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https://www.readbyqxmd.com/read/28331797/paradoxical-response-with-increased-tumor-necrosis-factor-%C3%AE-levels-to-anti-tuberculosis-treatment-in-a-patient-with-disseminated-tuberculosis
#1
Sho Watanabe, Yugo Kaneko, Hironori Kawamoto, Tomoki Maehara, Yuri Baba, Ikumi Fujisaki, Nayuta Saito, Kai Ryu, Aya Seki, Tsugumi Horikiri, Akira Kinoshita, Hiroshi Takeda, Keisuke Saito, Kazuyosi Kuwano
It has been reported that tuberculosis (TB) worsens after cessation of tumor necrosis factor-α inhibitors and starting anti-TB treatment. Little is known about the immunological pathogenesis of this paradoxical response (PR). We report the first case of a TB patient in whom PR occurred concurrently with elevation of circulating tumor necrosis factor-α (TNFα) levels. A 75-year-old woman, who had been treated with adalimumab for SAPHO syndrome, developed disseminated TB. Soon after administration of anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol), and after discontinuation of adalimumab, a PR occurred...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28331796/an-unexpected-finding-in-a-man-with-multiple-pulmonary-nodules-a-pleural-effusion-and-respiratory-failure
#2
Yik Lam Pang, Quentin Jones
We report the case of a 47-year old Caucasian man with a history of depression and high alcohol intake who presented with a one-month history of weight loss, dry cough and abdominal pain. He had no smoking history of note. The patient was treated for a suspected chest infection, however developed respiratory failure and was intubated. A CT showed multiple pulmonary nodules, left pleural thickening extending to the mediastinum and bilateral pleural effusions-larger on the left, suggestive of disseminated malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28331044/effectiveness-and-safety-of-clofazimine-in%C3%A2-multidrug-resistant-tuberculosis-a%C3%A2-nationwide-report-from-brazil
#3
Margareth Dalcolmo, Regina Gayoso, Giovanni Sotgiu, Lia D'Ambrosio, Jorge L Rocha, Liamar Borga, Fatima Fandinho, Jose U Braga, Vera M N Galesi, Draurio Barreira, Denise A Sanchez, Fernanda Dockhorn, Rosella Centis, Jose A Caminero, Giovanni B Migliori
Although clofazimine is used to treat multidrug-resistant tuberculosis (MDR-TB), there is scant information on its effectiveness and safety. The aim of this retrospective, observational study was to evaluate these factors as well as the tolerability of clofazimine in populations in Brazil, where it was administered at a daily dose of 100 mg·day(-1) (body weight ≥45 kg) as part of a standardised MDR-TB treatment regimen until 2006 (thereafter pyrazinamide was used).All MDR-TB patients included in the Sistema de Informação de Tratamentos Especiais da Tuberculose (SITETB) individual electronic register were analysed...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28329197/systematic-review-meta-analysis-and-cost-effectiveness-of-treatment-of-latent-tuberculosis-infection-to-reduce-progression-to-multidrug-resistant-tuberculosis
#4
Suzanne M Marks, Sundari R Mase, Sapna Bamrah Morris
Background: Evidence-based recommendations for treating persons having presumed latent tuberculosis infection (LTBI) after contact to infectious multidrug-resistant tuberculosis (MDR TB) are lacking because published data consist of small observational studies. TB incidence in persons treated for latent multidrug-resistant-TB infection (MDR LTBI) is unknown. Methods: We conducted a systematic review of studies published (1/1/1994-12/31/2014) to analyze TB incidence, treatment completion and discontinuation, and cost effectiveness...
March 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28327117/preliminary-evaluation-of-anti-tuberculosis-potential-of-siderophores-against-drug-resistant-mycobacterium-tuberculosis-by-mycobacteria-growth-indicator-tube-drug-sensitivity-test
#5
Karuna Gokarn, Ramprasad B Pal
BACKGROUND: Alternative treatment strategies have become essential in overcoming the problem of drug-resistant Mycobacterium tuberculosis (Mtb). In this preliminary in vitro study, the anti-tuberculosis (anti-TB) activity of exogenous iron chelators (xenosiderophores) such as Exochelin-MS (Exo-MS) and Deferoxamine-B (DFO-B) was evaluated against ten multi-drug-resistant (MDR) and seven pyrazinamide-resistant (PZA (R) ) Mtb isolates. METHODS: Mycobacteria Growth Indicator Tube-Drug Susceptibility Test was used to assess the anti-TB effect of Exo-MS or DFO-B individually and their combinations with isoniazid (INH), rifampicin (RIF) and pyrazinamide (PZA)...
March 21, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28318196/-paradoxical-reaction-to-antituberculosis-treatment-in-an-immunocompetent-girl-with-pulmonary-tuberculosis
#6
Ignacio Ruiz Del Olmo Izuzquiza, Claudia Orden Rueda, Laura Ochoa Gómez, Nuria Clavero Montañés, Enrique Berdún Chéliz, Carmelo Guerrero Laleona
Paradoxical reaction to antituberculosis treatment is rare in paediatric population. We report a 9-year-old girl with high fever and productive cough for the last three weeks. Tuberculine test and Quantiferon were positive, erythrocyte sedimentation rate was 64 mm/h, culture and polymerase chain reaction for M. tuberculosis negative, and chest X ray showed a widened right mediastinum. Tuberculosis was diagnosed, therefore treatment with standard doses of rifampicin, isoniazid, pyrazinamide and ethambutol was started...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28303436/mutations-in-catalase-peroxidase-katg-from-isoniazid-resistant-mycobacterium-tuberculosis-clinical-isolates-insights-from-molecular-dynamics-simulations
#7
Arethusa Lobo Pimentel, Regiane Bertin de Lima Scodro, Katiany Rizzieri Caleffi-Ferracioli, Vera Lúcia Dias Siqueira, Paula Aline Zanetti Campanerut-Sá, Luciana Dias Ghiraldi Lopes, Aryadne Larissa de Almeida, Rosilene Fressatti Cardoso, Flavio Augusto Vicente Seixas
The current multidrug therapy for tuberculosis (TB) is based on the use of isoniazid (INH) in combination with other antibiotics such as rifampin, ethambutol and pyrazinamide. Literature reports have shown that Mycobacterium tuberculosis, the causative agent of TB, has become resistant to this treatment by means of point mutations in the target enzymes of these drugs, such as catalase-peroxidase (KatG). By means of equilibrium molecular dynamics in the presence of the ligand, this work evaluated ten point mutations described in the enzyme KatG that are related to resistance to INH ...
April 2017: Journal of Molecular Modeling
https://www.readbyqxmd.com/read/28289033/population-pharmacokinetics-of-pyrazinamide-in-patients-with-tuberculosis
#8
Abdullah Alsultan, Rada Savic, Kelly E Dooley, Marc Weiner, William Whitworth, William R Mac Kenzie, Charles A Peloquin
The current treatment used for tuberculosis (TB) is lengthy and needs to be shortened and improved. Pyrazinamide (PZA) has potent sterilizing activity and has the potential to shorten TB treatment duration, if optimized. The goals of this study were (a) to develop a population pharmacokinetic (PK) model for PZA among patients enrolled in PK sub-studies of Tuberculosis Trial Consortium (TBTC) trials 27 and 28, and (b) to determine covariates that affect PZA PK. We also (c) performed simulations and target attainment analysis using the proposed targets of Cmax >35 mcg/ml or AUC >363 mcg*hr/ml to see if higher weight-based dosing could improve PZA efficacy...
March 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28284261/tuberculosis-drug-resistance-in-southern-mozambique-results-of-a-population-level-survey-in-the-district-of-manhi%C3%A3-a
#9
S Valencia, D Respeito, S Blanco, R M Ribeiro, E López-Varela, V G Sequera, B Saavedra, E Mambuque, M Gómez Morillo, H Bulo, F Cobelens, E Macete, P L Alonso, J A Caminero, A L García-Basteiro
SETTING: Mozambique, one of the world's high tuberculosis (TB) burden countries, has conducted only one national-level drug resistance survey, in 2007-2008. OBJECTIVE: To determine the drug resistance patterns of laboratory-confirmed TB cases. DESIGN: This was a population-level survey conducted over a 1-year period in the district of Manhiça. All laboratory-confirmed cases were evaluated for first-line anti-tuberculosis drug susceptibility testing using liquid culture...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28281443/central-nervous-system-tuberculosis
#10
John M Leonard
Central nervous system tuberculosis (CNS-TB) takes three clinical forms: meningitis (TBM), intracranial tuberculoma, and spinal arachnoiditis. TBM predominates in the western world and presents as a subacute to chronic meningitis syndrome with a prodrome of malaise, fever, and headache progressing to altered mentation and focal neurologic signs, followed by stupor, coma, and death within five to eight weeks of onset. The CSF formula typically shows a lymphocytic pleocytosis, and low glucose and high protein concentrations...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28277228/utility-of-phenotypic-and-genotypic-testing-in-the-study-of-mycobacterium-tuberculosis-resistance-to-first-line-anti-tuberculosis-drugs
#11
Luz María Alba Álvarez, José María García García, M Dolores Pérez Hernández, Susana Martínez González, Juan José Palacios Gutiérrez
OBJECTIVE: To determine the utility of molecular techniques in the diagnosis of resistance and the extent of resistance to first-line drugs in our region. MATERIAL AND METHOD: From 2004 to 2013, 1,889 strains of Mycobacterium tuberculosis complex isolated in Asturias, Spain, were studied using phenotypic (Clinical and Laboratory Standards Institute guidelines) and molecular (INNOLiPA RIF-TB(©); GenotypeMDRplus(©); GenotypeMDRsl(©)) sensitivity tests. RESULTS: 1,759 strains (94...
October 27, 2016: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28275074/same-day-diagnostic-and-surveillance-data-for-tuberculosis-via-whole-genome-sequencing-of-direct-respiratory-samples
#12
Antonina A Votintseva, Phelim Bradley, Louise Pankhurst, Carlos Del Ojo Elias, Matthew Loose, Kayzad Nilgiriwala, Anirvan Chatterjee, E Grace Smith, Nicolas Sanderson, Timothy M Walker, Marcus R Morgan, David H Wyllie, A Sarah Walker, Tim E A Peto, Derrick W Crook, Zamin Iqbal
Routine full characterization of Mycobacterium tuberculosis (TB) is culture-based, taking many weeks. Whole-genome sequencing (WGS) can generate antibiotic susceptibility profiles to inform treatment, augmented with strain information for global surveillance; such data could be transformative if provided at or near point of care.We demonstrate a low-cost DNA extraction method for TB WGS direct from patient samples. We initially evaluated the method using the Illumina MiSeq sequencer (40 smear-positive respiratory samples, obtained after routine clinical testing, and 27 matched liquid cultures)...
March 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28271875/in-vivo-selected-pyrazinoic-acid-resistant-m-tuberculosis-strains-harbor-missense-mutations-in-the-aspartate-decarboxylase-pand-and-the-unfoldase-clpc1
#13
Pooja Gopal, Rokeya Tasneen, Michelle Yee, Jean-Philippe Lanoix, Jansy Passiflora Sarathy, George Rasic, Liping Li, Veronique Dartois, E Nuermberger, Thomas Dick
Through mutant selection on agar containing pyrazinoic acid (POA), the bioactive form of the prodrug pyrazinamide (PZA), we recently showed that missense mutations in the aspartate decarboxylase PanD and the unfoldase ClpC1, and loss-of-function mutation of polyketide synthases Mas and PpsA-E involved in phthiocerol dimycocerosate synthesis, cause resistance to POA and PZA in Mycobacterium tuberculosis. Here we first asked whether these in vitro-selected POA/PZA-resistant mutants are attenuated in vivo, to potentially explain the lack of evidence of these mutations among PZA-resistant clinical isolates...
March 8, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28260424/posttransplant-tuberculosis
#14
Erol Demir, Mehmet Sukru Sever
Tuberculosis is a major problem in the posttransplantation period, because of its high incidence and prevalence, difficulty in diagnosis as well as high risk of morbidity and mortality. In solid-organ transplant recipients, the diagnosis of tuberculosis is complex because it is paucisymptomatic. Tuberculin skin testing results may be negative, and interferon-gamma release assays may be insufficiently sensitive. Furthermore, imaging technique findings are mostly atypical, and sputum smear results can be negative despite the presence of active disease...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28244290/additional-drug-resistance-patterns-among-multidrug-resistant-tuberculosis-patients-in-korea-implications-for-regimen-design
#15
Jeong Ha Mok, Bo Hyoung Kang, Taehoon Lee, Hyun Kyung Lee, Hang Jea Jang, Yu Ji Cho, Doosoo Jeon
Detailed information on additional drug resistance patterns of multidrug-resistant tuberculosis (MDR-TB) is essential to build an effective treatment regimen; however, such data are scarce in Korea. We retrospectively analyzed the results of phenotypic drug susceptibility testing (DST) of culture confirmed-TB patients from January 2010 to December 2014 in 7 university hospitals in Korea. MDR-TB was identified among 6.8% (n = 378) of 5,599 isolates. A total of 57.1% (n = 216) of the MDR-TB patients had never been treated for TB...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28242663/factors-influencing-tuberculosis-treatment-outcome-in-adult-patients-treated-with-thrice-weekly-regimens-in-india
#16
Geetha Ramachandran, A K Hemanth Kumar, V Chandrasekaran, T Kannan, R Vijayalakshmi, V N Azger Dusthackeer, K Ramesh, J Lavanya, Soumya Swaminathan
The Indian Revised National Tuberculosis (TB) Control Programme uses thrice-weekly treatment with standard drug dosages. The role of plasma drug levels and other factors in determining TB treatment outcomes is not well understood. We aimed to determine factors influencing 2-hour post-dosing concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) in adult TB patients and to study factors impacting TB treatment outcome. We recruited 1912 adult TB patients (new and re-treatment) with pulmonary/extrapulmonary TB, receiving anti-TB treatment (ATT) in the RNTCP in Chennai city...
February 27, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28240568/-re-moving-the-needle-prospects-for-all-oral-treatment-for-multidrug-resistant-tuberculosis
#17
M Milstein, A Brzezinski, F Varaine, C D Mitnick
BACKGROUND: Currently recommended regimens for multidrug-resistant tuberculosis (MDR-TB) contain painful daily injections and are unsuccessful in approximately half of patients. Removal of the injectable agent to fashion all-oral regimens could transform MDR-TB treatment and access to care. OBJECTIVE: To explore evidence for all-oral treatment regimens. DESIGN: We review evidence on drugs that could be included in injection-free MDR-TB regimens...
December 1, 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28237037/the-effect-size-of-type-2-diabetes-mellitus-on-tuberculosis-drug-resistance-and-adverse-treatment-outcomes
#18
Lucia Monserrat Perez-Navarro, Blanca I Restrepo, Francisco Javier Fuentes-Dominguez, Ravindranath Duggirala, Jaime Morales-Romero, Juan Carlos López-Alvarenga, Iñaki Comas, Roberto Zenteno-Cuevas
OBJECTIVE: To evaluate the effect size of type 2 diabetes mellitus (T2DM) on tuberculosis (TB) treatment outcomes and multi drug resistance (MDR). METHODS: A cohort with 507 individuals with diagnosed TB included 183 with coexistence of T2DM and TB (TB-T2DM). Participants were identified at the time of TB diagnosis and followed during the course of TB treatment. Then we computed relative risks and adjustments by Cox proportional hazards for outcome variables (drug resistance, death, relapse, treatment failure), and the size of their effect as Cohen's-d...
March 2017: Tuberculosis
https://www.readbyqxmd.com/read/28222243/studies-on-the-binding-of-modest-modulators-of-the-human-enzyme-sirtuin-6-using-std-nmr
#19
Beatriz E Bolívar, John T Welch
Pyrazinamide (PZA), an essential constituent of short course tuberculosis chemotherapy, binds weakly but selectively to Sirtuin 6 (SIRT6). Despite structural similarities between nicotinamide (NAM), PZA, and pyrazinoic acid (POA), these inhibitors modulate SIRT6 via different mechanisms and binding sites, as suggested by Saturation Transfer Difference (STD) Nuclear Magnetic Resonance (NMR). Available experimental evidence, such as that derived from crystal structures and kinetic experiments, is of only limited utility in the elucidation of the mechanistic details of sirtuin inhibition by NAM or other inhibitors...
February 21, 2017: Chembiochem: a European Journal of Chemical Biology
https://www.readbyqxmd.com/read/28221125/comparison-of-sputum-culture-conversion-for-mycobacterium-bovis-and-m-tuberculosis
#20
Colleen Scott, Joseph S Cavanaugh, Benjamin J Silk, Julia Ershova, Gerald H Mazurek, Philip A LoBue, Patrick K Moonan
Current US guidelines recommend longer treatment for tuberculosis (TB) caused by pyrazinamide-resistant organisms (e.g., Mycobacterium bovis) than for M. tuberculosis TB. We compared treatment response times for patients with M. bovis TB and M. tuberculosis TB reported in the United States during 2006-2013. We included culture-positive, pulmonary TB patients with genotyping results who received standard 4-drug treatment at the time of diagnosis. Time to sputum-culture conversion was defined as time between treatment start date and date of first consistently culture-negative sputum...
March 2017: Emerging Infectious Diseases
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