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1.
An Bras Dermatol ; 96(2): 125-138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33637397

RESUMO

In this nonsystematic review, the complementary diagnosis, treatment, prevention, and control of human papillomavirus are discussed. The histopathology is addressed regarding its indications, main findings and limitations, as a complementary diagnostic method largely used by dermatologists. Electron microscopy is briefly reviewed, along with its contribution to the accumulated knowledge on HPV, as well as the relevance of research in using this technology for future advances in diagnosis and treatment. Molecular information about the virus is continuously increasing, and the practical applications of HPV serology, molecular identification and genotyping are discussed. Vaccines are a valuable tool in primary HPV infection prevention and are now available in many countries; their composition, indications, and adverse effects are revisited. Local and systemic treatment options are reviewed and off-label prescriptions are discussed. Finally, health education focusing on HPV infection as a sexually transmitted infection of worldwide relevance and the many barriers to improve primary and secondary prevention are addressed.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Fatores de Risco
2.
An Bras Dermatol ; 96(1): 1-16, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33341319

RESUMO

Infection with human papilloma virus (HPV) is related to a great number of cutaneous and mucosal manifestations. The spectrum of HPV ranges from inapparent infections, through various clinical benign presentations including cutaneous and mucosal disease, to malignant and premalignant conditions. New HPV types are currently described in the literature; many of them are characterized as high-risk types due to their oncogenic potential. Knowledge regarding their epidemiology and pathogenesis is important to understand not only infection and disease processes, but also to formulate the clinical and laboratory basis for diagnosis, therapeutics, and prophylactic measures. This non-systematic review aims to discuss and to update those aspects, with an emphasis on relevant topics for dermatologists. HPV infection and related diseases in the Brazilian scenario are highlighted, including common dermatologic conditions seen at clinics as well as the condition of a public health problem as a sexually transmitted infection. The oncogenicity of the virus and the variety of clinical outcomes - especially in the immunocompromised individuals - are addressed.


Assuntos
Alphapapillomavirus , Papillomaviridae , Infecções por Papillomavirus , Lesões Pré-Cancerosas , Brasil/epidemiologia , Humanos , Infecções por Papillomavirus/epidemiologia
3.
Microb Pathog ; 125: 230-239, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30195647

RESUMO

The aim of this study was to identify phenotypic and functional biomarkers associated with distinct clinical status of leprosy or leprosy reactions. The study included tuberculoid/borderline (BB/BT/T) and lepromatous (BL/L) leprosy poles as well as Type-1 and Type-2 leprosy reactions along with healthy controls (NI). A range of peripheral blood biomarkers of innate (neutrophils - NEU and monocytes - MON) and adaptive immunity (CD4+ and CD8+ T-cells) were evaluated ex vivo and upon in vitro stimuli with M. leprae antigen. Data analysis allowed the selection of NEUTLR4+ (ex vivo) and CD4+IL-10+ (in vitro) as universal biomarkers increased in all leprosy patients and those exhibiting leprosy reactions. A range of biomarkers were commonly found in both poles of leprosy patients, including decreased levels of MONTGF-ß+ (ex vivo) and increased levels of MONTNF-α+, CD4+TGF-ß+, CD8+TLR2+, CD8+TNF-α+, CD8+IL-4+ and CD8+TGF-ß+ (in vitro). Noteworthy was that MONHLA-DR+ (ex vivo) and CD8+IL-10+ (in vitro) were particularly found in BL/L patients. Leprosy patients with Type-1 reaction exhibited a larger list of altered biomarkers, mainly involving activation markers (TLR2, TLR4, HLA-DR and DAF-2T) in NEU and MON along with CD4+ and CD8+ cells. In summary, this study provided insights about immunological features of leprosy poles and leprosy reactional episodes with putative applicability, including novel biomarkers for complementary diagnosis and future therapeutic approaches in clinical studies.


Assuntos
Imunidade Adaptativa , Biomarcadores/análise , Imunidade Inata , Hanseníase/patologia , Adolescente , Adulto , Antígenos de Bactérias/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium leprae/imunologia , Adulto Jovem
4.
An Bras Dermatol ; 93(2): 279-281, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29723380

RESUMO

Lobomycosis or lacaziosis is a chronic granulomatous fungal infection caused by Lacazia loboi. Most cases are restricted to tropical regions. Transmission is believed to occur through traumatic inoculation in the skin, mainly in exposed areas. It is characterized by keloid-like nodules. There are only a few hundred cases reported. The differential diagnoses include many skin conditions, and treatment is difficult. The reported case, initially diagnosed as keloid, proved to be refractory to surgical treatment alone. It was subsequently approached with extensive surgery, cryotherapy every three months and a combination of itraconazole and clofazimine for two years. No signs of clinical and histopathological activity were detected during follow-up.


Assuntos
Otopatias/patologia , Otopatias/terapia , Queloide/patologia , Lobomicose/patologia , Lobomicose/terapia , Adulto , Antifúngicos/uso terapêutico , Biópsia , Clofazimina/uso terapêutico , Crioterapia/métodos , Diagnóstico Diferencial , Otopatias/diagnóstico , Humanos , Itraconazol/uso terapêutico , Queloide/diagnóstico , Lobomicose/diagnóstico , Masculino , Resultado do Tratamento
5.
An. bras. dermatol ; 93(2): 279-281, Mar.-Apr. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-887199

RESUMO

Abstract: Lobomycosis or lacaziosis is a chronic granulomatous fungal infection caused by Lacazia loboi. Most cases are restricted to tropical regions. Transmission is believed to occur through traumatic inoculation in the skin, mainly in exposed areas. It is characterized by keloid-like nodules. There are only a few hundred cases reported. The differential diagnoses include many skin conditions, and treatment is difficult. The reported case, initially diagnosed as keloid, proved to be refractory to surgical treatment alone. It was subsequently approached with extensive surgery, cryotherapy every three months and a combination of itraconazole and clofazimine for two years. No signs of clinical and histopathological activity were detected during follow-up.


Assuntos
Humanos , Masculino , Adulto , Otopatias/patologia , Otopatias/terapia , Lobomicose/patologia , Lobomicose/terapia , Queloide/patologia , Biópsia , Resultado do Tratamento , Clofazimina/uso terapêutico , Itraconazol/uso terapêutico , Crioterapia/métodos , Diagnóstico Diferencial , Otopatias/diagnóstico , Lobomicose/diagnóstico , Queloide/diagnóstico , Antifúngicos/uso terapêutico
6.
An Bras Dermatol ; 92(4): 573-574, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28954118

RESUMO

Infective dermatitis associated with HTLV-1 (IDH) is the main cutaneous marker of HTLV-1 infection. This disease occurs primarily in children and should be differentiated from other eczemas, especially from atopic dermatitis. The largest series of IDH are from Jamaica and Brazil. There are an estimated 15 to 20 million infected people in the world, and Brazil is one of the endemic regions. Studies suggest that IDH in children may be a marker for the development of T-cell leukemia/lymphoma (ATL) or myelopathy associated with HTLV-1/tropical spastic paraparesis (HAM / TSP) in adulthood.


Assuntos
Dermatite/diagnóstico , Infecções por HTLV-I/diagnóstico , Dermatopatias Virais/diagnóstico , Dermatite/virologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/virologia , Diagnóstico Diferencial , Eczema/diagnóstico , Eczema/virologia , Feminino , Infecções por HTLV-I/complicações , Humanos , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Dermatopatias Virais/complicações , Adulto Jovem
7.
Rev. bras. educ. méd ; 41(3): 432-441, jul.-set. 2017. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-898127

RESUMO

RESUMO O sofrimento psíquico do estudante de Medicina é conhecido e já estudado. O papel do professor em detectar dificuldades geradoras de sofrimento psíquico em seus alunos e saber como lidar com elas é fundamental para a prevenção desse sofrimento. Entretanto, nem sempre os professores estão preparados para esses desafios. Objetivo: Estudar a percepção dos docentes do curso de Medicina da Universidade Federal de Minas Gerais (UFMG) em relação ao sofrimento psíquico de seus alunos. Método: Estudo transversal quantitativo realizado com os docentes do ciclo profissional do curso de Medicina da UFMG. A amostra de 102 docentes foi obtida por sorteio aleatório e dividida em quatro estratos: masculino até dez anos de docência, masculino com mais de dez anos, feminino com até dez anos de docência e feminino com mais de dez anos. Foi elaborado um questionário autoaplicativo de 28 itens com cinco opções da escala de Likert. Para análise dos dados foram construídos quatro indicadores: indicador de percepção de sofrimento psíquico (IPSP), indicador de compromisso do professor com as dificuldades emocionais do estudante (ICDE), indicador de atuação frente ao sofrimento psíquico (IAPS) e indicador geral (IG). Realizou-se análise dos quartis e calculou-se a diferença entre os grupos utilizando testes não paramétricos. Cinco questões não incluídas nos indicadores foram analisadas separadamente. Resultados: Dos 102 sorteados, 79 docentes responderam e sete se negaram a participar da pesquisa. Foi constatada preocupação com o sofrimento psíquico dos estudantes, variável entre os estratos. Para o IG, as professoras com mais tempo de docência obtiveram a mediana mais elevada em relação aos homens com menos tempo (p<0,05). Para os demais indicadores, apesar da diferença entre os quartis, a comparação das medianas não mostrou diferenças estatisticamente significativas. Para as perguntas não incluídas nos indicadores, do total de professores, 85% já tiveram alunos com dificuldades emocionais. Os homens, com maior frequência, afirmaram desconhecer a existência de problemas emocionais entre os estudantes. Houve desconhecimento das instâncias de acolhimento psicólogico aos estudantes por 16,5% dos professores. A ocorrência de bullying na FMUFMG não foi percebida por mais de 50% dos professores. Apenas 28% admitiram que seus atos ou atitudes teriam desencadeado sofrimento psíquico no estudante. Ao se perguntar sobre apoio ao professor, 75,9% desejavam uma instância de apoio emocional ao professor. Conclusão: Este estudo, apesar das limitações, é inédito ao avaliar a percepção do docente do curso de Medicina em relação ao sofrimento psíquico dos estudantes. Tempo de docência e sexo feminino parecem exercer um papel importante na percepção do docente sobre o sofrimento psíquico do estudante. Parcela significativa de professores desconhece a existência das instâncias de apoio psicológico aos estudantes. Situações de assédio e bullying na escola médica permanecem negadas por muitos docentes.


ABSTRACT The psychological distress suffered by medical students is well-known. The role of the teaching staff in detecting difficulties causing students psychological distress and their knowledge of how to handle them is fundamental for preventing such problems. However, medical teachers are not always prepared to deal with these challenges. Objective: To study the perception of the teaching staff of the medical school at the Universidade Federal de Minas Gerais (FMUFMG) concerning the psychological distress of the students. Method: A cross-sectional quantitative study carried out with the faculty of the UFMG medical school. The sample of 102 teachers was obtained by random draw and divided into four groups: males with up to ten (10) years of teaching, males with more than ten (10) years, females with up to ten (10) years of teaching, and females with more than ten (10)years. A self-applied 28-item questionnaire with a 5-point Likert scale from strongly agree to strongly disagree was prepared. For the data analysis four indicators were elaborated: psychological distress perception indicator (IPSP), commitment of the teacher to the student emotional difficulties indicator (ICDE), performance in the face of psychological distress indicator (IAPS) and a general indicator (IG). Quartile analysis was carried out and the difference among the groups was calculated using nonparametric tests. Five questions that were not included in the indicators were independently analyzed. Results: Seven teachers refused to participate and 79 answers were collected. The results showed varying degrees of concern among the groups in relation to the psychological distress of students. For the IG, the female teachers with longer teaching experience obtained a higher median in relation to the men with less teaching experience (p<0.05). For the other indicators, despite the difference between the quartiles, the comparison of the medians showed no statistically significant differences. For questions not included in the indicators, it was shown that 85% of the sample had perceived psychological distress among their students. Male teachers more frequently deny psychological distress among students. 16.5% of the teachers did not know of any instances of institutional psychological care. The occurrence of bullying failed to be noted by more than 50% of the teachers. Only 28% of the teachers admitted that their actions or attitudes could precipitate a student's psychological distress. When questioned about emotional support for teachers, 75.9% would appreciate some institutional support. Conclusion: The present study, despite its limitations, is unique in assessing the perception of the medical teaching staff in relation to the psychological distress of the students. Teaching experience and being female seem to play an important role in the teacher's perception of psychological distress among students. A significant portion of the teaching staff ignores the existence of psychological support programs for students.

8.
An. bras. dermatol ; 92(4): 573-574, July-Aug. 2017. graf
Artigo em Inglês | LILACS | ID: biblio-886987

RESUMO

Abstract: Infective dermatitis associated with HTLV-1 (IDH) is the main cutaneous marker of HTLV-1 infection. This disease occurs primarily in children and should be differentiated from other eczemas, especially from atopic dermatitis. The largest series of IDH are from Jamaica and Brazil. There are an estimated 15 to 20 million infected people in the world, and Brazil is one of the endemic regions. Studies suggest that IDH in children may be a marker for the development of T-cell leukemia/lymphoma (ATL) or myelopathy associated with HTLV-1/tropical spastic paraparesis (HAM / TSP) in adulthood.


Assuntos
Humanos , Feminino , Adulto Jovem , Infecções por HTLV-I/diagnóstico , Dermatopatias Virais/diagnóstico , Dermatite/diagnóstico , Infecções por HTLV-I/complicações , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Dermatopatias Virais/complicações , Dermatite/virologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/virologia , Diagnóstico Diferencial , Eczema/diagnóstico , Eczema/virologia
9.
PLoS Negl Trop Dis ; 11(7): e0005725, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28704363

RESUMO

BACKGROUND: Leprosy control is based on early diagnosis and multidrug therapy. For treatment purposes, leprosy patients can be classified as paucibacillary (PB) or multibacillary (MB), according to the number of skin lesions. Studies regarding a uniform treatment regimen (U-MDT) for all leprosy patients have been encouraged by the WHO, rendering disease classification unnecessary. METHODOLOGY AND FINDINGS: An independent, randomized, controlled clinical trial conducted from 2007 to 2015 in Brazil, compared main outcomes (frequency of reactions, bacilloscopic index trend, disability progression and relapse rates) among MB patients treated with a uniform regimen/U-MDT (dapsone+rifampicin+clofazimine for six months) versus WHO regular-MDT/R-MDT (dapsone+rifampicin+clofazimine for 12 months). A total of 613 newly diagnosed, untreated MB patients with high bacterial load were included. There was no statistically significant difference in Kaplan-Meyer survival function regarding reaction or disability progression among patients in the U-MDT and R-MDT groups, with more than 25% disability progression in both groups. The full mixed effects model adjusted for the bacilloscopic index average trend in time showed no statistically significant difference for the regression coefficient in both groups and for interaction variables that included treatment group. During active follow up, four patients in U-MDT group relapsed representing a relapse rate of 2.6 per 1000 patients per year of active follow up (95% CI [0·81, 6·2] per 1000). During passive follow up three patients relapsed in U-MDT and one in R-MTD. As this period corresponds to passive follow up, sensitivity analysis estimated the relapse rate for the entire follow up period between 2·9- and 4·5 per 1000 people per year. CONCLUSION: Our results on the first randomized and controlled study on U-MDT together with the results from three previous studies performed in China, India and Bangladesh, support the hypothesis that UMDT is an acceptable option to be adopted in endemic countries to treat leprosy patients in the field worldwide. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00669643.


Assuntos
Clofazimina/administração & dosagem , Dapsona/administração & dosagem , Hansenostáticos/administração & dosagem , Hanseníase Multibacilar/tratamento farmacológico , Rifampina/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Quimioterapia Combinada/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
s.l; s.n; 2017. 19 p. tab, graf.
Não convencional em Inglês | Sec. Est. Saúde SP, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1053535

RESUMO

BACKGROUND: Leprosy control is based on early diagnosis and multidrug therapy. For treatment purposes, leprosy patients can be classified as paucibacillary (PB) or multibacillary (MB), according to the number of skin lesions. Studies regarding a uniform treatment regimen (U-MDT) for all leprosy patients have been encouraged by the WHO, rendering disease classification unnecessary. METHODOLOGY AND FINDINGS: An independent, randomized, controlled clinical trial conducted from 2007 to 2015 in Brazil, compared main outcomes (frequency of reactions, bacilloscopic index trend, disability progression and relapse rates) among MB patients treated with a uniform regimen/U-MDT (dapsone+rifampicin+clofazimine for six months) versus WHO regular-MDT/R-MDT (dapsone+rifampicin+clofazimine for 12 months). A total of 613 newly diagnosed, untreated MB patients with high bacterial load were included. There was no statistically significant difference in Kaplan-Meyer survival function regarding reaction or disability progression among patients in the U-MDT and R-MDT groups, with more than 25% disability progression in both groups. The full mixed effects model adjusted for the bacilloscopic index average trend in time showed no statistically significant difference for the regression coefficient in both groups and for interaction variables that included treatment group. During active follow up, four patients in U-MDT group relapsed representing a relapse rate of 2.6 per 1000 patients per year of active follow up (95% CI [0·81, 6·2] per 1000). During passive follow up three patients relapsed in U-MDT and one in R-MTD. As this period corresponds to passive follow up, sensitivity analysis estimated the relapse rate for the entire follow up period between 2·9- and 4·5 per 1000 people per year. CONCLUSION: Our results on the first randomized and controlled study on U-MDT together with the results from three previous studies performed in China, India and Bangladesh, support the hypothesis that UMDT is an acceptable option to be adopted in endemic countries to treat leprosy patients in the field worldwide.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Recidiva , Rifampina/administração & dosagem , Fatores de Tempo , Brasil , Resultado do Tratamento , Clofazimina/administração & dosagem , Dapsona/administração & dosagem , Quimioterapia Combinada/métodos , Hanseníase Multibacilar/tratamento farmacológico , Hansenostáticos/administração & dosagem
11.
Rev. bras. educ. méd ; 40(3): 393-400, jul.-set. 2016. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-829812

RESUMO

ABSTRACT Objectives To evaluate teaching on leprosy at a public medical school located in a metropolis in southeastern Brazil with a low leprosy prevalence rate. Results An analysis performed by means of a comparative cross-sectional study on two parallel groups of students (freshmen and interns) demonstrated that most students began the medical course with some knowledge of the signs and symptoms of the disease. The interns were shown to have more theoretical knowledge and more favorable attitudes toward the disease compared to the freshmen. Most of the interns stated that the topic had been addressed during the course but that practical teaching was insufficient. Students who had had the opportunity for practical experience with patients were more confident in their ability to attend to similar cases. Conclusion Although from a statistical point of view the results may seem very favorable, the same cannot be said when assessing the situation from the perspective of education and public health, since a large number of final-year medical students have not been provided with basic information on the disease.


RESUMO Objetivo Avaliar o ensino sobre hanseníase numa escola médica localizada em metrópole do Sudeste brasileiro com baixo coeficiente de prevalência para hanseníase. Resultados Em análise realizada, utilizando um estudo comparativo entre dois grupos paralelos de estudantes do curso médico (ingressantes e internos), observou-se que a maioria dos estudantes ingressa no curso com conhecimentos sobre sinais e sintomas da doença. Os internos mostraram maior conhecimento teórico, assim como atitudes mais favoráveis em relação à doença, quando comparados aos ingressantes. A maioria dos internos afirmou que o tema foi abordado durante o curso médico, mas que o ensino prático foi insuficiente. Estudantes que tiveram experiência prática mostraram maior confiança em sua habilidade para atender casos semelhantes. Conclusão Embora do ponto de vista estatístico os resultados possam parecer favoráveis, não se pode afirmar o mesmo sob a perspectiva da educação e da saúde pública, uma vez que grande número de estudantes do último ano não possui informações básicas a respeito da doença.

12.
J Bras Nefrol ; 37(1): 131-4, 2015.
Artigo em Português | MEDLINE | ID: mdl-25923761

RESUMO

Leprosy is still a public health concern in Brazil, where more than 30,000 new cases are detected every year. There are few reports of this mycobacteriosis in immunosuppressed patients, despite the increasing number of solid organ transplantation and the use of post-transplant drugs in this country. The authors describe a case of multibacillary leprosy in a renal transplant recipient, detected 12 years after the procedure, and discuss the therapy, adverse effects and management of leprosy reactions in patients immunosuppressed by drugs.


Assuntos
Transplante de Rim , Hanseníase Multibacilar , Complicações Pós-Operatórias , Adulto , Humanos , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/terapia , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia
13.
J. bras. nefrol ; 37(1): 131-134, Jan-Mar/2015. tab, graf
Artigo em Português | LILACS | ID: lil-744443

RESUMO

O Brasil é um país onde a hanseníase ainda é um problema de saúde pública, apresentando mais de 30.000 novos casos por ano nos últimos anos. Apesar do crescente número de transplante de órgãos sólidos realizados no país, sobretudo o transplante renal, não são frequentes os relatos dessa micobacteriose em pacientes imunossuprimidos pelas medicações póstransplante. Os autores relatam um caso de hanseníase multibacilar manifestada 12 anos depois do transplante renal, acompanhado desde o diagnóstico, durante a poliquimioterapia, tratamento e seguimento do eritema nodoso hansênico.


Leprosy is still a public health concern in Brazil, where more than 30,000 new cases are detected every year. There are few reports of this mycobacteriosis in imunossupressed pacients, despite the increasing number of solid organ transplantation and the use of post-transplant drugs in this country. The autors describe a case of multibacillary leprosy in a renal transplant recipient, detected 12 years after the procedure, and discuss the therapy, adverse effects and management of leprosy reactions in pacients imunosupressed by drugs.


Assuntos
Humanos , Masculino , Adulto , Transplante de Rim , Hanseníase Multibacilar , Complicações Pós-Operatórias , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/terapia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia
14.
An Bras Dermatol ; 89(3): 454-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24937820

RESUMO

In the context of declining leprosy endemicity worldwide, keeping the interest in knowledge and expertise in leprosy alive has been a matter of concern. Approaching the problem only in primary care, without the proper integration with other levels of care in the health system fails to account for the complexity of the disease. Training professionals to work at different levels of health care is a current challenge. The objective of this review was to look for experiences related to the teaching of leprosy both in undergraduate courses in the field of health sciences and in training programs for professionals who work in patient care. We highlight the role of the dermatologist in the management of control programs, diagnosis and treatment of the disease, as well as in the continuous education of other health professionals.


Assuntos
Dermatologia/educação , Educação de Graduação em Medicina/tendências , Hanseníase , Brasil , Currículo/tendências , Previsões , Humanos , Atenção Primária à Saúde
15.
An. bras. dermatol ; 89(3): 454-459, May-Jun/2014.
Artigo em Inglês | LILACS | ID: lil-711620

RESUMO

In the context of declining leprosy endemicity worldwide, keeping the interest in knowledge and expertise in leprosy alive has been a matter of concern. Approaching the problem only in primary care, without the proper integration with other levels of care in the health system fails to account for the complexity of the disease. Training professionals to work at different levels of health care is a current challenge. The objective of this review was to look for experiences related to the teaching of leprosy both in undergraduate courses in the field of health sciences and in training programs for professionals who work in patient care. We highlight the role of the dermatologist in the management of control programs, diagnosis and treatment of the disease, as well as in the continuous education of other health professionals.


Assuntos
Humanos , Dermatologia/educação , Educação de Graduação em Medicina/tendências , Hanseníase , Atenção Primária à Saúde , Brasil , Currículo/tendências , Previsões
16.
Rev. méd. Minas Gerais ; 24(1)jan.-mar. 2014.
Artigo em Português | LILACS | ID: lil-720022

RESUMO

Homem de 34 anos de idade foi atendido na Unidade Básica de Saúde comodinofagia, eritema conjuntival, mal-estar geral, mialgia e temperatura corpórea de 39°C, tendo sido tratado empiricamente com dipirona e amoxicilina. Relatou picadas de carrapatos nesse mesmo dia. Poucas horas após o uso da medicação prescrita, evoluiu com erupção eritematoviolácea, placas confluentes e vesículas sero-hemorrágicas em face, tronco e membros, com acometimento de mucosa oral e peniana. Iniciou há dois meses o uso de alopurinol e atenolol para tratamento de, respectivamente, hiperuricemia e hipertensão arterial sistêmica.


Assuntos
Humanos , Masculino , Adulto , Choque Séptico/diagnóstico , Febre Maculosa das Montanhas Rochosas/diagnóstico , Pênfigo/diagnóstico , Síndrome de Stevens-Johnson/complicações , Síndrome de Stevens-Johnson/diagnóstico , Biópsia , Choque Séptico/terapia , Diagnóstico Diferencial , Síndrome de Stevens-Johnson/tratamento farmacológico
17.
Recurso educacional aberto em Português | CVSP - Brasil | ID: una-2016

RESUMO

Este material contempla a disciplina optativa " Vigilância à saúde: endemias e epidemias: tuberculose e hanseníase" do Curso de Especialização Estratégia Saúde da Família (2014). Esta disciplina busca incentivar a equipe multidisciplinar das equipes de Saúde da Família a se organizar para o controle da tuberculose e hanseníase. O conteúdo está distribuído em quatro seções: Seção 1: Fatores determinantes e condicionantes das epidemias e endemias. Seção 2: Abordagem específica de doenças endêmicas e epidêmicas. Seção 3: Situação da tuberculose e da hanseníase. Seção 4: Casos clínicos: tuberculose e hanseníase


Assuntos
Doenças Endêmicas , Epidemias , Hanseníase , Tuberculose
18.
PLoS Negl Trop Dis ; 7(7): e2328, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23936564

RESUMO

In the present study, the frequency, the activation and the cytokine and chemokine profile of HTLV-1 carriers with or without dermatological lesions were thoroughly described and compared. The results indicated that HTLV-1-infected patients with dermatological lesions have distinct frequency and activation status when compared to asymptomatic carriers. Alterations in the CD4(+)HLA-DR(+), CD8(+) T cell, macrophage-like and NKT subsets as well as in the serum chemokines CCL5, CXCL8, CXCL9 and CXCL10 were observed in the HTLV-1-infected group with skin lesions. Additionally, HTLV-1 carriers with dermatological skin lesions showed more frequently high proviral load as compared to asymptomatic carriers. The elevated proviral load in HTLV-1 patients with infectious skin lesions correlated significantly with TNF-α/IL-10 ratio, while the same significant correlation was found for the IL-12/IL-10 ratio and the high proviral load in HTLV-1-infected patients with autoimmune skin lesions. All in all, these results suggest a distinct and unique immunological profile in the peripheral blood of HTLV-1-infected patients with skin disorders, and the different nature of skin lesion observed in these patients may be an outcome of a distinct unbalance of the systemic inflammatory response upon HTLV-1 infection.


Assuntos
Doenças Autoimunes/complicações , Infecções por HTLV-I/complicações , Infecções por HTLV-I/imunologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Dermatopatias/complicações , Adulto , Portador Sadio/epidemiologia , Portador Sadio/imunologia , Feminino , Infecções por HTLV-I/epidemiologia , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Humanos , Células Matadoras Naturais/imunologia , Subpopulações de Linfócitos/imunologia , Macrófagos/imunologia , Masculino , Pessoa de Meia-Idade , Carga Viral
19.
AIDS Res Hum Retroviruses ; 29(9): 1199-202, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23617363

RESUMO

The incidence of human T cell lymphotropic virus type 1 (HLTV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is not well defined in the literature. Several studies have reported different incidence rates, and recent publications suggest a higher incidence and prevalence of HAM/TSP. The interdisciplinary HTLV Research Group (GIPH) is a prospective open cohort study of individuals infected with HTLV-1/2. This study describes the demographic data and HAM/TSP incidence rate observed in 181 HTLV-1-seropositive individuals and compares the results with previous reports in the literature. HAM/TSP was diagnosed on the basis of the World Health Organization diagnostic criteria and De Castro-Costa et al. [Proposal for diagnostic criteria of tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). AIDS Res Hum Retroviruses 2006;22:931-935]. Seven HAM/TSP incident cases were observed during the follow-up. The HAM/TSP incidence density was 5.3 cases per 1,000 HTLV-1-seropositive cases per year (95% confidence interval: 2.6-10.9), with a mean follow-up of 7±4 years (range: 1 month to 15 years). HAM/TSP was more frequent in women in their 40s and 50s with probable infection via the sexual route. The HAM/TSP incidence density among HTLV-1-seropositive cases observed in the present study is higher than that in previous studies. HAM/TSP may be underdiagnosed in countries like Brazil where HTLV infection is prevalent. Orientation and prevent transmission of HTLV programs are needed. Currently, preventing HTLV-1 transmission is the most effective way to reduce the impact of HAM/TSP on society.


Assuntos
Doenças Assintomáticas/epidemiologia , Infecções por HTLV-I/epidemiologia , Paraparesia Espástica Tropical/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos de Coortes , Feminino , Infecções por HTLV-I/sangue , Infecções por HTLV-I/etiologia , Vírus Linfotrópico T Tipo 1 Humano , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica Tropical/complicações , Paraparesia Espástica Tropical/virologia , Estudos Prospectivos , Adulto Jovem
20.
Recurso educacional aberto em Português | CVSP - Brasil | ID: una-2018

RESUMO

Este módulo integra a disciplina optativa " Vigilância à saúde: endemias e epidemias: tuberculose e hanseníase" do Curso de Especialização Estratégia Saúde da Família (2014). Esta disciplina busca incentivar a equipe multidisciplinar das equipes de Saúde da Família a se organizar para o controle da tuberculose e hanseníase. O conteúdo está distribuído em quatro seções: Seção 1: Fatores determinantes e condicionantes das epidemias e endemias. Seção 2: Abordagem específica de doenças endêmicas e epidêmicas. Seção 3: Situação da tuberculose e da hanseníase. Seção 4: Casos clínicos: tuberculose e hanseníase


Assuntos
Doenças Endêmicas , Epidemias , Hanseníase , Tuberculose
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