Se han desarrollado y optimizado dos nanoemulsiones que contienen Nistatina (N1 y N2) para su aplicación en piel y mucosa oral, respectivamente. Estas formulaciones tuvieron un tamaño de gota nanométrico y resultaron ser estables a lo largo del tiempo. Adicionalmente se determinó el comportamiento reológico de ambos sistemas resultando ser fluidos newtonianos. Se evaluó la actividad antifúngica in vitro, observado que la potencia de la nistatina aumentó al ser introducida en las nanoemulsiones, cuando se comparaba con la nistatina libre. El mecanismo de liberación de la nistatina de las nanoemulsiones siguió una cinética de orden uno para ambas formulaciones. Trás el ensayo de permeación ex vivo en piel humana con la nanoemulsion N1 se observó que la cantidad de fármaco permeada fue muy baja, pudiendo descartarse la posible aparición de efectos adversos a nivel sistémico. De la misma manera se realizó el ensayo de permeación ex vivo en mucosa oral porcina para la formulación N2 llegando a la misma conclusión que en el caso de la permeación en piel. En ambos casos la cantidad de fármaco retenido en el tejido (tanto en piel o mucosa) es suficiente para observar un efecto fungistático, fungicida y un prolongado efecto post-antifungico (PAFE). Con el fin de determinar el efecto de la nanoemulsion N2 sobre la mucosa oral se visualizó la ultra-estructura del tejido y no observándose variaciones significativas cuando se comparaban con el control (mucosa no tratada con la nanoemulsion). Las nanoemulsiones N1 y N2 son formulaciones prometedoras para el potencial tratamiento clínico de candidiasis muco-cutáneas. / Muco-cutaneous candidosis is a common opportunistic infection must be treated to prevent other tissue invasion. Nystatin is one of the most prescribed drugs to treat this pathology, but due to its physicochemical properties its pharmaceutical-technological requirements make it a challenge. The purpose of this work was the development and characterization of an optimal nystatin delivery system for the potential treatment of oral candidosis avoiding undesirable side effects and toxicity of potential systemic absorption. Two nanoemulsion (N1 and N2) was developed, evaluated and characterized. It has been formulated successfully as a stable nanoemulsion with a droplet size of 75 and 138 nm, respectively. First order release parameters were estimated using different mathematical approaches and ex vivo permeation of nystatin through human skin and porcine buccal mucosa were found no systemic effects would happen. Microbiologic studies performed revealed an enhanced antifungal effect of the nystatin loaded nanoemulsion. Also the evaluation of buccal mucosa ultrastructure by transmission electron microscopy methodology showing a harmless effect in the mucosa microstructure. We can infer that the selected nystatin nanoemulsion could be potentially used on candidosis infection under mucositis conditions.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Made available in DSpace on 2016-12-23T13:55:58Z (GMT). No. of bitstreams: 1 Marisa Simon Brezinscki - Parte 1.pdf: 8765013 bytes, checksum: 34dcc19e4bb7677d326886ae43d4ad27 (MD5) Previous issue date: 2013-08-12 / Introduction: Skin infectious diseases of fungal, bacterial and viral etiology are frequent in HIV-infected patients. HIV infection may change the epidemiology of infectious diseases, leading to atypical manifestations Objectives: 1 Determine the etiologic agents and the more frequent clinical forms of mycoses in HIV infected patients. 2 - Correlate the occurrence of mycoses with CD4 s levels and viral load. 3-Evaluate the frequency of bacterial and viral skin diseases. Methods: A descriptive cross sectional study, which evaluated 86 patients with HIV infection. Sociodemographic and laboratory data collection, dermatological examination were performed and when necessary, scraping the lesion for direct microscopy and fungal culture, if necessary. Results: The mean age was 44.02 (± 12.17) years, 66.3% were men, and the gender ratio 1.97 men: 1 woman. The average time of diagnosis of HIV infection o was 5.59 years. Injuries caused by fungi, bacteria or viruses in keratinized tissues were observed in 58,14% of the patients (39.53% fungal, 18.6% bacterial and 10.46% viral). Onychomycosis was the most common mycoses, and Candida spp. the most frequent agent in these cases. Trichophyton rubrum was the most frequently isolated agent in the whole sample. Patients with CD4 levels less than 50 cells / uL and viral load greater than 50,000 copies / mL had more mycoses. Viral wart was the most frequent viral skin disease and folliculitis was the most frequent bacterial disease. Conclusions: The etiology of superficial mycoses in HIV patients did not differ from those found in the population immunocompetent. However, in some cases, fungal infections manifested in subtle form, with little inflammatory reaction or with more severe and extensive clinical aspects than those usually observed. The higher frequency of cutaneous mycosis was observed in patients with more advanced degrees of immunosuppression / Introdução: Dermatoses infecciosas de etiologia fúngica, viral e bacteriana são frequentes nos pacientes infectados pelo HIV. A infecção pelo HIV pode alterar a epidemiologia de doenças infecciosas, levando a manifestações atípicas. Objetivos: 1- Determinar os agentes etiológicos e formas clínicas mais frequentes das micoses cutâneas nos pacientes infectados pelo HIV. 2- Correlacionar a ocorrência destas micose com os níveis de linfócitos T CD4 e da carga viral. 3- Avaliar a frequência das dermatoses bacterianas e virais. Métodos: Estudo descritivo tipo corte transversal, que avaliou 86 pacientes com infecção pelo HIV. Foram realizados: coleta de dados sociodemográficos e laboratoriais, exame dermatológico e quando necessário, raspado da lesão para EMD (exame micológico direto) e cultura para fungos. Resultados: A média da idade foi 44,02 (± 12,17) anos; 66,3% eram homens, e a razão de sexo 1,97 homem : 1 mulher. Tempo médio de diagnóstico de infecção pelo HIV foi de 5,59 anos. Lesões causadas por fungos, bactérias ou vírus em tecidos queratinizados foram observadas em 58,14% dos pacientes (39,53% fúngicas, 18,6% virais e 10,46% bacterianas). Micose mais frequente foi a onicomicose, sendo a Candida spp. o agente mais frequente nestes casos. Trichophyton rubrum foi o agente mais isolado em toda a amostra. Pacientes com níveis de linfócitos T CD4 inferiores a 50 células/μL e carga viral maior do que 50.000 cópias/mL apresentavam mais micose cutânea. Dermatose viral mais frequente foi a verruga viral; e bacteriana, a foliculite. Conclusões: A etiologia das micoses superficiais em pacientes com HIV não diferiu daquelas encontradas na população imunocompetente. Contudo, em alguns casos, as micoses se manifestaram de forma sutil, com pouca reação inflamatória ou com quadros clínicos mais graves e extensos do que os habitualmente observados. A maior frequência de micoses cutâneas foi observada nos pacientes com graus mais avançados de imunossupressão

Made available in DSpace on 2014-10-09T12:41:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:03Z (GMT). No. of bitstreams: 0 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP / FAPESP:09/50926-1

Made available in DSpace on 2014-10-09T12:41:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:03Z (GMT). No. of bitstreams: 0 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Os hidrogéis foram obtidos a partir de material polimérico reticulado por processo de radiação ionizante de acordo com a técnica de Rosiak. Nos últimos 40 anos o uso dos hidrogéis têm sido investigado para diversas aplicações como curativos. Neste trabalho foram sintetizadas membranas de hidrogéis com poli(N-2- pirolidona) (PVP), poli(álcool vinílico) (PVAl), quitosana e argila laponita em encapsulamento do fármaco para liberação controlada de glucantime sobre a superfície cutânea de tecidos lesados por leishmaniose. O tratamento tradicional dos pacientes infectados pelos parasitas é feito com antimoniato pentavalente de forma injetável. Entretanto estes antimoniatos são muito tóxicos e provocam efeitos colaterais nestes pacientes, além disso, pacientes portadores de doenças cardíacas e renais não podem fazer uso deste tratamento. No tratamento com membranas de hidrogéis aplicadas na superfície de tecidos lesados pela leishmaniose, o fármaco é liberado diretamente no ferimento de forma controlada, diminuindo os efeitos colaterais. As membranas preparadas neste trabalho foram caracterizadas por difração de raios X (DRX), análise de termogravimetria (TG), intumescimento, fração gel, espectroscopia no infravermelho (FTIR), microscopia eletrônica de varredura (MEV) e microscopia de força atômica (AFM). As caracterizações funcionais foram feitas com teste de citotoxicidade e de liberação do fármaco in vitro e in vivo, de acordo com o protocolo de ética do Instituto de Medicina Tropical do Hospital das Clinicas da Faculdade de Medicina da USP. O teste \"in vivo\" dessas membranas provou ser eficiente na liberação controlada de fármacos diretamente nas superfícies lesadas pela leishmaniose. Nos testes \"in vivo\" as membranas de PVP/PVAl/argila 1,5% e glucantime apresentaram evidente contribuição para redução do ferimento chegando a uma cura clínica. / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP / FAPESP:09/50926-1

INTRODUÇÃO: As dermatoses bolhosas autoimunes são um grupo heterogêneo de afecções da pele e/ou mucosas associadas à produção de autoanticorpos dirigidos às moléculas de adesão epitelial. Podem ser classificadas em dermatoses bolhosas intraepidérmicas (pênfigos) ou subepidérmicas (penfigóides, epidermólise bolhosa adquirida). Nos últimos anos, a transição entre dermatoses bolhosas autoimunes ou coexistência de autoanticorpos de diferentes dermatoses têm sido relatadas em alguns pacientes e atribuída ao fenômeno de epitope spreading (ES): a diversificação de epítopos reconhecidos pelo sistema imune evocaria uma reação secundária a antígenos distintos e não relacionados aos da doença primária. Neste trabalho avaliamos a ocorrência de fenômenos de ES em pacientes portadores de pênfigo. CASUÍSTICA E MÉTODOS: Inicialmente, foi realizada análise de dados clínicos e laboratoriais (exame histopatológico, de imunofluorescência direta-IFD, indireta IFI e ELISA) de 351 pacientes portadores de pênfigos acompanhados no Ambulatório de dermatoses bolhosas autoimunes do Departamento de Dermatologia da Faculdade de Medicina da Universidade de São Paulo no período de dezembro de 2002 a dezembro de 2012. Foram selecionados pacientes com quadro sugestivo de conversão à dermatose bolhosa distinta da doença primária. RESULTADOS: Nove pacientes apresentaram sinais sugestivos de fenômeno de ES e foram incluídos no estudo: 8 com a conversão de Pênfigo vulgar (PV) a foliáceo (PF) 2,3% (grupo1) e um de PF a Epidermólise bolhosa adquirida (EBA) 0,3% (grupo 2). No grupo 1 o intervalo mediano para a conversão foi de 3,5 anos. Cinco pacientes apresentaram modificação histopatológica de clivagem intraepidérmica na camada suprabasal para clivagem na camada subcórnea durante a suspeita de ES; 2 apresentaram clivagem na camada epidérmica média durante a transição e um manteve clivagem suprabasal, apesar de quadro clínico sugestivo de PF. Todos os pacientes apresentavam depósitos intercelulares de IgG e/ou C3 durante o diagnóstico de PV e PF à IFD. Títulos de IFI variaram de 1:160 a 1:5120. Os valores de ELISA para Dsg1 variaram de 22 a 319; e para Dsg3 de 0.4 a 224 (positivo se > 20). A relação Dsg1/Dsg3 correspondeu à mudança PV-PF. No grupo 2, o ES para EBA ocorreu sete anos após o diagnóstico de inicial de PF. No momento da suspeita de ES o paciente apresentava-se em remissão clínica do quadro de pênfigo folíaceo. A avaliação laboratorial mostrou clivagem subepidérmica neutrofílica, IFD com IgG intercelular intraepidérmica e depósitos de IgM, IgA, IgG e C3 na zona da membrana basal. IFI com técnica de salt split skin revelou depósitos de IgG do lado dérmico. Ao immunobloting houve reconhecimento de colágeno VII e ELISA para Dsg1 foi positivo. CONCLUSÃO: A frequência de ES em pacientes portadores de pênfigo foi de 2,6%. Estudos serão necessários para elucidar a patogênese deste evento e sua importância na progressão dos pênfigos / BACKGROUND: Autoimmune bullous skin diseases represent a heterogeneous group of disorders of skin and mucosa associated with autoantibodies against distinct adhesion molecules. They can be classified, based on the level of loss of adhesion in intraepidermal and sub epidermal dermatosis. The shift from an autoimmune blistering disease to another has been recently described and attributed to the \"epitope spreading\" (ES) phenomena. It occurs when a primary inflammatory/autoimmune process releases \"hidden\" epitopes which are recognized by the lymphocytes and evoke a secondary reaction to antigens distinct from, and non-cross-reactive, with the disease causing-epitope. This study attempted to characterize the occurrence of ES in pemphigus patients. METHODS: We analyzed data from 351 pemphigus patients treated ambulatorially at the Department of Dermatology, Faculty of Medicine, University of São Paulo, from December 2002 to December 2012. A careful search for clinical and laboratorial (histopathology, direct-DIF and indirect-IIF immunofluorescence, ELISA) changes suggestive of shift to a secondary bullous disease was performed. RESULTS: Nine out of 351 patients presented clínical shift and were included in the study: eight from pemphigus vulgaris (PV) to foliaceus (PF) 2.3% (group 1) and one from PF to epidermolysis bullosa acquisita (EBA) 0.3% (group 2). In group 1, median interval of disease shift was 3.5 years. Of 8 patients with clinical PF, five showed change of histopathology pattern from suprabasilar cleavage to subcorneal acantholysis, two had cleavage within the middle epidermal layer, and one sustained the suprabasilar acantholysis. One shifted back to PV after clinical and histopatological changes of PF. All patients showed intercellular IgG and/or C3 deposits during PV and PF diagnosis by DIF. IIF titers varied from 1:160 to 1:5120. ELISA index for Dsg1 varied from 22 to 319; and for Dsg3 from 0.4 to 224 (positive if > 20). Dsg1/Dsg3 indexes corresponded to the clinical PV-PF changes. In group 2, onset of PF occurred at the age of 25, and ES to EBA 7 years later in the absence of PF lesions. Laboratory evaluation showed sub epidermal cleavage with neutrophils, IgG intercellular staining in the epidermis and IgM, IgA, IgG and C3 deposits at BMZ by DIF, IgG deposits by indirect salt-split, recognition of collagen VII by immunoblotting, and positive ELISA for Dsg1. CONCLUSIONS: Intermolecular ES occurred in 2.6% (9/351) of pemphigus patients. Futures studies will be necessary to elucidate the pathogenesis of this event and its significance in pemphigus progression

Introdução: A dermatite atópica (DA) é uma enfermidade cutânea inflamatória de caráter crônico, na qual o prurido é constante, e com marcada xerose. Dermatose que geralmente se inicia na infância, e pode surgir em indivíduos com história pessoal ou familiar de asma, rinite alérgica e/ou DA. A pele com DA apresenta colonização por Staphylococcus aureus (S. aureus) em 80-100% dos casos, sendo responsável pela produção enterotoxinas, capazes de exacerbar a resposta inflamatória na DA. Nesta enfermidade, existem distintos subtipos de células apresentadoras de antígeno ou dendríticas (DC), tanto na pele quanto circulantes. As DC exercem papel relevante na inflamação da DA, em especial um subgrupo de células dendríticas mieloides (mDC), as chamadas células dendríticas inflamatórias epidérmicas (IDEC). Objetivo: Avaliar o fenótipo e a função das mDC (IDEC-like) em células mononucleares do sangue periférico (PBMC) na DA do adulto. Métodos: Foram selecionados 21 pacientes com DA (idades entre18 e 65 anos, sendo 13 homens e oito mulheres) e 21 controles (idades entre 21 e 41 anos, sendo oito homens e 13 mulheres), nos quais foram realizadas as avaliações fenotípica e funcional das mDC (IDEC-like) em PBMC. Para tal, foram analisadas as expressões de: Fc?RI, TNF, IFN-y, IL-10, CD36 e CD83 nas mDC, estimuladas com enterotoxina estafilocócica B (SEB), agonistas de TLR2 (Pam3CSK4), TLR4 (LPS) e de TLR7/8 (CL097) através da citometria de fluxo. Resultados: Os principais achados nos pacientes com DA foram: aumento da frequência de células IDEC-like frente ao estímulo com agonista de TLR2 (Pam3CSK4); aumento da frequência de IFN-y em condição não estimulada, e de IL-10 frente a estímulo com agonista de TLR7/8 (CL097) nesta população de células dendríticas. Conclusão: A caracterização das mDC circulantes na DA evidencia perfil pró-inflamatório em condição não estimulada, impactando na resposta imune adaptativa. O aumento significativo na frequência de células IDEC-like nos pacientes com DA sugere sua participação na perpetuação do processo inflamatório da DA / Introduction: Atopic dermatitis (AD) is an inflammatory skin disease with a chronic course, with constant pruritus and marked xerosis. It usually starts during childhood, and a personal or familial history of skin and/or respiratory allergy may be present. Around 80-100% of the patients show a cutaneous colonization of Staphylococcus aureus (S. aureus), which produces enterotoxins that may exacerbate the inflammatory response in AD. In this disease, there are distinct subtypes of antigen-presenting cells or dendrytic cells (DC), either circulating or present in the affected tissue. DC exert a relevant role in AD inflammation, especially a subgroup of myeloid cells (mDC), known as epidermal inflammmatory dendritic cells (IDEC). Objective: To evaluate the phenotype and function of mDC (IDEC-like) in mononuclear cells of the peripheral blood (PBMC) of adults with AD. Methods: Twenty-one adults with AD (age 18/65; male/female: 13/8) and 21 healthy controls (age 21/41; male/female: 8/13) were selected for the current study. Phenotypical and functional analysis of mDC (IDEC-like) of PBMC were performed, through the expression of Fc?RI ,TNF, IFN-y, IL-10, CD36 and CD83 in mDC, stimulated with enterotoxin B (SEB) and with agonists of TLR2 (Pam3CSK4), TLR4 (LPS) and TLR7/8 (CL097) by flow cytometry. Results: Main findings of AD patients included: elevation of IDEC-like cell frequency with TLR2 (Pam3CSK4) agonist, augmented unstimulated frequency of IFN-y, and of IL-10 with TLR7/8(CL097) agonist of this population of dendritic cells. Conclusion: Characterization of circulating mDC on AD shows proinflammatory profile in unstimulated conditions, therefore causing impact on the adaptive immune response. The significant increase in the frequency of IDEC-like cells in AD patients suggest a role in the maintenance of inflammation in AD

The thesis deals with design and implementation of a tool for simulating marks of chosen skin diseases into a synthetic fingerprint. The diseases selected to work with are warts and atopic eczema. The marks of diseases are generated into a synthetic fingerprint image created by the SFinGe application. Existing disesase-affected fingerprints from the STRaDe database are analysed in detail. Then, methods for simulating the diseases into a synthetic fingerprint are proposed, implemented, and the results are evaluated.

No / In recent years, different genes and proteins have been highlighted as potential biomarkers for psoriasis, one of the most common inflammatory skin diseases worldwide. However, most of these markers are not only psoriasis-specific but also found in other inflammatory disorders. We performed an unsupervised cluster analysis of gene expression profiles in 150 psoriasis patients and other inflammatory skin diseases (atopic dermatitis, lichen planus, contact eczema, and healthy controls). We identified a cluster of IL-17/tumor necrosis factor-alpha (TNFalpha)-associated genes specifically expressed in psoriasis, among which IL-36gamma was the most outstanding marker. In subsequent immunohistological analyses, IL-36gamma was confirmed to be expressed in psoriasis lesions only. IL-36gamma peripheral blood serum levels were found to be closely associated with disease activity, and they decreased after anti-TNFalpha-treatment. Furthermore, IL-36gamma immunohistochemistry was found to be a helpful marker in the histological differential diagnosis between psoriasis and eczema in diagnostically challenging cases. These features highlight IL-36gamma as a valuable biomarker in psoriasis patients, both for diagnostic purposes and measurement of disease activity during the clinical course. Furthermore, IL-36gamma might also provide a future drug target, because of its potential amplifier role in TNFalpha- and IL-17 pathways in psoriatic skin inflammation. / Deutsche Forschungsgemeinschaft (DFG) to JW (WE-4428), the René Touraine Foundation (for AD), and the PTJ reference number 0306v12 as part of the Technology and Innovation Program (TIP) North-Rhine Westphalia (gene expression analyses)

Les risques liés à l’environnement immédiat, notamment le manque d’accès à l’eau potable, à l’assainissement, à un logement décent et à un milieu de vie sain constituent un des facteurs à l’origine de la mauvaise santé des enfants de moins de cinq ans dans les pays en développement. Les objectifs principaux poursuivis dans cette recherche sont de mesurer l’influence de ces risques de l’environnement immédiat sur la prévalence des symptômes des troubles oculaires et celle des symptômes des troubles cutanés chez les enfants de moins de cinq ans à Ouagadougou et de rechercher les autres déterminants sous-jacents de la prévalence de ces symptômes dans cette ville. Nous utilisons les données de l’enquête réalisée en février 2010 sur l’état de santé et le comportement sanitaire associé aux maladies et symptômes récents et les données sur les événements démographiques et sur les conditions de vie des ménages collectées en mai 2009 durant le round 1 de l’enquête ménage. L’échantillon de l’étude est constitué de 950 enfants issus de 736 ménages sélectionnés aléatoirement dans cinq quartiers périphériques de la ville de Ouagadougou. Nous avons recouru à l’analyse descriptive fondée sur les tableaux croisés et les tests du chi-2, et à l’analyse de la régression logistique multivariée ayant permis d’étudier les risques relatifs de la survenue desdits symptômes. L’analyse descriptive montre que certaines variables de l’environnement immédiat, en l’occurrence le mode d’évacuation des ordures ménagères, le type de toilette utilisé le plus souvent par la plupart des membres du ménage et le type de quartier de résidence, sont associés à la prévalence des troubles oculaires. Mais une analyse approfondie à l’aide de la régression logistique multivariée n’a confirmé que l’effet du type de quartier de résidence. Concernant la prévalence des symptômes des troubles cutanés, en analyse bi-variée, les variables de l’environnement immédiat qui y sont associées sont la nature du sol intérieur et le mode d’évacuation des eaux usées. L’analyse multivariée semble confirmer les effets de ces variables. Nous avons relevé quelques limites des données utilisées, notamment la faible taille de l’échantillon, la non-confirmation par voie médicale des données sanitaires et le caractère transversal desdites données. Toutefois, les résultats trouvés pourront être utiles aux planificateurs et décideurs qui ont la charge de la gestion de l’espace urbain dans le but de mieux concevoir de nouvelles politiques urbaines mettant l’accent sur la restructuration des quartiers précaires afin de mieux combattre les maladies évitables. En conclusion, en tenant compte des limites relevées, il serait utile de procéder à d’autres investigations afin de tirer des conclusions moins sujettes à débat du point de vue méthodologique. / Risks related to domestic environment, including a lack of access to safe drinking water, inadequate sanitation, poor housing conditions and an unhealthy environment are some of the factors that can explain the poor health of young children in developing countries. The main goals of this research are to assess the influence of such local environmental risks on the prevalence of symptoms of eye and skin diseases among children aged under five and to examine the effects of other possible determinants of these problems in Ouagadougou, capital city of Burkina Faso. Data are from a survey conducted in February 2010 that collected information on the health status and behaviors associated with recent disease episodes; these are linked to data collected in May 2009 by an earlier round of the Ouagadougou DSS on demographic events and the living conditions of households. Our sample consists of 950 children from 736 randomly selected households in five suburbs of the city. The descriptive analysis (cross-tabulations and chi-2 tests) showed that several variables of domestic environment, namely the waste disposal, the type of toilet used by the members of the household and the type of neighborhood are associated with the prevalence of the symptoms of eye diseases. The multivariate analysis using multivariate logistic regressions, however, confirmed only the effect of neighborhood type – zoned versus spontaneous settlements. Concerning the skin diseases, the descriptive analysis indicated that the only aspects of the domestic environment that are associated with their symptoms are the type of floor in the living union and the method of household waste disposal. The multivariate analysis confirmed the significant effects of these variables on children’s health. We note some limitations of the data used, including the relatively small size of the sample, the fact that disease symptoms were reported by the children’s guardians and not verified by doctors, and the cross-sectional nature of the data. The data however do provide unusual information on the domestic living environment and are of relatively good quality. The results of the study may be useful to planners and decision makers who are responsible for the management of urban space, in order to improve the design of policies aiming to improve the structure and living conditions in precarious (spontaneous, non-zoned) neighborhoods to better fight preventable diseases. That said, further research is needed to attain stronger conclusions that are based on larger data sets that are less subject to possible self-reporting inaccuracies.