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1.
Obesity (Silver Spring) ; 29(12): 1978-1981, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34813174

RESUMO

The North American Association for the Study of Obesity (NAASO), the precursor of The Obesity Society (TOS), was founded in 1981 and turns 40 years old in 2021. The Society was organized by George Bray along with John Brunzell, C. Wayne Callaway, M.R.C. Greenwood, and Judith Stern. It held its foundational meeting with a theme of "Types of Obesity: Animal Models and Clinical Applications" at Vassar College in the fall of 1982 along with symposia and an NIH workshop titled "Methods of Characterizing Human Obesity." At a follow-up meeting during the Fourth International Congress on Obesity, Barbara Hansen was elected President, Judith Stern Secretary, and Anne Sullivan Treasurer. Incorporation of NAASO occurred in 1984.


Assuntos
Obesidade , Animais , Escolaridade , História do Século XX
2.
PLoS One ; 16(11): e0260243, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34797854

RESUMO

BACKGROUND: Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients' quality of life (QoL). This study aimed at assessing factors influencing management practice, and QoL and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia. MATERIALS AND METHODS: A cross sectional study was conducted in 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients' chart review. Dermatology Life Quality Index (DLQI) was used to measure patients' QoL. Patients' characteristics were summarized using descriptive statistics and predictors of QoL were identified by binary logistic regression. RESULTS: Among 207 study participants, 122 (58.9%) were females. The mean age of the study population was 37.92 (SD = 14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32 (SD = 13.7) years ranging from 10 to 62 years. The duration of the disease in 112 (54.1%) patients were more than or equal to 5 years. Majority of study participants 145 (70.0%) had plaque psoriasis followed by sebopsoriasis, 24 (11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21 (14.5%) treated by methotrexate alone. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female [AOR = 0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR = 0.12 (95% CI: 0.02, 0.56)], [AOR = 0.06 (95% CI:0.01, 0.32)], and [AOR = 0.03 (95% CI: 0.01, 0.22)]), respectively, and primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] was predictor of better QoL. Poor QoL was predominant in females [AOR = 0.17 (95%CI: 0.06, 0.48)], low income [AOR = 0.12 (95% CI: 0.02, 0.56] patients, and patients with primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)]. Patients on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] had good QoL. CONCLUSION: Our study identified that topical corticosteroids were the mainstay of psoriasis treatment in the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Moderate effect QoL was achieved by study participants based on DLQL score.


Assuntos
Psoríase/tratamento farmacológico , Adolescente , Adulto , Criança , Estudos Transversais , Escolaridade , Etiópia , Feminino , Humanos , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Qualidade de Vida , Adulto Jovem
3.
Indian J Dermatol Venereol Leprol ; 87(3): 341-347, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33943064

RESUMO

BACKGROUND: Lichen planus pigmentosus can have a negative impact on the quality of life; however, this has not been studied in detail. OBJECTIVES: To study the quality of life in patients with lichen planus pigmentosus and compare it with patients with vitiligo and melasma. METHODS: This was a cross-sectional study conducted in a tertiary-care center in north India from January 2018 to May 2019. Patients ≥ 18 years of age with lichen planus pigmentosus (n = 125), vitiligo (n = 113) and melasma (n = 121) completed the Dermatology Life Quality Index (DLQI) questionnaire and answered a global question on the effect of disease on their lives. In addition, patients with vitiligo completed the Vitiligo Impact Scale (VIS)-22 questionnaire, while those with lichen planus pigmentosus and melasma filled a modified version of VIS-22. RESULTS: The mean DLQI scores in patients with lichen planus pigmentosus, vitiligo and melasma were 10.9 ± 5.95, 9.73 ± 6.51 and 8.39 ± 5.92, respectively, the difference being statistically significant only between lichen planus pigmentosus and melasma (P < 0.001). The corresponding mean modified VIS-22/VIS-22 scores were 26.82 ± 11.89, 25.82 ± 14.03 and 18.87 ± 11.84, respectively. This difference was statistically significant between lichen planus pigmentosus and melasma, and between vitiligo and melasma (P < 0.001 for both). As compared to vitiligo, patients with lichen planus pigmentosus had a significantly greater impact on "symptoms and feelings" domain (P < 0.001) on DLQI, and on "social interactions" (P = 0.02) and "depression" (P = 0.04) domains on VIS-22. As compared to melasma, patients with lichen planus pigmentosus had significantly higher scores for "symptoms and feelings," "daily activities," "leisure" and "work and school" domains of DLQI, and all domains of VIS-22. Female gender was more associated with impairment in quality of life in patients with lichen planus pigmentosus, while lower education, marriage, younger age and increasing disease duration showed a directional trend. LIMITATIONS: Use of DLQI and modified version of VIS-22 scales in the absence of a pigmentary disease-specific quality-of-life instrument. CONCLUSION: Patients with lichen planus pigmentosus have a significantly impaired quality of life. The psychosocial burden of lichen planus pigmentosus is quantitatively similar to that of vitiligo, but significantly greater than melasma.


Assuntos
Líquen Plano/psicologia , Melanose/psicologia , Transtornos da Pigmentação/psicologia , Qualidade de Vida , Vitiligo/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Escolaridade , Feminino , Humanos , Índia , Líquen Plano/complicações , Masculino , Estado Civil , Pessoa de Meia-Idade , Transtornos da Pigmentação/etiologia , Fatores Sexuais , Centros de Atenção Terciária , Adulto Jovem
4.
Acta Trop ; 218: 105884, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33676938

RESUMO

OBJECTIVE: To analyse the association between social inequalities and the leprosy burden in a low endemicity scenario in the state of São Paulo, Brazil. METHODS: This ecological study was carried out in the city of Ribeirão Preto, state of São Paulo, Brazil, considering leprosy cases notified from 2006 to 2016. Regarding social inequalities, dimensions related to high household density, literacy, home occupation conditions, health conditions, household income, ethnicity and age were considered. The generalised additive model for location, scale and shape (GAMLSS) was used to verify the association between the social inequalities and leprosy burden. RESULTS: The increase in men and women with no education and people with an income of 1 to 2 minimum wages was associated with a relative increase in the number of leprosy cases (7.37%, 7.10% and 2.44%, respectively). Regarding the ethnicity variables, the increase in the proportion of men (black) and women (mixed race) with no schooling was associated with a relative increase in the number of cases of the disease (10.77% and 4.02%, respectively). Finally, for people of mixed race or ethnicity, the increase in the proportion of households with 1/2 to 1 minimum wage was related to a relative decrease in the total number of cases (-4.90%). CONCLUSION: The results show that the determinants associated with the increase in leprosy cases are similar to those in Brazilian hyperendemic regions, and that even in cities with low endemicity, social inequality is one of the main determinants of the disease.


Assuntos
Doenças Endêmicas/estatística & dados numéricos , Hanseníase/epidemiologia , Fatores Socioeconômicos , Adulto , Brasil/epidemiologia , Brasil/etnologia , Cidades/epidemiologia , Cidades/etnologia , Escolaridade , Meio Ambiente , Feminino , Humanos , Hanseníase/etnologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
BMC Infect Dis ; 21(1): 290, 2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752632

RESUMO

BACKGROUND: Leprosy continues to be an important cause of physical disability in endemic countries such as Brazil. Knowledge of determinants of these events may lead to better control measures and targeted interventions to mitigate its impact on affected individuals. This study investigated such factors among the most vulnerable portion of the Brazilian population. METHODS: A large cohort was built from secondary data originated from a national registry of applicants to social benefit programs, covering the period 2001-2015, including over 114 million individuals. Data were linked to the leprosy notification system utilizing data from 2007 until 2014. Descriptive and bivariate analyses lead to a multivariate analysis using a multinomial logistic regression model with cluster-robust standard errors. Associations were reported as Odds Ratios with their respective 95% confidence intervals. RESULTS: Among the original cohort members 21,565 new leprosy cases were identified between 2007 and 2014. Most of the cases (63.1%) had grade zero disability. Grades 1 and 2 represented 21 and 6%, respectively. Factors associated with increasing odds of grades 1 and 2 disability were age over 15 years old (ORs 2.39 and 1.95, respectively), less schooling (with a clear dose response effect) and being a multibacillary patient (ORs 3.5 and 8.22). Protective factors for both grades were being female (ORs 0.81 and 0.61) and living in a high incidence municipality (ORs 0.85 and 0.67). CONCLUSIONS: The findings suggest that the developing of physical disabilities remains a public health problem which increases the burden of leprosy, mainly for those with severe clinical features and worse socioeconomic conditions. Early diagnosis is paramount to decrease the incidence of leprosy-related disability and our study points to the need for strengthening control actions in non-endemic areas in Brazil, where cases may be missed when presented at early stages in disease. Both actions are needed, to benefit patients and to achieve the WHO goal in reducing physical disabilities among new cases of leprosy.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Hanseníase/diagnóstico , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Coortes , Bases de Dados Factuais , Escolaridade , Feminino , Humanos , Incidência , Hanseníase/epidemiologia , Hanseníase/patologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , População Rural , Adulto Jovem
6.
Indian J Dermatol Venereol Leprol ; 87(2): 154-175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33769736

RESUMO

Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.


Assuntos
Tinha/epidemiologia , Distribuição por Idade , Uso Indevido de Medicamentos , Escolaridade , Glucocorticoides/efeitos adversos , Humanos , Doença Iatrogênica , Incidência , Índia/epidemiologia , Ocupações , Prevalência , Qualidade de Vida , Recidiva , Fatores de Risco , População Rural , Distribuição por Sexo , Classe Social , Tinha/diagnóstico , População Urbana
7.
Indian J Dermatol Venereol Leprol ; 87(3): 375-378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31464197

RESUMO

BACKGROUND AND AIMS: Pemphigus vulgaris is a rare autoimmune intraepidermal vesiculobullous disease involving the skin and mucosa. It impacts the quality of life of both patients and their families. METHODS: A total of 70 patients with pemphigus vulgaris (either outpatient or hospitalized) were enrolled using the simple sampling method between 2016 and 2017 from the dermatology clinic at Faghihi Hospital, Shiraz, Iran. A validated Persian version of the Family Dermatology Life Quality Index (FLDQI) questionnaire was filled by a family caregiver. The questionnaire contained 10 items assessing the quality of life of the family. Demographic variables were recorded in a separate form. RESULTS: The mean age of the patients was 51 ± 11.3 years and that of the family caregivers was 32 ± 8.8 years. The FLDQI score was higher (poorer quality of life) if the patient was male, older, had shorter disease duration or had fewer disease recurrences (P = 0.046, 0.01, 0.001 and >0.001, respectively). Higher scores were also obtained in the less-educated caregivers (P = 0.026) but there was no association with either gender or age (P = 0.399, 0.1). CONCLUSION: Pemphigus vulgaris significantly affects the Family Dermatology Life Quality Index. Education and counseling of family caregivers by various support groups such as Pemphigus Family Associations could be effective in improving the quality of life of the caregivers. LIMITATIONS: This study did not assess the effect of comprising domain analysis, severity of disease, patients' Dermatology Life Quality Index (DLQI), mucosal involvement, response to treatment, outpatient or admitted status, socioeconomic status, or the quality of life among the various family members.


Assuntos
Cuidadores/psicologia , Pênfigo/psicologia , Qualidade de Vida , Adulto , Fatores Etários , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários
8.
Rev Esc Enferm USP ; 54: e03659, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33295532

RESUMO

OBJECTIVE: To evaluate the epidemiological characteristics and tendency of new leprosy cases in people younger than 15 years in the state of Bahia, Brazil, between 2007 and 2017. METHOD: Quantitative, cross-sectional, descriptive study of cases registered in the Notifiable Diseases Information System. The sociodemographic variables were statistically analyzed through the G-test and trend classification was analyzed through linear regression, along with the tendency or percentage change. RESULTS: The study comprised 2,298 new cases and presented decreasing rate of detection, growing proportion of investigated contacts, and decreasing proportion of healing. Paucibacillary cases are emphasized, with a 63.27% proportion and predominance among females with incomplete primary education and brown race/color living in urban zones. Regarding clinical forms, physical disabilities, and modes of detection, 26.68% were tuberculoid, 73.72% were grade zero, and 36.42% were referral, respectively. CONCLUSION: The increased tendency in the proportion of investigated contacts and the decrease in the proportion of healing revealed a need for the health system to improve patient follow-up during treatment against leprosy.


Assuntos
Hanseníase , Adolescente , Brasil/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Hanseníase/epidemiologia , Masculino , Encaminhamento e Consulta , População Urbana
9.
Rev Soc Bras Med Trop ; 53: e20200515, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33263688

RESUMO

INTRODUCTION: The Integrated Program of Leprosy Control was initiated in 2003 in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy. Here, we present the evolution of the indicators of leprosy within the established period in children aged <15 years. METHODS: This is a descriptive study based on an active search for cases and spontaneous healthcare demand for leprosy, with an evolutionary analysis of the detection coefficient of new cases. We considered individuals aged <15 years diagnosed with leprosy from January 2003 to December 2015. To evaluate the factors associated with clinical and operational forms, Chi-square, Fisher's exact, or Fisher-Freeman-Halton tests were performed. RESULTS: A total of 61 new cases were detected (6.9% of the total leprosy cases diagnosed in the municipality during the study period), and the majority was found in males (62.3%). The most frequent operational classification was paucibacillary (67.2%), and this association increased with age. The tuberculoid clinical form was the most prevalent in both sexes and in the age range of 10 to <15 years. There was a reduction in the detection coefficient from 21.84/100,000 inhabitants in 2003 to 2.79/100,000 in 2015. CONCLUSIONS: Despite the progress in the control of leprosy, this historical series shows that it is necessary to strengthen educational measures and implement control actions, so that the disease ceases to be a public health problem in the population aged <15 years.


Assuntos
Doenças Endêmicas , Hanseníase , Adolescente , Brasil/epidemiologia , Criança , Escolaridade , Feminino , Humanos , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Masculino , Saúde Pública
10.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(1): 33-36, jun 17, 2020. tab
Artigo em Português | LILACS | ID: biblio-1358660

RESUMO

Objetivo: caracterizar o doador de sangue e seu conhecimento sobre a hanseníase, visando contribuir para identificar pontos de vulnerabilidade sobre a doença. Metodologia: foram entrevistados doadores de sangue (n=199) através de um questionário estruturado abordando características socioeconômicas e o conhecimento sobre a hanseníase. Para a análise dos dados foi utilizado o método de Goodman e considerado significativo p<0,05. Resultados: dentre as perguntas sobre a hanseníase, a maioria dos participantes (65,83%) não tinha conhecimento da doença e nem o seu modo de transmissão (75,88%) e quando computado o conhecimento da Hanseníase, 1,51% conheciam, 39,70% conheciam pouco e 58,79% não conheciam a doença. Nossos resultados demonstraram que somente a escolaridade teve associação significativa com a falta de conhecimento sobre a hanseníase (p=0,0273). Conclusão: verificou-se déficit de conhecimento da população geral quanto à hanseníase. Sugerimos um aprimoramento da divulgação das informações quanto à doença a fim de promover melhoras nos serviços de saúde, acompanhamento dos doentes e prevenção da população saudável.


Objective: to characterize the blood donor and his knowledge about leprosy, aiming to contribute to identify vulnerability points about the disease. Methodology: blood donors (n=199) were interviewed through a structured questionnaire addressing socioeconomic characteristics and knowledge about leprosy. For the data analysis, the Goodman method was used and considered significant p<0.05. Results: Among the questions about leprosy, most participants (65.83%) did not know about the disease and its mode of transmission (75.88%) and when computing the knowledge of leprosy, 1.51% knew, 39,70% knew little and 58.79% did not know the disease. Our results showed that only schooling had a significant association with the lack of knowledge about leprosy (p=0,0273). Conclusion: there was a lack of knowledge of the general population regarding leprosy. We suggest an improved dissemination of information about the disease to promote improvements in health services, patient monitoring and prevention of the healthy population.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doadores de Sangue , Conhecimento , Hanseníase , Classe Social , Estado Civil , Escolaridade
11.
Int J Dermatol ; 59(7): 856-861, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32358972

RESUMO

BACKGROUND: Leprosy can cause acute reactions, which may be type 1 (reverse reaction) or type 2 (erythema nodosum leprosum - ENL). ENL has been classified as mild, moderate, or severe. In order to standardize the classification, the Erythema Nodosum Leprosum International Study (ENLIST) Group has developed an objective scale, the ENLIST ENL Severity Scale (EESS), which was the first validated severity scale of ENL in the world. The goal of the study was to describe the sociodemographic and clinical characteristics of patients with ENL attending a tertiary hospital in Piauí, Brazil, classifying them according to the EESS. METHODS: A descriptive cross-sectional observational study was conducted on 26 patients recruited sequentially from May 2017 to February 2018. Their data were statistically analyzed and compared against each other through a structured questionnaire. RESULTS: According to the score obtained in the scale, the patients were divided into two groups: mild ENL and moderate/severe ENL. The extent and number of nodules were related to the severity of the cases, and these data were statistically significant. The majority of the patients were male, between the ages of 31 and 49 years old, with low educational level, and residents in the urban area. CONCLUSIONS: This was the first study to use EESS in Brazil. This scale is easy to apply and allows for the enhancement of treatment protocols. The study also showed a correlation between the number and extension of nodules and the severity of the condition.


Assuntos
Eritema Nodoso/epidemiologia , Hanseníase Virchowiana/epidemiologia , Índice de Gravidade de Doença , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Escolaridade , Eritema Nodoso/complicações , Eritema Nodoso/patologia , Feminino , Febre/microbiologia , Humanos , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/patologia , Masculino , Pessoa de Meia-Idade , Dor/microbiologia , Prevalência , Fatores Sexuais , Inquéritos e Questionários , População Urbana , Adulto Jovem
12.
Indian J Dermatol Venereol Leprol ; 86(4): 375-381, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31857521

RESUMO

BACKGROUND: Psoriasis is a systemic autoinflammatory disease that is related to an increased risk of organic and psychological comorbidities. Type D personality has been related to poor quality of life and worse physical and psychological outcomes in different diseases. AIMS: The aim of this study is to explore whether type D personality is associated with an increased risk of presenting physical and/or psychological comorbidities, their relationship with the capacity of social adaptation, and health-related quality of life (HRQOL) in patients with psoriasis. METHODS: This was a cross-sectional study. In all, 130 patients with moderate to severe psoriasis were included in this study. Participants completed the DS14 test and different validated questionnaires regarding quality of life and psychological morbidities. RESULTS: Type D personality was present in 38.4% (50/130) of the participants of the study. Patients with psoriasis and type D personality presented a higher risk of depression and anxiety. We observed that type D personality was associated with a lower educational level. These patients also presented a worse HRQOL in different dimensions of the Short Form Health Survey-36 questionnaire, more sleep problems, poor social adaptation, and a higher frequency of sexual disturbances. LIMITATIONS: Due to the cross-sectional design of the study, we could not confirm causality. Selection of sample was not random. Diagnoses of physical comorbidity were collected through clinical interview of patients under active treatment, which may imply a classification bias. CONCLUSION: Type D personality could represent a frequent personality profile in patients with psoriasis that could identify subjects with poor coping abilities to the disease with poorer levels of quality of life, increased psychological comorbidities, and inadequate social adaptation mechanisms.


Assuntos
Personalidade , Psoríase/psicologia , Qualidade de Vida/psicologia , Ajustamento Social , Adaptação Psicológica , Adulto , Ansiedade/etiologia , Estudos Transversais , Depressão/etiologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Saúde Sexual , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários
13.
Rev. Soc. Bras. Med. Trop ; 53: e20200515, 2020. tab, graf
Artigo em Inglês | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143861

RESUMO

Abstract INTRODUCTION The Integrated Program of Leprosy Control was initiated in 2003 in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy. Here, we present the evolution of the indicators of leprosy within the established period in children aged <15 years. METHODS: This is a descriptive study based on an active search for cases and spontaneous healthcare demand for leprosy, with an evolutionary analysis of the detection coefficient of new cases. We considered individuals aged <15 years diagnosed with leprosy from January 2003 to December 2015. To evaluate the factors associated with clinical and operational forms, Chi-square, Fisher's exact, or Fisher-Freeman-Halton tests were performed. RESULTS A total of 61 new cases were detected (6.9% of the total leprosy cases diagnosed in the municipality during the study period), and the majority was found in males (62.3%). The most frequent operational classification was paucibacillary (67.2%), and this association increased with age. The tuberculoid clinical form was the most prevalent in both sexes and in the age range of 10 to <15 years. There was a reduction in the detection coefficient from 21.84/100,000 inhabitants in 2003 to 2.79/100,000 in 2015. CONCLUSIONS Despite the progress in the control of leprosy, this historical series shows that it is necessary to strengthen educational measures and implement control actions, so that the disease ceases to be a public health problem in the population aged <15 years.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças Endêmicas , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Brasil/epidemiologia , Saúde Pública , Escolaridade
15.
Rev Soc Bras Med Trop ; 52: e20180385, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30994805

RESUMO

INTRODUCTION: Thalidomide, used to treat erythema nodosum leprosum (ENL), is associated with severe adverse events (AEs) and is highly teratogenic. METHODS: A cross-sectional study was conducted on thalidomide-treated patients with ENL. AEs and selected variables were investigated through interviews and assessment of medical records. Odds ratios with 95% confidence intervals were estimated via logistic regression. RESULTS: Peripheral neuropathy symptoms and deep vein thrombosis (DVT) were the most common AEs reported. Although women of reproductive age used contraceptives, <50% of patients reported using condoms. Polypharmacy was associated with all endpoints, except DVT. CONCLUSIONS: Pharmacovigilance is crucial to prevent harmful thalidomide-associated AEs.


Assuntos
Hansenostáticos/efeitos adversos , Hanseníase/tratamento farmacológico , Talidomida/efeitos adversos , Estudos Transversais , Escolaridade , Feminino , Humanos , Hansenostáticos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Talidomida/uso terapêutico
17.
Rev. Soc. Bras. Med. Trop ; 52: e20180385, 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1041594

RESUMO

Abstract INTRODUCTION: Thalidomide, used to treat erythema nodosum leprosum (ENL), is associated with severe adverse events (AEs) and is highly teratogenic. METHODS: A cross-sectional study was conducted on thalidomide-treated patients with ENL. AEs and selected variables were investigated through interviews and assessment of medical records. Odds ratios with 95% confidence intervals were estimated via logistic regression. RESULTS: Peripheral neuropathy symptoms and deep vein thrombosis (DVT) were the most common AEs reported. Although women of reproductive age used contraceptives, <50% of patients reported using condoms. Polypharmacy was associated with all endpoints, except DVT. CONCLUSIONS: Pharmacovigilance is crucial to prevent harmful thalidomide-associated AEs.


Assuntos
Humanos , Masculino , Feminino , Talidomida/efeitos adversos , Hansenostáticos/efeitos adversos , Hanseníase/tratamento farmacológico , Talidomida/uso terapêutico , Estudos Transversais , Escolaridade , Hansenostáticos/uso terapêutico , Pessoa de Meia-Idade
18.
Artigo em Inglês | MEDLINE | ID: mdl-29972464

RESUMO

Hansen's disease is probably the human disease that causes more damage. The aim of this study was to investigate the association between the occurrence of the association of grade 1 and 2 physical disabilities in Hansen's disease, as well as implications of joint analysis and strength of association with independent demographic and clinical variables. This is a quantitative, descriptive, retrospective, population-based and documentary study developed from 2009 to 2014 in a Hansen's disease reference center in Joao Pessoa, PB. It involved 414 medical records, the diagnosis and discharge data on socio-demographic, clinical and simplified neurological evaluation variables. Data were analyzed using descriptive (absolute frequency and percentage) and inferential (Chi-Square and Prevalence Ratio (PR) statistics techniques. Both in the diagnosis and discharge, low education level, multibacillary classification and presence of affected nerves were statistically associated to the development of disabilities (p <0.05). The gender showed association only at discharge (p <0.05). Male gender, low education level, multibacillary classification and presence of affected nerves were identified as factors associated with the development of disabilities, and the individuals were more likely to develop disabilities at discharge. There is a need for development of surveillance actions for the population group identified for the detection and early treatment of the disease. Higher chances of developing disabilities in the discharge period makes the promotion of guidelines that standardize the care of these individuals imperative.


Assuntos
Pessoas com Deficiência , Hanseníase/complicações , Adulto , Avaliação da Deficiência , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
19.
Trans R Soc Trop Med Hyg ; 112(1): 31-35, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29566236

RESUMO

Background: Leprosy, a disease caused by Mycobacterium leprae, is an important cause of preventable disability. Methods: The present cross-sectional study was undertaken among leprosy-affected persons in a rural block in Kanchipuram District, Tamil Nadu, India in the year 2013. The sample included treatment completed leprosy affected persons ≥18 y of age. Persons with difficulty in cognition and those who were not willing to participate in the study were excluded. Subjects were also graded for any deformities of the body using World Health Organization (WHO) disability grading. Results: The present study, carried out among 171 people affected with leprosy in a rural block, showed the lifetime prevalence of disability was 88.3% (95% confidence interval 83.4 to 93.1). The mean age of the study participants was 61.58±12.31 y with almost equal distribution of males (49.7%) and females (50.3%). WHO disability grading showed that 147 (86%) of the subjects were grade 2 (visible deformity) while only 4 (2.3%) were grade 1. It was found that education, occupation, income and duration since diagnosis had statistical significance with disability. Conclusions: Disability was observed more in males and the most common type of deformity was hand and foot deformity. Further studies are needed to assess those patients who completed treatment and recommends periodic neurological assessment of those in treatment.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Hanseníase/epidemiologia , Hanseníase/fisiopatologia , Saúde da População Rural/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Escolaridade , Emprego , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda , Índia/epidemiologia , Hanseníase/complicações , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Distribuição por Sexo , Adulto Jovem
20.
HU rev ; 44(3): 303-309, 2018.
Artigo em Português | LILACS | ID: biblio-1048081

RESUMO

Introdução: a hanseníase é uma doença infecciosa cujo diagnóstico, quando realizado tardiamente, resulta em dano neural e incapacidades físicas que restringem a participação social do indivíduo e contribuem para o estigma e discriminação. Além disso, fatores de risco ambientais, socioeconômicos e individuais podem contribuir para a vulnerabilidade ao adoecimento e evolução para incapacidades físicas. Objetivo: analisar a influência da escolaridade na ocorrência de incapacidades físicas no diagnóstico da hanseníase no Vale do Jequitinhonha, Minas Gerais. Material e Métodos: trata-se de um estudo transversal realizado na população de casos de hanseníase diagnosticados no Vale do Jequitinhonha, no período de 2001 a 2017, a partir de dados obtidos no Sistema de Informação de Agravos de Notificação (SINAN). A variável dependente foi o grau de incapacidade física no diagnóstico da hanseníase e a variável explicativa o nível de escolaridade dos casos. A análise estatística compreendeu a realização dos testes qui-quadrado, coeficiente de correlação de Spearman e odds ratio. Resultados: foram notificados 1.940 casos de hanseníase no Vale do Jequitinhonha com uma taxa média de detecção de 47 casos/100.000 habitantes. Houve uma correlação inversamente proporcional entre as variáveis escolaridade e grau de incapacidade com significância estatística (-0,17; p<0,0001). Indivíduos sem escolaridade tiveram 82% mais chance de apresentarem incapacidades no diagnóstico de hanseníase quando comparados àqueles com nível fundamental (OR = 1,82; p = <0,0001), a chance de incapacidades foi ainda maior na comparação com a escolaridade de nível médio (OR = 4,03; p<0,0001). Conclusão: o aumento no nível de escolaridade dos casos reduziu a chance de ser diagnosticado com alguma incapacidade instalada.


Introduction: leprosy is an infectious disease whose diagnosis, when performed late, results in neural damage and physical disabilities that restrict the individual's social participation and contribute to stigma and discrimination. In addition, environmental, socioeconomic and individual risk factors can contribute to vulnerability to illness and evolution to physical disabilities. Objective: to analyze the influence of schooling on the occurrence of physical disabilities in the diagnosis of leprosy in the Jequitinhonha Valley, Minas Gerais. Material and Methods: the present cross-sectional study was undertaken among leprosy patients diagnosed in the Jequitinhonha Valley from 2001 to 2017. The data was obtained from the SINAN (National Notifiable Diseases Information System). The dependent variable was the degree of physical disability in the diagnosis of leprosy and the explanatory variable was the educational level of the cases. statistical analysis included the chi-square test, Spearman's correlation coefficient and odds ratio. Results: 1.940 cases of leprosy were reported in the Jequitinhonha Valley with an average detection rate of 47 cases/100.000 inhabitants. There was an inversely proportional correlation between the variables schooling and degree of disability with statistical significance (-0.17, p <0.0001). Individuals with no schooling were 82% more likely to have physical disabilities in the diagnosis of leprosy when compared to those with a low level (OR = 1.82; p = <.0001), the chance of disability was even higher when compared to a intermediate level of schooling (OR = 4.03, p <0.0001). Conclusion: the increase in the level of schooling reduced the chance of being diagnosed with physical disabilities in leprosy patients.


Assuntos
Escolaridade , Hanseníase , Saúde Pública , Epidemiologia , Doenças Transmissíveis , Fatores de Risco , Enfermagem , Participação Social , Discriminação Social , Hanseníase/epidemiologia
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