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TUBERCULOSIS IN THE PREGNANCY

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https://www.readbyqxmd.com/read/28538284/the-advance-study-a-groundbreaking-trial-to-evaluate-a-candidate-universal-antiretroviral-regimen
#1
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...
May 19, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
April 12, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28403027/candidates-for-inclusion-in-a-universal-antiretroviral-regimen-tenofovir-alafenamide
#8
Dzintars Gotham, Andrew Hill, Anton L Pozniak
PURPOSE OF REVIEW: Tenofovir disoproxil fumarate (TDF) is a standard first-line therapy for HIV. Recently, tenofovir alafenamide (TAF), a different prodrug for the same active moiety, has been approved. In this review, we have conducted a meta-analysis comparing efficacy and safety data for TDF and TAF, to inform a discussion of which drug would be best for a proposed 'universal antiretroviral (ARV) regimen'. RECENT FINDINGS: We identified 10 randomized controlled trials comparing TDF with TAF (6969 patients, 8043 patient-years of follow-up)...
April 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28344965/tuberculous-peritonitis-in-the-first-trimester-of-pregnancy
#9
Sukyung Jung, Nae Ri Yun, Jeong Ok Kim, Jeong Hoon Lee, Ho Yeon Kim, Eunseop Song, Byoung Ick Lee, Sung Ook Hwang, Soo Ran Choi
Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28317816/hemophagocytic-syndrome-secondary-to-tuberculosis-at-24-week-gestation
#10
Alexandra Arteaga Fernández, David Fernández de Velasco Pérez, M C Jiménez Fournier, J C Moreno Del Prado, B Paraíso Torras, M L Cañete Palomo
Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28317804/a-survey-on-undiagnosed-active-pulmonary-tuberculosis-among-pregnant-mothers-in-mekelle-and-surrounding-districts-in-tigray-ethiopia
#11
Dawit Gebreegziabiher, Kelemework Adane, Markos Abebe
OBJECTIVE/BACKGROUND: To determine the prevalence of undiagnosed active pulmonary tuberculosis (PTB) cases and sensitivity, specificity, and positive and negative predictive values of symptom combinations for undiagnosed TB infection in human immunodeficiency virus (HIV)-positive and HIV-negative pregnant mothers attending antenatal care (ANC) clinics. Mycobacterium TB and HIV are the leading causes of death among women of reproductive age worldwide. Symptom screening is the first step in the World Health Organization (WHO)-recommended TB intensified case finding algorithm for people living with HIV...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28264655/screening-in-maternity-to-ascertain-tuberculosis-status-smats-study
#12
Edward Broughton, Samson Haumba, Marianne Calnan, Sandile Ginindsa, Rosanna Jeffries, Gugu Maphalala, Sikhathele Mazibuko, Munamato Mirara, Surbhi Modi, Pasipamire Munyaradzi, Peter Preko, Batsabile Simelane
BACKGROUND: Diagnosis of tuberculosis is difficult among pregnant women because the signs and symptoms of the disease, such as fatigue, shortness of breath, sweating, cough, and mild fever are similar to some manifestations of pregnancy. It is particularly challenging among HIV-infected women as symptoms are often masked or atypical. Currently, WHO recommends a standard four-symptom screening tool for pregnant and lactating women. There is evidence from South Africa that this screening tool (which, despite complex symptomology in this population, recommends identification of patients with weight loss, fever, current cough and night sweats), may be missing true active TB cases...
March 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28219359/congenital-tuberculosis-in-an-extremely-preterm-infant-conceived-after-in-vitro-fertilization-case-report
#13
Veronica Samedi, Stephen K Field, Essa Al Awad, Gregory Ratcliffe, Kamran Yusuf
BACKGROUND: Congenital tuberculosis is a rare manifestation of tuberculosis. The diagnosis is often delayed, especially in preterm neonates because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy. CASE PRESENTATION: We report a case of congenital tuberculosis in an infant born at 24 weeks of gestation to a mother who presented with uncontrolled seizures during preterm labor. Maternal diagnosis was initially made by placental pathology, and later confirmed by isolation of Mycobacterium tuberculosis in urine, gastric aspirates and sputum...
February 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28217610/disseminated-tuberculosis-in-a-newborn-infant
#14
Tanu Sagar, Kavita Gupta, Mayuri Rani, Iqbal Rajinder Kaur
Tuberculosis (TB) remaining as one of the deadliest communicable diseases. Congenital infection by vertical transmission is rare but high neonatal mortality (up to 60%) and morbidity warrant early and accurate diagnosis of newborns suffering from TB. Intrauterine infection of tuberculosis is most commonly caused by haematogenous spread from the mother causing placental seedling. The organisms reach the fetus via the umbilical vein and the primary focus is often in the fetal liver in hematgenous spread. Another route of infection is by direct ingestion or aspiration of infected amniotic fluid if the placental caseous lesion ruptures directly into the amniotic cavity...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28184323/congenital-tuberculosis-a-newborn-case-report-with-rare-manifestation
#15
Hadi Khorsand Zak, Shahin Mafinezhad, Ali Haghbin
INTRODUCTION: Congenital tuberculosis is an infrequently encountered condition and only 300 cases were reported in the literature till 1989. There are no specific signs and symptoms pathognomonic for congenital TB, and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period. CASE PRESENTATION: In this paper we report on a case of congenital TB in a newborn who was admitted to our clinic with seizures and intraventricular hemorrhage (IVH) due to TB meningitis...
October 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28166914/role-of-anti-tubercular-treatment-for-positive-endometrial-aspirate-dna-pcr-reproductive-outcome-in-infertile-patients-in-indian-setting-a-randomized-trial
#16
A Kriplani, A Bahadur, V Kulshrestha, N Agarwal, S Singh, U B Singh
AIMS: The aim of the study was to determine the effect of anti-tubercular therapy (ATT) versus no ATT on reproductive outcome in patients with positive endometrial aspirate DNA-PCR for tuberculosis. SETTINGS AND DESIGN: Department of Obstetrics and Gynecology in collaboration with the Department of Microbiology at the All India Institute of Medical Sciences, New Delhi, India. METHODS AND MATERIALS: This prospective randomized study was conducted on 100 women in the reproductive age group with primary or secondary infertility, attending the Gynecology OPD at AIIMS...
January 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28027281/virologic-response-to-first-line-efavirenz-or-nevirapine-based-anti-retroviral-therapy-in-hiv-infected-african-children
#17
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
#18
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
#19
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...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28011331/multi-drug-resistant-female-genital-tuberculosis-a-preliminary-report
#20
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...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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