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TUBERCULOSIS IN THE PREGNANCY

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https://www.readbyqxmd.com/read/29017245/a-community-perspective-on-the-inclusion-of-pregnant-women-in-tuberculosis-drug-trials
#1
Lindsay McKenna, Mike Frick, Cynthia Lee, Dorothy Namutamba, Liani Smit, Marie Theunissen, Wim Vandevelde, Suraj Madoori, Kathryn Snow, Barbara Seaworth
Affecting both mother and the existing pregnancy, tuberculosis (TB) increases the likelihood of poor birth outcomes. Despite substantial clinical need for TB prevention and treatment, pregnant women remain neglected by research initiatives. As members of 3 community advisory boards that provide input into TB drug trials, we offer a community perspective on the inclusion of pregnant women in TB drug research and discuss (1) our perspective on the risk/benefit tradeoff of including pregnant women in research to address different forms of TB; (2) recent examples of progress in this area; (3) lessons learned from the human immunodeficiency virus research field, where pregnant women have enjoyed better-although imperfect-representation in research; and (4) recommendations for different stakeholders, including researchers, regulatory authorities, ethics committees, and policymakers...
October 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28912984/caecal-perforation-from-primary-intestinal-tuberculosis-in-pregnancy
#2
Soe Lwin, Nina Lau Lee Jing, Haris Suharjono, Mardiana Binti Kipli, Tin Moe Nwe, Myat San Yi, Lucas Luk Tien Wee
The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of extrapulmonary TB (EPTB) can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. We present a case of caecal TB in pregnancy, which resulted in caecal perforation, a right hemicolectomy, and severe preterm delivery...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28885339/role-of-chemotherapy-and-thrombolysis-in-treatment-of-choriocarcinoma-accompanied-with-pulmonary-embolism-a-case-report-with-literature-review
#3
Mei Yang, Li Peng
RATIONALE: Choriocarcinoma accompanied with pulmonary embolism (PE) is rare and difficult to diagnose and treat. There are about 25 cases reported in literature, which presented variable clinical characteristics and prognosis. PATIENT CONCERNS: We reported a case of choriocarcinoma presenting PE as the first manifestation in a 26-year-old Chinese female. DIAGNOSES: Four months before her admission to our hospital, she presented to a local hospital with respiratory manifestations, and was first diagnosed as bronchitis and treated with antibiotics without improvement, and subsequently suspected of having pulmonary tuberculosis and receive anti-tuberculosis therapy, with no response...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28870263/effect-of-maternal-vitamin-d3-supplementation-on-maternal-health-birth-outcomes-and-infant-growth-among-hiv-infected-tanzanian-pregnant-women-study-protocol-for-a-randomized-controlled-trial
#4
Christopher R Sudfeld, Karim P Manji, Christopher P Duggan, Said Aboud, Alfa Muhihi, David M Sando, Fadhlun M Alwy Al-Beity, Molin Wang, Wafaie W Fawzi
BACKGROUND: Vitamin D has significant immunomodulatory effects on both adaptive and innate immune responses. Observational studies indicate that adults infected with HIV with low vitamin D status may be at increased risk of mortality, pulmonary tuberculosis, and HIV disease progression. Growing observational evidence also suggests that low vitamin D status in pregnancy may increase the risk of adverse birth and infant health outcomes. As a result, antiretroviral therapy (ART) adjunct vitamin D3 supplementation may improve the health of HIV-infected pregnant women and their children...
September 4, 2017: Trials
https://www.readbyqxmd.com/read/28862174/genital-tuberculosis-in-females
#5
REVIEW
G Angeline Grace, D Bella Devaleenal, Mohan Natrajan
The morbidity and mortality due to tuberculosis (TB) is high worldwide, and the burden of disease among women is significant, especially in developing countries. Mycobacterium tuberculosis bacilli reach the genital tract primarily by haematogenous spread and dissemination from foci outside the genitalia with lungs as the common primary focus. Genital TB in females is a chronic disease with low-grade symptoms. The fallopian tubes are affected in almost all cases of genital TB, and along with endometrial involvement, it causes infertility in patients...
April 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28820423/-risk-factors-and-special-aspects-forgenital-tuberculosis-diagnostics
#6
G Lortkipanidze, N Kintraia, K Vacharadze, F Tsaava
Was examined 453 women, who applied to National Center for Tuberculosis and Lung Diseases for genital tuberculosis diagnostics. GTB was detected in 289 cases, in 164 cases GTB results was negative (control group). In 10 cases GTB was combined with pulmonary tuberculosis (OR-1,13). Risk factors are previous diseases of female reproductive organs- intracellular infection (OR-1,08), sexually transmitted diseases (OR-1,25), nonspecific inflammatory diseases (OR-1,009), interruption of pregnancy (OR-1,26), artificial abortions (OR-1,11), the most specific signs of Genital Tuberculosis is a pain in the stomach area (P-0,023), dysmenorrhoea (P-0,00001), intestinal obstruction (P-0,0006), heat (P-0,00001), liquid presence in posterior vault (P-0,007), hydrosalpinx (P-0,00001), Fallopian tubes deformation (P-0,000003), oophoritic cyst (P-0,067), adhesive process in small pelvis (P-0,0006)...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28808611/red-snappers-and-red-herrings-pelvic-tuberculosis-causing-elevated-ca-125-and-mimicking-advanced-ovarian-cancer-a-case-report-and-literature-review
#7
Johnnie Alphonse Yates, Olivia Ann Collis, Thanasak Sueblinvong, Tarquin Kamakana Collis
Female genital tuberculosis (FGTB) is a form of extra-pulmonary tuberculosis that has been primarily described in developing countries, where it is an important cause of infertility, ectopic pregnancy, and miscarriage. FGTB is rare in the United States and because its clinical presentation is non-specific and often insidious, FGTB may be misdiagnosed as a gynecologic malignancy or endometriosis. The tendency of tuberculosis to dramatically increase serum CA 125 levels contributes to the potential for FGTB to be mistaken for ovarian cancer in particular...
August 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28792382/bedaquiline-and-linezolid-for-extensively-drug-resistant-tuberculosis-in-pregnant-woman
#8
Marie Jaspard, Elisabeth Elefant-Amoura, Isabelle Melonio, Inés De Montgolfier, Nicolas Veziris, Eric Caumes
A woman with extremely drug-resistant tuberculosis treated with a drug regimen including linezolid and bedaquiline during her last 3 weeks of pregnancy gave birth to a child without abnormalities. No fetal toxicities were noted by 2 years after delivery. This drug combination might be safe during the late third trimester of pregnancy.
October 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28659187/tuberculous-meningoencephalitis-associated-with-brain-tuberculomas-during-pregnancy-a-case-report
#9
Sadie Namani, Shemsedin Dreshaj, Arieta Zogaj Berisha
BACKGROUND: Tuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy...
June 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28638075/mycobacterial-heat-shock-protein-65-mediated-metabolic-shift-in-decidualization-of-human-endometrial-stromal-cells
#10
Elavarasan Subramani, Arun Prabhu Rameshbabu, Manivannan Jothiramajayam, Bhuvaneshwaran Subramanian, Debangana Chakravorty, Gunja Bose, Mamata Joshi, Chaitali Datta Ray, Indrani Lodh, Ratna Chattopadhyay, Sudipto Saha, Anita Mukherjee, Santanu Dhara, Baidyanath Chakravarty, Koel Chaudhury
Successful implantation is dependent on the appropriate decidualization of endometrial stromal cells for the establishment of pregnancy in women. Mycobacterial heat shock protein 65 (HSP65) is involved in pathogenesis of the genital tuberculosis (GTB), one of the common causes of infertility in emerging countries. Though implantation failure appears to be the major cause, understanding the status of decidualizaiton process in women diagnosed with GTB has not been thoroughly addressed. We, therefore, explored the effect of HSP65 protein on the endometrial cell metabolism during in vitro decidualization...
June 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28633705/household-food-insecurity-is-associated-with-low-interferon-gamma-levels-in-pregnant-indian-women
#11
A Vaidya, R Bhosale, P Sambarey, N Suryavanshi, S Young, V Mave, S Kanade, V Kulkarni, P Deshpande, U Balasubramanian, J Elf, N Gupte, A Gupta, J S Mathad
SETTING: Over 20% of tuberculosis (TB) cases during pregnancy occur in India. OBJECTIVE: To determine the association between household food insecurity and interferon-gamma (IFN-γ) levels in pregnancy. DESIGN: Pregnant women in India were administered the Household Food Insecurity Access Scale (HFIAS) questionnaire and underwent an IFN-γ release assay. Logistic regression was used to identify factors associated with food insecurity. RESULTS: Of 538 women, 60 (11%) had household food insecurity, 47 (78%) of which were moderate or severe food insecure...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28579016/executive-summary-of-the-gesida-national-aids-plan-consensus-document-on-antiretroviral-therapy-in-adults-infected-by-the-human-immunodeficiency-virus-updated-january-2017
#12
(no author information available yet)
Antiretroviral therapy (ART) is recommended for all patients infected by HIV-1. The objective of ART is to achieve an undetectable plasma viral load (PVL). Initial ART should be based on a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors (tenofovir in either of its two formulations plus emtricitabine or abacavir plus lamivudine) and another drug from a different family. Four of the recommended regimens, all of which have an integrase inhibitor as the third drug (dolutegravir, elvitegravir boosted with cobicistat or raltegravir), are considered preferential, whereas a further 3 regimens (based on elvitegravir/cobicistat, rilpivirine, or darunavir boosted with cobicistat or ritonavir) are considered alternatives...
May 31, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28553027/a-ten-year-audit-of-maternal-mortality-millennium-development-still-a-distant-goal
#13
Anshuja Singla, Shalini Rajaram, Sumita Mehta, Gita Radhakrishnan
OBJECTIVE: To assess various causes of maternal mortality over a ten year period. DESIGN: Retrospective audit of hospital case records. SETTING: Tertiary care hospital. POPULATION: Pregnant women who expired in the premises of GTB Hospital. MATERIALS AND METHODS: A retrospective audit of case records of maternal deaths was conducted for a ten year period (January 2005 to December 2014). RESULTS: There were a total of 647 maternal deaths out of 1,16,641 live births...
April 2017: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/28538284/the-advance-study-a-groundbreaking-trial-to-evaluate-a-candidate-universal-antiretroviral-regimen
#14
Willem D F Venter, Polly Clayden, Celicia Serenata
PURPOSE OF REVIEW: Current WHO-recommended first-line therapy in low-income and middle-income countries has been very successful in saving millions of lives but still has toxicity concerns and a low barrier to resistance. RECENT FINDINGS: Two candidate antiretrovirals may substantially transform first-line therapy in low-income and middle-income countries, yielding a safer, more robust and cheaper regimen. Tenofovir alafenamide carries toxicity and cost benefits over tenofovir disoproxil fumarate...
July 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28534220/is-decompressive-surgery-the-only-treatment-option-a-case-series-of-patients-with-spinal-tuberculosis-in-advanced-pregnancy
#15
Ashok K Rathod, Vishwajeet Singh, Prateek Patil, Hemant Singh
PURPOSE: To present cases of spinal tuberculosis in advanced pregnancy treated on anti-tuberculous drug regimen with successful outcome and proposing alternative paradigm to surgical decompression. A case series of five patients in stages of advanced pregnancy with neurologic deterioration and spinal tuberculosis were reported and treated. METHODS: Five patients with backache in advanced stages of pregnancy were reported. Patients were diagnosed as cases of spinal tuberculosis on further imaging studies...
May 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28505015/virologic-response-to-first-line-efavirenz-or-nevirapine-based-antiretroviral-therapy-in-hiv-infected-african-children
#16
Adeodata Kekitiinwa, Alexander J Szubert, Moira Spyer, Richard Katuramu, Victor Musiime, Tawanda Mhute, Sabrina Bakeera-Kitaka, Oscar Senfuma, Ann Sarah Walker, Diana M Gibb
BACKGROUND: Poorer virologic response to nevirapine- versus efavirenz-based antiretroviral therapy (ART) has been reported in adult systematic reviews and pediatric studies. METHODS: We compared drug discontinuation and viral load (VL) response in ART-naïve Ugandan/Zimbabwean children ≥3 years of age initiating ART with clinician-chosen nevirapine versus efavirenz in the ARROW trial. Predictors of suppression <80, <400 and <1000 copies/mL at 36, 48 and 144 weeks were identified using multivariable logistic regression with backwards elimination (P = 0...
June 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28496303/development-of-a-potent-invigorator-of-immune-responses-endowed-with-both-preventive-and-therapeutic-properties
#17
REVIEW
Gursaran P Talwar, Jagdish C Gupta, Abu S Mustafa, Hemanta K Kar, Kiran Katoch, Shreemanta K Parida, Prabhakara P Reddi, Niyaz Ahmed, Vikram Saini, Somesh Gupta
This article reviews briefly the making of an immunoprophylactic-cum-immunotherapeutic vaccine against leprosy. The vaccine is based on cultivable, heat-killed atypical mycobacteria, whose gene sequence is now known. It has been named Mycobacterium indicus pranii. It has received the approval of the Drug Controller General of India and the US Food and Drug Administration. Besides leprosy, M. indicus pranii has found utility in the treatment of category II ("difficult to treat") tuberculosis. It also heals ugly anogenital warts...
2017: Biologics: Targets & Therapy
https://www.readbyqxmd.com/read/28489769/retroperitoneal-metastatic-poorly-differentiated-carcinoma-with-%C3%AE-human-chorionic-gonadotropin-secretion-presenting-as-a-psoas-abscess-a-case-report-and-review-of-the-literature
#18
Bingjin Wang, Weifang Liu, Zengwu Shao, Xianlin Zeng
RATIONALE: Psoas abscesses generally arise from a contiguous intra-abdominal or pelvic infectious process or hematogenous spreading of bacteria. The serum β-human chorionic gonadotropin has been used to detect normal or ectopic pregnancy. It also can be utilized in following up carcinomas. PATIENT CONCERNS: Here, we reported a case of a 47-year-old woman who presented with a left psoas mass presumptively diagnosed as an abscess secondary to lumbar tuberculosis In addition, the patient had abnormal increase of β-human chorionic gonadotropin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28482961/low-prevalence-of-malnourishment-among-household-contacts-of-patients-with-tuberculosis-in-guinea-bissau
#19
C B Patsche, F Rudolf, S W Mogensen, A Sifna, V F Gomes, S Byberg, C Wejse
SETTING: An urban demographic surveillance site in Bissau, the capital of Guinea-Bissau, West Africa.BACKGROUND We hypothesised that if previous malnutrition plays a part in acquiring active tuberculosis (TB) disease, households of TB cases would have a higher prevalence of malnutrition than those of healthy controls. DESIGN: A cross-sectional study comparing nutritional and socio-economic status of all newly diagnosed patients with TB in 2014 with household contacts (persons residing in the household of TB cases) and random controls...
June 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28410249/when-could-new-antiretrovirals-be-recommended-for-national-treatment-programmes-in-low-income-and-middle-income-countries-results-of-a-who-think-tank
#20
Marco Vitoria, Nathan Ford, Polly Clayden, Anton L Pozniak, Andrew M Hill
PURPOSE OF REVIEW: To discuss barriers and opportunities for the introduction of new antiretrovirals into national treatment programmes in low-income and middle-income countries to support further treatment scale-up. Invitees to a WHO Think Tank in February 2017 evaluated recently published results. RECENT FINDINGS: There is not sufficient clinical experience of dolutegravir (DTG), tenofovir alafenamide (TAF) or efavirenz 400 mg (EFV400) to recommend their use in pregnancy...
July 2017: Current Opinion in HIV and AIDS
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