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TUBERCULOSIS IN THE PREGNANCY

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https://www.readbyqxmd.com/read/28027281/virologic-response-to-first-line-efavirenz-or-nevirapine-based-anti-retroviral-therapy-in-hiv-infected-african-children
#1
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 vs 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 vs 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...
December 23, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28018449/congenital-miliary-tuberculosis-in-an-18-day-old-boy
#2
Jue Seong Lee, Chang Hoon Lim, Eunji Kim, Hyunwook Lim, Yoon Lee, Ji Tae Choung, Young Yoo
Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#3
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28011331/multi-drug-resistant-female-genital-tuberculosis-a-preliminary-report
#4
J B Sharma, Alka Kriplani, Eshani Sharma, Sangeeta Sharma, Sona Dharmendra, Sunesh Kumar, P Vanamail, S K Sharma
OBJECTIVE: Evaluation of 6 patients presenting with tubo-ovarian mass or infertility with multi drug resistant (MDR) female genital tuberculosis (FGTB). STUDY DESIGN: It was an observational study in a tertiary referral centre, India on subjects with MDR FGTB on clinical examination and investigations. All patients were given category IV drugs using kanamycin (intramuscular), levofloxacin, pyrazinamide, cycloserine, ethionamide and ethambutol (or para aminosalicylic acid [PAS] for ethambutol resistant cases) for 6 months intensive phase followed by oral levofloxacin, cycloserine, ethionamide and ethambutol (or PAS for ethambutol resistant cases) for 18 months continuation phase...
December 12, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27999684/a-perspective-of-the-diagnosis-and-management-of-congenital-tuberculosis
#5
REVIEW
Manou Irmina Saramba, Dongchi Zhao
Tuberculosis continues to be a prevalent disease in the world and a global public health issue in many countries. The disease is more complicated in pregnant women because it imperils unborn offspring and results in congenital tuberculosis later if undiagnosed and untreated. Congenital tuberculosis is rare entity and an uncommon disease along with a high mortality rate. Congenital tuberculosis, a severe clinical type of tuberculosis caused by Mycobacterium tuberculosis, is a serious and fatal disease if left untreated...
2016: Journal of Pathogens
https://www.readbyqxmd.com/read/27938369/achieving-development-goals-for-hiv-tuberculosis-and-malaria-in-sub-saharan-africa-through-integrated-antenatal-care-barriers-and-challenges
#6
EDITORIAL
Freya J I Fowkes, Bridget L Draper, Margaret Hellard, Mark Stoové
BACKGROUND: The global health community is currently transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Unfortunately, progress towards maternal, newborn and infant health MDGs has lagged significantly behind other key health goals, demanding a renewed global effort in this key health area. The World Health Organization and other institutions heralded integrated antenatal care (ANC) as the best way to address the inter-related health issues of HIV, tuberculosis (TB) and malaria in the high risk groups of pregnant women and infants; integrated ANC services also offer a mechanism to address slow progress towards improved maternal health...
December 12, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27931336/risk-of-tuberculosis-during-pregnancy-in-mongolia-a-high-incidence-setting-with-low-hiv-prevalence
#7
N L Rendell, N Batjargal, N Jadambaa, C C Dobler
OBJECTIVE: To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. DESIGN: We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931054/-tb-screening-of-pregnant-women-in-accordance-with-the-german-protection-against-infection-act
#8
(no author information available yet)
Pregnant women should be tested with immune tests for tuberculosis when they undergo TB screening according to the German Infectious Diseases Protection Act. Interferon Gamma Release Assays (IGRAs) should be the priority tests used for pregnant refugees and asylum seekers, especially when migrating from high incidence countries (> 20 cases/100.000 population according to the ECDC) or when they fled from crisis regions; positive tuberculin skin tests should be veryfied with IGRA. Once immunological tests are suggesting a latent tuberculosis infection it should be considered that pregnant women have an increased risk of developing active tuberculosis with potential health threats for the unborn child...
December 2016: Pneumologie
https://www.readbyqxmd.com/read/27862893/maternal-and-perinatal-mortality-and-morbidity-associated-with-tuberculosis-during-pregnancy-and-the-postpartum-period-a-systematic-review-and-meta-analysis
#9
REVIEW
S Sobhy, Zoe Babiker, J Zamora, K S Khan, H Kunst
BACKGROUND: There is a dearth of data on the clinical features and outcomes of active tuberculosis (TB) in pregnancy. Studies have shown varied results and the relationship between TB and adverse pregnancy outcomes remains unclear. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate pregnancy outcomes associated with TB. SEARCH STRATEGY: Major databases were searched from inception until December 2015 without restrictions using the terms: 'TB', 'pregnancy', 'maternal morbidity', 'mortality' and 'perinatal morbidity', 'mortality'...
November 11, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27812086/tuberculosis-disease-during-pregnancy-and-treatment-outcomes-in-hiv-infected-and-uninfected-women-at-a-referral-hospital-in-cape-town
#10
Adrie Bekker, Hendrik S Schaaf, Heather R Draper, Magdalena Kriel, Anneke C Hesseling
BACKGROUND: Tuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings. METHODS: A prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status...
2016: PloS One
https://www.readbyqxmd.com/read/27729022/pregnancy-in-patients-with-tuberculosis-a-tbnet-cross-sectional-survey
#11
Graham H Bothamley, Cordula Ehlers, Irina Salonka, Alena Skrahina, Angels Orcau, Luigi R Codecasa, Maurizio Ferrarese, Dragica Pesut, Ivan Solovic, Andrii Dudnyk, Luis Anibarro, Claudia Denkinger, Lorenzo Guglielmetti, Inge Muylle, Marco Confalonieri
BACKGROUND: Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. METHOD: Design: A cross-sectional survey. SETTING: 13 tuberculosis clinics within different European countries and the USA. POPULATION/SAMPLE: All patients with tuberculosis seen at these clinics for a period > 1 year...
October 12, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27725039/active-tuberculosis-case-finding-among-pregnant-women-a-pilot-project-in-burkina-faso
#12
G Sulis, S Gnanou, A Roggi, A Konseimbo, P F Giorgetti, F Castelli, A Matteelli
Tuberculosis (TB) is a leading cause of death among women of childbearing age, and may be responsible for severe complications during pregnancy. Between August 2014 and March 2015, we conducted a pilot project to promote active TB case finding in antenatal care (ANC) clinics in the Central Region of Burkina Faso. Our results show very limited TB diagnostic practices and possible severe underdiagnosis of TB at ANC clinics, despite adequate screening practices. Integration of training and supervision of TB diagnosis and treatment into ANC services is required...
October 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27610260/postpartum-tuberculosis-a-diagnostic-and-therapeutic-challenge
#13
Vijay Kodadhala, Alemeshet Gudeta, Aklilu Zerihun, Odene Lewis, Sohail Ahmed, Jhansi Gajjala, Alicia Thomas
Tuberculosis (TB) infection in pregnant women and newborn babies is always challenging. Appropriate treatment is pivotal to curtail morbidity and mortality. TB diagnosis or exposure to active TB can be emotionally distressing to the mother. Circumstances can become more challenging for the physician if the mother's TB status is unclear. Effective management of TB during pregnancy and the postpartum period requires a multidisciplinary approach including pulmonologist, obstetrician, neonatologist, infectious disease specialist, and TB public health department...
2016: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/27578855/pregnancy-outcomes-in-women-with-tuberculosis-a-10-year-experience-from-an-indian-tertiary-care-hospital
#14
Seema Chopra, Sujata Siwatch, Neelam Aggarwal, Pooja Sikka, Vanita Suri
Our study sought to determine the characteristics of antenatal patients with tuberculosis (TB) and their pregnancy outcomes. Case records of 50 antenatal women with extra-pulmonary and pulmonary TB at a tertiary centre in India were compared to 150 antenatal women not suffering from TB, for adverse medical, obstetric and neonatal outcomes. The prevalence of TB was 1.16 per 1000 deliveries. Of these, 62% had extra-pulmonary TB. There were two maternal deaths. TB in pregnancy was associated with a five times higher risk of prematurity and three times higher risk of intrauterine growth restriction than the norm...
August 30, 2016: Tropical Doctor
https://www.readbyqxmd.com/read/27530490/medical-and-obstetric-outcomes-among-pregnant-women%C3%A2-with-tuberculosis-a-population-based-study%C3%A2-of%C3%A2-7-8%C3%A2-million%C3%A2-births
#15
Amira El-Messidi, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim Arie Abenhaim
BACKGROUND: Worldwide, tuberculosis remains a major health concern, with an estimated 9.6 million people infected in the year 2014, of which one-third were women. Tuberculosis is estimated to be even more prevalent in pregnant women than the general population. To date there has been conflicting evidence on the maternal and neonatal complications of tuberculosis in pregnancy. OBJECTIVE: We sought to determine trends in the incidence of tuberculosis in pregnancy and to examine the associations between tuberculosis in pregnancy and maternal and fetal complications...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27509237/community-based-hiv-and-health-testing-for-high-risk-adolescents-and-youth
#16
Lindsey K Reif, Vanessa Rivera, Bianca Louis, Rachel Bertrand, Mireille Peck, Benedict Anglade, Grace Seo, Elaine J Abrams, Jean W Pape, Daniel W Fitzgerald, Margaret L McNairy
Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care...
August 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27504359/intracranial-tuberculoma-presenting-as-atypical-eclampsia-a-case-report
#17
Sendhil Coumary Arumugam, Sharmila Murugesan, Sunitha Pradeep, Lopamudra John, Vasavi Kolluru
Occurrence of eclampsia before 20 weeks of pregnancy and after 48 hours of delivery in the absence of typical signs of hypertension and or proteinuria is termed as atypical eclampsia. Atypical or non-classic eclampsia will have some symptoms of eclampsia but without the usual proteinuria or hypertension. All patients with atypical onset should undergo neurological evaluation to rule out neurologic causes of seizures. Cerebral tuberculosis is a rare and serious form of disease secondary to haematogenous spread of Mycobacterium tuberculosis...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27476253/-genital-tuberculosis-atypical-manifestation-in-the-pregnancy-case-report
#18
A Franco-Sansaloni, J Vizcaíno-Torres, J Gaona-Morales, D Estellés-Morant, J Antonio-Serrano
BACKGROUND: In the last years has been an increase in cases of tu- berculosis, representing a global health problem that is also reflected in an increased of cases in pregnant population. Especially in developed countries has been observed a direct relation with VIH patients,and groups of immigrants from countries where the infection is endemic. Tuberculous disease during pregnancy presents good outcome if it is diagnosed and treated properly. CASE REPORT: We present the case of a romanian patient with uncon- trolled 23 weeks gestation that enters with the suspicion of chorioam- nionitis and after late septic miscarriage and clinical sepsis criteria, leaks out of the hospital reentering with signs of neurologic involvement and pelviperitonitis as a result of genital tuberculous...
May 2016: Ginecología y Obstetricia de México
https://www.readbyqxmd.com/read/27391900/six-months-versus-nine-months-anti-tuberculous-therapy-for-female-genital-tuberculosis-a-randomized-controlled-trial
#19
Jai B Sharma, Neeta Singh, Sona Dharmendra, Urvashi B Singh, Vanamail P, Sunesh Kumar, K K Roy, Smriti Hari, V Iyer, S K Sharma
OBJECTIVE: To compare six months versus nine months anti-tuberculous therapy in patients of female genital tuberculosis. STUDY DESIGN: It was a randomized controlled trial in a tertiary referral center teaching institute on 175 women presenting with infertility and found to have female genital tuberculosis on clinical examination and investigations. Group I women (86 women) were given 9 months of intermitted anti-tuberculous therapy under directly observed treatment short course (DOTS) strategy while Group II (89 women) were given 6 months of anti-tuberculous therapy under DOTS...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27338778/adalimumab-long-term-safety-infections-vaccination-response-and-pregnancy-outcomes-in-patients-with-rheumatoid-arthritis
#20
Gerd R Burmester, Robert Landewé, Mark C Genovese, Alan W Friedman, Nathan D Pfeifer, Nupun A Varothai, Ana P Lacerda
BACKGROUND: Adalimumab has been used in patients with moderately to severely active rheumatoid arthritis (RA) for over 10 years and has a well-established safety profile across multiple indications. OBJECTIVE: To update adverse events (AEs) of special interest from global adalimumab clinical trials in patients with RA. METHODS: This analysis includes 15 132 patients exposed to adalimumab in global RA clinical trials. AEs of interest included overall infections, laboratory abnormalities and AEs associated with influenza vaccination...
June 23, 2016: Annals of the Rheumatic Diseases
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