leprosy

麻风病
  • 文章类型: Journal Article
    背景:汉森病,或者麻风病,在人类历史上长期存在,我们的研究独特地深入研究了希腊这种情况的最后幸存者之一的个人的经历。在1930年代初期,来自Spinalonga的汉森病患者,在克里特岛的一个与世隔绝的地方,被转移到雅典的一家医疗机构。此事件代表了该疾病的管理和治疗的重大历史变化。斯皮纳隆加关闭后,出现了疗养院,演变成希腊唯一的汉森疾病中心和当今患者的避难所,强调与疾病相关的持久耻辱和遗弃。
    方法:我们的研究,通过六次非结构化时间表的采访进行,为这些人提供了分享个人见解的独特机会,提供他们的解释和经验的深刻理解。
    结果:通过解释性现象学分析,我们发掘了四个上级主题:诊断的关键性质,疾病对身体的明显影响,与麻风病相关的耻辱及其对个体的影响,以及“家”作为一个安慰和接受的地方的意义。
    结论:这些主题共同描绘了参与者所经历的深刻的情感创伤,揭示了历史压力源的持久影响,禁闭做法,以及以贬值的身份生活的挑战,塑造他们深刻的自我意识。
    BACKGROUND: Hansen\'s disease, or leprosy, has a long-standing presence in human history, and our study uniquely delves into the experiences of individuals who are among the last survivors of this condition in Greece. During the early 1930s, patients with Hansen\'s disease from Spinalonga, an isolated location in Crete, were moved to a medical facility in Athens. This event represents a significant historical change in the management and treatment of the disease. Following Spinalonga\'s closure, a Sanatorium emerged, evolving into Greece\'s sole Hansen\'s disease center and the present-day refuge for patients, underscoring the enduring stigma and abandonment associated with the disease.
    METHODS: Our study, conducted through six interviews with unstructured schedules, provides a unique opportunity for these individuals to share personal insights, offering a profound understanding of their interpretations and experiences.
    RESULTS: Through interpretative phenomenological analysis, we unearthed four superordinate themes: the pivotal nature of the diagnosis, the visible impact of the disease on the body, the stigma associated with leprosy and its effects on individuals, and the significance of \'home\' as a place of solace and acceptance.
    CONCLUSIONS: These themes collectively depict the deep emotional trauma experienced by the participants, shedding light on the enduring impact of historical stressors, confinement practices, and the challenges of living with a devalued identity, shaping their profound sense of self.
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  • 文章类型: Case Reports
    汉森氏病(麻风病)是一种罕见的传染病,在美国每年记录的病例少于300例。在这份报告中,我们介绍了一位80岁的白人男性,有三年的缓慢进步史,粉色,界限分明,和环形斑块,斑块,丘疹从他的大腿开始扩散到他的腹部,胸部,回来,和上肢。在活检的序列鉴定证实了麻风病的诊断后,患者接受了每月莫西沙星的替代方案治疗,rifabutin,还有米诺环素.经过一个月的治疗,患者报告皮疹减少。本报告重点介绍了美国东南部的一例多杆菌麻风病。这是一项非常有趣的研究,因为该患者的治疗选择很复杂,他最终接受了另一种治疗方案。该病例还突出了美国该地区麻风病发病率的上升,并强调了监测指示该诊断的警告信号以促进该疾病的早期治疗和减弱的重要性。
    Hansen\'s disease (leprosy) is a rare infectious disease with less than 300 recorded cases in the United States every year. In this report, we present an 80-year-old White male with a three-year history of slowly progressive, pink, well-demarcated, and annular patches, plaques, and papules that started on his thighs and spread to his abdomen, chest, back, and upper extremities. After sequence identification on biopsies confirmed the diagnosis of leprosy, the patient was treated with an alternative regimen of monthly moxifloxacin, rifabutin, and minocycline. After a month of treatment, the patient reported a reduction in his rash. This report highlights a case of multibacillary leprosy in the southeastern United States. It is a very interesting study as the selection of this patient\'s treatment was complex, and he ultimately received an alternative therapeutic regimen. This case also highlights the rising incidence of leprosy in this region of the United States and stresses the importance of monitoring for warning signs indicative of this diagnosis to facilitate early treatment and attenuation of this disease.
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  • 文章类型: Case Reports
    背景:严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染在中国首次被发现,并已被宣布为全球大流行。还报道了由于SARS-CoV-2感染引起的几种严重的肺外表现,并与高凝性血栓性血管病变有关。此外,已知麻风分枝杆菌感染病例与凝血异常有关。方法:这里,我们报告了一名56岁的男性,患有冠状病毒病-19(COVID-19),伴有麻风病感染,表现为龟头阴茎坏死,出现急性阴茎疼痛的急诊科。这种情况是独特的,因为在射线照相成像中未观察到流向阴茎的闭塞血流。我们通过文献综述描述了这种情况下的潜在病理生理学。结果:患者根据COVID-19方案接受治疗,并给予低分子量肝素(LMWH)治疗4天。在后续行动中,阴茎的临床和功能状况显着改善。结论:微血栓受累,SARS-CoV-2和麻风病合并感染导致的血小板异常和止血受损是该病例报告中的假设。
    UNASSIGNED: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality.
    UNASSIGNED: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review.
    UNASSIGNED: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 days. During the follow up, the clinical and functional condition of the penis showed significant improvement.
    UNASSIGNED: Microthrombus involvement, platelet abnormalities and impaired hemostasis due to SARS-CoV-2 and leprosy co-infection are the hypothesis in this case report.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    (1)背景:麻风病的全球负担并没有平均分配;大多数病例是在巴西诊断的,印度,和印度尼西亚。了解在高流行和低流行地区使用的主动病例检测(ACD)方法对于未来筛查计划的发展至关重要。(2)方法:系统检索三个数据库,PubMed,Embase和WebofScience,是针对英语论文进行的,自2000年以来发表,其中讨论了使用主动病例检测方法进行麻风病筛查。本文利用综合筛选作用模型(I-SAM)作为分析这些方法的工具。(3)结果:来自11个不同国家的23篇论文。论文确定了6种不同的主动案例检测方法:家庭接触/社会接触识别;上门案例检测;筛查问卷分发;快速村庄调查;基于学校的筛查;和基于监狱的筛查。15个位于高流行区,其中8个位于低流行区。(4)结论:选择合适的主动病例查找方法,必须考虑麻风病的流行。这些发现有助于制定政策,从而可以设计更成功的未来麻风病病例检测计划,最终减轻全球疾病负担,实现世界卫生组织的零麻风病目标。
    (1) Background: The global burden of leprosy is not shared equally; with the majority of cases being diagnosed in Brazil, India, and Indonesia. Understanding the methods of active case detection (ACD) used in high and low endemic regions is vital for the development of future screening programs. (2) Methods: A systematic search of three databases, PubMed, Embase and Web of Science, was conducted for English language papers, published since the year 2000, which discussed the use of active case detection methods for leprosy screening. The paper utilised the Integrated Screening Action Model (I-SAM) as a tool for the analysis of these methods. (3) Results: 23 papers were identified from 11 different countries. The papers identified 6 different methods of active case detection: Household contact/social contact identification; door-to-door case detection; screening questionnaire distribution; rapid village surveys; school-based screening; and prison-based screening. 15 were located in high endemic regions and 8 of these were located in low endemic regions. (4) Conclusions: For selecting the appropriate methods of active case finding, the leprosy endemicity must be taken into consideration. The findings contribute to policy decision making allowing for more successful future leprosy case detection programs to be designed, ultimately reducing the global burden of the disease, and achieving the WHO\'s aim of zero leprosy.
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  • 文章类型: Journal Article
    目的:分析戈亚州麻风病的流行病学风险趋势,巴西,以及它的健康宏观区域,2010年至2021年。
    方法:这是Goiás的复合麻风病流行病学风险指数的时间序列分析。我们使用了在应通报健康状况信息系统上保存的案例,分别计算指标和风险,归类为高,中等,低和非常低。使用Prais-Winsten线性回归分析趋势,并生成风险图。
    结果:Goiás在2019年至2021年期间表现出高度麻风病流行(24.8例/100,000居民)和中等流行病学风险(0.58)。发现了一个平稳的趋势(年度百分比变化,0.50;95%置信区间,-3.04;4.16)在整个Goiás及其中西部和中东南宏观地区的麻风病风险。
    结论:需要采取行动降低麻风病的流行病学风险,尤其是在它的趋势稳定的地方,这包括新病例的早期筛查和健康教育。
    结果:戈亚州的麻风病持续存在,巴西,以特有的形式,具有异质性分布。麻风病流行风险较高的市镇数量有所减少,但挑战包括主动传播和晚期诊断。
    长期预防策略,早期发现,需要对麻风病人及其接触者进行治疗和监测。
    结论:在戈亚州,加强针对麻风病的卫生政策至关重要,优先为在整个领土工作的卫生专业人员提供继续教育和培训计划。
    OBJECTIVE: To analyze trends in epidemiological risk of leprosy in Goiás state, Brazil, and its health macro-regions, between 2010 and 2021.
    METHODS: This is a time series analysis of the composite leprosy epidemiological risk index in Goiás. We used cases held on the Notifiable Health Conditions Information System for calculating indicators separately and risk, classified as high, medium, low and very low. Trends were analyzed using Prais-Winsten linear regression and risk maps were produced.
    RESULTS: Goiás showed high leprosy endemicity (24.8 cases/100,000 inhabitants) and medium epidemiological risk between 2019 and 2021 (0.58). A stationary trend was found (annual percentage change, 0.50; 95% confidence interval, -3.04; 4.16) for risk of leprosy in Goiás as a whole and in its Central-West and Central-Southeast macro-regions.
    CONCLUSIONS: There is need for actions to reduce the epidemiological risk of leprosy, especially where its trend is stationary, this includes early screening for new cases and health education.
    RESULTS: Leprosy persists in Goiás state, Brazil, in an endemic form, with heterogeneous distribution. There has been a reduction in the number of municipalities with high epidemiological risk of leprosy, but challenges include active transmission and late diagnosis.
    UNASSIGNED: Long-term strategies for prevention, early detection, treatment and monitoring of people with leprosy and their contacts are needed.
    CONCLUSIONS: It is crucial to strengthen health policies targeting leprosy in Goiás state, prioritizing continuing education and training programs for health professionals working in the entire territory.
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  • 文章类型: Journal Article
    麻风病,也被称为汉森病,是由麻风分枝杆菌引起的空气传播疾病(M.麻风)通常表现为皮肤损伤,周围神经病变,和眼部受累。该报告描述了一名患者,该患者在完成结核性麻风病的抗菌治疗四年后,因慢性鼻泪管阻塞而出现泪溢。在鼻内镜泪囊鼻腔吻合术(DCR)时,泪囊显示慢性泪囊炎伴肉芽肿性炎症和Fite阳性染色细菌杆状结构。手术标本的病理学检查显示,在血管周围和神经分布中存在许多非坏死性肉芽肿,与先前治疗的麻风分枝杆菌感染的后遗症相容。患者在手术后6个月保持无症状。
    Leprosy, also known as Hansen disease, is an airborne spread disease caused by Mycobacterium leprae (M. leprae) which commonly presents with skin lesions, peripheral neuropathy, and ocular involvement. This report describes a patient who presented with epiphora secondary to chronic nasolacrimal duct obstruction four years after completing antimicrobial treatment for tuberculoid leprosy. At the time of endoscopic dacryocystorhinostomy (DCR), the lacrimal sac demonstrated chronic dacryocystitis with granulomatous inflammation and a Fite positive staining bacterial rod-like structure. Pathological examination of the surgical specimen demonstrated numerous non-necrotizing granulomas in a perivascular and neural distribution, compatible with sequelae of previously treated M. leprae infection. The patient has remained symptom free six months after surgery.
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  • 文章类型: Journal Article
    麻风病仍然主要在中低收入国家发现。打破麻风病传播链需要各种方式,特别是通过健康教育增加麻风病预防知识。尽管有几项研究提到了健康教育的有效性,关于使用的最佳方法仍然存在不确定性。因此,本综述研究符合系统评价和荟萃分析(PRISMA)2020版首选报告项目。搜索涉及PubMed的相关文献,ScienceDirect,ERIC,科克伦,和ProQuest数据库,用于2000年至2023年期间发表的研究,纳入标准包括增加知识,改变态度和行为,增加正面的污名。研究的质量是使用关键评估技能计划进行评估的,以及使用CochraneRoB工具的偏差风险。对数据库的总体搜索共得到184,681篇文章。只有六项研究有资格纳入本综述。在符合条件的研究中使用了各种教育方法,包括MHMobile,关于麻风病游戏的神话或真相,海报,小叶,社区会议,远程教育网络,讨论列表,聊天,活动日记,图像3D视频,关于视频流的课程,视频会议,案例模拟,讲座,和接触干预(教育,证词(直接接触),视频,和漫画)。所有使用的方法都有可能提高知识,态度,并实践并减少对麻风病的负面污名。在预防麻风病方面,没有比其他方法更好的健康教育方法。
    Leprosy is still found mainly in lower-middle-income countries. Breaking the chain of leprosy transmission requires various ways, especially by increasing knowledge of leprosy prevention through health education. Although several studies have mentioned the effectiveness of health education, there is still uncertainty about the best method to use. Therefore, the review question should be answered: what forms of health education have been developed about Leprosy in the community? This review study complies with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) version 2020. The search for relevant literature involved PubMed, ScienceDirect, ERIC, Cochrane, and ProQuest databases for the studies published in the 2000 to 2023 period with the inclusion criteria such as increasing knowledge, changing attitudes and behavior, and increasing positive stigma. The quality of the study was assessed using the Critical Appraisal Skills Program, and the Risk of Bias using the Cochrane RoB tool. Overall search on databases resulted in a total of 184,681 articles. Only six studies were eligible to be included in this review. Various educational methods were used in the eligible studies, including MH Mobile, the myth or truth on Leprosy game, posters, leaflets, community meetings, tele-education the web, discussion lists, chats, activity diaries, iconographic 3D videos, classes on video streaming, video conference, case simulation, lecture, and the contact intervention (education, testimonies (direct contact), videos, and comics). All of the methods used had the potential to improve knowledge, attitude, and practice and reduce negative stigma regarding Leprosy. There is no method of health education superior to another on Leprosy prevention.
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  • 文章类型: Journal Article
    背景:喀拉拉邦通过对远端社会决定因素采取行动,在健康方面取得了成就,但是像部落这样的某些社区被推回了社会发展和健康成就的潮流。随后,部落的生活方式和恶劣的生活条件使他们更容易患上多种疾病,包括皮肤病。然而,很少评估包括喀拉拉邦在内的几个地区的部落人口的负担和状况。
    方法:对症状缺乏认识,并发症,和管理选择作为社会落后的一部分,导致某些疾病如麻风病集中在部落社区。此外,部落人口受到具有公共卫生意义的传染病的威胁,例如利什曼病(CL)。由于无知,部落人口忽视了皮肤损伤或使用当地的补救措施。部落可能一直在使用许多当地补救措施来解决他们的问题,但是,新出现的皮肤病可能不适合当地的补救措施,并且经常引起重大的公共卫生问题。在这些难以到达的地形中发展和维持有效运作的卫生系统也是一项挑战。居住在环境敏感地区的部落中的皮肤病模式是需要更多社会,经济和地理空间包容。部落人口的皮肤病变应通过综合健康信息平台(IHIP)进行积极的监测活动,如果有聚集,应采取警惕的公共卫生对策。应开发一个专门的循证系统,利用当地资源和社区一级的工作人员,诊断和治疗远离专家护理的部落人民的皮肤病。
    结论:部落中猖獗的皮肤病是其不可接受的社会经济地位和生活条件的产物。只有通过关注健康的社会决定因素的干预措施才能改善。改善部落的生活条件是可持续的长期解决方案,但是这种解决方案应该与中期和短期战略相结合。
    BACKGROUND: Kerala has a history of achievements in health through acting on the distal social determinants, but certain communities like tribals were pushed back from the stream of social development and health achievements. Subsequently, the lifestyle and the poor living conditions of tribes make them more prone to several diseases including skin diseases. However, neither the burden nor the situation of the same in the tribal population in several parts including Kerala is seldom assessed.
    METHODS: The lack of awareness about the symptoms, complications, and management options as a part of the social backwardness has led to the concentration of certain diseases like Leprosy among the tribal community. In addition, the tribal population is under the threat of infectious diseases of public health significance like Leishmaniasis (CL). The tribal population owing to ignorance neglects the skin lesions or uses their local remedies. Tribes might have been using many local remedies for their issues, but the emerging skin diseases may not be amenable to local remedies and often impose significant public health concerns. Developing and maintaining an effectively functioning health system in these difficult-to-reach terrains is also a challenge. The pattern of skin diseases among tribals residing in environmentally sensitive localities is an indicator for the need for more social, economic and geospatial inclusion. Skin lesions of the tribal population should be kept under active surveillance activities through the integrated health information platform (IHIP) and it should follow a vigilant public health response if there are clusterings. A dedicated evidence-based system should be developed to diagnose and treat skin diseases of tribal people residing away from the availability of specialist care using local resources and community-level workers.
    CONCLUSIONS: The rampant skin diseases among tribals are the product of their unacceptable socio-economic status and living conditions. It could only improve through interventions focusing on social determinants of health. Improvements in the living conditions of tribals are sustainable long-term solutions, but such solutions should be coupled with medium-term and short-term strategies.
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  • 文章类型: Journal Article
    麻风病是一种传染病,仍然是公共卫生问题。它是由耐酸的麻风芽孢杆菌引起的,主要影响皮肤和周围神经,可能导致长期残疾和耻辱。然而,当前和以前的努力集中在开发更好的麻风病诊断和治疗干预措施,它的预防需要解决。在这次审查中,我们组织目前发表的论文,并提供有关全球流行病学的最新信息,诊断,治疗,和预防麻风病。几个在线数据库,包括MEDLINE(国家医学图书馆,贝塞斯达,MD),PubMed,EMBASE,WebofScience,和谷歌学者,进行了搜索,以收集相关的已发表论文。作为一个公共卫生问题,世界卫生组织设定了消除麻风病的目标,每10,000人的患病率<1例,这一目标在2000年实现,到2010年在大多数国家实现,主要是由于从1980年开始使用药物治疗麻风病,以及自1995年以来患者免费获得治疗。尽管诊断和治疗技术有所改善,麻风病的新发生仍然是全球严重的疾病负担.随着麻风病诊断和治疗技术的不断进步,获得更多相关的医疗保健知识和预防麻风病残疾至关重要。
    Leprosy is an infectious disease that remains a public health concern. It is caused by acid-fast Bacillus leprae, which primarily affects the skin and peripheral nerves, potentially leading to long-term disability and stigma. However, current and previous efforts have focused on developing better diagnostic and therapeutic interventions for leprosy, and its prevention needs to be addressed. In this review, we organize the currently published papers and provide updates on the global epidemiology, diagnosis, treatment, and prevention of leprosy. Several online databases, including MEDLINE (National Library of Medicine, Bethesda, MD), PubMed, EMBASE, Web of Science, and Google Scholar, were searched to collect relevant published papers. As a public health issue, the World Health Organization set the goal of leprosy elimination with a prevalence of <1 case per 10,000 people, which was achieved in 2000 and in most countries by 2010, mainly owing to the treatment of leprosy using drugs starting in 1980 and no-cost access for patients since 1995. Although diagnostic and therapeutic techniques have improved, the new occurrence of leprosy remains a critical global disease burden. With continuous technological improvements in diagnosing and treating leprosy, obtaining more relevant healthcare knowledge and preventing leprosy disability are crucial.
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