scholarly journals A Retrospective Study: Epidemiology, Onset, and Duration of Erythema Nodosum Leprosum in Surabaya, Indonesia

2021 ◽  
Vol 33 (1) ◽  
pp. 8
Author(s):  
Cindy Fransisca ◽  
Iskandar Zulkarnain ◽  
Evy Ervianti ◽  
Damayanti Damayanti ◽  
Maylita Sari ◽  
...  

Background: Erythema nodosum leprosum (ENL) has a chronic and recurrent nature which could reduce patient’s quality of life in addition to the onset of ENL that occurs before, during, or after multidrug treatment, further emphasizing the importance of regular control and education.Purpose:This study aimed to evaluate the epidemiology, onset, duration, and recurrence of ENL. Methods:Data from medical records were obtained for a 3-year retrospective study of multibacillary leprosy patients at the Leprosy Division of the Dermatology and Venereology Outpatient Department, Dr. Soetomo General Hospital Surabaya, with a minimum of 2–5 years follow-up period.Result:The prevalence of  ENL continued to increase almost every year especially in 2017 (32% in 2015; 32% in 2016; and 36% in 2017). ENL most often occurs during the first year of multi-drug therapy (MDT) administration followed by after the release from treatment (RFT) with the latest onset occurring 4 years after RFT. The majority of patients experienced chronic and recurrent reactions with the longest reactions lasting up to 4.5 years (55 months). Conclusion:Knowledge about the onset, duration, and recurrences of ENL are essential, and strict supervision for routine control shall be encouraged to increase the patients’ compliance so as to increase their quality of life.

2017 ◽  
Vol 88 (4) ◽  
pp. 488-498 ◽  
Author(s):  
Bob Bowers ◽  
C. Ruth Butlin ◽  
Khorshed Alam ◽  
Diana N.J. Lockwood ◽  
Stephen L. Walker

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min-hao Wu ◽  
Ling-fei Xiao ◽  
Fei-fei Yan ◽  
Shi-Liang Chen ◽  
Chong Zhang ◽  
...  

Abstract Objective The present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors. Methods This single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system. Results Of the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing. Conclusion In our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.


BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
B. M. Traore ◽  
S. El Fakir ◽  
H. Charaka ◽  
N. Benaicha ◽  
A. Najdi ◽  
...  

2021 ◽  
Vol 9 (1) ◽  
pp. 30
Author(s):  
Sri Linuwih Susetyo Wardhani Menaldi ◽  
Valensia Vivian The ◽  
Inosensia Diajeng Kusumo ◽  
Melani Marissa

Abstrak Kusta dapat menyebabkan disabilitas permanen yang memengaruhi fisik dan psikis pasien. Stigmadiri dan stigma sosial menyebabkan pasien mengalami dehabilitasi yang dapat menurunkan kualitashidup penyandangnya. Penelitian ini merupakan studi pendahuluan yang bertujuan untuk mendapatkanprofil dehabilitasi pasien kusta termasuk orang yang pernah mengalami kusta (OYPMK). Penelitian inimenggunakan metode potong lintang untuk menilai profil dehabilitasi pasien kusta dan OYPMK menggunakanskala dehabilitasi Anandaraj di RS Kusta Alverno Singkawang, bulan Juli 2019. Delapan puluh delapan subjekdiikutkan dalam penelitian ini. Analisis data dilakukan menggunakan uji Mann Whitney untuk menilai hubungantipe kusta dan derajat dehabilitasi, serta uji Kruskal Wallis untuk melihat hubungan antara reaksi kusta danderajat disabilitas terhadap skala dehabilitasi. Analisis dilakukan menggunakan perangkat lunak SPSS formac. Subjek terbanyak adalah laki-laki, usia produktif, bekerja sebagai petani, berpenghasilan kurang dari 1,5juta per bulan, tidak bersekolah, sudah menikah, etnis Tionghoa, tinggal di dalam rumah yang padat, memilikikeluarga serumah yang menderita kusta, terdiagnosis kusta tipe multibasiler, pernah mengalami reaksi dantelah menyelesaikan pengobatan. Dari penelitian ini didapatkan bahwa tipe kusta dan disabilitas derajat noldan dua berhubungan dengan skala dehabilitasi Anandaraj (p<0.05). Stigma terhadap kusta hingga kinimerupakan masalah yang belum dapat diatasi. Stigma dan disabilitas akibat kusta berperan penting terhadapkejadian dehabilitasi yang menyebabkan penurunan kualitas hidup pasien kusta dan OYPMK. Kata kunci: Anandaraj, dehabilitasi, kusta, Singkawang.   Dehabilitation Profile of Leprosy Patients in Alverno Singkawang Hospital: a Preliminary Study Abstract Leprosy causes permanent disability that affects both physical and psychological aspect of the patient.Self-stigma and social stigma cause dehabilitation; therefore, reducing the quality of life of the patients. Thisresearch is a preliminary study to assess the dehabilitation profile of leprosy patients, including people whohave had leprosy (OYPMK). A cross-sectional method was used to assess the dehabilitation scale of leprosypatients in Alverno Leprosy Hospital, Singkawang, using the Anandaraj dehabilitation scale. Eighty-eightsubjects were included in the analysis. Mann-Whitney test was done to analyze the association betweentype of leprosy and dehabilitation scale, and Kruskal Wallis test was done to analyze the association betweenleprosy reaction and grade of disability with dehabilitation scale. Most subjects are male, productive age,farmers, less than 1.5 million wages per month, uneducated, married, Chinese ethnicity, living in a crowdedhouse, had a family with leprosy, diagnosed with multibacillary leprosy, had an episode of leprosy reaction danreleased from treatment. Type of leprosy and WHO disability grade 0 and 2 are related to the dehabilitationscale. Leprosy stigmatization is still a worrisome problem. Together with the disability, stigmatization affectsthe dehabilitation scale of leprosy patients leading to reduced quality of life. Keywords: Anandaraj, dehabilitation, leprosy, Singkawang.


2019 ◽  
Vol 77 (1) ◽  
pp. 67-72
Author(s):  
R. Bouceiro-Mendes ◽  
A. Ortins-Pina ◽  
T. Marques ◽  
M. Viveiros ◽  
D. Machado ◽  
...  

Leprosy is a chronic granulomatous disease with a long incubation period caused by Mycobacterium leprae that mainly affects the skin, mucous membranes and the peripheral nervous system. It carries the risk of per-manent sequels with a significant impact on the patient’s quality of life. It has a considerable clinically diver-sity and possible atypical presentations. We present a case of a 31-year-old, skin phototype V woman with multibacillary leprosy characterized by multiple outbreaks of erythema nodosum leprosum, as an inaugural manifestation of the disease. The disease was acquired within a group of children and adolescents from an endemic region of Africa, evolved untreated for 3 years, and presented with unusual features and remarkable lymphatic involvement. We highlight the importance of building and maintaining collaboration between expert centers and institutional partnerships in order to provide the adequate diagnostic resources and appropriate care to the affected populations.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1217.2-1217
Author(s):  
I. Hernandez ◽  
L. Abasolo ◽  
B. Fernandez ◽  
A. Madrid García ◽  
J. Font ◽  
...  

Background:Uveitis are characterized by inflammation of the middle layer of the eye wall. In developed countries uveitis are the second major treatable cause of blindness in those 20–65 years of age. Additionally, more than 50% of the subjects affected with these conditions will develop complications related to the uveitis, and more than 30% will suffer visual impairment. As a result, these conditions are associated with an important burden. The assessment of the patient’s quality of life (QoL) through standardized and validated questionnaires allows us to evaluate objectively the burden of the disease. Several studies have shown that the QoL of uveitis patients is reduced when compared with that of general population. Moreover, several socio-demographic and clinical related characteristics have been associated with impaired QoL. However, no longitudinal analysis of the vision-related (VR) QoL in clinical practice has been carried out.Objectives:To describe VR-QoL in non-infectious uveitis (NIU) patients during a follow-up period of two years. Furthermore, to analyse the influence of socio-demographic, clinical and treatment factors on the progression of VR-QoL.Methods:Longitudinal prospective study which includes patients examined in a multidisciplinary tertiary uveitis clinic, with a diagnosis of NIU. In each of these patients a yearly determination of VR-QoL was carried out following the VFQ-25 questionnaire, finally including all those who had completed at least an initial questionnaire and a second one after two years of follow-up. Analysis of risk factors at baseline in repeated VFQ-25 measurements was carried out by generalized estimating equations (GEE) models. Variables related to demographic, clinical and treatment factors with a determination of p-value <0.15 were included in multivariable models, which were then compared using theQuasi Akaike Information Criteria(qAIC). A local Ethics Committee approved the execution of this project.Results:128 patients were included, 117 of which also had an evaluation after the first year of follow-up. 55.5% were female with a median age of 34 years at the start of symptoms and of 37 years at the moment of attending our clinic for the first time. First evaluation of VR-QoL was determined a median (p25-p75) of 6.1 (1.8-13.1) years after that first visit. The most frequent locations of NIU were anterior (41.1%), panuveitis (27.4%), posterior (16.1%) and intermediate (15.3%). At our first evaluation, 27.3% of patients were receiving treatment with topical steroids, 22.3% oral, 49.2% immunosuppressant drugs (both synthetic and/or biological) and 19.05% biological therapies. The median (p25-p75) VFG25 determinations at baseline, first and second years of follow-up were 0.87 (0.78-0.93), 0.88 (0.80-0.93) y 0.89 (0.81-0.94), with no significant differences (first year vs. Baseline p = 0.54; 2 years vs. Baseline p = 0.61).In the GEE multivariable models the presence at baseline of permanent incapacity due to NIU, concomitant thyroid disease, worse visual acuity, unilateral pattern, cataracts, retinal vasculitis, epiretinal membrane and use of azathioprine were independently associated with a worse VR-QoL (Table 1).Table 1.Risk factors related to VR-QoL in patients with NIUVariablesCoef. (IC 95%)p-valueVisual acuity23.6 (12.3 - 34.8)<0.01Permanent incapacity-24.8 (-33.7 - -15.9)<0.01Unilateral NIU-2.9 (-5.7 - -0.006)0.05Cataracts-5.2 (-10 - -0.3)0.037Vasculitis-13.3 (-23.4 - -3.1)0.011Epiretinal membrane-6.8 (-12.7 - -0.8)0.026Azathioprine-7.5 (-14.7 - -0.3)0.041Conclusion:During these two years of follow-up, no significant changes have taken place regarding VR-QoL in patients with NIU assessed at a tertiary centre. Other than visual acuity at baseline, certain ocular manifestations and clinical comorbidities have also been shown to have an independent effect on the VR-QoL of these patients.Disclosure of Interests:None declared


2020 ◽  
Vol 33 (2) ◽  
pp. 237-244
Author(s):  
Asad M. Lak ◽  
Amina Rahimi ◽  
Abdullah M. Abunimer ◽  
Ian Tafel ◽  
Sharmila Devi ◽  
...  

OBJECTIVEMetastatic spinal cord compression (MSCC) imposes significant impairment on patient quality of life and often requires immediate surgical intervention. In this study the authors sought to estimate the impact of surgical intervention on patient quality of life in the form of mean quality-adjusted life years (QALY) gained and identify factors associated with positive outcomes.METHODSThe authors performed a retrospective chart review and collected data for patients who had neurological symptoms resulting from radiologically and histologically confirmed MSCC and were treated with surgical decompression during the last 12 years.RESULTSA total of 151 patients were included in this study (mean age 60.4 years, 57.6% males). The 5 most common metastatic tumor types were lung, multiple myeloma, renal, breast, and prostate cancer. The majority of patients had radioresistant tumors (82.7%) and had an active primary site at presentation (67.5%). The median time from tumor diagnosis to cord compression was 12 months and the median time from identification of cord compression to death was 4 months. Preoperative presenting symptoms included motor weakness (70.8%), pain (70.1%), sensory disturbances (47.6%), and bowel or bladder disturbance (31.1%). The median estimated blood loss was 500 mL and the average length of hospital stay was 10.3 days. About 18% of patients had postoperative complications and the mean follow-up was 7 months. The mean pre- and postoperative ECOG (Eastern Cooperative Oncology Group) performance status grades were 3.2 and 2.4, respectively. At follow-up, 58.3% of patients had improved status, 31.5% had no improvement, and 10.0% had worsening of functional status. The mean QALY gained per year in the entire cohort was 0.55. The mean QALY gained in the first 6 months was 0.1 and in the first year was 0.4. For patients who lived 1–2, 2–3, 3–4, or 4–5 years, the mean QALY gained were 0.8, 1.4, 1.7, and 2.3, respectively. Preoperative motor weakness, bowel dysfunction, bladder dysfunction, and ASA (American Society of Anesthesiologists) class were identified as independent predictors inversely associated with good outcome.CONCLUSIONSThe mean QALY gained from surgical decompression in the first 6 months and first year equals 1.2 months and 5 months of life in perfect health, respectively. These findings suggest that surgery might also be beneficial to patients with life expectancy < 6 months.


2019 ◽  
Vol 90 (1) ◽  
pp. 68-77
Author(s):  
Diana Neves ◽  
Anna Maria Sales ◽  
José Augusto Da Costa Nery ◽  
Ximena Illarramendi ◽  
Rogério Valls De Souza ◽  
...  

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