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1.
PLoS Negl Trop Dis ; 15(3): e0009214, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33690671

RESUMO

BACKGROUND: Leprosy continues to be a public health problem in Brazil. Furthermore, detection rates in elderly people have increased, particularly those of multibacillary (L-Lep) patients, who are responsible for transmitting M. leprae. Part of the decline in physiological function during aging is due to increased oxidative damage and change in T cell subpopulations, which are critical in defense against the disease. It is not still clear how age-related changes like those related to oxidation affect elderly people with leprosy. The aim of this work was to verify whether the elderly leprosy patients have higher ROS production and how it can impact the evolution of leprosy. METHODOLOGY/PRINCIPAL FINDINGS: 87 leprosy patients, grouped according to age range and clinical form of leprosy, and 25 healthy volunteers were analyzed. Gene expression analysis of antioxidant and oxidative burst enzymes were performed in whole blood using Biomark's microfluidic-based qPCR. The same genes were evaluated in skin lesion samples by RT-qPCR. The presence of oxidative damage markers (carbonylated proteins and 4-hydroxynonenal) was analyzed by a DNPH colorimetric assay and immunofluorescence. Carbonylated protein content was significantly higher in elderly compared to young patients. One year after multidrug therapy (MDT) discharge and M. leprae clearance, oxidative damage increased in young L-Lep patients but not in elderly ones. Both elderly T and L-Lep patients present higher 4-HNE in cutaneous lesions than the young, mainly surrounding memory CD8+ T cells. Furthermore, young L-Lep demonstrated greater ability to neutralize ROS compared to elderly L-Lep patients, who presented lower gene expression of antioxidant enzymes, mainly glutathione peroxidase. CONCLUSIONS/SIGNIFICANCE: We conclude that elderly patients present exacerbated oxidative damage both in blood and in skin lesions and that age-related changes can be an important factor in leprosy immunopathogenesis. Ultimately, elderly patients could benefit from co-supplementation of antioxidants concomitant to MDT, to avoid worsening of the disease.


Assuntos
Hansenostáticos/uso terapêutico , Hanseníase/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Aldeídos , Antioxidantes , Carga Bacteriana , Brasil , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Humanos , Hansenostáticos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Mycobacterium leprae , Estresse Oxidativo , Carbonilação Proteica , Pele/metabolismo , Pele/patologia
2.
Nature ; 591(7850): 438-444, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33627868

RESUMO

Stromal cells in adult bone marrow that express leptin receptor (LEPR) are a critical source of growth factors, including stem cell factor (SCF), for the maintenance of haematopoietic stem cells and early restricted progenitors1-6. LEPR+ cells are heterogeneous, including skeletal stem cells and osteogenic and adipogenic progenitors7-12, although few markers have been available to distinguish these subsets or to compare their functions. Here we show that expression of an osteogenic growth factor, osteolectin13,14, distinguishes peri-arteriolar LEPR+ cells poised to undergo osteogenesis from peri-sinusoidal LEPR+ cells poised to undergo adipogenesis (but retaining osteogenic potential). Peri-arteriolar LEPR+osteolectin+ cells are rapidly dividing, short-lived osteogenic progenitors that increase in number after fracture and are depleted during ageing. Deletion of Scf from adult osteolectin+ cells did not affect the maintenance of haematopoietic stem cells or most restricted progenitors but depleted common lymphoid progenitors, impairing lymphopoiesis, bacterial clearance, and survival after acute bacterial infection. Peri-arteriolar osteolectin+ cell maintenance required mechanical stimulation. Voluntary running increased, whereas hindlimb unloading decreased, the frequencies of peri-arteriolar osteolectin+ cells and common lymphoid progenitors. Deletion of the mechanosensitive ion channel PIEZO1 from osteolectin+ cells depleted osteolectin+ cells and common lymphoid progenitors. These results show that a peri-arteriolar niche for osteogenesis and lymphopoiesis in bone marrow is maintained by mechanical stimulation and depleted during ageing.


Assuntos
Arteríolas , Linfopoese , Osteogênese , Nicho de Células-Tronco , Tecido Adiposo/citologia , Envelhecimento , Animais , Células da Medula Óssea/citologia , Osso e Ossos/citologia , Feminino , Fatores de Crescimento de Células Hematopoéticas/metabolismo , Lectinas Tipo C/metabolismo , Linfócitos/citologia , Masculino , Camundongos , Receptores para Leptina/metabolismo , Fator de Células-Tronco , Células Estromais/citologia
5.
Birth Defects Res ; 109(4): 296-299, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-28398668

RESUMO

BACKGROUND: Between 1957 and 1962 thalidomide was used as a nonaddictive, nonbarbiturate sedative that also was successful in relieving the symptoms of morning sickness in early pregnancy. Infamously, thousands of babies were subsequently born with severe birth defects. The drug is used again, today, to successfully treat leprosy, and tragically, there is a new generation of thalidomide damaged children in Brazil. While the outward damage in babies has been documented, the effects of the damage upon the survivors as they grow up, the lifestyle changes and adaptations required to be made, as well as studies into ageing in survivors, has received little attention and remains understudied. METHODS: A unique multidisciplinary meeting was organized at the University of York bringing together thalidomide survivors, clinicians, scientists, historians, and social scientists to discuss the past, the current and the future implications of thalidomide. RESULTS: There is still much to learn from thalidomide, from its complex history and ongoing impact on peoples' lives today, to understanding its mechanism/s to aid future drug safety, to help identify new drugs retaining clinical benefit without the risk of causing embryopathy. CONCLUSION: For thalidomide survivors, the original impairments caused by the drug are compounded by the consequences of a lifetime of living with a rare disability, and early onset age-related health problems. This has profound implications for their quality of life and need for health and social care services. It is vital that these issues are addressed in research, and in clinical practice if thalidomide survivors are to "age well". Birth Defects Research 109:296-299, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Anormalidades Induzidas por Medicamentos/psicologia , Envelhecimento/efeitos dos fármacos , Hipnóticos e Sedativos/efeitos adversos , Imunossupressores/efeitos adversos , Hansenostáticos/efeitos adversos , Talidomida/efeitos adversos , Anormalidades Induzidas por Medicamentos/patologia , Anormalidades Induzidas por Medicamentos/fisiopatologia , Adulto , Envelhecimento/patologia , Criança , Pessoas com Deficiência/psicologia , Feminino , Humanos , Hipnóticos e Sedativos/administração & dosagem , Imunossupressores/administração & dosagem , Estudos Interdisciplinares , Hansenostáticos/administração & dosagem , Pessoa de Meia-Idade , Farmacovigilância , Gravidez , Qualidade de Vida/psicologia , Talidomida/administração & dosagem , Reino Unido
6.
Enferm. glob ; 16(46): 336-348, abr. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-161738

RESUMO

La lepra, junto con el envejecimiento trae cambios físicos que afectan a la dependencia y a la autonomía. El objetivo fue evaluar el aspecto físico y el impacto en la calidad de vida y la independencia de las personas mayores afectadas por la lepra. Estudio descriptivo con un enfoque cuantitativo, con 60 ancianos en dos centros de rehabilitación en Sao Luis - MA. Se utilizó el dominio físico de la WHOQOL - bref y Facetas «Habilidades sensoriales» y «Autonomía» del WHOQOL -.OLD, de la Organización Mundial de la Salud. Se observó problemas con el dolor / malestar (31,3%), fatiga (21 3%) y el sueño / descanso (23,3%), actuando en la incapacidad para el transporte (23,3%), la realización de actividades cotidianas (16,6%) y el trabajo (33,3%), así como relacionados con la dependencia de medicamentos / tratamientos (56,6%). La calidad de vida se alteró por la pérdida sensorial (33,3%), así como la capacidad de realizar actividades (28,3%) e interactuar con personas (23,3%). En cuanto a la autonomía, la mayoría de las personas mayores se sintieron libres para tomar decisiones (53,3%) y se sintieron respetadas por tomarlas (55,0%), aunque afirmaron no hacer todo lo que quisieran (38,3 %). Por lo tanto, se concluye que la enfermedad ante el proceso de la senescencia y / o proceso de la senilidad puede haber contribuido negativamente sobre los aspectos físicos y calidad de vida de las personas mayores (AU)


A hanseníase, aliada ao processo de envelhecimento, traz alterações físicas que interferem na dependência e autonomia. O objetivo foi avaliar o aspecto físico e as repercussões na qualidade de vida e autonomia de idosos afetados por hanseníase. Estudo descritivo, de abordagem quantitativa, com 60 idosos em dois Centros de Reabilitação em São Luís - MA. Utilizou-se o Domínio Físico do WHOQOL - bref e as Facetas «Habilidades Sensoriais» e «Autonomia» do WHOQOL - OLD, da Organização Mundial de Saúde. Observou-se problemas com dor/desconforto (31,6%), fadiga (21,6%) e sono/repouso (23,3%), atuando na incapacidade para locomoção (23,3%), realização de atividades diárias (16,6%) e trabalho (33,3%), bem como relacionados à dependência de medicamentos/tratamentos (56,6%). A qualidade de vida foi alterada por perdas sensoriais (33,3%), bem como a capacidade de realizar atividades (28,3%) e interagir com pessoas (23,3%). No que tange a autonomia, a maioria dos idosos se sentia livre para tomar decisões (53,3%) e sentia-se respeitada por tomá-las (55,0%), embora afirmasse não realizar tudo o que deseja (38,3%). Assim, conclui-se que a doença, diante do processo de senescência e/ou senilidade, pode ter contribuído negativamente sobre os aspectos físicos e qualidade de vida dos idosos (AU)


Leprosy, coupled with aging process, brings physical changes, which interfere in dependency and autonomy. The objective was to evaluate the physical aspect and the impact on the quality of life and the autonomy of elderly people affected by leprosy. This is a descriptive study of a quantitative approach, conducted with 60 elderly people in two rehabilitation centers in São Luís (MA). We used the Physical Domain of the WHOQOL-Bref and facets «Sensory Skills» and «Autonomy» of WHOQOL-OLD, from the World Health Organization. There were observed problems with pain/discomfort (31.6 percent), fatigue (21.6%) and sleep/rest (23.3 percent), acting in the inability for locomotion (23.3%), carrying out daily activities (16.6%), and work (33.3 percent), as well as related to the dependency on drugs/treatments (56.6%). The quality of life has changed by loss of sensory (33.3%), as well as the ability to perform activities (28.3%) and interact with people (23.3%). Regarding autonomy, most seniors felt free to make decisions (53.3%) and respected by taking them (55.0%), although stated that do not perform all who desire (38.3%). Thus, it was concluded that the disease, before the process of senescence and/or senility, might have contributed negatively about the physical aspects and quality of life of the elderly (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Hanseníase/enfermagem , Hanseníase/psicologia , Qualidade de Vida/psicologia , Autonomia Pessoal , Envelhecimento/psicologia , Pessoas com Deficiência/psicologia , Perfil de Impacto da Doença , 25783/estatística & dados numéricos
7.
Indian J Dermatol Venereol Leprol ; 83(2): 205-211, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27647359

RESUMO

BACKGROUND: There are few population-based studies on prevalence of cutaneous problems in diabetes mellitus. AIMS: To identify skin problems associated with diabetes mellitus among elderly persons in a village in Kerala. METHODS: In this population-based cross-sectional survey, we compared the prevalence of skin problems among 287 elderly diabetics (aged 65 years or more) with 275 randomly selected elderly persons without diabetes mellitus. RESULTS: Numbness, tingling and burning sensation of extremities,"prayer sign", finger pebbling, skin tags, stiff joints and acanthosis nigricans were noted more frequently in diabetics as compared to non-diabetics. Ache in extremities, dermatophytosis, candidiasis, seborrheic keratoses/dermatosis papulosa nigra, xerosis/ichthyosis, idiopathic guttate hypomelanosis, nonspecific itching, and eczema were equally frequent in both groups. Among the diagnostic categories, neurovascular, metabolic and autoimmune findings were associated with diabetes mellitus, whereas bacterial and fungal infections were not. LIMITATIONS: Initial misclassification errors, no laboratory confirmation of dermatological diagnosis during survey, coexistence of findings related to aging and not analyzing the effects of glycemic level, concurrent diseases and medications. CONCLUSIONS: Numbness, tingling and burning sensation of extremities, prayer sign, finger pebbling, skin tags, stiff joints and acanthosis nigricans were associated with diabetes mellitus among elderly persons in a village in Kerala.


Assuntos
Envelhecimento/patologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Vigilância da População , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Prurido/diagnóstico , Prurido/epidemiologia , Distribuição Aleatória
8.
Age Ageing ; 44(2): 312-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25362502

RESUMO

OBJECTIVE: To study the utility of nerve biopsy in providing diagnostic, therapeutic or prognostic information that aid in clinical management in elderly subjects with peripheral neuropathy. METHODS: Clinico-pathological data of 100 elderly subjects aged 65 and above with peripheral neuropathy who underwent nerve biopsy in the last decade (2002-2011) was reviewed. RESULTS: The study included 100 subjects (M:F 78:22). Mean age at biopsy and symptom duration was 69.62±4.8 years and 24.17±40.4 months, respectively. The most common pattern of was distal symmetric sensorimotor polyneuropathy (35%), followed by multiple mononeuropathy (29%) and asymmetric sensorimotor neuropathy (15%). The nerve biopsy was 'diagnostic' in 24%, (definite vasculitis in 12, leprosy in 10 and acute inflammatory demyelinating polyradiculoneuropathy in 2) and proved 'essential' or 'helpful' in therapeutic management in 81% subjects. In 60 (60%) patients, where a pre-biopsy aetiological diagnosis could be arrived at based on the available data, nerve biopsy confirmed the diagnosis in 29 of 60 (48.3%), and offered a new diagnosis in 25 (41.7%). A higher yield of biopsy was noted in subjects with asymmetric/multiple mononeuropathy compared with symmetric neuropathies (32.7% versus 17.7%). In 40 (40%) patients without a pre-biopsy aetiological diagnosis, nerve biopsy was 'essential' in 7 of 40 (17.5%) as it provided a definitive diagnosis (definite vasculitis: 5, leprosy: 2), and 'helpful' in 21 of 40 (52.5%) (ischaemic neuropathy: 10, possible vasculitis: 9, probable vasculitis: 2). CONCLUSION: Nerve biopsy aided in the detection of potentially treatable disorders and influenced patient management in a significant proportion of elderly subjects with peripheral neuropathy (81%), particularly in subset with undiagnosed neuropathies confirming that it's a useful tool in diagnosis of neuropathy in the elderly. With minor differences, the aetiological profile in our biopsied neuropathic elderly subjects may reflect the findings in other similar cohorts.


Assuntos
Envelhecimento/patologia , Biópsia , Nervos Periféricos/patologia , Doenças do Sistema Nervoso Periférico/patologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Doenças do Sistema Nervoso Periférico/terapia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos
9.
Indian J Dermatol Venereol Leprol ; 80(5): 395-401, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25201838

RESUMO

BACKGROUND: The color of Indian skin shows great diversity and pigmentary disorders are a major concern of Indian women. Despite great variations in climate, diet, and social parameters within India, studies of the range of skin types have been rather scarce. AIMS: This study was aimed at characterizing the color of Indian skin in various geographical locations, its characteristics in terms of overall skin complexion and pigmentary disorders, and the impact of age on these features. METHODS: An extensive descriptive study, including skin color parameters (objective measurements and evaluations by dermatologists, clinically or from photographs) was carried out involving 1,204 female volunteers of different ages living in four different Indian cities. RESULTS: Important differences in skin complexion according to the geographical location were observed. Age seemed to have little impact on complexion. Hyperpigmented spots were frequent and were noted at early stages and many lentigines were found. Melasma affected about 30% of middle-aged women, but many other ill defined, pigmented macules were also observed. Additionally, we found pigmented lip corners associated with marionette lines, and linear nasal pigmentation. CONCLUSIONS: Indian skin color is diverse and pigmentary disorders are common. Skin complexion is not greatly affected by age. Some hyperpigmented disorders occur at early stages and increase with age, contributing to overall unevenness of facial color.


Assuntos
Transtornos da Pigmentação/etnologia , Pigmentação da Pele/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Feminino , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Características de Residência , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-23974581

RESUMO

Premature graying is an important cause of low self-esteem, often interfering with socio-cultural adjustment. The onset and progression of graying or canities correlate very closely with chronological aging, and occur in varying degrees in all individuals eventually, regardless of gender or race. Premature canities may occur alone as an autosomal dominant condition or in association with various autoimmune or premature aging syndromes. It needs to be differentiated from various genetic hypomelanotic hair disorders. Reduction in melanogenically active melanocytes in the hair bulb of gray anagen hair follicles with resultant pigment loss is central to the pathogenesis of graying. Defective melanosomal transfers to cortical keratinocytes and melanin incontinence due to melanocyte degeneration are also believed to contribute to this. The white color of canities is an optical effect; the reflection of incident light masks the intrinsic pale yellow color of hair keratin. Full range of color from normal to white can be seen both along individual hair and from hair to hair, and admixture of pigmented and white hair is believed to give the appearance of gray. Graying of hair is usually progressive and permanent, but there are occasional reports of spontaneous repigmentation of gray hair. Studies evaluating the association of canities with osteopenia and cardiovascular disease have revealed mixed results. Despite the extensive molecular research being carried out to understand the pathogenesis of canities, there is paucity of effective evidence-based treatment options. Reports of repigmentation of previously white hair following certain inflammatory processes and use of drugs have suggested the possibility of cytokine-induced recruitment of outer sheath melanocytes to the hair bulb and rekindled the hope for finding an effective drug for treatment of premature canities. In the end, camouflage techniques using hair colorants are outlined.


Assuntos
Envelhecimento/patologia , Envelhecimento/fisiologia , Cor de Cabelo/fisiologia , Doenças do Cabelo/patologia , Doenças do Cabelo/fisiopatologia , Doenças Ósseas Metabólicas/complicações , Doença da Artéria Coronariana/complicações , Doenças do Cabelo/etiologia , Humanos , Melanócitos/patologia , Melanócitos/fisiologia
12.
In. Trench, Belkis; Rosa, Tereza Etsuko da Costa. Nós e o Outro: envelhecimento, reflexões, práticas e pesquisa. São Paulo, Instituto de Saúde, 2011. p.267-296. (Temas em saúde coletiva, 13).
Monografia em Português | LILACS, SES-SP, SESSP-ISPROD, SES-SP, SESSP-ISACERVO | ID: biblio-1078898
13.
Nepal Med Coll J ; 14(3): 193-5, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24047013

RESUMO

Geriatric health care has become a major issue worldwide. There are no data regarding geriatric dermatologic diseases are available from Nepal. Patients of 60 years and above were enrolled in the Nepali fiscal year 2067(April 2010-April 2011). The data included age, sex, place, and diagnosis. The aim of the study is to determine the characteristic pattern and frequency of dermatoses in dermatologic patients aged 60 years and above. There were total of 6442 patients who visited out patients department. Out of which frequency of geriatric patients were 330, which constitute about 5.1%. The male to female ratio was 50% each. The most common cutaneous dermatoses was eczema 35.8%, fungal infection 13.6%, viral infection 7%, followed by pruritus 7.3%, scabies and photodermatitis 4.5% each, Inflammatory papulosquamous disorder 3.3%, Bacterial infection and Icthyosis 2.1% each, vesiculobullous 1.8%, tumors and pigmentary disorder 0.6% and Miscellaneous group (keratoderma, callus, urticaria, diabetic ulcer, burgers disease, burning feet syndrome, Rosacea, Drug rash-amoxicillin, senile acne, prurigo nodularis, hansens disease, pellagra, Actinic cheilitis) 15.8%. Few patients had more than one dermatoses which constitute < 1% .Photodermatitis was found to be statistically significant. The most common dermatoses were Eczema in females followed by Photodermatitis and comparatively in males viral and fungal infections were common. This study depicts various characteristic patterns of dermatoses seen in elderly. Eczema and infections was found to be most common diseases seen in elderly. Further epidemiologic studies including treatment, follow-up of elderly patients has to be carried out to know the burden of the disease and decrease morbidity and psychological concern associated with diseases.


Assuntos
Envelhecimento , Geriatria/estatística & dados numéricos , Dermatopatias/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Retrospectivos , Distribuição por Sexo
15.
Proc Natl Acad Sci U S A ; 107(45): 19326-31, 2010 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-20974969

RESUMO

DDS, 4,4'-diaminodiphenylsulfone, is the most common drug prescribed to treat Hansen disease patients. In addition to its antibacterial activity, DDS has been reported to be involved in other cellular processes that occur in eukaryotic cells. Because DDS treatment significantly enhances the antioxidant activity in humans, we examined its effect on lifespan extension. Here we show that DDS extends organismic lifespan using Caenorhabditis elegans as a model system. DDS treatment caused a delay in aging and decreased the levels of a mitochondrial complex. The oxygen consumption rate was also significantly lowered. Consistent with these data, paraquat treatment evoked less reactive oxygen species in DDS-treated worms, and these worms were less sensitive to paraquat. Interestingly enough, all of the molecular events caused by DDS treatment were consistently reproduced in mice treated with DDS for 3 mo and in the C2C12 muscle cell line. Structural prediction identified pyruvate kinase (PK) as a protein target of DDS. Indeed, DDS bound and inhibited PK in vitro and inhibited it in vivo, and a PK mutation conferred extended lifespan of C. elegans. Supplement of pyruvate to the media protected C2C12 cells from apoptosis caused by paraquat. Our findings establish the significance of DDS in lowering reactive oxygen species generation and extending the lifespan, which renders the rationale to examining the possible effect of DDS on human lifespan extension.


Assuntos
Caenorhabditis elegans/fisiologia , Dapsona/farmacologia , Longevidade/efeitos dos fármacos , Envelhecimento/efeitos dos fármacos , Animais , Antioxidantes , Linhagem Celular , Proteínas Mitocondriais/efeitos dos fármacos , Músculo Esquelético/citologia , Músculo Esquelético/efeitos dos fármacos , Consumo de Oxigênio/efeitos dos fármacos , Paraquat/farmacologia , Piruvato Quinase/antagonistas & inibidores , Piruvato Quinase/genética , Espécies Reativas de Oxigênio
17.
Nurs Philos ; 10(1): 34-41, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19154295

RESUMO

From the Middle Ages onto the 19th century, following the trend set in leper hospitals, madness was to be hidden, secluded in dark places, far away from the mainstream of society. The emergence of the mad person, perceived as inevitably different, allows to make the boundaries between reason and folly, between human and inhuman, irrelevant. If leper hospitals have almost emptied out, if there are much fewer confinement facilities, the values and images related to the leper or the mad person, as well as the sense of exclusion, continue to persist. The purpose of this paper is to show clearly that this matter of exclusion is a serious legacy that could very well apply nowadays to other figures that, each in their own way, symbolize menace or mockery. It applies notably to the aged and the dying who both appear as the opposite of modern society and its values of efficiency, productivity and profitability. The multiplication of places where old people are left to die, and the elderly who are crowded in old folks homes, stand as proof of their exclusion from society. Nevertheless, youth and old age coexist, as well as life and death. If care of others is the trait of a humane civilization, must it be understood that barbarism consists in ignoring its own humanity as well as that of others? In view of such practices of exclusion, policy statements based on recognition of human dignity, where ethical obligation rests on recognition of others and humanism, are rather paradoxical. Is this a paradox or a deadlock; a condition of exclusion or of reconnaissance?


Assuntos
Atitude Frente a Saúde , Individualidade , Institucionalização/história , Filosofia/história , Distância Psicológica , Envelhecimento , Atitude Frente a Morte , História do Século XX , Humanos , Hanseníase/história , Transtornos Mentais/história , Preconceito , Alienação Social , Controle Social Formal , Valores Sociais , Estereotipagem
18.
Am J Trop Med Hyg ; 77(5): 829-33, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17984336

RESUMO

Leprosy affects skin and peripheral nerves, and acute inflammatory type 1 reactions (reversal reaction) can cause neurologic impairment and disabilities. Single skin lesion paucibacillary leprosy volunteers (N = 135) recruited in three Brazilian endemic regions, treated with single-dose rifampin, ofloxacin, and minocycline (ROM), were monitored for 3 years. Poor outcome was defined as type 1 reactions with or without neuritis. IgM anti-phenolic glycolipid I, histopathology, Mitsuda test, and Mycobacterium leprae DNA polymerase chain reaction (ML-PCR) were performed at baseline. chi(2) test, Kaplan-Meir curves, and Cox proportional hazards were applied. The majority of volunteers were adults with a mean age of 30.5 +/- 15.4 years; 44.4% were ML-PCR positive. During follow-up, 14.8% of the patients had a poor clinical outcome, classified as a type 1 reaction. Older age (> or = 40 years), ML-PCR positivity, and lesion size > 5 cm were associated with increased risk. In multivariate analysis, age (> or = 40 years) and ML-PCR positivity remained baseline predictors of type 1 reaction among monolesion leprosy patients.


Assuntos
DNA Bacteriano/isolamento & purificação , Eritema Nodoso/epidemiologia , Hanseníase/tratamento farmacológico , Hanseníase/microbiologia , Minociclina/uso terapêutico , Mycobacterium leprae/isolamento & purificação , Ofloxacino/uso terapêutico , Rifampina/uso terapêutico , Adolescente , Adulto , Envelhecimento , Estudos de Coortes , Eritema Nodoso/sangue , Eritema Nodoso/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Fatores de Risco , Fatores de Tempo
19.
Lepr Rev ; 77(3): 203-9, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17172000

RESUMO

OBJECTIVE: To investigate the prevalence and characteristics of depressed patients living in a Japanese leprosarium who have been isolated by national law and are now becoming very elderly. METHODS: We surveyed the prevalence of depressed patients living in the National Tamazenshouen Sanatorium, a major leprosarium in Japan. We also investigated the characteristics of patients who had suffered a depressive episode during the last 5 years (2000-2004). The characteristics of residents who committed suicide were also studied. RESULTS: At the time of the investigation, 48 out of 385 (12.5%) patients were depressed or had experienced a depressive episode. Forty-one residents had committed suicide since the leprosarium was established in 1907. Somatic symptoms and depressive moods were the predominant symptoms and were not limited to symptoms unique to leprosy. The period of isolation was not statistically correlated with the GDS-SF or PGC morale scale scores. CONCLUSION: The findings of this study emphasize the importance of consultation psychiatric for elderly leprosy residents and could be used as a reference for treatment in countries with ageing leprosy residents.


Assuntos
Envelhecimento , Transtorno Depressivo/epidemiologia , Hanseníase/psicologia , Isolamento Social , Idoso , Idoso de 80 Anos ou mais , Transtorno Depressivo/etiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Suicídio , Inquéritos e Questionários
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