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INTRODUCTION: In leprosy, immune system mediators that regulate the infectious process act in a complex manner and can lead to several clinical outcomes. To understand the behavior of these mediators we quantified the expression of annexin-A1 (ANXA1) in the peripheral blood and plasma as well as tissue leukocytes in all clinical forms of leprosy and compared with healthy controls. METHODS: Seventy healthy controls and 70 patients with leprosy, tuberculoid (TT) (n = 13), borderline tuberculoid (BT) (n = 15), borderline borderline (BB) (n = 13), borderline lepromatous (BL) (n = 15), and lepromatous leprosy (LL) (n = 14), were selected. Phenotyping of the lymphocyte cells and the intracellular expression of ANXA1 in leukocytes was performed by immunofluorescence. Plasma protein levels were determined by enzyme-linked immunosorbent assay. RESULTS: Histiocytes and CD4+ and CD8+ T cells in the skin of BL and LL patients had higher ANXA1 expression. ANXA1 expression was also high in circulating polymorphonuclear, monocytes, and CD4+ and CD8+ T cells in the blood of LL patients compared to those of TT, BT, BB, and BL patients, and these levels were similar to those in healthy controls. Plasma ANXA1 levels indicate an increase in paracrine release in patients with LL. CONCLUSIONS: The data indicate that ANXA1 expression is enhanced in the leukocytes and plasma of patients with LL, and may contribute to the inhibition of leukocyte action, leading to inadequate functioning of the immune system and thus contributing to the spread of M. leprae infection.

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Abstract INTRODUCTION In leprosy, immune system mediators that regulate the infectious process act in a complex manner and can lead to several clinical outcomes. To understand the behavior of these mediators we quantified the expression of annexin-A1 (ANXA1) in the peripheral blood and plasma as well as tissue leukocytes in all clinical forms of leprosy and compared with healthy controls. METHODS Seventy healthy controls and 70 patients with leprosy, tuberculoid (TT) (n = 13), borderline tuberculoid (BT) (n = 15), borderline borderline (BB) (n = 13), borderline lepromatous (BL) (n = 15), and lepromatous leprosy (LL) (n = 14), were selected. Phenotyping of the lymphocyte cells and the intracellular expression of ANXA1 in leukocytes was performed by immunofluorescence. Plasma protein levels were determined by enzyme-linked immunosorbent assay. RESULTS Histiocytes and CD4+ and CD8+ T cells in the skin of BL and LL patients had higher ANXA1 expression. ANXA1 expression was also high in circulating polymorphonuclear, monocytes, and CD4+ and CD8+ T cells in the blood of LL patients compared to those of TT, BT, BB, and BL patients, and these levels were similar to those in healthy controls. Plasma ANXA1 levels indicate an increase in paracrine release in patients with LL. CONCLUSIONS The data indicate that ANXA1 expression is enhanced in the leukocytes and plasma of patients with LL, and may contribute to the inhibition of leukocyte action, leading to inadequate functioning of the immune system and thus contributing to the spread of M. leprae infection.

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INTRODUCTION:: Currently, there are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy. The aim of this study was to analyze the clinical characteristics of patients with leprosy and investigate their immunological profile, comparing this with the type of lesion and the presence or absence of a Bacillus Calmette-Guérin (BCG) vaccination scar. METHODS:: Statistical analyzes were performed by employing comparative tests (Pearson´s chi-square) to evaluate the variables in different clinical forms, considering significance at the 5% level. RESULTS:: The study identified a predominance of lepromatous leprosy (26.9%) in patients aged between 34-53 years. Caucasians predominantly had borderline tuberculoid (BT) clinical forms (42%); a predominance of males with borderline lepromatous (19%) and lepromatous leprosy (26.9%) forms was observed; and the presence of BCG vaccination scars (27.5%) and lower limb nerves were more affected (38%) predominantly in the BT clinical form. Significant differences were identified, which included hypochromic lesions predominantly in the BT clinical form (24%); diffuse-type lesions predominantly in the tuberculoid (TT) clinical form (28%); ill-defined lesion border dominance in lepromatous leprosy (LL) clinical forms (30%); an irregular lesion limit predominantly in LL clinical forms (32%); and a predominant Th1 immune response in the BT clinical form (41.7%). CONCLUSIONS:: The evaluation of the immunological profile in leprosy patients may contribute to the more detailed diagnosis and possibly better characterization of the prognosis for these individuals.

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Abstract INTRODUCTION: Currently, there are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy. The aim of this study was to analyze the clinical characteristics of patients with leprosy and investigate their immunological profile, comparing this with the type of lesion and the presence or absence of a Bacillus Calmette-Guérin (BCG) vaccination scar. METHODS: Statistical analyzes were performed by employing comparative tests (Pearson´s chi-square) to evaluate the variables in different clinical forms, considering significance at the 5% level. RESULTS: The study identified a predominance of lepromatous leprosy (26.9%) in patients aged between 34-53 years. Caucasians predominantly had borderline tuberculoid (BT) clinical forms (42%); a predominance of males with borderline lepromatous (19%) and lepromatous leprosy (26.9%) forms was observed; and the presence of BCG vaccination scars (27.5%) and lower limb nerves were more affected (38%) predominantly in the BT clinical form. Significant differences were identified, which included hypochromic lesions predominantly in the BT clinical form (24%); diffuse-type lesions predominantly in the tuberculoid (TT) clinical form (28%); ill-defined lesion border dominance in lepromatous leprosy (LL) clinical forms (30%); an irregular lesion limit predominantly in LL clinical forms (32%); and a predominant Th1 immune response in the BT clinical form (41.7%). CONCLUSIONS: The evaluation of the immunological profile in leprosy patients may contribute to the more detailed diagnosis and possibly better characterization of the prognosis for these individuals.

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Esta pesquisa teve como objetivo identificar as características profissionais dos gerentes que atuam nas Unidades de Saúde da Família. É um estudo descritivo, quantitativo, realizado com 7 gerentes. A técnica para a coleta foi a entrevista estruturada. Os resultados apontam que o critério para a escolha do cargo de gerente é através de indicação política e os gerentes não possuem qualificação na área de gerenciamento, apresentam-se como líderes democráticos e fazem uso das ferramentas de administração. Observa-se que os gerentes não apresentam características adequadas ao cargo que ocupam...

This research aimed to identify the characteristics of professional managers working in Family Health Units. It is a descriptive, quantitative, conducted with 7 managers. The technique for collection was the structured interview. The results show that the criterion for choosing the position of manager is through political appointment and managers have no qualifications in management, present themselves as democratic leaders and make use of management tools. It is observed that managers do not exhibit characteristics suitable for the position they occupy...

Esta investigación tuvo como objetivo identificar las características de los gestores profesionales que trabajan en Centros de Salud Familiar. Es un estudio descriptivo, cuantitativo, realizado con 7 gestores. La técnica de recolección fue la entrevista estructurada. Los resultados muestran que el criterio para elegir el cargo de gerente es a través de nombramiento político y los gerentes no tienen las cualificaciones en la gestión, se presentan como los líderes democráticos y hacer uso de herramientas de gestión. Se observa que los gerentes no presentan características adecuadas para el puesto que ocupan...(AU)

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Os autores revisam o estudo radiologico do ombro traumatizado, salientando a utilidade das incidencias antero-posterior e perfil verdadeiro. Preconizam o uso rotineiro destas incidencias no Hospital de Pronto Socorro

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Revisam-se os conceitos básicos da síndrome compartimental, dando ênfase para a necessidade do diagnóstico precoce. Ressalta-se a importância da medida da pressäo tissular e descreve-se o método proposto por Thomas Whitesides que pela sua simplicidade e baixo custo do material empregado pode ser praticado em qualquer hospital. Exemplifica-se com o relato de um caso

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Foram revisados os prontuários de todos os pacientes baixados no Hospital de Pronto Socorro de Porto Alegre, por fratura supra-condiliana do úmero nos anos de 1981, 1982 e 1983, totalizando 100 pacientes. Inicialmente foi feito um estudo estatístico registrando-se, entre outros dados, o tipo de deslocamento da fratura, o método de tratamento utilizado e as condiçöes de alta. Destes pacientes, 46 foram revisados em março de 1985. Consignou-se no cotovelo fraturado uma parte média de 10- da flexäo, 6- da extensäo e 11- de valgismo. O dado mais surpreendente foi que 19 destes pacientes, ou seja, 41%, tiveram que se submeter a nova intervençäo após a alta do H. P. S. O trabalho conclui que as prováveis causas destes resultados desfavoráveis sejam a falta de continuidade no tratamento, a ausência de variantes na conduta, terapêutica, a falta de pessoal técnico e deficiência de material

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