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Tuberculosis treatment

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https://www.readbyqxmd.com/read/28813536/tuberculosis-patients-in-an-indian-mega-city-where-do-they-live-and-where-are-they-diagnosed
#1
Ramnath Subbaraman, Beena E Thomas, Senthil Sellappan, Chandra Suresh, Lavanya Jayabal, Savari Lincy, Agnes L Raja, Allison McFall, Sunil Suhas Solomon, Kenneth H Mayer, Soumya Swaminathan
OBJECTIVE: Tuberculosis (TB) is a major source of mortality in urban India, with many structural challenges to optimal care delivery. In the government TB program in Chennai, India's fourth most populous city, there is a 49% gap between the official number of smear-positive TB patients diagnosed and the official number registered in TB treatment within the city in 2014. We hypothesize that this "urban registration gap" is partly due to rural patients temporarily visiting the city for diagnostic evaluation...
2017: PloS One
https://www.readbyqxmd.com/read/28811354/safety-and-efficacy-of-baricitinib-through-128-weeks-in-an-open-label-longterm-extension-study-in-patients-with-rheumatoid-arthritis
#2
Edward C Keystone, Mark C Genovese, Douglas E Schlichting, Inmaculada de la Torre, Scott D Beattie, Terence P Rooney, Peter C Taylor
OBJECTIVE: To assess the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) up to 128 weeks in a phase IIb study (NCT01185353). METHODS: After a 24-week blinded period, eligible patients entered an initial 52-week open-label extension (OLE); patients receiving 8 mg once daily (QD) continued with that dose and all others received 4 mg QD. Doses could be escalated to 8 mg QD at 28 or 32 weeks at investigator discretion when ≥ 6 tender and ≥ 6 swollen joints were present...
August 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28811344/the-capacity-of-mycobacterium-tuberculosis-to-survive-iron-starvation-might-enable-it-to-persist-in-iron-deprived-microenvironments-of-human-granulomas
#3
Krishna Kurthkoti, Hamel Amin, Mohlopheni J Marakalala, Saleena Ghanny, Selvakumar Subbian, Alexandra Sakatos, Jonathan Livny, Sarah M Fortune, Michael Berney, G Marcela Rodriguez
This study was conducted to investigate the role of iron deprivation in the persistence of Mycobacterium tuberculosis We present evidence of iron restriction in human necrotic granulomas and demonstrate that under iron starvation M. tuberculosis persists, refractive to antibiotics and capable of restarting replication when iron is made available. Transcriptomics and metabolomic analyses indicated that the persistence of M. tuberculosis under iron starvation is dependent on strict control of endogenous Fe utilization and is associated with upregulation of pathogenicity and intrinsic antibiotic resistance determinants...
August 15, 2017: MBio
https://www.readbyqxmd.com/read/28810911/outcomes-from-patients-with-presumed-drug-resistant-tuberculosis-in-five-reference-centers-in-brazil
#4
D M P Ramalho, P F C Miranda, M K Andrade, T Brígido, M P Dalcolmo, E Mesquita, C F Dias, A N Gambirasio, J Ueleres Braga, A Detjen, P P J Phillips, I Langley, P I Fujiwara, S B Squire, M M Oliveira, A L Kritski
BACKGROUND: The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. METHODS: Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28810840/the-association-between-tuberculosis-and-the-development-of-insulin-resistance-in-adults-with-pulmonary-tuberculosis-in-the-western-sub-district-of-the-cape-metropole-region-south-africa-a-combined-cross-sectional-cohort-study
#5
Lauren Philips, Janicke Visser, Daan Nel, Renée Blaauw
BACKGROUND: The existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative factor for IR remains unclear. The study aimed to determine if an association existed between tuberculosis and IR development in adults with newly diagnosed pulmonary tuberculosis at baseline. It was additionally aimed to document changes in IR status during TB follow-up periods...
August 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28810312/-analysis-of-infection-and-drug-resistance-in-6-107-cases-of-extrapulmonary-tuberculosis-in-chengdu-area
#6
D M Wang, Q F Li, M Zhu, Y H Xu, J Luo, Y J Li, J Zhong, Z J Wu
Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years...
August 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28809501/microencapsulated-solid-lipid-nanoparticles-as-a-hybrid-platform-for-pulmonary-antibiotic-delivery
#7
Diana P Gaspar, Maria Manuela Gaspar, Carla V Eleutério, Ana Grenha, Mateo Blanco, Lídia M D Gonçalves, Pablo Taboada, António J Almeida, Carmen Remuñán-López
Solid lipid nanoparticles (SLN) containing rifabutin (RFB), with pulmonary administration purposes, were developed through a technique that avoids the use of organic solvents or sonication. To facilitate their pulmonary delivery, the RFB-loaded SLN were included in microspheres of appropriate size using suitable excipients (mannitol and trehalose) through a spray-drying technique. Confocal analysis microscopy showed that microspheres are spherical and that SLN are efficiently microencapsulated and homogeneously distributed throughout the microsphere matrices...
August 15, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28808447/predictors-for-mortality-among-multidrug-resistant-tuberculosis-patients-in-tanzania
#8
Edson W Mollel, Jaffu O Chilongola
PROBLEM: Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported. OBJECTIVES: To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital. METHODOLOGY: This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined...
2017: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28808382/allium-sativum-constituents-exhibit-anti-tubercular-activity-in-vitro-and-in-raw-264-7-mouse-macrophage-cells-infected-with-mycobacterium-tuberculosis-h37rv
#9
Swapna S Nair, Sujay S Gaikwad, Savita P Kulkarni, Alka Pravin Mukne
BACKGROUND: Long duration of treatment, side-effects of currently used anti-tubercular drugs and emergence of drug-resistant forms of Mycobacterium tuberculosis (MTB) warrants the need to develop new drugs to tackle the scourge of tuberculosis (TB). Garlic is an edible plant reported to have anti-tubercular activity. However, previous researches on anti-tubercular effect of garlic were focused mostly on preliminary in vitro screening. OBJECTIVE: To identify constituents responsible for anti-tubercular activity of thiosulfinate-derivative rich extract of garlic (GE) and to evaluate activity of the most active constituent in RAW 264...
July 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28807917/bedaquiline-inhibits-the-atp-synthase-in-mycobacterium-abscessus-and-is-effective-in-infected-zebrafish
#10
Christian Dupont, Albertus Viljoen, Sangeeta Thomas, Françoise Roquet-Banères, Jean-Louis Herrmann, Kevin Pethe, Laurent Kremer
Pulmonary infections caused by Mycobacterium abscessus are emerging as a global threat, especially in cystic fibrosis patients. Further intensifying the concern of M. abscessus infection is the recent evidence of human-to-human transmission of the infection. M. abscessus is a naturally multidrug resistant, fast-growing pathogen for which pharmacological options are limited. Repurposing antitubercular drugs represents an attractive option for the development of chemotherapeutic alternatives against M. abscessus infections...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807911/systematic-review-and-meta-analyses-of-the-effect-of-chemotherapy-on-pulmonary-mycobacterium-abscessus-outcomes-and-disease-recurrence
#11
Jotam G Pasipanodya, Deborah Ogbonna, Beatriz E Ferro, Gesham Magombedze, Shashikant Srivastava, Devyani Deshpande, Tawanda Gumbo
Background. In pharmacokinetic/pharmacodynamics models of pulmonary Mycobacterium abscessus complex, the recommended macrolide-containing combination therapy has poor kill rates. However, clinical outcomes are unknown.Methods We searched the literature for studies published between 1990-2017 that reported microbial outcomes in patients treated for pulmonary M. abscessus disease. Good outcome was defined as sustained sputum culture conversion (SSCC) without relapse. Random effects models were used to pool studies and estimate proportions of patients with good outcomes...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807190/socioeconomic-differences-in-mortality-in-the-antiretroviral-therapy-era-in-agincourt-rural-south-africa-2001-13-a-population-surveillance-analysis
#12
Chodziwadziwa W Kabudula, Brian Houle, Mark A Collinson, Kathleen Kahn, Francesc Xavier Gómez-Olivé, Stephen Tollman, Samuel J Clark
BACKGROUND: Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001-13. METHODS: We used data from 21 villages of the Agincourt Health and socio-Demographic Surveillance System (HDSS). We calculated the probabilities of death from birth to age 5 years and from age 15 to 60 years, life expectancy at birth, and cause-specific and age-specific mortality by sex (not in children <5 years), time period, and socioeconomic status (household wealth) quintile for HIV/AIDS and tuberculosis, other communicable diseases (excluding HIV/AIDS and tuberculosis) and maternal, perinatal, and nutritional causes, non-communicable diseases, and injury...
September 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28807188/the-global-burden-of-tuberculosis-mortality-in-children-a-mathematical-modelling-study
#13
Peter J Dodd, Courtney M Yuen, Charalambos Sismanidis, James A Seddon, Helen E Jenkins
BACKGROUND: Tuberculosis in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015. Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric tuberculosis mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality. We aimed to produce a global mortality burden estimate in children using a complementary approach not dependent on vital registration data...
September 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28807020/feasibility-study-of-strengthening-the-public-private-partnership-for-tuberculosis-case-detection-in-bandung-city-indonesia
#14
Bony Wiem Lestari, Nita Arisanti, Adiatma Y M Siregar, Estro Dariatno Sihaloho, Gelar Budiman, Philip C Hill, Bachti Alisjahbana, Susan McAllister
OBJECTIVE: Private practitioner's (PPs) collaboration for detection, diagnosis and treatment of tuberculosis (TB) is recommended by the World Health Organization and encouraged by the Indonesian National TB control programme. TB case management by PPs, however, are mostly not in line with current guidelines. Therefore, we developed an intervention package for PPs comprising of TB training, implementation of a mobile phone application for notification of TB cases and a 6-month regular follow-up with PPs...
August 14, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28806025/brain-tuberculoma-a-case-report-and-literature-review
#15
Khalil Aloreidi, Jamal Dodin, Jeremy Berg, Wendell Hoffman
We are reporting on a rare case of central nervous system tuberculosis (TB) in the state of South Dakota. Our case features one of the most infrequent forms of TB in the brain: multiple tuberculomas. A 44-year-old immunocompetent man was admitted complaining of a headache and fever for a week. His physical exam was unremarkable. A magnetic resonance imaging scan of his brain showed two ring-enhancing lesions. The largest lesion was excised surgically and the histopathology exam was consistent with tuberculoma...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28805776/-diagnostic-and-curative-bronchoscopy-for-purulent-destructive-pulmonary-diseases
#16
T P Pinchuk, O O Yasnogorodsky, Yu V Guryanova, M V Taldykin, A S Kachikin, Yu A Catane
AIM: To assess an efficacy of diagnostic and curative bronchoscopy in patients with purulent-destructive pulmonary diseases. MATERIAL AND METHODS: Diagnosis and treatment of 34 patients with purulent-destructive pulmonary diseases including small-focal destruction (14) and lung abscesses (19) were analyzed. 33 patients underwent diagnostic fibrobronchoscopy (FBS) with brush and transbronchial biopsy. Curative endoscopy included bronchial tree sanation, peribronchial administration of antibiotics (5) and transbronchial drainage of abscess (14)...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28805143/a-pre-term-infant-of-32-weeks-gestation-with-congenital-tuberculosis-treated-successfully-with-antituberculosis-chemotherapy
#17
Xiaoyi Fang, Ruizhi Mai, Jizhong Guo, Niyang Lin
An infant of 32 weeks gestation was separated from her mother at birth for treatment of hyaline membrane disease and, on recovery, was cared for by adoptive parents. At 25 days, she was treated for pneumonia with immunoglobulins and multiple antibiotics and appeared to respond. Her symptoms recurred at 8 weeks and tuberculosis was confirmed by detection in an acid-fast bacilli smear of gastric aspirate. Her mother presented with disseminated tuberculosis with meningitis 1 month after delivery. Criteria for the diagnosis of congenital tuberculosis in the infant were confirmed...
August 14, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28803492/rifampin-vs-rifapentine-what-is-the-preferred-rifamycin-for-tuberculosis
#18
Omamah Alfarisi, Wael A Alghamdi, Mohammad H Al-Shaer, Kelly E Dooley, Charles A Peloquin
One-third of the world's population is infected with Mycobacterium tuberculosis (M.tb.). Latent tuberculosis infection (LTBI) can progress to tuberculosis disease, the leading cause of death by infection. Rifamycin antibiotics, like rifampin and rifapentine, have unique sterilizing activity against M.tb. What are the advantages of each for LTBI or tuberculosis treatment? Areas covered: We review studies assessing the pharmacokinetics (PK), pharmacodynamics (PD), drug interaction risk, safety, and efficacy of rifampin and rifapentine and provide basis for comparing them...
August 14, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28802409/exploring-the-potential-of-t7-bacteriophage-protein-gp2-as-a-novel-inhibitor-of-mycobacterial-rna-polymerase
#19
J du Plessis, R Cloete, L Burchell, P Sarkar, R M Warren, A Christoffels, S Wigneshweraraj, S L Sampson
Over the past six decades, there has been a decline in novel therapies to treat tuberculosis, while the causative agent of this disease has become increasingly resistant to current treatment regimens. Bacteriophages (phages) are able to kill bacterial cells and understanding this process could lead to novel insights for the treatment of mycobacterial infections. Phages inhibit bacterial gene transcription through phage-encoded proteins which bind to RNA polymerase (RNAP), thereby preventing bacterial transcription...
September 2017: Tuberculosis
https://www.readbyqxmd.com/read/28802407/immunological-characterization-of-latent-tuberculosis-infection-in-a-low-endemic-country
#20
Roelof A de Paus, Krista E van Meijgaarden, Corine Prins, Margreet H Kamphorst, Sandra M Arend, Tom H M Ottenhoff, Simone A Joosten
The diagnosis of a latent tuberculosis infection (LTBI) is based on detection of immunity against Mycobacterium tuberculosis (Mtb). The tuberculin skin test (TST), the Quantiferon (QFT) and a prolonged lymphocyte stimulation test using either ESAT-6/CFP-10 (LST-EC) or PPD (LST-PPD) were evaluated in a cohort of 495 individuals, suspected to have LTBI, in a low endemic country. While the TST and LST-PPD were both positive in the majority (75%) of individuals, only one third responded in the LST-EC and in the QFT...
September 2017: Tuberculosis
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