scholarly journals Leprosy in Buriticupu, state of Maranhão: active search in the general population

2012 ◽  
Vol 45 (2) ◽  
pp. 199-202 ◽  
Author(s):  
Antonio Rafael da Silva ◽  
Ana Raquel Ribeiro dos Santos ◽  
Gisele Maria Campelo dos Santos ◽  
Vitor Emmanuel Bouças Silva ◽  
Eloisa da Graça do Rosário Gonçalves

INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1%) cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04), and the generalized exact test showed that there was no association between age and clinical form (p = 0.438) and between age and gender (p = 0.083). CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.

1970 ◽  
Vol 1 (2) ◽  
pp. 81-86 ◽  
Author(s):  
K Gautam ◽  
RR Pai ◽  
S Bhat

Background: Granulomatous skin lesions often present as a diagnostic challenge to dermatopathologists due to various modes of presentation and identical histological picture produced by several causes. The aim of the study was to study different granulomatous skin lesions and to determine the relative frequency, the level of clinicopathologic concordance and to compare our results with those of other workers. Materials and Methods: A retrospective analysis of skin biopsies received over a period of two years from January 2007 to December 2008; was performed, and cases of granulomatous dermatitis reported on histopathological examination were reviewed along with special stains. Results: Out of a total of 1590 skin biopsies 106 (6.67%) cases were found to have a granulomatous reaction. It was common in males (63.21%) with most occurring in the fourth to fifth decades. Majority of cases (79 cases, 74.5%) were categorized as infectious granulomatous lesions with predominance of leprosy (63 cases, 79.7%) followed by tuberculosis (6 cases, 7.6%). An overall clinicopathologic concordance was seen in 97% of cases of leprosy. Conclusion: In this study leprosy is the most common cause of granulomatous skin lesions. It can be concluded that histopathology plays an important role in classification of leprosy, and in diagnosis and management of a variety of granulomatous skin diseases. Special stains play a supportive role in infectious granulomas. Keywords: Granulomatous skin lesion; Leprosy; Skin biopsy DOI: http://dx.doi.org/10.3126/jpn.v1i2.5397 JPN 2011; 1(2): 81-86


2021 ◽  
Vol 12 ◽  
Author(s):  
Maaike M. Rademaker ◽  
Adriana L. Smit ◽  
Anne E. M. Brabers ◽  
Judith D. de Jong ◽  
Robert J. Stokroos ◽  
...  

Introduction: Tinnitus prevalence numbers in the literature range between 5 and 43%, depending on the studied population and definition. It is unclear when tinnitus becomes pathologic.Objectives: To assess the tinnitus prevalence in the Dutch general population with different cutoffs for definition.Methods: In this cross-sectional study, a questionnaire was sent to a sample (n = 2,251) of the Nivel (Netherlands Institute for Health Services Research) Dutch Health Care Consumer Panel. Three questions were asked to assess the presence of tinnitus, duration, and frequency of the complaint. We classified people as having pathologic tinnitus when participants experienced it for 5–60 min (daily or almost daily or weekly), or tinnitus for >60 min or continuously (daily or almost daily or weekly or monthly), so tinnitus impact on daily life was measured with the Tinnitus Functional Index (TFI) and a single-item question. Answers were stratified to mid-decade years of age. Prevalence numbers were weighted by gender and age to match the Dutch population.Results: Nine hundred thirty-two of 2,251 participants (41%) filled out the questionnaire. The median age was 67.0 (IQR 17) years. Three hundred thirty-eight of 932 (36%) experienced tinnitus for an undefined amount of time during the last year. Two hundred sixteen of 932 (23%) met our definition of having pathologic tinnitus (21% when weighted for age and gender). The median TFI score for all pathologic tinnitus participants was 16.6 (IQR 21.8). A percentage of 50.4% of the pathologic tinnitus participants had a TFI in the range 0–17, which can be interpreted as not a problem.Conclusion: Twenty-three percent (unweighted) or 21% (weighted) of our sample met our definition of pathologic tinnitus, which was based on a combination of duration and frequency over the last year. The TFI score of 47.7% of the pathologic tinnitus participants is ≥18. This indicates that they consider the tinnitus to be at least “a small problem” [11.1% (unweighted) or 8.9% (weighted) of the total study group]. This study illustrates the difficulties with defining pathologic tinnitus. In addition, it demonstrates that tinnitus prevalence numbers vary with different definitions and, consequently, stresses the importance of using a uniform definition of tinnitus.


2017 ◽  
Vol 63 (3) ◽  
pp. 227
Author(s):  
G. D. GIANNOULOPOULOS (Γ.Δ. ΓΙΑΝΝΟΥΛΟΠΟΥΛΟΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Δ. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ)

Canine acrai lick dermatitis is a complicated and challenging syndrome occurring in companion animal dermatology. Skin lesions are caused by intense and prolonged licking of a localized area, usually on the lower parts of the limbs that progressively may result in plaque or nodule formation with alopecia, erythema, hyperpigmentation, exudation,erosion and ulceration. Aerai lick dermatitis develops more often in male dogs of large breeds and has a multifactorial aetiology. The underlying causes may be broadly separated into organic (e.g., pruritic skin diseases, painful conditions) and psychogenic. The former subset includes mainly deep bacterial pyoderma, atopic dermatitis, food allergy, foreign bodies, sensory neuropathies and painful bone and articular diseases. The psychogenic subset may be either a primary (e.g., the result of long-standing anxiety, boredom, attention-seeking or stereotypic behavior) or a psychosomatic behavioural abnormality.Regardless of the aetiology and the primary role it may play, the most common complication in the psychogenic aerai lick dermatitis is actually the deep bacterial pyoderma observed in the majority of the cases. Diagnosis of the disorder is reached after exclusion of similar-looking skin diseases, such as ringworm kerion, demodicosis, leishmaniosis, sterile granulomas and neoplasia. An extensive list of diagnostic tests is necessary to identify the underlying cause(s) and includes cytological examination, bacterial culture and antibiotic susceptibility testing, histopathological examination, imaging of the affected area and hypoallergenic food trial. A prerequisite to diagnosing the psychogenic subset of the disease is to rule-out potential organic causes, coupled with persistence of skin licking, despite resolution of deep bacterial pyoderma.Regardless of the underlying cause, therapy should always include mechanical restrain, as well as the long-term topical and systemic use of antimicrobials that ideally should be selected based on the results of antimicrobial susceptibility testing. Specific treatment in also warranted to resolve potential organic causes of the syndrome, whereas, management of its psychogenic subset should be based on avoidance of the causative and triggering factors, desensitization and counter conditioning, along with the administration of psychotropic medication. Alternative therapeutic modalities, considered supplementary or employed when everything else fails, may include topical glucocorticoids, dimethyl sulfoxide, capsaicin or tacrolimus, as well as cryosurgery, laser surgery, acupuncture or radiation therapy.


Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33


Author(s):  
Francesco Maria Romano ◽  
Guido Sciaudone ◽  
Silvestro Canonico ◽  
Francesco Selvaggi ◽  
Gianluca Pellino

: Hemorrhoidal Disease (HD) is widely diffused throughout the general population. The system of classification currently used to categorize this pathology is that of Goligher (1975). This system only defines the morphology of the most represented hemorrhoid bearing. Several attempts in literature have been made to replace this system, but as of yet, no single system has been universally accepted. Some studies, however, have succeeded in identifying specific characteristics, besides morphology, that would be able to aptly define HD. An analysis of this literature, with careful consideration of the scores that have previously been proposed, is necessary in order to deepen and stimulate discussion about a possible new definition of HD.


Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 465
Author(s):  
Gregorio P. Milani ◽  
Mario G. Bianchetti ◽  
Giuseppe Togni ◽  
Andreas W. Schoenenberger ◽  
Franco Muggli

It is assumed that healthcare workers are at the highest risk to be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few data from healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection support this assumption. We investigated the prevalence of immunoglobulin G (Ig G) against SARS-CoV-2 among healthcare workers who do not primarily take care of patients with SARS-CoV-2 infection and the general population in a well-defined geographical area. The first part of the study was conducted in May 2020 in Val Mesolcina (Southern Switzerland), a valley with ~8000 inhabitants. All healthcare workers were invited. All participants (n = 488) of the Swiss Longitudinal Cohort Study (SWICOS), a cohort representative of the general population, were also invited. Circulating Ig G against spike protein subunit 1 of SARS-CoV-2 were tested in each subject. Subjects with positive Ig G were tested again after 6 months. The condition of being a healthcare worker, rather than a part of the general population, was tested as a predictor of seroprevalence positivity by both simple and multiple (adjusted for age and sex) logistic regression. Eleven (2.6%) of the 423 SWICOS participants and 46 (16%) out of 289 healthcare workers were positive for antibodies against SARS-CoV-2. The seroprevalence OR was 7.01 (95% CI: 3.53–15.47) for healthcare workers as compared to SWICOS participants. After adjusting for age and gender, the seroprevalence OR was 5.13 (95% CI: 2.54–10.40). About three quarters of the subjects in the SWICOS (73%) and in healthcare (79%) group with a previous positive serology still presented positive Ig G against the SARS-CoV-2 after 6 months. The present seroprevalence data point out that the SARS-CoV-2 infection is seven times higher among healthcare workers than in the general population of Val Mesolcina. Efforts to effectively protect all the healthcare personnel are needed.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1530.1-1530
Author(s):  
G. Kaynar ◽  
O. C. İçaçan ◽  
S. Çelik ◽  
M. Yalçin Mutlu ◽  
C. Bes

Background:Purpura are lesions that occur after bleeding on the skin, mucous or serosal surfaces. Purpura can be classified into 2 subgroups; which are linked to thrombocytopenia and non-trombocytopenic purpura. While thrombocytopenic purpura often occurs due to a hematological disease; in non-trombocytopenic purpura etiological causes are very variable, and systemic vasculitis has an important place among them.Objectives:The demographic features of the patients applying with purpura and the underlying causes and diseases were aimed to be revealed.Methods:44 consecutive patients (22 women, 22 men) who were admitted to the hospital in the last 6 months, due to purpura were evaluated. Average age of patients was 49.6 ± 19.6 years. Patients were questioned about a recent infection, drug use, concomitant or underlying diseases. The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate.Results:While 4 (9%) patients had widespread purpura on the trunk-upper-lower extremities, in 22 (50%) patients purpuric lesions were limited only to the lower limb. The period between the onset of the first symptom and the admission to the hospital was longer than 4 weeks in 35 (79.5%) patients, and shorter than 1 week in 9 (20.5%) patients. 24 (54%) patients had an anamnesis of infection 2-3 weeks before purpura, and 20 (45%) patients had an anamnesis of drug use. The most common accompanying symptom was abdominal pain and was present in 15 (34%) patients. Biopsy was performed from the skin lesion in 37 patients. Histopathological examination of all was compatible with leukocytoclastic vasculitis. In indirect immunofluorescence staining, 17 were found to be IgA positive. 2 (4.5%) patients were diagnosed PR3-ANCA positive granulomatosis with polyangiitis. 1 patient had Hepatitis B virus infection was detected in 1 patient (2.2%), HIV infection was detected in 1 patient (2.2%) and malignancy was detected in 1 patient (2.2%).Conclusion:In our study, the most common reason was found as IgA vasculitis in patients presenting with palpable purpura. Although vasculitic involvement was limited to the skin in most patients, organ-threatening systemic vasculitis was detected in a few patients. Patients applying with Purpura should be questioned for infection and drug use, should be examined for underlying diseases including systemic vasculitis, and closely monitored for organ involvement.Disclosure of Interests:None declared


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043963
Author(s):  
Jorge López Fernández ◽  
Alejandro López-Valenciano ◽  
Xián Mayo ◽  
Elizabeth Horton ◽  
Ivan Clavel ◽  
...  

Objectives(1) To describe the physical activity (PA) levels of the members of a Spanish leisure centre operator according to age and gender; (2) to describe the differences in the three PA levels between the members of a Spanish leisure centre operator and the general Spanish population considering the PA Eurobarometer data according to their gender and age and (3) to explore the intensity origin of the PA either in Spanish members of leisure centres or the Spanish population considering their gender.DesignDescriptive epidemiology study.ParticipantsData from 16 Spanish leisure centres (n=3627) and from the 2017 Eurobarometer 472 for Spain (n=1002) were used for this research.Primary and secondary outcomes measuresThe PA levels were analysed with the International Physical Activity Questionnaire short version, and respondents were grouped into physical inactivity (PIA), moderate-PA and high-PA. Moreover, gender (men or women) and age (18–29 years; 30–44 years; 45–59 years; 60–69 years; ≥70 years) were considered. Total metabolic equivalent (MET)-min/week, as well as total MET-min/week for walking intensity, moderate intensity and vigorous intensity were recorded.ResultsLeisure centres showed a lower prevalence of PIA and a higher prevalence of high-PA than the general population (p<0.05). Women displayed a higher prevalence of PIA and lower prevalence of high-PA than men (p<0.05). The prevalence of PIA increases with age while the prevalence of high-PA decreases.ConclusionLeisure centres engage most of their members in regular PA, including women and older adults, and these members also perform a higher number of MET in vigorous PA, than the general population.


Molecules ◽  
2021 ◽  
Vol 26 (15) ◽  
pp. 4409
Author(s):  
Jinjoo Kang ◽  
Soyoung Lee ◽  
Namkyung Kim ◽  
Hima Dhakal ◽  
Taeg-Kyu Kwon ◽  
...  

The extracts of Schisandra chinensis (Turcz.) Baill. (Schisandraceae) have various therapeutic effects, including inflammation and allergy. In this study, gomisin M2 (GM2) was isolated from S. chinensis and its beneficial effects were assessed against atopic dermatitis (AD). We evaluated the therapeutic effects of GM2 on 2,4-dinitrochlorobenzene (DNCB) and Dermatophagoides farinae extract (DFE)-induced AD-like skin lesions with BALB/c mice ears and within the tumor necrosis factor (TNF)-α and interferon (IFN)-γ-stimulated keratinocytes. The oral administration of GM2 resulted in reduced epidermal and dermal thickness, infiltration of tissue eosinophils, mast cells, and helper T cells in AD-like lesions. GM2 suppressed the expression of IL-1β, IL-4, IL-5, IL-6, IL-12a, and TSLP in ear tissue and the expression of IFN-γ, IL-4, and IL-17A in auricular lymph nodes. GM2 also inhibited STAT1 and NF-κB phosphorylation in DNCB/DFE-induced AD-like lesions. The oral administration of GM2 reduced levels of IgE (DFE-specific and total) and IgG2a in the mice sera, as well as protein levels of IL-4, IL-6, and TSLP in ear tissues. In TNF-α/IFN-γ-stimulated keratinocytes, GM2 significantly inhibited IL-1β, IL-6, CXCL8, and CCL22 through the suppression of STAT1 phosphorylation and the nuclear translocation of NF-κB. Taken together, these results indicate that GM2 is a biologically active compound that exhibits inhibitory effects on skin inflammation and suggests that GM2 might serve as a remedy in inflammatory skin diseases, specifically on AD.


Sign in / Sign up

Export Citation Format

Share Document