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1.
PLoS Negl Trop Dis ; 15(1): e0009019, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33411735

RESUMO

Coronavirus Disease 2019 (COVID-19), a disease caused by the betacoronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has only recently emerged, while Mycobacterium leprae, the etiological agent of leprosy, has endured for more than 2,000 years. As soon as the initial reports of COVID-19 became public, several entities, including the Brazilian Leprosy Society, warned about the possible impact of COVID-19 on leprosy patients. It has been verified that COVID-19 carriers can be either asymptomatic or present varying degrees of severe respiratory failure in association with cytokine storm and death, among other diseases. Severe COVID-19 patients show increased numbers of neutrophils and serum neutrophil extracellular trap (NET) markers, in addition to alterations in the neutrophil-to-lymphocyte ratio (NLR). The absence of antiviral drugs and the speed of COVID-19 transmission have had a major impact on public health systems worldwide, leading to the almost total collapse of many national and local healthcare services. Leprosy, an infectious neurological and dermatological illness, is widely considered to be the most frequent cause of physical disabilities globally. The chronic clinical course of the disease may be interrupted by acute inflammatory episodes, named leprosy reactions. These serious immunological complications, characterized by cytokine storms, are responsible for amplifying peripheral nerve damage. From 30% to 40% of all multibacillary leprosy (MB) patients experience erythema nodosum leprosum (ENL), a neutrophilic immune-mediated condition. ENL patients often present these same COVID-19-like symptoms, including high levels of serum NET markers, altered NLR, and neutrophilia. Moreover, the consequences of a M. leprae-SARS-CoV-2 coinfection have yet to be fully investigated. The goal of the present viewpoint is to describe some of the similarities that may be found between COVID-19 and leprosy disease in the context of neutrophilic biology.


Assuntos
/imunologia , Hanseníase/imunologia , Neutrófilos/fisiologia , /complicações , Humanos , Hanseníase/complicações
2.
Am J Trop Med Hyg ; 103(5): 1810-1812, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32901601

RESUMO

Persons from the Republic of the Marshall Islands have among the highest rates of Hansen's disease (HD) in the world; the largest Marshallese community in the continental United States is in northwest Arkansas. In 2017, the HD Ambulatory Care Clinic in Springdale, Arkansas, informed the Arkansas Department of Health (ADH) that Marshallese persons with HD had severe disease with frequent complications. To characterize their illness, we reviewed ADH surveillance reports of HD among Marshallese persons in Arkansas treated during 2003-2017 (n = 42). Hansen's Disease prevalence among Marshallese in Arkansas (11.7/10,000) was greater than that in the general U.S. population. Complications included arthritis (38%), erythema nodosum leprosum (21%), and prolonged treatment lasting > 2 years (40%). The majority (82%) of patients treated for > 2 years had documented intermittent therapy. Culturally appropriate support for therapy and adherence is needed in Arkansas.


Assuntos
Hanseníase/complicações , Hanseníase/epidemiologia , Grupo com Ancestrais Oceânicos , Adolescente , Adulto , Arkansas/epidemiologia , Criança , Feminino , Humanos , Hanseníase/etnologia , Masculino , Micronésia , Pessoa de Meia-Idade , Adulto Jovem
3.
Fontilles, Rev. leprol ; 32(5): 303-317, mayo-ago. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-198458

RESUMO

OBJETIVO: identificar las afecciones oculares diagnosticadas en los pacientes con Lepra que asistieron a consulta oftalmológica en el servicio de Uveitis e Inflamaciones Oculares (SUIO) del Instituto Cubano de Oftalmología Ramon Pando Ferrer en el periodo 2017-2019. MÉTODOS: se realizó un estudio descriptivo prospectivo observacional en pacientes con diagnóstico de lepra quienes cumplieron los criterios de inclusión y exclusión de la investigación. Las variables estudiadas fueron: edad, sexo, afecciones oftalmológicas y grado de discapacidad. RESULTADOS: predomino el sexo masculino y el grupo de edad entre 45-59 años, la mayoría de los pacientes se diagnosticaron tardíamente después del ano del comienzo de los síntomas, las afecciones oculares predominaron en el segmento anterior del ojo y se diagnosticaron cuatro pacientes con diferentes grados de discapacidad ocular. CONCLUSIONES: las afecciones oculares del segmento anterior son frecuentes en los pacientes con lepra, sobre todo en las formas lepromatosas y pueden aparecer en el momento del diagnóstico, durante o después del tratamiento. Muchas de las causas de afecciones oculares en los pacientes con lepra son prevenibles, es primordial garantizar la asistencia oftalmológica en los mismos


OBJECTIVE: to identify the ocular affections in patient with a diagnosis of leprosy in the department of Uveitis and Ocular (SUIO) Inflammations of the Cuban Institute of Ophthalmology Ramon Pando Ferrer during the period 2017-2019. METHODS: a prospective observational descriptive study in patients with diagnosis of leprosy who completed the admission or exclusion criteria of the investigation was carried out. The studied variables were age, sex, ophthalmological affections and grade of incapacity. RESULTS: The male gender and the age group among 45-59 years prevailed. Most of the patients were diagnosed belatedly after the year of the beginning of the symptoms, the ocular affections prevailed in the segment previous of the eye, and four patients were diagnosed with different grades of ocular discapacity. CONCLUSIONS: the ocular affections of the previous segment are frequent in the patients with leprosy, mainly in the lepromatous type of the disease and they can appear during the presentation of the patient and diagnosis or during or after the treatment. Many of the causes of ocular affections in the patients with leprosy can be prevented and the required ophthalmological care to avoid them must be provided


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Hanseníase/complicações , Oftalmopatias/etiologia , Oftalmopatias/epidemiologia , Hanseníase/epidemiologia , Estudos Prospectivos , Distribuição por Idade e Sexo , Hanseníase/patologia , Índice de Gravidade de Doença , Cuba/epidemiologia
5.
Am J Trop Med Hyg ; 103(4): 1439-1440, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32700675

RESUMO

Leprosy is a rare, chronic granulomatous disease, and India accounts for two-thirds of the new cases reported worldwide. Hypercalcemia is a rare complication of granulomatous disease. Here, we report a case of an older adult patient with leprosy and type I lepra reaction presenting with severe hypercalcemia.


Assuntos
Hipercalcemia , Hanseníase/complicações , Idoso , Eritema Nodoso/tratamento farmacológico , Humanos , Hipercalcemia/complicações , Hipercalcemia/tratamento farmacológico , Índia , Hansenostáticos/uso terapêutico , Masculino
6.
PLoS Negl Trop Dis ; 14(6): e0008393, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32598386

RESUMO

BACKGROUND: Non-healing plantar ulcers are one of the significant causes of disability in leprosy patients. Plantar ulcers often take months or years to heal, affecting the patient's quality of life. Presence of comorbid conditions in these patients can delay wound healing. The study aimed to evaluate the role of associated comorbid conditions as risk factors in ulcer healing. METHODOLOGY/PRINCIPAL FINDINGS: A total of 66 leprosy patients with plantar ulcers registered at LEPRA Society-Blue Peter Public Health and Research Center (BPHRC), Hyderabad, India from June 2018 to June 2019 were studied. Comprehensive clinical assessment was done, including screening for comorbid conditions and treated as per the recommended guidelines. About two-thirds of the participants were aged 50 and above, of which more than half were illiterates, and 93.5% were living below the poverty line. Majority of ulcers were seen on the forefoot; with the head of meta-tarsal bone 27 (41.6%) as the commonest site, followed by calcaneum 23 (38.3%) and great toe 10 (16.6%). Mean ulcer depth was 0.61 (0.57) cm, the area was 5.24 (6.73) cm2 and ulcer volume was 4.72 (14.33) cm3. Ulcer dimensions were significantly associated with low body mass index, hypertension and smoking. CONCLUSIONS/SIGNIFICANCE: Identifying the risk factors delaying wound healing and detailed assessment of ulcers are of profound importance to predict the outcome of plantar ulcers in leprosy patients. The study findings indicate the need for better policies by the leprosy control program for the comprehensive management of plantar ulcers.


Assuntos
Comorbidade , Úlcera do Pé/complicações , Hanseníase/complicações , Adulto , Idoso , Estudos Transversais , Feminino , , Úlcera do Pé/epidemiologia , Humanos , Índia/epidemiologia , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade , Pobreza , Fatores de Risco , Cicatrização
7.
Am J Trop Med Hyg ; 103(1): 209-213, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32285768

RESUMO

Identification of Mycobacterium leprae DNA by polymerase chain reaction (PCR) is a reliable and an affordable method to confirm leprosy. DNA from 87 nerve samples (61 from paraffin blocks and 26 fresh samples) was extracted. Mycobacterium leprae DNA was amplified by PCR from 80/87 (92%) specimens. Patients were seen over a period of 11 years (2007-2019), and leprosy was diagnosed based on clinical and characteristic histopathology findings. The clinical diagnostic possibilities were as follows: leprous neuropathy in 73/80 (91.3%), mononeuritis multiplex of unknown etiology in four (5.0%), vasculitic neuropathy in two (2.5%), and distal symmetric sensory motor neuropathy in one (1.3%). The biopsied nerves were as follows: superficial radial = 34 (42.6%), dorsal cutaneous branch of ulnar = 19 (23.8%), sural = 18 (22.5%), and superficial peroneal = 9 (11.3%), and corresponding neurological deficits were recorded in 77 (96.3%) cases. The histopathological diagnoses in total group were as follows: (borderline tuberculoid (BT) = 52, tuberculoid (TT) = 8, borderline lepromatous (BL) = 8, borderline borderline (BB) = 3, nonspecific inflammation = 3, healed/fibrosed = 4, and axonopathy = 2). Acid fast bacilli (AFB) was demonstrated in 11 (13.7%) samples. For comparison, 31 clinically and histopathologically defined non-leprous disease control nerves (inherited neuropathy = 20, vasculitis = 8, and nutritional neuropathy = 3) subjected to PCR were negative for M. leprae DNA. In most instances, there are multiple thickened peripheral nerves in suspected cases of leprosy, but neurological deficits pertaining to the thickened nerve are not as widespread. The current findings emphasize the importance of selecting the most appropriate nerve for biopsy to obtain a positive PCR result. We infer that clinical, histopathological, and PCR tests complement each other to help achieve a definitive diagnosis of leprosy particularly in pure neuritic leprosy and in leprous neuropathy with negative skin smears/biopsy.


Assuntos
Hanseníase/diagnóstico , Mycobacterium leprae/genética , Nervos Periféricos/microbiologia , Doenças do Sistema Nervoso Periférico/microbiologia , Reação em Cadeia da Polimerase , Adolescente , Adulto , Idoso , Criança , DNA Bacteriano/genética , Humanos , Hanseníase/complicações , Hanseníase/microbiologia , Hanseníase/patologia , Hanseníase Paucibacilar/complicações , Hanseníase Paucibacilar/diagnóstico , Hanseníase Paucibacilar/microbiologia , Hanseníase Paucibacilar/patologia , Hanseníase Tuberculoide/complicações , Hanseníase Tuberculoide/diagnóstico , Hanseníase Tuberculoide/microbiologia , Hanseníase Tuberculoide/patologia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/patologia , Reação em Cadeia da Polimerase/métodos , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-32074217

RESUMO

Tropical diseases are mainly found in the tropical regions of Asia, Africa and Latin America. They are a major Public Health problem in these regions, most of them are considered neglected diseases and remain as important contributors to the development of AKI (Acute Kidney Injury), which is associated with increased patients' morbidity and mortality. In most countries, kidney disease associated to tropical diseases is attended at health services with poor infrastructure and inadequate preventive measures. The long-term impacts of these infections on kidney tissue may be a main cause of future kidney disease in these patients. Therefore, the investigation of novel kidney injury biomarkers in these tropical diseases is of utmost importance to explain the mechanisms of kidney injury, to improve their diagnosis and prognosis, as well as the assessment to health systems by these patients. Since 2011, our group has been studying renal biomarkers in visceral and cutaneous leishmaniasis, schistosomiasis, leptospirosis and leprosy. This study has increased the knowledge on the pathophysiology of kidney disease in the presence of these infections and has contributed to the early diagnosis of kidney injury, pointing to glomerular, endothelial and inflammatory involvement as the main causes of the mechanisms leading to nephropathy and clinical complications. Future perspectives comprise establishing long-term cohort groups to assess the development of kidney disease and the patients' survival, as well as the use of new biomarkers such as urinary exosomes to detect risk groups and to understand the progression of kidney injuries.


Assuntos
Lesão Renal Aguda/etiologia , Leishmaniose Visceral/complicações , Hanseníase/complicações , Leptospirose/complicações , Doenças Negligenciadas/complicações , Esquistossomose/complicações , Dengue Grave/complicações , Lesão Renal Aguda/sangue , Biomarcadores/sangue , Humanos , Doenças Negligenciadas/sangue , Fatores de Risco
9.
PLoS Negl Trop Dis ; 14(2): e0008030, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32023242

RESUMO

BACKGROUND: Skin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. METHODS: To explore patient experiences of integrated case management for skin NTDs, in 2018, we conducted a field-based qualitative case series in a leprosy rehabilitation centre in Ganta, Liberia where BU services were recently introduced. Twenty patients with BU (n = 10) and leprosy (n = 10) participated in in-depth interviews that incorporated photography methods. We contextualised our findings with field observations and unstructured interviews with health workers. FINDINGS: The integration of care for BU and leprosy prompted new conceptualisations of these diseases and experiences of NTD stigma. Some patients felt anxiety about using services because they feared being infected with the other disease. Other patients viewed the two diseases as 'intertwined': related manifestations of the same condition. Configurations of inter-disease stigma due to fear of transmission were buffered by joint health education sessions which also appeared to facilitate social support between patients in the facility. For both diseases, medication and wound care were viewed as the cornerstones of care and appreciated as interventions that led to rehabilitation of the whole patient group through shared experiences of healing, avoidance of physical deformities and stigma reduction. Patient accounts of intense pain during wound care for BU and inability of staff to manage severe complications, however, exposed some shortcomings of medical care for the newly integrated service, as did patient fears of long-lasting disability due to lack of physiotherapy services. SIGNIFICANCE: Under integrated care policies, the possibility of new discourses about skin NTD identities emerging along with new configurations of stigma may have unanticipated consequences for patients' experiences of case management. The social experience of integrated medication and wound dressing has the potential to link patients within a single, supportive patient community. Control programmes with resource constraints should anticipate potential challenges of integrating care, including the need to ameliorate lasting disability and provide adequate clinical management of severe BU cases.


Assuntos
Úlcera de Buruli/complicações , Úlcera de Buruli/epidemiologia , Administração de Caso , Hanseníase/complicações , Hanseníase/epidemiologia , Doenças Negligenciadas , Humanos , Libéria/epidemiologia , Estigma Social , Apoio Social , Clima Tropical , Medicina Tropical
10.
Diagn Microbiol Infect Dis ; 96(4): 114984, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31954594

RESUMO

Simple measures that can facilitate early recognition of leprosy complications are still lacking. We therefore evaluated a lateral flow-based rapid diagnostic test and fast enzyme-linked immunosorbent assay measuring anti-LID-NDO antibody responses among leprosy cases in Cebu, Philippines. Responses were measured at diagnosis, then during and after the provision of standard multidrug therapy. Our data indicate that both platforms are highly sensitive tools for the primary diagnosis of, in particular, multibacillary leprosy. A gradual, quantifiable decline in both magnitude of response and percent positive responders was observed during and after treatment. As a group, patients that developed erythema nodosum leprosum (ENL) had a significantly higher response at diagnosis than patients that either developed reversal reactions or did not develop reactions. Although higher initial anti-NDO-LID responses were a risk factor for ENL, neither platform, however, could reliably predict the time of emergence of reactional episodes.


Assuntos
Anticorpos Antibacterianos/sangue , Hansenostáticos/uso terapêutico , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Mycobacterium leprae/efeitos dos fármacos , Adulto , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática/normas , Eritema Nodoso/diagnóstico , Eritema Nodoso/tratamento farmacológico , Feminino , Humanos , Imunoensaio , Imunoglobulina M/sangue , Hanseníase/complicações , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/tratamento farmacológico , Estudos Longitudinais , Masculino , Filipinas , Testes Sorológicos
12.
Am J Trop Med Hyg ; 102(1): 42-47, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31769407

RESUMO

In addition to the complications of leprosy, people affected by leprosy (PALs) can suffer from chronic diseases. We evaluated the recent pattern of deaths among Korean PALs and compared it with that in the general population. We analyzed the death certificate data of 1,359 PALs from 2010 through 2013. The all-cause and cause-specific standardized mortality ratio (SMR) and standardized mortality with 95% CI were calculated. Malignancy had the highest standardized mortality, with 130.9 deaths per 100,000 persons, followed by cardiovascular diseases (CVDs; 85.5 deaths) and respiratory diseases (38.2 deaths). Of malignancies, liver cancer caused the greatest number of cancer deaths (40.0 deaths). The all-cause mortality of PALs was significantly lower than that in the general population, corresponding to an SMR of 0.84 (95% CI 0.79-0.88). Deaths from malignancy and CVDs were significantly lower, corresponding to SMRs (95% CIs) of 0.88 (0.79-0.98) and 0.75 (0.67-0.84), respectively. The death rates for lung and stomach cancers were lower, whereas mortality due to liver cancer was higher, with an SMR of 1.79 (95% CI 1.43-2.22). Except for liver cancer and infection, the causes of mortality of PALs tend to be lower than that in the general population. The most common underlying cause of death in PALs was stroke, followed by ischemic heart disease, liver cancer, and pneumonia.


Assuntos
Hanseníase/epidemiologia , Hanseníase/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Humanos , Hanseníase/complicações , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia
13.
Dis Mon ; 66(7): 100920, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31796204

RESUMO

BACKGROUND: Leprosy represents a chronic progressive debilitating disease. The severe morbidity associated with leprosy predisposes the patients to opportunistic infections. To assess the oral candida prevalence and species specificity in lepromatous leprosy patients. METHODS: The cross-sectional study included 70 lepromatous leprosy patients under a multi-drug regimen for less than 1 year (group 1) and 70 healthy volunteers (group 2). Both group 1 and 2 were matched for potential confounding factors including age, gender, ethnicity, absence of HIV co-infection. Oral swab samples obtained from both groups were subjected to a series of conventional and molecular diagnostic modalities. RESULTS: Yeast growth was statistically higher (0.0006) in group 1 (45.7%) than in group 2 (18.5%). 28 of the 32 yeast growth in group 1 and all 13 yeast growth in group 2 were identified as candida. Among the 28 candida species in group 1, 23 (71.88%) were Candida albicans, 3 (9.37%) were Candida parapsilosis, 1 (3.13%) was Candida lusitaniae and 1 (3.13%) was Candida nivariensis. Among group 2, 11 (84.6%) were Candida albicans, 1 (7.7%) was Candida parapsilosis and 1 was Candida tropicalis. CONCLUSION: Oral candida prevalence is higher in leprosy patients than in healthy individuals, indicating a predisposition towards opportunistic infections. The increasing prevalence of the non-candida albicans species in leprosy is a major concern as they have shown to possess inherent resistant towards common anti-fungal agents.


Assuntos
Candida/crescimento & desenvolvimento , Candidíase Bucal/epidemiologia , Hanseníase/tratamento farmacológico , Infecções Oportunistas/epidemiologia , Adulto , Candida/genética , Candida/ultraestrutura , Candida albicans/genética , Candida albicans/crescimento & desenvolvimento , Candida albicans/ultraestrutura , Candida parapsilosis/genética , Candida parapsilosis/crescimento & desenvolvimento , Candida parapsilosis/ultraestrutura , Candida tropicalis/genética , Candida tropicalis/crescimento & desenvolvimento , Candida tropicalis/ultraestrutura , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Hanseníase/complicações , Hanseníase/microbiologia , Hanseníase/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Especificidade da Espécie
14.
Am J Trop Med Hyg ; 102(2): 448-450, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31802737

RESUMO

We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.


Assuntos
Hanseníase/complicações , Miíase/diagnóstico , Miíase/patologia , Rinite Atrófica/complicações , Administração Tópica , Idoso de 80 Anos ou mais , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Humanos , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Ivermectina/administração & dosagem , Ivermectina/uso terapêutico , Masculino , Miíase/cirurgia
15.
Rio de Janeiro; s.n; 2020. 11 p. ilus.
Não convencional em Inglês | Sec. Est. Saúde SP, CONASS, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1146417

RESUMO

BACKGROUND: Although Mycobacterium leprae (ML) is well characterised as the causative agent of leprosy, the pathophysiological mechanisms underlying peripheral nerve damage still need further understanding. In vitro and in vivo studies have yielded insights into molecular mechanisms of ML interaction with Schwann cells (SC), indicating the regulation of genes and proteins crucial to neural plasticity. OBJECTIVES: We aimed to investigate the effect of ML on neurotrophins expression in human SC (hSC) and mice sciatic nerves to better understand their role in leprosy neuropathy, and aiming to contribute to future therapeutic approaches. METHODS: We evaluated mRNA and protein expression of BDNF, NGF, NT-3, NT-4 in hSC from amputation nerve fragments, as well as in athymic nude mice, infected by ML for eight months. FINDINGS and MAIN CONCLUSIONS: Our in vitro results showed a trend to decline in NGF and BDNF mRNA in ML-treated hSC, compared to controls. The immunodetection of BDNF and NT-4 was significantly downregulated in ML-treated hSC. Conversely, ML-infected mice demonstrated upregulation of NT-3, compared to non-infected animals. Our findings indicate that ML may be involved in neurotrophins regulation, suggesting that a pathogen-related imbalance of these growth factors may have a role in the neural impairment of leprosy(AU).


Assuntos
Humanos , Animais , Camundongos , Células de Schwann/imunologia , Mycobacterium leprae/imunologia , Doenças do Sistema Nervoso Periférico , Hanseníase/complicações , Fatores de Crescimento Neural
16.
s.l; s.n; 2020. 8 p. graf.
Não convencional em Inglês | Sec. Est. Saúde SP, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1102410

RESUMO

Leprosy neuropathy is a chronic degenerative infectious disorder of the peripheral nerve caused by the intracellular obligate pathogen Mycobacterium leprae (M. leprae). Among all nonneuronal cells that constitute the nerve, Schwann cells are remarkable in supporting M. leprae persistence intracellularly. Notably, the success of leprosy infection has been attributed to its ability in inducing the demyelination phenotype after contacting myelinated fibres. However, the exact role M. leprae plays during the ongoing process of myelin breakdown is entirely unknown. Here, we provided evidence showing an unexpected predilection of leprosy pathogen for degenerating myelin ovoids inside Schwann cells. In addition, M. leprae infection accelerated the rate of myelin breakdown and clearance leading to increased formation of lipid droplets, by modulating a set of regulatory genes involved in myelin maintenance, autophagy, and lipid storage. Remarkably, the blockage of myelin breakdown significantly reduced M. leprae content, demonstrating a new unpredictable role of myelin dismantling favouring M. leprae physiology. Collectively, our study provides novel evidence that may explain the demyelination phenotype as an evolutionarily conserved mechanism used by leprosy pathogen to persist longer in the peripheral nerve.


Assuntos
Células de Schwann/microbiologia , Doenças do Sistema Nervoso Periférico/metabolismo , Mycobacterium leprae/patogenicidade , Bainha de Mielina/microbiologia , Doenças Desmielinizantes/microbiologia , Hanseníase/complicações
18.
Artigo em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1050132

RESUMO

A compreensão das condições de vida dos pacientes com hanseníase e o apoio para superar a vulnerabilidade são algumas das principais atribuições dos profissionais da saúde da atenção primária. Objetivou-se identificar e analisar as evidências disponíveis na literatura sobre as variáveis da vulnerabilidade com a incapacidade física dos casos de hanseníase atendidos na atenção primária. Trata-se de uma revisão narrativa a partir de estudos nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Base de dados da Enfermagem (Bdenf), e PubMed. Utilizaram-se as palavras chaves nas expressões: "vulnerability and leprosy and disability"; "leprosy and vulnerability" e "leprosy and disability. Desenvolveu-se a partir da estratégia de identificação do Problema, da Variável de Interesse e do Resultado. Foram encontrados 366 artigos, porém apenas 14 elegíveis para o estudo. A maioria dos estudos mostrou a vulnerabilidade dos pacientes com hanseníase de forma ampla, e relacionou as incapacidades físicas com as variáveis: baixas condições sócias econômicas, presença de comorbidades, sexo masculino, presença de profissionais que referem possuir capacitação insuficiente sobre prevenção de incapacidades, o baixo acesso dos pacientes aos benefícios sociais e danos psicológicos. Conclui-se que, a vulnerabilidade está presente na maioria dos pacientes com incapacidades físicas provocadas pela hanseníase. Ressaltando que as ações ainda estão insuficientes, sendo necessário desenvolvimento de estratégias principalmente na Atenção Básica para atender o paciente de forma integral.


Assuntos
Humanos , Atenção Primária à Saúde , Hanseníase , Hanseníase/complicações , Hanseníase/epidemiologia
20.
Rev. bras. cir. plást ; 34(4): 497-503, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047912

RESUMO

Introdução: A úlcera plantar por hanseníase é uma lesão no pé resultante da falta de sensibilidade plantar. O objetivo é descrever o tratamento realizado em portadores de úlceras plantares por hanseníase. Métodos: Estudo de prontuários de portadores de úlcera plantar atendidos no Hospital Sarah em Brasília, de 2006 a 2016, quanto ao sexo, idade, etiologia, localização e tratamento. Resultados: Foram atendidos 27 pacientes, 17(62,96%) homens e 10 (37,04%) mulheres, procedentes de Goiás e DF, na faixa etária de 41 a 60 anos (40,74%). Todos necessitaram de um ou mais procedimentos cirúrgicos. Conclusão: Observou-se maior frequência no sexo masculino, grau avançado, localizadas no primeiro artelho. Todos necessitaram de procedimentos cirúrgicos e não cirúrgicos, evoluindo com cicatrização completa da ferida, amputação transtibial em um caso e de artelhos em sete casos, e 90% dos casos apresentaram recorrência da úlcera após um ano.


Introduction: Leprosy-induced plantar ulcers result from a lack of plantar sensitivity. Objective: This study aimed to describe the treatment provided to patients with leprosy-induced plantar ulcers. Methods: We retrospectively reviewed the medical records of patients with plantar ulcers treated at Sarah Hospital in Brasilia from 2006 to 2016 and collected information about sex, age, etiology, location, and treatment. Results: A total of 27 patients (17 [62.96%] men, 10 [37.04%] women; 40.74% were aged 41­60 years) were treated from Goiás and the Federal District. All required ≥1 surgical procedure. Conclusion: A higher frequency of advanced grade was observed in men, primarily on the first toe. All needed surgical and non-surgical procedures and achieved complete wound healing. Transtibial amputation was required in 1 case and toe amputation in 7 cases; 90% patients developed ulcer recurrence after 1 year.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Reabilitação , Terapêutica , Tratamento Terciário , Registros Médicos , Úlcera do Pé , Hanseníase , Reabilitação/métodos , Reabilitação/estatística & dados numéricos , Terapêutica/métodos , Terapêutica/estatística & dados numéricos , Tratamento Terciário/métodos , Tratamento Terciário/estatística & dados numéricos , Registros Médicos/normas , Registros Médicos/estatística & dados numéricos , Úlcera do Pé/cirurgia , Úlcera do Pé/complicações , Úlcera do Pé/terapia , Hanseníase/cirurgia , Hanseníase/complicações , Hanseníase/terapia
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