Therapeutic outcomes of pemphigus in a referral service in Northern Brazil: a retrospective study of 32 patients.

BACKGROUND: Pemphigus are rare chronic autoimmune blistering disorders with challenging therapeutic management. OBJECTIVE: To investigate the therapeutic outcomes of pemphigus patients admitted to a dermatology referral service in northern Brazil. MATERIALS AND METHODS: We conducted a retrospective analysis of 32 patients with histopathological diagnosis of pemphigus between 2010 and 2016. Clinical and epidemiological data were collected. Therapeutic outcome was evaluated according to the criteria proposed by the International Pemphigus Committee. Pemphigus Disease Area Index (PDAI) was used to quantify disease severity. RESULTS: Of the 32 patients, 68.75% had pemphigus vulgaris (PV) and 31.25% had pemphigus foliaceus (PF). Female-to-male ratio was 1:1. The average age was 49.5 years. All patients received oral prednisone as the first-line therapy. Adjuvant immunosuppressive drugs were gradually added in refractory and/or severe cases. After 24 months of treatment, disease control and complete remission rates were 37.5% and 25%, respectively. The mortality rate was 9.37%. PDAI score was significantly lower at 24 months of therapeutic follow-up (p < .0001). CONCLUSION: Therapeutic management with corticosteroids and/or immunosuppressive drugs was able to induce disease control/complete remission in most of patients. PDAI was a useful tool for objective assessment of disease severity during therapeutic follow-up.

Percepção e conhecimento dos estudantes de medicina acerca do HIV e da AIDS / Perceptions and knowledge of medical students about HIV and AIDS / Percepción y conocimiento de los estudiantes de medicina sobre el VIH y el SIDA

Justificativa e Objetivos: O grau de informação não se restringe às questões informativas e de oportunidade de conhecimento, mas também ao desenvolvimento de uma percepção individual consciente para a adoção de práticas de prevenção da transmissão do vírus. Assim, objetivou-se avaliar a percepção e o conhecimento dos graduandos de medicina, acerca do HIV e da AIDS. Métodos: Caracteriza-se como um estudo transversal, observacional e unicêntrico, por meio da aplicação de um questionário estruturado e dois referentes à atitude frente à AIDS e ao indivíduo/percepção de risco e sobre o conhecimento dos meios de transmissão. Aplicaram-se os testes T-Student e Qui-quadrado de Pearson, com p<0,05. Participaram 223 estudantes de medicina do 1º ao 8º semestres. Resultados: A maioria dos universitários referiu ter compaixão (90,58%) e não culpabilização (97,31%) frente ao HIV e a AIDS. Todavia, 69,06% não se sentem preparados para atender esses pacientes. Ademais, 76,68% referiram não possuir risco de contrair o HIV, fato preocupante pelo risco inerente à profissão. Das 20 questões sobre o conhecimento dos meios de transmissão, o grau de acerto variou de 18,2 e 19,4 pontos. Prevenção (85,2%), preconceito (75,78%) e preservativo (72,65%) foram os principais valores simbólicos associados à AIDS. Conclusão: Os estudantes apresentaram atitudes éticas e humanísticas frente ao paciente com HIV ou com AIDS e um elevado grau de conhecimento acerca dos meios de transmissão do HIV. Sobre a percepção de risco, ressalta-se a necessidade de uma abordagem mais direcionada nas disciplinas de Saúde Pública, de Infectologia e de Imunologia.(AU)

Background and Objectives: The degree of information is not restricted to informative and opportunity questions of knowledge, but also to the development of a conscious individual perception for the adoption of practices of prevention of virus transmission. Thus, the objective was to evaluate the perception and knowledge of medical students about HIV and AIDS. Methods: It is characterized as a transversal, observational and unicentric study, through the application of a structured questionnaire and two referring to the attitude towards AIDS and the individual / perception of risk and about the knowledge of the means of transmission. Student's T-test and Pearson's Chi-square test were applied, with p <0.05. 223 medical students participated in the 1st to 8th semesters. Results: Most university students reported having compassion (90.58%) and no blame (97.31%) for HIV and AIDS. However, 69.06% do not feel prepared to treat these patients. In addition, 76.68% reported not having a risk of contracting HIV, a fact of concern for the inherent risk of the profession. Of the 20 questions on the knowledge of the means of transmission, the degree of accuracy ranged from 18.2 and 19.4 points. Prevalence (85.2%), prejudice (75.78%) and condom (72.65%) were the main symbolic values associated with AIDS. Conclusion: Students presented ethical and humanistic attitudes towards patients with HIV or AIDS and a high degree of knowledge about the means of HIV transmission. Regarding the perception of risk, the need for a more focused approach in the disciplines of Public Health, Infectology and Immunology is emphasized.(AU)

Justificación y Objetivos: El grado de información no se restringe a las cuestiones informativas y de oportunidad de conocimiento, sino también al desarrollo de una percepción individual consciente para la adopción de prácticas de prevención de la transmisión del virus. Así, se objetivó evaluar la percepción y el conocimiento de los graduandos de medicina, acerca del VIH y del SIDA. Métodos: Se caracteriza como un estudio transversal, observacional y unicéntrico, por medio de la aplicación de un cuestionario estructurado y dos referentes a la actitud frente al SIDA y al individuo / percepción de riesgo y sobre el conocimiento de los medios de transmisión. Se aplicaron las pruebas T-Student y Qui-cuadrado de Pearson, con p <0,05. Participaron 223 estudiantes de medicina del 1º al 8º semestres. Resultados: La mayoría de los universitarios refirió tener compasión (90,58%) y no culpabilización (97,31%) frente al VIH y el SIDA. Sin embargo, el 69,06% no se siente preparado para atender a estos pacientes. Además, el 76,68% mencionó no tener riesgo de contraer el VIH, hecho preocupante por el riesgo inherente a la profesión. De las 20 preguntas sobre el conocimiento de los medios de transmisión, el grado de acierto varió de 18,2 y 19,4 puntos. Prevención (85,2%), preconcepto (75,78%) y preservativo (72,65%) fueron los principales valores simbólicos asociados al SIDA. Conclusión: Los estudiantes presentaron actitudes éticas y humanísticas frente al paciente con VIH o con SIDA y un alto grado de conocimiento acerca de los medios de transmisión del VIH. Sobre la percepción de riesgo, se resalta la necesidad de un enfoque más direccionado en las disciplinas de Salud Pública, de Infectología e Inmunología.(AU)