Hansenologia internationalis最新文献

Seventeen patients, presenting Hansen's disease, were studied by the Tendon-test. Nine presented pathological answers and 4 did not answer at all, probably due to serious damage. So the amount of pathological answers reached to 76.5% (13 patients). On the other hand, the answer of two patients was considered within the limits and they were classified with the normal answering patients that reached to 23.5% (4 patients). In order to find out if the tibial nerves are also injured simultaneously wit the ulnar and the median ones, it is advisable to employ this method in a larger number of patients and in a different social-geographical environment.

The in vitro phagocytic capacity of human macrophages facing M. leprae was analysed in a selected sample of healthy and hanseniasis patients (Virchowian and tuberculoid) individuals. Families where at least one of the spouses presented Hansen's disease were selected and 176 white people were studied. The analysis of the macrophages' behavior was performed by reading the slides in the 5th, 10th, 15th, 20th and 30th days after inoculation of M. leprae. The classification is discussed. The results showed a high variability. The main conclusions reached are: (a) people differ in their capacity to lyse M. leprae, as measured by their macrophages' behavior in vitro; (b) the results obtained give support to Beiguelman's theory of the lysis threshold.

The lysogenic capacity of human macrophages facing M. leprae in vitro may be dependent on an important genetic component. Although the family aggregation of the trait is demonstrated, this is a necessary but not sufficient condition to prove genetic influence. The data do not fit some simple genetic models (autosomal dominant or incompletely dominant gene; dominant or recessive sex-linked gene). The results obtained are consistent with the hypothesis that the macrophages' lysogenic capacity is mainly due to a major gene with variable expressivity. This hypothesis may be too simple to account for the whole variability detected and therefore must be considered just as a working hypothesis.

The importance of sanitary education in the prophylaxis of Hansen's disease is emphasized and the educational programs concerning Hansen's disease developed only to physicians, other professionals in the medical area, patients and contacts is suggested since the people in general are not interested in these sorts of campaign. It is also stressed that the patients that are adequately informed may become efficient collaborators in the discovery of new cases and in the prophylaxis of this disease.

Resulting from the the research that has been performed in the Health Center of Campos--RJ, Sanitary Dermatology Service, a total of 854 cases of Hansen's disease were analysed in its principal clinical and epidemiological aspects, in the period from August 1937 until December 1980.

A detailed study on the histopathology of Mitsuda's reaction was made in 100 adult non-contact hanseniasis patients inoculated with lepromin A (armadillo). It was found that the histological structure of Mitsuda's reaction with lepromin A does not differ from the one observed with lepromin H. There is also no difference between the histological picture observed in healthy non-contacts and the one found in tuberculoid patients and in contact healthy persons. Mitsuda's reaction in non-contact hanseniasis patients presented variations of histological degree--Classes O (-) I (+/-) II (+) III (++) IV ( )--from no inflammatory reaction and positive bacilli, until formation of a complete tuberculoid granuloma and absence of bacilli. In 97% of the cases reaction was positive. Class III, i.e., represented by incomplete tuberculoid granuloma formed by epithelioid cells with follicular arrangement and lymphocytic halo, predominated in the series (42%). The findings of this research state, once again, that an efficient result of the Mitsuda's reaction depends fundamentally of the histological examination, since in only 16 cases the clinical reading coincided with histopathology. Disaccordance found on the remaining 84 cases was attributed to the secondary alterations (necrosis and suppuration) associated to the histological structure of the Mitsuda reaction follows the Jadassohn-Lewandowsky law and are in accordance with the morphological concept and classification of polar granulomas proposed by Michalany & Michalany.

An epidemiological study of hanseniasis carried on in the State of Paraíba, Brazil, after the establishment of a program of health and sanitation is presented. It is based on reports and statistical data gathered by the regional health centers during 1981.

Some references of the history of Mitsuda reaction and its antigen, as well as for the results and significance of this unique reaction are presented. In spite of the great advances of modern immunology. Mitsuda reaction is still the best method for the diagnosis of the forms of hanseniasis and for the prognosis of the disease in patients and in healthy persons.