Search

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hansen's disease, synonymously and commonly referred to as leprosy, is an important consideration when treating any chronic skin disorder and rheumato- logic disorder. Personal clinical experience and a review of the literature highlight a lack of awareness for this disease by U.S. clinicians. In this country, accurate diagnosis is delayed. One cannot ensure swift and proper treatment without timely, accurate diagnosis. Unfortunately, severe debilitating nerve and tissue damage can occur within months. The authors draw upon recent personal and clinical experiences diagnosing and treating cases of the disease during a current resurgence in Florida. The authors aim to encourage readers to increase awareness for this ancient disease. In doing so, its relevance today and essential points in diagnosis and treatment are emphasized. This article is a compilation of our recent clinical experiences, in consultation with one of the world's leading authorities in the diagnosis and treatment of the disease and its complications: The National Hansen's Disease Program within the U.S. Department of Health and Human Services, Health Resources and Services Administration, Baton Rouge, Louisiana. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the frequency of people with leprosy-related physical disabilities after release from multidrug treatment and to analyze their spatial distribution. METHODS: Descriptive cross-sectional study with 232 leprosy patients treated between 1998 and 2006. Physical disabilities were assessed using the World Health Organization disability grading and the eye-hand-foot (EHF) sum score. The residential address of patients and rehabilitation centers were geocoded. It was estimated the overall frequency of physical disability and frequency by disability grade (grade 0, grade 1, and grade 2) according to the WHO disability grading taking into consideration clinical and sociodemographic variables in the descriptive analysis. Student's t-test, chi-square test (χ²), and Fisher's test were used as appropriate at a 5% significance level. RESULTS: Of the patients studied, 51.6% were female, mean age 54 years old (SD 15.7), 30.5% had less than 2 years of formal education, 43.5% were employed, and 26.9% were retired. Borderline leprosy was the most prevalent form of leprosy (39.9%). A total of 32% of these patients had disabilities according to the WHO disability grading and the EHF score. Disabilities increased with age (p = 0.029), they were more common in patients with multibacillary leprosy (p = 0.005) and poor self-rated physical health (p < 0.001). Those who required prevention/rehabilitation care traveled on average 5.5 km to the rehabilitation center. People with physical disabilities lived scattered across the city but they were mostly concentrated in the most densely populated and socioeconomically deprived area. CONCLUSIONS: There is a high frequency of people with leprosy-related disabilities after release from multidrug therapy. Prevention and rehabilitation actions should target uneducated and older patients, those who had multibacillary forms of leprosy and poor self-rated physical health. The travel distance to rehabilitation centers calls for reorganization of local care networks. [ABSTRACT FROM AUTHOR]

Summary: PknB is an essential serine/threonine kinase of Mycobacterium tuberculosis with possible roles in a number of signalling pathways involved in cell division and metabolism. We screened a library of >50,000 compounds for inhibitors of the in vitro phosphorylation of GarA (Rv1827) by PknB and identified a number of inhibitors. A program of synthetic medicinal chemistry was subsequently conducted around one class of inhibitors and was successful in generating ATP competitive inhibitors with potency in the nanomolar range. Compounds in this class showed cross-reactivity with the related M. tuberculosis kinase, PknF, but not with PknG in an in vitro autophosphorylation assay. These synthesised inhibitors were able to prevent the growth of M. tuberculosis in an Alamar blue assay and in an intracellular model of infection, but only in the micromolar range. We attempted to determine if cell wall permeability was an explanation for the discrepancy between the potent in vitro compared with relatively poor in vivo activity, but found no evidence that the activity of the inhibitors could be improved by weakening the cell wall. Despite a number of drug discovery efforts attempting to develop inhibitors against PknB, it is yet to be reported that any such inhibitors prevent mycobacterial growth at submicromolar concentrations. [ABSTRACT FROM AUTHOR]

We report on a 24-year-old, male Ugandan patient with a 2-week history of itchy papules, vesicles, erosions, and crusts distributed on the entire body, accompanied by minor erosions on the palate, tongue, and lower lip. Conjunctivae and genital mucosa were not involved. Circulating IgG and IgA autoantibodies were found against recombinant full-length BP180, BP180 4575, and the C-terminus of BP230. In addition, IgG reactivity was observed against the 16th noncollagenous region of the BP180 ectodomain, the cell-derived soluble ectodomain of BP180 (linear IgA disease antigen 1), and the α3 and γ2 chains of laminin 5. No reactivity was detected with type VII collagen, α6β4 integrin, and the p200 protein. Oral prednisolone and dapsone led to clearance of lesions that mostly healed with scarring and milia formation. Here, we describe a scarring mucocutaneous variant of an autoimmune blistering skin disorder that extends the current clinical and immunopathologic spectrum of this group of diseases. [Copyright &y& Elsevier]

Abstract: Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It commonly affects nasal mucosa and conjunctiva. Subcutaneous disease is unusual and it is often mistaken for soft-tissue sarcoma. Such tumoral rhinosporidiosis has never been reported in children. This report describes, for the first time, an 11-year-old girl who presented with nasal polyp and multiple metastatic swellings of rhinosporidial origin. Fine-needle aspiration cytology and histopathology were diagnostic. Surgical excision, followed by dapsone therapy, was found to be useful. [Copyright &y& Elsevier]

Background: A new aqueous gel formulation of dapsone has been developed that allows clinically-effective doses of dapsone to be administered topically with minimal systemic absorption. Objectives: The goal of these studies was to evaluate the efficacy and safety of dapsone gel, 5% in the treatment of acne. Methods: Patients 12 years of age and older with acne vulgaris (N = 3010) participated in two identically-designed 12-week, randomized, double-blind studies of twice-daily monotherapy with dapsone gel, 5%, versus a vehicle gel. Results: Dapsone gel–treated patients achieved superior results in terms of the investigator''s global acne assessment (P < .001) and the mean percentage reduction in inflammatory, noninflammatory, and total lesion counts (all, P < .001) at week 12. Reductions in inflammatory lesion counts favoring dapsone gel over vehicle were apparent as early as 2 weeks and reached statistical significance by 4 weeks. No clinically significant changes in laboratory parameters, including hemoglobin, even among glucose-6-phosphate dehydrogenase–deficient patients, were observed. Adverse events were comparable between the treatment groups and rarely led to discontinuation. Limitations: Adjunctive topical treatments and their impact on acne were not studied in this trial. Conclusions: Dapsone gel, 5% appears to be an effective, safe, and well-tolerated treatment for acne vulgaris, with a rapid onset of action. [Copyright &y& Elsevier]