos en lepra / Progress in leprosy therapeutic

Se comentan los recientes aportes terapéuticos, dividiéndose el trabajo en los siguientes capítulos: I)Resistencia bacteriana a los diversos fármacos, en especial a la D.D.S. en su forma secundaria, así como la primaria. Dosis a emplear con la monoterapia. Causas de aparición de la resistencia (tratamiento irregular y/o bajas dosis). II) Asociación medicamentosa: sus ventajas y los principales esquemas en enfermos vírgenes y en casos de resistencia a las sulfonas. III) Tratamiento de la reacción leprosa. IV) Inmunoterapia en lepra: sus objetivos, los medios más comúnmente empleados, sus riesgos y efectos colaterales

[Efficacy of multidrug therapy in treatment of paucibacillary leprosy patients--preliminary results]. / Eficácia da MDT no tratamento de pacientes hansenianos paucibacilares--resultados preliminares.

The efficaciousness evaluation of the polychemotherapics regimens recommended by WHO to the hansenian paucibacillary patients, is carried out mainly by the suitable follow up of patients after therapeutic discharge. The criterion for inclusion of patients as paucibacillary ones is another point of importance. The authors based on the follow up of 66 patients that completed treatment and in the absence of relapses until the moment, advise that together with the clinical classification it should be considered factors like: the Mitsuda test, the number of lesions and the bacilloscopy result.

Eficácia da MDT no tratamento de pacientes hansenianos paucibacilares: resultados preliminares / Efficacy of multidrug therapy in treatment of paucibacillary leprosy patients: preliminary results

A avaliaçäo da eficácia dos regimes poliquimioterápicos recomendados para pacientes hansenianos paucibacilares pela OMS, é feita principalmente pelo adequado acompanhamento dos pacientes após a alta terapêutica. O critério para inclusäo de pacientes como paucibacilares, é outro ponto de importância. Os autores baseados no seguimento de 66 pacientes que completaram o tratamento e na ausência de recaídas até o momento, recomendam que sejam levados em consideraçäo junto com a classificaçäo clínica, fatores como: teste de Mitsuda, p número de lesöes, e o resultado do exame baciloscópico

A follow up study of borderline tuberculoid leprosy under sulphone monotherapy.

A retrospective study is presented herewith of 94 cases classified as BT and treated with sulphone monotherapy. A system of scoring based on the number and extent of lesions, and nerve involvement was followed. It was observed that cases with a clinical score of 2 or having more than 15 lesions or patients with extensive lesions covering 3 or more of 7 sectors of the body had a bad prognosis in respect of time taken for subsidence, occurrence of deformities and most importantly occurrence of relapses. Hence it is suggested that such cases should be considered as Multibacillary and treated as such, despite bacteriological findings which may be either negative or a bacteriological positivity of less than 2 at any one site.

Clinical trial of DADDS in lepromatous leprosy.

This presentation reports the results of a short clinical trial with DADDS in 23 patients of lepromatous leprosy. Injections of DADDS administered intramuscularly in a dose of 225 mg every 70 days produced clinical regression noticeable earliest at few week after the secondn injection. A fall in the morphological index from 5.0 to 0.6 was observed in patients who had received from 3 to 7 injections. Erythema nodosum leprosum was encountered in 7 cases, four of which had moderate to severe grades of reaction. It is advisible to discontinue further injection of DADDS if initial signs of ENL are noticed, which are likely to occur after the second injection. These ENL responded well to the usual line of antireaction treatment. DDS level in blood was found to be more than 10 ng/ml before the fresh administration of DADDS upto the seventh injection, representing the period of follow-up in this study.

Chromosomal aberrations in leucocyte metaphases of leprosy patients under dapsone therapy

Chromosome analyses were made on leukocyte metaphases of 18 leprosy patients who were ingesting daily doses of 50 mg or 100 mg of DDS and of 40 healthy individuals used for control. These analyses have shown that the proportion of numerical chromosomal aberrations in the leukocyte metaphases of the leprosy patients did not differ significantly from that observed in the cells of the controls. In contrast, the frequency of cells with chromatid or chromosome breaks and gaps was significantly increased in the leukocytesof leprosy patients. Multiple regression analysis applied to the data recorded has shown that the increase of breaks and gaps in the chromosomes of leprosy patients can not be attributed to age, years under sulfonetherapy or to concentration of DDS in blood.

Observacoes sobre o emprego da rifampicina em hansenianos aparentemente sulfono-resistentes / Observations on the use of rifampicin in apparently sulfone-resistant hanseniasis patients

Os autores relatam os resultados obtidos com a rifampicina no tratamento de 10 pacientes de hanseníase virchoviana, clinicamente resistentes à sulfonoterapia. São apresentadas as observações clínicas, os exames baciloscópicos, histopatológicos, de sangue, urina e as provas de função hepática. Os resultados siginificativos levam os autores a confirmar a ação do medicamento e sua indicação como de escolha nos casos de hanseníase sulfono-resistente.