Diss. (sammanfattning) Stockholm : Karol. inst., 1999. / Härtill 6 uppsatser.

Thesis (Ph. D.) -- University of Adelaide, Dept. of Anatomy, 1959. / [Typewritten].

[Typewritten]

No description available.

MMed (Dermatology), Faculty of Health Sciences, University of the Witwatersrand / Introduction: Cutaneous tuberculosis (TB) accounts for about 2 - 3% of all cases of tuberculosis. It is as a result of direct infection of the skin or immune responses to antigenic components of Mycobacterium tuberculosis, known as tuberculids. In sub-Saharan Africa around 70% of patients with tuberculosis are co - infected with the human immunodeficiency virus (HIV). The prevalence of HIV in South Africa is approximately 11.4%. There are no studies in South Africa on the manifestations of cutaneous tuberculosis in the setting of HIV infection. Aims: The objectives of this study were to determine the clinical and histopathological spectrum of cutaneous tuberculosis in the Johannesburg area and to assess the correlation of HIV infection and CD4 count, on the clinical and pathological presentation. Patients and Methods: This was a prospective, hospital-based study conducted over a period of 3 ½ years from Oct 2004 - March 2008. A total of 74 patients diagnosed with cutaneous tuberculosis who were seen during the above mentioned period were enrolled for the study. Patients were enrolled from the three academic hospitals, Johannesburg, Chris Hani Baragwanath and Helen Joseph. Inclusion criteria included patients aged 10 years and older diagnosed with cutaneous tuberculosis. Patients from whom consent could not be obtained and those with lesions caused by non-tuberculous mycobacteria were excluded from the study. v The diagnosis was based on clinical and histopathological features as well as supportive diagnostic tests. Data was captured onto Epi-Info spreadsheet and then analyzed using STATA data software. Results: The entire clinical spectrum of lesions of cutaneous TB was seen with the exception of the nodular and phlebetic tuberculids. Erythema induratum, a tuberculid was the most common form of cutaneous TB accounting for more than a third (36.5%) of all cases. Scrofuloderma was the most common true infection accounting for about 29.7% of all cases. HIV-TB co-infection rate was 61.4%. The histology ranged from a granulomatous inflammation with absence of bacilli to a diffuse inflammation with abundance of bacilli. Conclusions: Despite the high prevalence of TB and high TB-HIV co-infection rate, cutaneous tuberculosis infection is still relatively uncommon. There is a however a relative increase in the frequency of true infections particularly scrofuloderma in comparison with the studies done previously here in South Africa. The association between HIV positive status and true infections was statistically significant with p = 0.024 and was not found to be statistically significant between HIV positive status and tuberculids with p = 0.71.

nÃo hà / A leishmaniose à um grupo de doenÃas com um extenso espectro, cosmopolita, porÃm com ampla e significativa incidÃncia na zona tropical. A leishmaniose apresenta-se sob duas formas, uma visceral envolvendo estruturas do sistema hemolinfopoiÃtico; outra com envolvimento cutÃneo e/ou mucoso, amiÃde, sem visceralizaÃÃo. Esta Ãltima, conhecida como leishmaniose tegumentar (LT), alvo deste estudo, tem como um dos grandes problemas o tratamento, realizado mediante formulaÃÃes injetÃveis com risco de complicaÃÃes no local da aplicaÃÃo e o risco de danos Ãs funÃÃes hepÃtica e renal, alÃm de alteraÃÃes cardÃacas. VÃrios ensaios mostram resultados satisfatÃrios utilizando o FluconazolÂ. Visando a consolidar os resultados descritos na literatura, este estudo procurou demonstrar a eficÃcia terapÃutica do Fluconazol em altas doses no tratamento da LT, em pacientes de uma Ãrea endÃmica no Sul do Estado do CearÃ, Brasil, MunicÃpio de Barbalha. Realizou-se um estudo prospectivo, randomizado, com dois grupos de pacientes. Sessenta do Grupo I fizeram uso de 300mg ou 450mg de Fluconazol durante seis semanas. Sessenta do Grupo II fizeram uso de Glucantime com 20mg/kg/dia, durante 20 dias consecutivos. O diagnÃstico de LT foi realizado com Imprint, cultura, biopsia com histopatolÃgico corado pelo Giemsa e Imuno-histoquÃmica, e a IntradermorreaÃÃo de Montenegro. Todos os pacientes foram avaliados clinicamente e acompanhados durante atà 90 dias. As variÃveis contÃnuas foram avaliadas pelo Test t de Student; para a correlaÃÃo de variÃveis, utilizou-se o Coeficiente de CorrelaÃÃo de Pearson (r). O tempo de cura de cada grupo teve sua avaliaÃÃo realizada pelo mÃtodo de Kaplan-Meier. Em todos os testes de hipÃtese o &#945; foi considerado significante quando menor do que 5% (p < 0,05). A eficÃcia terapÃutica (ET) foi calculada com base na reduÃÃo do risco relativo. A populaÃÃo estudada era predominantemente constituÃda de indivÃduos com faixa etÃria entre 30 e 40 anos de idade, cor de pele parda, rurÃcolas agricultores, com discreta prevalÃncia do sexo feminino. Os resultados mostraram uma eficÃcia terapÃutica de 38,7%. A cura teve relaÃÃo com o tamanho da lesÃo, dados estatatiscamente representativos p< 0,0001. LesÃes com tamanho inferior a 30 mm (isolada ou somatÃrio de vÃrias lesÃes), responderam prontamente ao FluconazolÂ.

In young healthy adults, characteristic obstacle avoidance reflexes (stumble corrective) were elicited with electrical stimulation during walking that were dependent on the anatomical location of cutaneous afferents stimulated (sole versus dorsum of the foot). We previously demonstrated an age-related erosion of these stumble corrective responses when the perturbation was applied to the dorsum of the foot. However, it is unknown whether similar age-related reflex erosion is present with stimulation to the sole of the foot. The purpose of this study was to identify age-dependent differences in stumbling reactions to electrically evoked stimulation of the tibial nerve at the ankle during walking in healthy young (19-39) and older adult (70 years and older) groups. Electromyograms (EMG) of the tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG), biceps femoris (BF) and vastus lateralis (VL) were recorded along with gait kinematics including angular displacement and velocity at the ankle and knee joint as well as toe clearance relative to the walking surface. The main finding of this study was the significant erosion of the kinematic and EMG stumbling reactions seen in the older adults compared to the young. Specifically, during mid-swing phase, there was reduced peak toe clearance and significantly smaller amplitudes in ankle dorsiflexion and knee flexion angular displacement as well as absent responses in TA and MG in older adults compared to the young. Further, these degraded responses were superimposed on altered mid-swing phase kinematics during unstimulated walking in the older adults showing reduced toe clearance, knee flexion and increased ankle dorsiflexion compared to the young. This combination of degraded reflexes and altered unstimulated kinematics resulted in significantly reduced toe clearance in the older adults and could suggest that these adults are in the prodromal stage of fall risk. / Graduate / 0566

No description available.

Thesis (M.D.)--University of Pennsylvania, 1805. / Microform version available in the Readex Early American Imprints series.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / A leishmaniose cutÃnea (LC) à a forma mais comum da leishmaniose, com 1 milhÃo de novos casos por ano. Apresenta um amplo espectro clÃnico, podendo ser confundida com outras doenÃas que acometem a pele. Desse modo, à de fundamental importÃncia o diagnÃstico rÃpido e preciso da doenÃa. O diagnÃstico parasitolÃgico à o mais utilizado na rotina laboratorial, entretanto o exame direto geralmente apresenta baixa sensibilidade. Em virtude disso, torna-se necessÃrio buscar tÃcnicas alternativas para o diagnÃstico das leishmanioses. Neste trabalho, comparou-se o teste do press imprint smear com o exame histolÃgico e a imuno-histoquÃmica, no diagnÃstico direto de leishmaniose cutÃnea. Pacientes com suspeita clinica de LC foram submetidos à coleta de duas biÃpsias da borda das lesÃes, com punch de 3 mm, para a realizaÃÃo dos testes: press imprint smear, exame histolÃgico e imuno-histoquÃmica. Este Ãltimo foi considerado o teste padrÃo ouro. O press imprint smear consistiu em esmagar o fragmento de biÃpsia entre duas lÃminas de vidro sob pressÃo, de tal modo que o extrato (suco) tissular se espalha na superfÃcie das duas lÃminas. Os esfregaÃos foram corados com Giemsa, para pesquisa de amastigotas. Outro fragmento foi fixado em formalina a 10%. Desta amostra, uma lÃmina foi utilizada no exame histolÃgico, corada com hematoxilina-eosina, e outra para o teste de imuno-histoquÃmica. Ao total, foram incluÃdos 78 pacientes com diagnÃstico clinico-epidemiolÃgico de LC. A tÃcnica do press imprint smear e o exame histolÃgico foram realizados na amostra de todos os pacientes. Entretanto, a imuno-histoquÃmica foi realizada em apenas 73 amostras. Setenta e dois (98,6%) foram positivos para Leishmania na imuno-histoquÃmica, com sensibilidade de 98,6%; o press imprint smear foi positivo em 48 pacientes (61,5%), com sensibilidade de 58,3%. No exame histolÃgico foram identificadas amastigotas em 35 pacientes (44,9%), apresentando sensibilidade de 45,8%. Os resultados mostraram que o press imprint smear apresentou maior sensibilidade do que o exame histolÃgico, para o diagnÃstico da leishmaniose cutÃnea. AlÃm disso, à uma tÃcnica de baixo custo e fÃcil execuÃÃo. / The cutaneous leishmaniasis (CL) is the most common form of leishmaniasis, with 1 million new cases per year. Presents a broad clinical spectrum, which may be confused with other diseases that affect the skin. Thus, it is of fundamental importance to rapid and accurate diagnosis of the disease. Parasitological diagnosis is the most used test in laboratory routine, however direct examination generally has low sensitivity. As a result, it becomes necessary to find alternative techniques for the diagnosis of leishmaniasis. This study compared the test press imprint smear with histological examination and immunohistochemistry, for the direct diagnosis of leishmaniasis. Patients with clinical suspicion of LC underwent a sampling from two samples of biopsies from the edge of the lesions, with a punch of 3 mm for the tests: press imprint smear, histological examination and immunohistochemistry. The latter was considered the gold standard test. The press imprint smear consisted in crushing the biopsy fragment between two glass plates under pressure so that the extract (juice) tissue spreads on the surface of the two blades. The smears were stained with Giemsa for the detection of amastigotes. Another fragment was fixed in 10% formalin. From this sample, a blade was used in histology, stained with hematoxylin-eosin, and one for the immunohistochemical test. In total, 78 patients were included with clinical and epidemiological diagnosis of LC. The press imprint smear technique and histologic examination were conducted on the sample of all patients. However, immunohistochemistry was performed in only 73 samples. Seventy-two (98,6%) were positive for leishmania in immunohistochemistry, with sensitivity of 98,6%; the press imprint smear was positive in 48 patients (61,5%), with sensitivity of 58,3%. In the histological examination were identified amastigotes in 35 patients (44,9%), with sensitivity of 45,8%. The press imprint smear was more sensitive than histological examination for the diagnosis of cutaneous leishmaniasis. In addition, a technique is inexpensive and easy to perform.