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1.
Curr Opin Ophthalmol ; 31(6): 514-520, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33002989

RESUMO

PURPOSE OF REVIEW: Ocular manifestations of leprosy do occur despite advances in the areas of leprosy research. Understanding the nuances in the domain shall guide the clinician for effective patient-centered care. RECENT FINDINGS: Despite the existence of microbiologic cure for leprosy, ocular manifestations of this disease do occur. Advances in genetic and genomic studies have better characterized the interaction that the bacteria has with the host. The ocular features vary with the spectrum of the disease. Its careful correlation can help to predict the bacillary load of the patient. Investigations are particularly relevant in multibacillary cases. The WHO suggests a treatment duration longer than the 2 years in ocular involvement. SUMMARY: The isolation of lepra bacilli from the iris biopsy in negative skin smear patients and multidrug therapy completion highlights the potential role of bactericidal agents in the planned intraocular treatment. Lepra reactions need careful titration of oral steroids and appropriate antibacterial agents. Advances in phacoemulsification with in the bag implantation of intraocular lenses is a game changer in the management of the most common cause of blindness of leprosy. Advances in vaccine research in leprosy are promising.


Assuntos
Oftalmopatias , Hanseníase , Animais , Biópsia , Quimioterapia Combinada , Oftalmopatias/tratamento farmacológico , Humanos , Lentes Intraoculares , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/microbiologia , Hanseníase/patologia , Facoemulsificação
2.
Artigo em Inglês | MEDLINE | ID: mdl-33027396

RESUMO

The study aimed to analyze the impact of health interventions carried out in the city of Palmas, Brazil, on the epidemiological and operational indicators of leprosy between 2007 and 2017. The intervention consisted of training healthcare personnel on the diagnosis and follow-up of patients and organizing the referral of patients to health units. Estimates of the impact were calculated by taking the differences between indicators reported in two equal periods of 1.5 years pre- and post-intervention, with a transition period of six months. During the study period, the database contained 1,875 notifications, with 66% of cases diagnosed in the post-intervention period. There was a predominance of males (52%); aged 50 years or more (34.9%); with mixed ethnicity (63.5%). The low level of education was noticeable, with more than half of the cases (51.7%) reporting illiteracy or ≤ 7 years of education. The intervention resulted in an increase in both, epidemiological and operational indicators, suggesting a positive impact of the intervention on leprosy detection and treatment. Our results also emphasize the need for further studies addressing the impact of pragmatic health interventions aiming at controlling and eliminating the disease.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hanseníase/epidemiologia , Brasil/epidemiologia , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47905

RESUMO

Um material focado em divulgar os direitos já garantidos às pessoas acometidas por hanseníase, e que, muitas vezes, não são tão conhecidos, e também com informações sobre como reivindicá-los. Esta é a mais nova Cartilha de Direitos Humanos das Pessoas Afetadas pela Hanseníase lançada pelo Morhan, com apoio da Sasakawa Health Foundation.


Assuntos
Hanseníase , Direitos Humanos
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47792

RESUMO

Esse canal é um dos meios que o projeto encontrou para difundir de ideias e conhecimento sobre a hanseníase. O projeto informa Hanseníase conta com um website e blog (infohansen.org) se destinando ao acesso gratuito de diversas publicações e comunicações (carta ao editor). Há espaços destinados a comunidade (Quero ouvir a sua voz), a publicação de imagens, a exibições virtual, além de um quadro de eventos. O projeto tem apoio institucional da Universidade Federal do Espírito Santo, e está formando parcerias com propósito de melhor viabilizar os conteúdos para divulgação. Finalmente, pretendemos divulgar o que está sendo feito no Brasil e no Mundo para promover uma melhor qualidade de vida para as pessoas afetadas pela hanseníase e um futuro sem esta doença.


Assuntos
Hanseníase/prevenção & controle , Hanseníase/terapia , Hanseníase/história , Comunicação em Saúde
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47793

RESUMO

Plataforma digital com disseminação ampla e acessível de conteúdo sobre a Hanseníase. Somos um programa de Extensão da Universidade Federal do Espírito Santo.


Assuntos
Hanseníase , Comunicação em Saúde
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47794

RESUMO

Plataforma digital com disseminação ampla e acessível de conteúdo sobre a Hanseníase. Somos um programa de Extensão da Universidade Federal do Espírito Santo.


Assuntos
Hanseníase , Comunicação em Saúde
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47795

RESUMO

Plataforma digital com disseminação ampla e acessível de conteúdo sobre a Hanseníase. Somos um programa de Extensão da Universidade Federal do Espírito Santo.


Assuntos
Hanseníase , Comunicação em Saúde
9.
Recurso na Internet em Inglês, Espanhol, Francês, Português | LIS - Localizador de Informação em Saúde | ID: lis-47784

RESUMO

O Informa Hanseníase (iH) é um projeto educativo que tem como base a produção e difusão do conhecimento sobre a hanseníase direcionado para acadêmicos, pesquisadores, profissionais da saúde, pessoas afetadas pela hanseníase e o público em geral. Este é também um projeto para divulgação de ideias e boas ações voltadas para a hanseníase e a comunidade. É composto por um time de voluntários, professores e alunos da Universidade Federal do Espírito Santo, que organizados em comissões ter por intuito produzir conteúdo de qualidade sobre a temática escolhida para cada edição.


Assuntos
Hanseníase/prevenção & controle , Hanseníase/história , Hanseníase/terapia , Comunicação em Saúde
10.
Recurso na Internet em Inglês, Espanhol, Francês, Português | LIS - Localizador de Informação em Saúde | ID: lis-47785

RESUMO

Como parte do projeto Info Hansen (https://br.infohansen.org/) são publicados neste blog artigos, informações, relatos de experiência, pontos de vista e fatos históricos com a temática Hanseníase.


Assuntos
Hanseníase/prevenção & controle , Hanseníase/história , Comunicação em Saúde
11.
PLoS One ; 15(8): e0237165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764785

RESUMO

This study's objective was to estimate the temporal trends of leprosy according to sex and age groups, as well as to estimate and predict the progression of the disease in a hyperendemic city located in the northeast of Brazil. This ecological time-series study was conducted in Imperatriz, Maranhão, Brazil. Leprosy cases diagnosed between 2006 and 2016 were included. Detection rates stratified by sex and age groups were estimated. The study of temporal trends was accomplished using the Seasonal-Trend Decomposition method and temporal modeling of detection rates using linear seasonal autoregressive integrated moving average model according to Box and Jenkins method. Trend forecasts were performed for the 2017-2020 period. A total of 3,212 cases of leprosy were identified, the average incidence among men aged between 30 and 59 years old was 201.55/100,000 inhabitants and among women in the same age group was 135.28/100,000 inhabitants. Detection rates in total and by sex presented a downward trend, though rates stratified according to sex and age presented a growing trend among men aged less than 15 years old and among women aged 60 years old or over. The final models selected in the time-series analysis show the forecasts of total detection rates and rates for men and women presented a downward trend for the 2017-2020 period. Even though the forecasts show a downward trend in Imperatriz, the city is unlikely to meet a significant decrease of the disease burden by 2020.


Assuntos
Doenças Endêmicas/estatística & dados numéricos , Previsões/métodos , Hanseníase/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Cidades/estatística & dados numéricos , Feminino , Humanos , Incidência , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
12.
PLoS Negl Trop Dis ; 14(8): e0008521, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32750059

RESUMO

India has the highest burden of leprosy in the world. Following a recent WHO guideline, the Indian National Leprosy Programme is introducing post-exposure prophylaxis with single-dose rifampicin (SDR-PEP) in all high-endemic districts of the country. The aim of this study is to estimate the long-term cost-effectiveness of SDR-PEP in different leprosy disability burden situations. We used a stochastic individual-based model (SIMCOLEP) to simulate the leprosy new case detection rate trend and the impact of implementing contact screening and SDR-PEP from 2016 to 2040 (25 years) in the Union Territory of Dadra Nagar Haveli (DNH) in India. Effects of the intervention were expressed as disability adjusted life years (DALY) averted under three assumption of disability prevention: 1) all grade 1 disability (G1D) cases prevented; 2) G1D cases prevented in PB cases only; 3) no disability prevented. Costs were US$ 2.9 per contact. Costs and effects were discounted at 3%. The incremental cost per DALY averted by SDR-PEP was US$ 210, US$ 447, and US$ 5,673 in the 25th year under assumption 1, 2, and 3, respectively. If prevention of G1D was assumed, the probability of cost-effectiveness was 1.0 at the threshold of US$ 2,000, which is equivalent to the GDP per capita of India. The probability of cost-effectiveness was 0.6, if no disability prevention was assumed. The cost per new leprosy case averted was US$ 2,873. Contact listing, screening and the provision of SDR-PEP is a cost-effective strategy in leprosy control in both the short (5 years) and long term (25 years). The cost-effectiveness depends on the extent to which disability can be prevented. As the intervention becomes increasingly cost-effective in the long term, we recommend a long-term commitment for its implementation.


Assuntos
Programas Governamentais , Hanseníase/tratamento farmacológico , Hanseníase/prevenção & controle , Profilaxia Pós-Exposição/economia , Quimioprevenção/economia , Análise Custo-Benefício , Humanos , Índia , Hansenostáticos/economia , Hansenostáticos/uso terapêutico , Hanseníase/diagnóstico , Hanseníase/economia , Profilaxia Pós-Exposição/métodos , Anos de Vida Ajustados por Qualidade de Vida , Rifampina/economia , Rifampina/uso terapêutico
13.
PLoS Pathog ; 16(8): e1008818, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32776973

RESUMO

Leprosy is a chronic disease caused by Mycobacterium leprae. Worldwide, more than 200,000 new patients are affected by leprosy annually, making it the second most common mycobacterial disease after tuberculosis. The MHC/HLA region has been consistently identified as carrying major leprosy susceptibility variants in different populations at times with inconsistent results. To establish the unambiguous molecular identity of classical HLA class I and class II leprosy susceptibility factors, we applied next-generation sequencing to genotype with high-resolution 11 HLA class I and class II genes in 1,155 individuals from a Vietnamese leprosy case-control sample. HLA alleles belonging to an extended haplotype from HLA-A to HLA-DPB1 were associated with risk to leprosy. This susceptibility signal could be reduced to the HLA-DRB1*10:01~ HLA-DQA1*01:05 alleles which were in complete linkage disequilibrium (LD). In addition, haplotypes containing HLA-DRB3~ HLA-DRB1*12:02 and HLA-C*07:06~ HLA-B*44:03~ HLA-DRB1*07:01 alleles were found as two independent protective factors for leprosy. Moreover, we replicated the previously associated HLA-DRB1*15:01 as leprosy risk factor and HLA-DRB1*04:05~HLA-DQA1*03:03 as protective alleles. When we narrowed the analysis to the single amino acid level, we found that the associations of the HLA alleles were largely captured by four independent amino acids at HLA-DRß1 positions 57 (D) and 13 (F), HLA-B position 63 (E) and HLA-A position 19 (K). Hence, analyses at the amino acid level circumvented the ambiguity caused by strong LD of leprosy susceptibility HLA alleles and identified four distinct leprosy susceptibility factors.


Assuntos
Aminoácidos/genética , Predisposição Genética para Doença , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Hanseníase/patologia , Mutação , Adolescente , Adulto , Feminino , Haplótipos , Humanos , Hanseníase/genética , Masculino , Adulto Jovem
14.
PLoS Negl Trop Dis ; 14(8): e0008563, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32797081

RESUMO

OBJECTIVE: Early diagnosis remains the primary goal for leprosy management programs. This study aims to determine whether active surveillance of patients with leprosy and their contact individuals increased identification of latent leprosy cases in the low-endemic areas. METHODS: This cross-sectional survey was carried out between October 2014 and August 2016 in 21 counties throughout Shandong Province. The survey was conducted among patients with leprosy released from treatment (RFT) and their contacts from both household and neighbors. RESULTS: A total of 2,210 RFT patients and 9,742 contacts comprising 7877 household contacts (HHCs), including 5,844 genetic related family members (GRFMs) and 2033 non-genetic related family members and 1,865 contacts living in neighboring houses (neighbor contacts, NCs), were recruited. Among identified individuals, one relapsed and 13 were newly diagnosed, giving a detection rate of 0.12%, corresponding to 120 times the passive case detection rate. Detection rates were similar for HHCs and NCs (0.114% vs. 0.214%, P = 0.287). Analysis of the family history of leprosy patients revealed clustering of newly diagnosed cases and association with residential coordinates of previously-diagnosed multibacillary leprosy cases. CONCLUSION: Active case-finding programs are feasible and contributes to early case detection by tracking HHCs and NCs in low-endemic areas.


Assuntos
Características da Família , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Hanseníase/terapia , Características de Residência , Conduta Expectante , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Família , Feminino , Humanos , Lactente , Recém-Nascido , Hanseníase Multibacilar , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
PLoS Negl Trop Dis ; 14(8): e0008329, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32760161

RESUMO

The drug thalidomide has resurged in the world market under restrictive conditions for marketing and use. In Brazil, there are still cases of pregnant women using thalidomide even after the implementation of laws that regulate the control of use (Law No. 10.651/2003 and Collegiate Board Resolution No. 11/2011). The objective of this study was to discuss the control of thalidomide use in Brazil, based on a scoping review of the scientific literature, documents, and data from the Ministry of Health. A total of 51 studies and documents related to the following subthemes were selected: (1) organization of access and use of thalidomide in the health system; (2) epidemiological and population characteristics of people affected by leprosy; and (3) occurrence of pregnancy and cases of embryopathy with the use of thalidomide. The results showed that Brazil has no unified information database about thalidomide patients. Furthermore, there is inconsistency in the accreditation of public health centers that dispense this medicine, in a country that has a high consumption of thalidomide in the Unified Health System. A large part of this amount of dispensed medicine is intended for the treatment of erythema nodosum leprosum, mainly in the North, Northeast, and Central-West regions of the country, which are endemic for leprosy. This disease is the only one among the clinical indications of the medicine approved in Brazil that does not have a Clinical Protocol and Therapeutic Guidelines. The control of thalidomide use in Brazil presents historical regulatory failures. These are currently linked to the organization and structure of primary healthcare in the country, as well as to the lack of leadership of the Ministry of Health and National Health Surveillance Agency when it comes to managing the process of control of this use.


Assuntos
Hanseníase/tratamento farmacológico , Talidomida/efeitos adversos , Talidomida/uso terapêutico , Anormalidades Induzidas por Medicamentos/epidemiologia , Brasil/epidemiologia , Eritema Nodoso/tratamento farmacológico , Feminino , Humanos , Hansenostáticos/efeitos adversos , Hansenostáticos/uso terapêutico , Hanseníase/epidemiologia , Hanseníase Virchowiana/tratamento farmacológico , Masculino , Gravidez
16.
Int J Mol Sci ; 21(17)2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32824985

RESUMO

The aim of this study is to examine the use of an inflammasome competitor as a preventative agent. Coronaviruses have zoonotic potential due to the adaptability of their S protein to bind receptors of other species, most notably demonstrated by SARS-CoV. The binding of SARS-CoV-2 to TLR (Toll-like receptor) causes the release of pro-IL-1ß, which is cleaved by caspase-1, followed by the formation and activation of the inflammasome, which is a mediator of lung inflammation, fever, and fibrosis. The NLRP3 (NACHT, LRR and PYD domains-containing protein 3) inflammasome is implicated in a variety of human diseases including Alzheimer's disease (AD), prion diseases, type 2 diabetes, and numerous infectious diseases. By examining the use of 4,4'-diaminodiphenyl sulfone (DDS) in the treatment of patients with Hansen's disease, also diagnosed as Alzheimer's disease, this study demonstrates the diverse mechanisms involved in the activation of inflammasomes. TLRs, due to genetic polymorphisms, can alter the immune response to a wide variety of microbial ligands, including viruses. In particular, TLR2Arg677Trp was reported to be exclusively present in Korean patients with lepromatous leprosy (LL). Previously, mutation of the intracellular domain of TLR2 has demonstrated its role in determining the susceptibility to LL, though LL was successfully treated using a combination of DDS with rifampicin and clofazimine. Of the three tested antibiotics, DDS was effective in the molecular regulation of NLRP3 inflammasome activators that are important in mild cognitive impairment (MCI), Parkinson's disease (PD), and AD. The specific targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by DDS may be responsible for its observed preventive effects, functioning as a competitor.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Dapsona/farmacologia , Inflamassomos/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Pneumonia Viral/tratamento farmacológico , Doença de Alzheimer/patologia , Clofazimina/farmacologia , Disfunção Cognitiva/patologia , Humanos , Interleucina-1beta/metabolismo , Hanseníase/tratamento farmacológico , Hanseníase/genética , Pandemias , Transtornos Parkinsonianos/patologia , Rifampina/farmacologia , Glicoproteína da Espícula de Coronavírus/metabolismo , Receptor 2 Toll-Like/genética
17.
Lancet Infect Dis ; 20(8): 900-901, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32738236

Assuntos
Hanseníase , Humanos
18.
Recurso na Internet em Inglês, Português | LIS - Localizador de Informação em Saúde | ID: lis-47749

RESUMO

Relatório da Relatora Especial das Nações Unidas, Alice Cruz, para a Eliminação da Discriminação contra as Pessoas Afetadas pela Hanseníase e seus Familiares. Brasília, 14 Maio de 2019. Disponível nos idiomas inglês e português.


Assuntos
Hanseníase , Direitos Humanos , Nações Unidas , Equidade em Saúde , Políticas Públicas não Discriminatórias
19.
PLoS Negl Trop Dis ; 14(7): e0007871, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32628669

RESUMO

Leprosy, caused by Mycobacterium leprae, has plagued humanity for thousands of years and continues to cause morbidity, disability and stigmatization in two to three million people today. Although effective treatment is available, the disease incidence has remained approximately constant for decades so new approaches, such as vaccine or new drugs, are urgently needed for control. Research is however hampered by the pathogen's obligate intracellular lifestyle and the fact that it has never been grown in vitro. Consequently, despite the availability of its complete genome sequence, fundamental questions regarding the biology of the pathogen, such as its metabolism, remain largely unexplored. In order to explore the metabolism of the leprosy bacillus with a long-term aim of developing a medium to grow the pathogen in vitro, we reconstructed an in silico genome scale metabolic model of the bacillus, GSMN-ML. The model was used to explore the growth and biomass production capabilities of the pathogen with a range of nutrient sources, such as amino acids, glucose, glycerol and metabolic intermediates. We also used the model to analyze RNA-seq data from M. leprae grown in mouse foot pads, and performed Differential Producibility Analysis to identify metabolic pathways that appear to be active during intracellular growth of the pathogen, which included pathways for central carbon metabolism, co-factor, lipids, amino acids, nucleotides and cell wall synthesis. The GSMN-ML model is thereby a useful in silico tool that can be used to explore the metabolism of the leprosy bacillus, analyze functional genomic experimental data, generate predictions of nutrients required for growth of the bacillus in vitro and identify novel drug targets.


Assuntos
Genoma Bacteriano , Hanseníase/microbiologia , Redes e Vias Metabólicas , Mycobacterium leprae/genética , Mycobacterium leprae/metabolismo , Animais , Humanos , Camundongos , Camundongos Nus , Mycobacterium leprae/crescimento & desenvolvimento
20.
Arq. ciências saúde UNIPAR ; 24(2): 105-111, maio-ago. 2020.
Artigo em Português | LILACS | ID: biblio-1116373

RESUMO

Este estudo analisou a bibliografia relacionada à hanseníase no Brasil, representada pela publicação de artigos científicos indexados na base de dados científica Web of Science, de 2000 a 2019. Por meio de análise bibliométrica, procurou-se delinear um panorama das produções científicas acerca do tema, identificando os autores, a evolução histórica do número de produções, as áreas de pesquisa que mais publicam, os tipos de artigos publicados e quais as agências financiadoras envolvidas nas publicações relacionadas ao tema. O corpus documental contou com 376 artigos completos, que demonstraram uma intensificação na produção de estudos sobre a hanseníase nos últimos anos, especialmente na área de Medicina Tropical, com predomínio de financiamento por agências brasileiras, e cuja maior fonte de publicações é uma revista científica internacional, dedicada ao estudo de doenças tropicais negligenciadas. Conclui-se que o interesse no estudo do tema se eleva com o passar dos anos, mas dentre as temáticas evidenciadas pela análise empreendida, as políticas públicas para controle e eliminação da doença, foram incipientes. Revela ainda a necessidade de maior aporte científico sobre a temática estimuladas por órgãos governamentais e que amplie as produções científicas por instituições de ensino e pesquisa, que possam alavancar reflexões direcionadas à implementação de diretrizes políticas efetivas para o controle e eliminação da doença.


This study analyzed the literature related to leprosy in Brazil, represented by the publication of scientific papers indexed in the Web of Science scientific database from 2000 to 2019. Through bibliometric analysis, the authors sought to delineate an overview of scientific productions on the topic, identifying the authors, the historical evolution of the number of productions, the areas of research that had most publications, the types of articles published and which funding agencies are involved in publications related to the topic. The documentary corpus consisted of 376 complete articles, which demonstrated an intensification in the production of studies on leprosy in recent years, especially in the area of Tropical Medicine, with a predominance of funding from Brazilian agencies, and whose largest source of publications is an international scientific journal dedicated to the study of neglected tropical diseases. It can be concluded that the interest in the study of the topic has increased over the years, but among the topics evidenced by the analysis undertaken, public policies for the control and elimination of the disease were incipient. It also reveals the need for greater scientific input on the topic stimulated by both government agencies and educational and research institutions, which can leverage reflections aimed at the implementation of effective political guidelines for the control and elimination of the disease.


Assuntos
Bibliometria/história , Política de Saúde/economia , Hanseníase/mortalidade , Política Pública/legislação & jurisprudência , Instituições Acadêmicas/estatística & dados numéricos , Doenças Negligenciadas/epidemiologia
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