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Id: 27307 Autor: Li, Huan-Ying; Hu, Lu-Fang; Huang, Wan-Biao; Liu, Guo-Cai; Yuan, Lian-Chao; Jin, Zheng; Li, Xiong; Li, Jin-Lan; Yang, Zhong-Min. Título: Risk of relapse in leprosy after fixed-duration multidrug therapy. Fonte: Int. J. Lepr;65(2):238-245, Jun. 1997. tab, mapas. Resumo: Between 1986 and 1995, 8307 leprosy patients have completed fixed-duration multidrug therapy (FD-MDT) and were followed annually for possible relapse. The mean relapse rate for multibacillary (MB) leprosy is 0.15/1000 person-years (py) and for paucibacillary (PB) 0.55/1000 py. There is no difference in the relapse rates between patients with or without chemotherapy before FD-MDT. In MB patients, the five relapses occurred between 4 and 7 years; in PB patients, five relapses occurred at 4-5 years after FD-MDT. Six additional PB relapses self-reported 1-4 years after the 5-year surveillance period and were not included in the relapse rates. Most PB patients relapsed into MB due to wrong classification and insufficient therapy. For the known 62 irregular MB patients the cumulative relapse rate is 6.5%. (AU)^ien. Descritores: Hanseníase/quimioter Hanseníase/epidemiol Hanseníase/prev Quimioterapia Combinada Limites: Humanos Localização: BR191.1

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Id: 27306 Autor: Li, Huan-Ying; Hu, Lu-Fang; Wu, Pei-Wei; Luo, Jiu-Si; Liu, Xue-Ming. Título: Fixed-duration multidrug therapy in multibacillary leprosy. Fonte: Int. J. Lepr;65(2):230-237, Jun. 1997. tab, mapas. Resumo: Six-hundred-fifty-seven active multibacillary (MB) leprosy patients were put on fixed-duration multidrug therapy (FD-MDT) between 1985 and 1992 (190 had had no and 235 had had previous treatment with dapsone) and were followed for 5 years after therapy. Two relapses occurred during year 5 of surveillance and both had received dapsone prior to chemotherapy, giving an overall relapse rate of 0.08/100 person-years (py). Excluding the two relapses, 99.4% of the MB patients converted to smear negativity at year 6 after a regular course of FD-MDT. The relapse rate for 35 MB patients with an initial bacterial index (BI) of > 4 with 5 years of surveillance was 0.24/100 py. Reactions occurred more frequently during the first 6 months of MDT, decreasing gradually thereafter, and reaching 0 in year 4 of surveillance. The deformity rate at intake was 22.7% and only 1.8% of MB patients developed new deformities or an increased grade in deformity during therapy. (AU)^ien. Descritores: Hanseníase/quimioter Hanseníase/epidemiol Hanseníase/prev Quimioterapia Combinada Limites: Humanos Masculino Feminino Localização: BR191.1

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Id: 27304 Autor: Saunderson, Paul R; Haile-Mariam, Negussie. Título: Monitoring steroid use in a field program; possible process indicators. Fonte: Int. J. Lepr;65(2):217-223, Jun. 1997. tab. Resumo: Two new indicators are proposed in order to make the task of monitoring certain prevention of disability (POD) activities more straightforward. The indicators are very similar to the case detection rates and the cohort analyses already used in both leprosy and tuberculosis (TB) control; this makes them very simple to put into practice. Despite their simplicity, it is argued that these indicators can give important information about the implementation of POD activities in a routine field program and could, therefore, help in improving the quality of those services to patients. The indicators are the steroid start rate (SSR) and the steroid completion rate (SCR). A number of possible confounding factors have been looked at and they are not negligible. However, the case detection rates for new cases of leprosy and treatment completion rates for multidrug therapy (MDT) are subject to similar biases, which are well recognized and which have not detracted from the usefulness of these indicators in evaluating leprosy control activities. The POD indicators, if used with an awareness of the possible biases involved, can help to improve the quality of certain POD activities. (AU)^ien. Descritores: Hanseníase/compl Hanseníase/quimioter Hanseníase/prev Quimioterapia Combinada Limites: Humanos Masculino Feminino Localização: BR191.1

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Id: 27076 Autor: Rada, Elsa; Aranzazu, Nacarid; Ulrich, Mariah; Convit, Jacinto. Título: Serologic response to mycobacterial proteins in Hansen's patients during multidrug treatment. Fonte: Int. J. Lepr;67(4):414-421, Dec., 1999. tab, graf. Resumo: Humoral immune responses were studied in 24 leprosy patients treated with multidrug therapy (MDT) and 16 contacts. The patients were monitored for 2 to 3 years with repeated determination of IgG antibody levels directed to different mycobacterial proteins (Mycobacterium tuberculosis, Mt70; M. bovis, Mb65; M. leprae, Ml36, 28, 18, 10 kDa, and the complete protein M. leprae extract, MLSA). All recombinant antigens were used at 5 micrograms/ml concentration and the complete soluble M. leprae extract at 2 micrograms/ml. The results shown in this study reveal a clear decline in IgG antibodies directed toward mycobacterial proteins in the 12 multibacillary (MB) patients when they were submitted to MDT. Initially we found strong reactivity toward complete cytosolic protein and M. leprae membrane protein. The most reactive recombinant proteins in MB patients were Ml10, Ml36, Mt70 kDa and, finally, Ml18 kDa when compared to the paucibacillary (PB) group. After treatment was completed all lepromatous and borderline lepromatous patients showed low or undetectable levels as compared with their initial values before starting treatment. (AU)^ien. Descritores: Hanseníase/quimioter Hanseníase/imunol Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/1999/pdf/v67n4/v67n4a07.pdf - en. Localização: BR191.1

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Id: 27042 Autor: Manimozhi, P. Vijayakumaran N; Jesudasan, Kumar. Título: Incidence of Late Lepra Reaction Among Multibacillary L eprosy Patients After MDT. Fonte: Int. J. Lepr;63(1):18-23, 1995. ^btab, ^bgraf. Resumo: Resumo: Multidrug therapy (MDT) recommended by the World Health Organization (WHO) had been administered in 1982 to a cohort of multibacillary (MB) leprosy patients. Treatment was administered for a minimum period of 2 years or until skin-smear negativity for acid-fast bacilli was achieved (whichever was later). Among 980 MB leprosy patients who completed treatment, 11 patients (1.1%) experienced lepra reactions during surveillance. Probable predictive factors are discussed. The incidence of lepra reaction seemed to be three times more common in borderline (BL) leprosy than in lepromatous (LL) leprosy. The majority of these events occurred during the first 3 years of surveillance. All of these episodes were treated with steroids without antileprosy chemotherapy. None of these patients was confirmed as experiencing a relapse during the subsequent period of surveillance. Descritores: Hanseníase/imunol Hanseníase/fisiopatol Quimioterapia Combinada Limites: Humanos Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/1995/pdf/v63n1/v63n1a03.pdf - en. Localização: BR191.1

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Id: 26852 Autor: Shaw, Isaac Neeraj; Natrajan, Mani Mozhi; Rao, Geetha Sunder; Jesudasan, Kumar; Christian, Melville; Kavitha, Masilamani. Título: Long-term follow up of multibacillary leprosy patients with high Bl treated with WHO/MDT regimen for a fixed duration of two years. Fonte: Int. J. Lepr;68(4):405-409, Dec., 2000. tab, graf. Resumo: Forty-six, newly detected, previously untreated multibacillary (MB) patients with a bacterial index (BI) of > or = 3+ who had received WHO/MDT for 2 years were followed up for a total duration of 424 person-years and a mean duration of 9.26 +/- 2.98 years per patient. The BIs of the patients continued to fall, and all of the patients, except one, reached skin-smear negativity. WHO/MDT was well accepted and well tolerated. Relapse, which was defined as an increase in the BI of 1+ or more with or without clinical evidence of activity, was observed in only one patient, giving a relapse rate of 2.2% or 0.23 per 100 person-years in patients with a BI of > or = 3+ after long-term follow up. This patient was started on a second course of WHO/MDT to which he responded favorably. WHO/MDT for a fixed duration of 2 years for MB patients as recommended by the WHO is vindicated. (AU)^ien. Descritores: Hanseníase/quimioter Hanseníase/terap Quimioterapia Combinada Limites: Humanos Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/2000/pdf/v68n4/v68n4a01.pdf - en. Localização: BR191.1

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Id: 26833 Autor: Shaw, Issac N; Ebenezer, Gigi; Rao, Geetha S; Natrajan, Mani Mozhi; Balasundaram, Babu. Título: Relapse as histoid leprosy after receiving multidrug therapy (MDT); a report of three cases. Fonte: Int. J. Lepr;68(3):272-276, Sept., 2000. ilus, tab. Resumo: The histoid type of leprosy has been described as occurring in lepromatous leprosy patients who relapse after many years of apparently successful dapsone monotherapy. Three patients who had received the World Health Organization-recommended regimens of multidrug therapy (WHO/MDT) relapsed as histoid leprosy 12-15 years after completion of treatment. In one patient, through mouse foot pad studies, the bacilli were found to be sensitive to rifampin and clofazimine and resistant to dapsone. In the other two patients mouse foot pad studies were inconclusive. The patients were re-started on WHO/MDT. Two patients took regular treatment and improved, both clinically and bacteriologically. One patient was irregular in treatment, and 1 year after re-starting WHO/MDT nodules were still present although the bacterial index had fallen slightly. (AU)^ien. Descritores: Hanseníase/quimioter Hanseníase/fisiopatol Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/2000/pdf/v68n3/v68n3a04.pdf - en. Localização: BR191.1

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Id: 26742 Autor: Lechat, Michel F. Título: Acceptance of WHO/MDT over the last 20 years. Fonte: Int. J. Lepr;69(3):241-246, Sept., 2001. . Descritores: Hanseníase/quimioter Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/2001/pdf/v69n3/v69n3edt.pdf - en. Localização: BR191.1

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Id: 26622 Autor: Kaur, Inderjeet; Dogra, Sunil; Kumar, Bhushan; Radotra, B. D. Título: Combined 12-month WHO/MDT MB regimen and Mycobacterium w. vaccine in multibacillary leprosy: a follow-up of 136 patients. Fonte: Int. J. Lepr;70(3):174-181, Sept., 2002. tab. Resumo: A total of 136 patients with BI > or = 2 having been followed up for at least 2 years or more were included in the analyses. Seventy-seven out of 136 patients had completed three years follow up. All patients were given WHO/MDT MB regimen for 12 months and additionally 4 doses of Mycobacterium w. vaccine at 3-month intervals. The age of the patients varied from 6 to 77 years (mean 34 +/- 11.3 years) and they had the disease varying from 3 months to 7 years (mean = 1.9 +/- 1.4 years). The mean of the BI before starting treatment was 3.6 +/- 1.3. At the end of 2 years follow-up, a total of 54 patients out of the 136 (39.7%) had become smear-negative. A larger proportion of patients, 39/46 (84.8%) with BI of < or = 3 had become smear-negative, whereas, only 10/32 (31.3%) patients with BI between 3.1 to 4 and 5/58 (8.6%) highly bacillated patients having initial BI > 4 had become smear-negative at the end of 2 years. Out of the 77 patients who were available for follow up at 3 years, 30/33 (90.9%) patients with BI of < or = 3, 15/20 (75%) patients with BI between 3.1 to 4 and 13/24 (54.2%) patients having initial BI > 4, respectively, had attained smear negativity. Reactions occurred more frequently after 6 months of therapy and over a period of time their frequency gradually decreased, however, they continued to occur even two years after RFT. During the course of MDT and thereafter in follow up 4.6% and 1.3% of the patients developed new deformities or an increase in the existing grade of deformities, respectively. Three relapses (2 in LL and 1 in BL) occurred in patients having initial BI of > 4. One patient relapsed in the second year and the other two relapsed in the third year of follow up and were successfully treated with reintroduction of the same MDT MB regimen. Local ulceration healing with scar formation and regional lymphadenopathy were the only local reactions to the vaccine seen in 47/136 (34.5%) patients. All the patients showed histopathological improvement in the form of a gradual reduction of granuloma fraction. Although the results of this limited period follow up are satisfactory, a long-term follow-up in larger number of patients will settle the issue of safety and efficacy of shortened MDT MB regimen and the place of immunotherapy with M. w. vaccine in multibacillary patients.(AU)^ien. Descritores: Hanseníase/quimioter Mycobacterium leprae/imunol Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/intjlepr/2002/pdf/v70n3/v70n3a02.pdf - en. Localização: BR191.1

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Id: 25873 Autor: Faria, J. Lopes de. Título: Revisão dos estudos experimentais sôbre a reação à lepromina relacionados com a natureza desta reação / Review of experimental studies on the reaction to lepromin related to the nature of this reaction Fonte: Rev. bras. Leprol;22(2):145-156, jun. 1954. . Resumo: O autor faz uma análise crítica dos trabalhos experimentais realizados nas duas últimas décadas, que contribuiram para o conhecimento da natureza e o mecanismo da reação de Mitsuda. Ao mesmo tempo assinala os pontos obscuros que precisam ser investigados. Analisa os trabalhos sôbre os seguintes aspectos: substâncias responsáveis pela reação de Mitsuda, histopatologia, histopatologia comparada, natureza e mecanismo desta reação. Os estudos realizados no cão permitiram-no concluir que neste animal a reação é divida à resistência natural e causada pela fração lip¡dica da lepromina. No estado atual dos conhecimentos não é poss¡vel dizer se a reação de Mitsuda, apresentada pelo leproso tuberculóide é divida à resitência natural, ou à resitência adquirida, quer específica, quer inespec¡ficamente. Admite que, na maioria dos casos de lepra tuberculóide, a resitência não depende da infecção leprosa e existia antes desta. (AU)^ipt. Descritores: Hanseníase/quimioter Hanseníase/imunol Hanseníase/fisiopatol Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/brasleprol/1954/PDF/v22n2/v22n2a04.pdf - pt. Localização: BR191.1

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Id: 25852 Autor: Paldrock, A. Título: Tratamento específico da lepra: um caso de cura / Specific treatment of leprosy: a case of cure Fonte: Rev. Lepr. São Paulo;2(2):113-116, 1935. ^bilus. Descritores: Hanseníase/quimioter Hanseníase/fisiopatol Hanseníase/reabil Hanseníase/terap Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/leprolsp/1935/PDF/v2n2/v2n2a05.pdf - pt. Localização: Br191.1

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Id: 25851 Autor: Anon. Título: A curabilidade da lepra / The curability of leprosy Fonte: Rev. Lepr. São Paulo;2(2):107-112, 1935. ^btab. Descritores: Hanseníase/fisiopatol Hanseníase/reabil Hanseníase/terap Quimioterapia Combinada Meio Eletrônico: http://hansen.bvs.ilsl.br/textoc/revistas/leprolsp/1935/PDF/v2n2/v2n2a04.pdf - pt. Localização: Br191.1

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Id: 25730 Autor: Anon Título: Regime MDT uniforme para todos os pacientes da hanseniase: protocolo rascunho Uniform MDT regimen for all leprosy patients: protocol draft- Fonte: s.l; s.n; s.d. 34 p. tab. Descritores: Hanseníase/fisiopatol Hanseníase/terap Quimioterapia Combinada Limites: Humanos Masculino Feminino Localização: BR191.1; 01140/d.a

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Id: 25728 Autor: Anon Título: Esquema uniforme de PQT para todos os casos de hanseniase: esboco do protocolo Schedule of uniform MDT for all cases of leprosy: the draft protocol- Fonte: s.l; s.n; 2002. 43 p. tab. Descritores: Hanseníase Dimorfa/quimioter Hanseníase Dimorfa/terap Hanseníase Virchowiana/quimioter Hanseníase Virchowiana/terap Hanseníase Tuberculóide/quimioter Hanseníase Tuberculóide/terap Hanseníase/quimioter Hanseníase/terap Quimioterapia Combinada Limites: Humanos Masculino Feminino Localização: BR191.1; 01138/d.a

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Id: 25718 Autor: Brasil. Ministerio da Saude; *.Secretaria de Politicas de Saude; *.Departamento de Atencao Basica; *.Area Tecnica de Dermatologia Sanitaria*. Título: Relatorio da II Reuniao da Alianca Global para a Eliminacao da Hanseniase Report of the Second Meeting of the Global Alliance for Elimination of Leprosy- Fonte: Brasilia; s.n; jan. 2002. [86] p. . Conferência: Apresentado em: Report of the international leprosy association technical forum, Paris, Feb. 25-28, 2002. Descritores: HANSENIASE/clas HANSENIASE/diag HANSENIASE/reabil HANSENIASE/compl HANSENIASE/epidemiol HANSENIASE/prev QUIMIOTERAPIA COMBINADA SAUDE PÚBLICA/clas SAUDE PÚBLICA/instrum SAUDE PÚBLICA/tend Localização: BR191.1; 01134/d.a

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Id: 25453 Autor: Consigny, Sophie; Bentoucha, Abdelhalim; Bonnafous, Pascale; Grosset, Jacques; Ji, Baohong Título: Bactericidal activities of HMR 3647, moxifloxacin, and rifapentine against Mycobacterium leprae in mice ..- Fonte: s.l; s.n; 2000. 3 p. tab. Resumo: Bactericidal activities of HMR 3647 (HMR), moxifloxacin (MXFX), and rifapentine (RPT) against Mycobacterium leprae, measured by the proportional bactericidal technique in the mouse footpad system, were compared with those of the established antileprosy drugs clarithromycin (CLARI), ofloxacin (OFLO), and rifampin (RMP. Administered in five daily doses of 100 mg/kg of body weight, HMR appeared slightly more bactericidal than CLARI. In a single dose, MXFX at 150 mg/kg was more active than the same dose of OFLO and displayed exactly the same level of activity as RMP at 10 mg/kg; the combination MXFX-minocycline (MINO) (MM) was more bactericidal than the combination OFLO-MINO (OM); RPT at 10mg/kg was more bactericidal than the same dose of RMP and even more active than the combination RMP-OFLO-MINO (ROM); the combination RPT-MXFX-MINO (PMM) killed 99.9% of viable M. leprae and was slighthy more bactericidal than RPT alone, indicating that the combination PMM showed an additive effect against M. leprae (AU). Descritores: HANSENIASE/quimioter HANSENOSTATICOS/admin HANSENOSTATICOS/farmacol HANSENOSTATICOS/farmacocin HANSENOSTATICOS/uso terap MYCOBACTERIUM LEPRAE TESTES DE SENSIBILIDADE MICROBIANA/métodos DROGAS EM INVESTIGACAO/admin DROGAS EM INVESTIGACAO/anal DROGAS EM INVESTIGACAO/uso terap - BACTERICIDAS  QUIMIOTERAPIA COMBINADA  MYCOBACTERIUM LEPRAE/metab  MYCOBACTERIUM LEPRAE/fisiol  DAPSONA/uso terap  RIFAMPINA/uso terap  CLOFAZIMINA/uso terap  OFLOXACINO/uso terap  MINOCICLINA/uso terap  CLARITROMICINA/uso terap Limites: ESTUDO COMPARATIVO Localização: BR191.1; 09311/s

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Id: 25435 Autor: Adrade, Vera Lucia Gomes de. Título: Letter to editor. Fonte: Hansen. int;31(2):47-48, 2006. tab, graf. Descritores: HANSENIASE/quimioter HANSENIASE/reabil HANSENIASE/terap QUIMIOTERAPIA COMBINADA Limites: ESTUDO COMPARATIVO Meio Eletrônico: - http://www.ilsl.br/revista/index.php/hi/article/viewFile/81/225. Localização: BR191.1

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Id: 25434 Autor: Andrade, Vera Lucia Gomes de. Título: Carta ao editor / Letter to the publisher Fonte: Hansen. int;31(2):45-46, 2006. tab, graf. Descritores: HANSENIASE/quimioter HANSENIASE/reabil HANSENIASE/terap QUIMIOTERAPIA COMBINADA Limites: ESTUDO COMPARATIVO Meio Eletrônico: - http://www.ilsl.br/revista/index.php/hi/article/viewFile/80/224. Localização: BR191.1

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Id: 25431 Autor: Barreto, Jaison Antonio; Goya, Flavio; Miranda, Rubem Mateus C. Título: Hanseniase dimorfa reativada: recidiva ou tratamento insuficiente em paciente imunologicamente suscetivel? / Reactivated borderline leprosy: relapse or insufficient tretment in immunological susceptible patient? Fonte: Hansen. int;31(2):35-38, 2006. ilus. Resumo: Um homem de 31 anos de idade procurou o serviço de saúde especializado devido a alterações de sensibilidade em braço esquerdo. O exame clínico deu suporte a esta queixa. Os esfregaços obtidos a partir da linfa colhida nesta área não desmontraram bacilos álcool-ácido-resistentes (BAAR). A reação de Mitsuda foi negativa e uma biópsia do local não mostrou bacilos ou reação inflamatória. Mesmo assim optou-se pelo diagnóstico de hanseníase indeterminada, e foi instituída a poliquimioterapia para paucibacilar. Nove anos após, o paciente retorna apresentando várias lesões de padrão dimorfo, com quadro histopatológico característico e baciloscopia do esfregaço e da biópsia positiva. Os autores consideram que este indivíduo já era um multibacilar por ocasião do primeiro diagnóstico em 1997 e o tratamento insuficiente não conseguiu destruir todos os bacilos. Nesta situação, os bacilos remanescentes poderiam ter proliferado lenta e progressivamente, reproduzindo o longo período de incubação próprio dos indivíduos Mitsuda negativos. Discutem-se as limitações do diagnóstico exclusivamente clínico e baseado no número de lesões específicas.(AU). Descritores: HANSENIASE DIMORFA/imunol HANSENIASE DIMORFA/patol GRANULOMA/imunol GRANULOMA/microbiol GRANULOMA/patol QUIMIOTERAPIA COMBINADA Limites: ESTUDO COMPARATIVO HUMANO ADULTO Meio Eletrônico: - http://www.ilsl.br/revista/index.php/hi/article/viewFile/72/52. Localização: BR191.1

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Id: 25396 Autor: Andrade, Vera. Título: Implementação da PQT/OMS no Brasil / Implementation of multidrug therapy against leprosy in Brazil Fonte: Hansen. int;31(1):[37-60], 2006. tab, graf. Descritores: QUIMIOTERAPIA COMBINADA HANSENIASE/quimioter HANSENIASE/imunol HANSENIASE/reabil HANSENIASE/terap Limites: ESTUDO COMPARATIVO Meio Eletrônico: - http://www.ilsl.br/revista/index.php/hi/article/viewFile/16/222. Localização: BR191.1

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