BACKGROUND: Leprosy or Hansen's disease is a chronic infectious disease with worldwide distribution. Although it is a curable disease, it remains as a public health problem, with Brazil being the second most endemic country in the world. The skin lesions and neural damage, which lead to physical disabilities, affect the patients' self-esteem, cause a decrease in quality of life and interfere in the patients' lives. OBJECTIVE: Identify the profile of the patients affected by leprosy seen at the Outpatient Clinic of Dermatology of Hospital Evangélico de Curitiba and characterize the levels of quality of life of the sample in the week prior to the survey by means of the Dermatology Life Quality Index questionnaire. METHOD: Application of the Dermatology Life Quality Index to 22 patients diagnosed with leprosy in the period from May to October 2009. RESULTS: Among the 22 patients who participated in the study, 55% were male and 45% were female, with a mean age of 50.2 years. The scores obtained with the Dermatology Life Quality Index ranged from 1 to 25 points, with a mean of 10.23. Most of the patients (50%) had scores in the range severe or very severe; 31.8% of the patients obtained scores in the range mild or moderate, and 18.2% of the patients reported that there was no impairment of their quality of life. CONCLUSION: The profile of the patients affected by leprosy in this study were men, with a mean age of 50 years and presenting the multibacillary form of the disease. The application of the Dermatology Life Quality Index questionnaire allowed us to verify that the score severe or very severe for quality of life was predominant in the sample, with higher impact on women and no significant difference concerning pauci or multibacillary leprosy. Keywords: Dermatology; Indicators of quality of life; Leprosy Resumo: FUNDAMENTOS: A hanseníase é uma enfermidade infecto-contagiosa, com distribuição mundial. Apesar de curável, permanece como um problema de saúde pública, sendo o Brasil o segundo país mais endêmico do mundo. As lesões cutâneas e o acometimento neural, que levam às principais incapacidades físicas, pioram a autoestima dos doentes, levam a uma queda da qualidade de vida e interferem na vida dos mesmos. OBJETIVO: Traçar um perfil dos pacientes acometidos pela hanseníase, atendidos no Ambulatório de Dermatologia do Hospital Evangélico de Curitiba, e caracterizar os níveis de qualidade de vida da amostra na semana prévia à pesquisa, por meio do questionário Dermatology Life Quality Index. MÉTODO: Aplicação do Dermatology Life Quality Index em 22 pacientes diagnosticados com hanseníase no período de maio a outubro de 2009. RESULTADOS: Em meio aos 22 pacientes que participaram do estudo, encontraram-se 55% do sexo masculino e 45% do sexo feminino, com idade média de 50,2 anos. Os escores obtidos na aplicação do Dermatology Life Quality Index variaram de 1 a 25 pontos, sendo a média 10,23. A maioria dos pacientes (50%) apresentou escore na dimensão do grave ou muito grave; 31,8% dos pacientes, do leve...
Introdução: A classe dos imunobiológicos, compostos por anti interleucina e anti TNF, são opção terapêutica aos pacientes com psoríase moderada a grave. Objetivo: Analisar dados de pacientes com psoríase moderada a grave em uso de medicamentos imunobiológicos. Método: Estudo transversal observacional de pacientes em uso de imunobiológicos acompanhados em ambulatório de psoríase. Todos apresentaram falha ou possuíam contraindicação ao uso de metotrexato, acitretin, fototerapia e/ou ciclosporina. Resultados: Foram analisados dados de 68 pacientes. O ustequinumabe foi o imunobiológico mais utilizado e a média de tempo de utilização foi de 51,3 meses. Do total, realizaram de um a três tratamentos com imunobiológicos prévios. A causa mais comum de troca foi perda de eficácia. Conclusão: É necessário atentar-se para as doenças oportunistas que podem acometer pacientes em uso de terapia com anti TNF-α, sendo que a principal delas é a tuberculose. Há necessidade da criação de diretriz e vigilância ativa nos pacientes em uso desse imunobiológicos
Pyoderma gangrenosum (PG) is a rare, ulcerative, and painful neutrophilic dermatosis of unknown cause associated with systemic diseases and/or pathergy phenomenon in 30% of cases. We report the case of a breast cancer patient submitted to oncoplastic conservative surgery followed by adjuvant radiotherapy, with long-term progression to PG. It’s rare and challeng ing nature reinforces the need for early diagnosis to increase treatment effectiveness and reduce morbidity.
BackgroundInfliximab is a monoclonal antibody approved for the treatment of inflammatory diseases. The best approach in adjusting the dose of infliximab because of the high interindividual variability in serum concentrations is with a Bayesian approach.PurposeOur aim was to estimate the precision and accuracy of five pharmacokinetic models (PopPKmodel) in patients with inflammatory bowel disease.Material and methodsAn observational retrospective study was designed. Patients with ulcerative colitis or Crohn’s disease treated with infliximab during 2014 were included. Trough blood samples for determining infliximab were drawn. Five PopPKmodels were implemented in NONMEM: PopPK in ulcerative colitis and Crohn’s disease. The Infliximab concentrations were estimated from five models at the sample times, through the empirical Bayesian of estimates (EBEs) of the pharmacokinetic parameters. To validate these models, bias of estimated concentrations were calculated as the mean residual predictive error (MRPE) and the precision was calculated as the root mean square predictive error (RMSPE) in our population.ResultsTwo hundred and seventy-three serum infliximab concentrations from 160 patients (54% males and 46% females) were included. The mean age was 36 years (CI 95%: 31 to 41), weight 73.1 kg (CI 95%: 71.1 to 75.2) and 3.92 mg/dL (CI 95%: 3.86 to 3.98) baseline serum albumin concentration. 62.5% of patients were diagnosed with Crohn’s disease and 36.3% for ulcerative colitis. The mean trough serum concentration of infliximab was 4.1 mg/L (CI 95%: 3.6 to 4.6). 68.1% of patients were treated with infliximab and 31.9% with biosimilar. Bias of estimated concentrations (MRPE) and precision (RMSPE):Abstract 4CPS-165 Table 1 Accuracy (mean, CI 95% ) Precision (mean, CI 95% ) Model 1 36.8 (92–18.3) 468 (65–1001) Model 2 54. 1 (142.5–34.2) 752 (137–1642) Model 3 442 (1213–328) 6558 (1345–14462) Model 4 17 (51–15) 285 (66–637) Model 5 73 (197–50) 1054 (197–2305) ConclusionIn our study, neither PopPKmodels overestimate infliximab concentrations in the population, although Model 4 was better, (i.e. closer to zero) in terms of bias and accuracy.Reference and/or Acknowledgements1. Fasanmade, et al. 2009: Model 1;2. Fasanmade, et al. 2011: Model 2; Buurman y col, 2015: Model 3; Dotan y col, 2014: Model 4 and Brandse y col, 2017: Model 5.No conflict of interest
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