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David W Dowdy, Grant Theron, Jeffrey A Tornheim, Robin Warren, Emily A Kendall
A novel, shorter-course regimen for treating multidrug-resistant (MDR) tuberculosis was recently recommended by the World Health Organization. However, the most appropriate use of drug susceptibility testing (DST) to support this regimen is less clear. Implementing countries must therefore often choose between using a standardized regimen despite high levels of underlying drug resistance or require more stringent DST prior to treatment initiation. The former carries a high likelihood of exposing patients to de facto monotherapy with a critical drug class (fluoroquinolones), whereas the latter could exclude large groups of patients from their most effective treatment option...
October 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Paolo Miotto, Andrea M Cabibbe, Emanuele Borroni, Massimo Degano, Daniela M Cirillo
Low-level rifampicin resistance associated with specific rpoB mutations (referred as "disputed") in Mycobacterium tuberculosis is easily missed by some phenotypic methods. To understand the mechanism by which some mutations are systematically missed by MGIT phenotypic testing we performed an in silico analysis of their effect on the structural interaction between the RpoB protein and rifampicin. We also characterized 24 representative clinical isolates by determining minimum inhibitory concentrations (MICs) on 7H10 agar, and testing them by an extended MGIT protocol...
March 14, 2018: Journal of Clinical Microbiology
Marja Visser, Trudie Gerrits, Fulco van der Veen, Monique Mochtar
When intended parents choose to have donor sperm treatment (DST), this may entail wide-ranging and long-lasting psychosocial implications related to the social parent not having a genetic tie with the child, how to disclose donor-conception and future donor contact. Counselling by qualified professionals is recommended to help intended parents cope with these implications. The objective of this study is to present findings and insights about how counsellors execute their counselling practices. We performed a qualitative study that included 13 counsellors working in the 11 clinics offering DST in the Netherlands...
March 14, 2018: Human Fertility: Journal of the British Fertility Society
Melissa Ventura Marra, Sowmyanarayanan V Thuppal, Elizabeth J Johnson, Regan L Bailey
Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45-64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls...
March 12, 2018: Nutrients
Michael Korenkov
The video-assisted subcutaneous destruction of the sinus tract (VADST) is a novel, minimally-invasive technique for the treatment of pilonidal sinus disease (PSD). This is an advancement of the previously described subcutaneous destruction of the sinus tract and the removal of hairs as well as the long-term vessel-loop drainage of the wound channel (DST). Although the first results of this operation seemed to be promising, some of my colleagues felt that the blind approach to this procedure could be its potential "weak point"...
March 12, 2018: Surgical Technology International
Seth Jonas, Kassandra Fronczyk, Lucas M Pratt
An extreme space weather event has the potential to disrupt or damage infrastructure systems and technologies that many societies rely on for economic and social well-being. Space weather events occur regularly, but extreme events are less frequent, with a small number of historical examples over the last 160 years. During the past decade, published works have (1) examined the physical characteristics of the extreme historical events and (2) discussed the probability or return rate of select extreme geomagnetic disturbances, including the 1859 Carrington event...
March 12, 2018: Risk Analysis: An Official Publication of the Society for Risk Analysis
Takehiko Kobayashi, Kazunari Tsuyuguchi, Shiomi Yoshida, Yu Kurahara, Naoya Ikegami, Maiko Naito, Shoko Sonobe, Toshiya Maekura, Taisuke Tsuji, Shojiro Minomo, Yoshikazu Inoue, Katsuhiro Suzuki
Background: Among Mycobacterium abscessus complex infections, patients with M. abscessus subsp. abscessus (MAA) lung disease are difficult to treat and no standard therapy has been established. Few reports have investigated the drug susceptibility of these strains. We retrospectively investigated how in vitro drug susceptibility testing (DST) of MAA affects the induction of sputum conversion using pharmacotherapy. Methods: Patients with MAA lung disease diagnosed and treated between 2010 and 2014 at our hospital were enrolled and divided into Group A (sputum conversion without relapse within 1 year) and Group B (persistent positive cultured or negative conversion with relapse)...
January 2018: International Journal of Mycobacteriology
Emilia Sbardella, Marianna Minnetti, Denise D'Aluisio, Laura Rizza, Maria Rosaria Di Giorgio, Fabio Vinci, Riccardo Pofi, Elisa Giannetta, Mary Anna Venneri, Annarita Vestri, Sergio Morelli, Andrea Lenzi, Andrea M Isidori
BACKGROUND: Low-grade incomplete post-dexamethasone cortisol suppression in patients with adrenal incidentalomas -recently defined as possible autonomous cortisol secretion (pACS)- has been associated with increased cardiovascular events and mortality. However, prospective studies documenting cardiac abnormalities in these patients are lacking. SUBJECTS AND METHODS: Between July 2016 and September 2017, 71 consecutive patients with adrenal lesions were prospectively screened for hypercortisolism by dexamethasone suppression test (NCT02611258)...
March 6, 2018: European Journal of Endocrinology
Erik J Groessl, Theodore G Ganiats, Naomi Hillery, Andre Trollip, Roberta L Jackson, Donald G Catanzaro, Timothy C Rodwell, Richard S Garfein, Camilla Rodrigues, Valeriu Crudu, Thomas C Victor, Antonino Catanzaro
BACKGROUND: Growth-based drug susceptibility testing (DST) is the reference standard for diagnosing drug-resistant tuberculosis (TB), but standard time to result (TTR) is typically ≥ 3 weeks. Rapid tests can reduce that TTR to days or hours, but accuracy may be lowered. In addition to the TTR and test accuracy, the cost of a diagnostic test may affect whether it is adopted in clinical settings. We examine the cost-effectiveness of rapid diagnostics for extremely drug-resistant TB (XDR-TB) in three different high-prevalence settings...
March 2, 2018: BMC Infectious Diseases
Serkan Yener, Mustafa Secil, Omer Demir, Basak Ozgen, Kutsal Yorukoglu
CONTEXT: To investigate whether any association between chemical shift magnetic resonance (MRI) findings, cortisol secretion and pathological findings exist that could predict subclinical hypercortisolism (SCH) in patients with adrenal incidentalomas (AI). DESIGN: Retrospective, cross sectional study in a tertiary centre. PATIENTS: Sixty-eight subjects with AIs and 13 patients with Cushing's syndrome (CS). Patients with AIs were categorized according to cortisol levels post 1mg dexamethasone (post-DST)...
March 1, 2018: Clinical Endocrinology
Amal Oudghiri, Hind Karimi, Fouad Chetioui, Fathiah Zakham, Jamal Eddine Bourkadi, My Driss Elmessaoudi, Amin Laglaoui, Imane Chaoui, Mohammed El Mzibri
BACKGROUND: The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global TB control. Although multi drug-resistant tuberculosis (MDR- TB) prevalence and associated genetic mutations in Morocco are well documented, scarce information on XDR TB is available. Hence, the evaluation of pre-XDR and XDR prevalence, as well as the mutation status of gyrA, gyrB, rrs, tlyA genes and eis promoter region, associated with resistance to second line drugs, is of great value for better management of M/XDR TB in Morocco...
February 27, 2018: BMC Infectious Diseases
Anick Verpalen, Fons Van de Vijver, Ad Backus
We set out to address the adequacy of dyslexia screening in Dutch and non-western immigrant children, using the Dutch Dyslexia Screening Test (DST-NL) and outcomes of the Dutch dyslexia protocol, both of which are susceptible to cultural bias. Using the protocol as standard, we conducted an ROC (Receiver Operating Characteristics) analysis in Dutch and immigrant third, fifth, and seventh graders, combining a cross-sectional and longitudinal design. Sensitivity and specificity increased with grade, but were non-significant for various subtests in the lowest grade, suggesting considerable non-convergence between the two measures...
February 23, 2018: Annals of Dyslexia
Robert Anderson, Jenny Norrman, Pär-Erik Back, Tore Söderqvist, Lars Rosén
Decision support tools (DST) are often used in remediation projects to aid in the complex decision on how best to remediate a contaminated site. In recent years, the sustainable remediation concept has brought increased attention to the often-overlooked contradictory effects of site remediation, with a number of sustainability assessment tools now available. The aim of the present study is twofold: (1) to demonstrate how and when different assessment views affect the decision support outcome on remediation alternatives in a DST, and (2) to demonstrate the contribution of a full sustainability assessment...
February 20, 2018: Science of the Total Environment
Lei Deng, Peng Jiao, Jing Pei, Zhenzhi Wu, Guoqi Li
Although deep neural networks (DNNs) are being a revolutionary power to open up the AI era, the notoriously huge hardware overhead has challenged their applications. Recently, several binary and ternary networks, in which the costly multiply-accumulate operations can be replaced by accumulations or even binary logic operations, make the on-chip training of DNNs quite promising. Therefore there is a pressing need to build an architecture that could subsume these networks under a unified framework that achieves both higher performance and less overhead...
February 2, 2018: Neural Networks: the Official Journal of the International Neural Network Society
Beatriz Grinsztejn, Brenda Hoagland, Ronaldo I Moreira, Esper G Kallas, Jose V Madruga, Silvia Goulart, Iuri C Leite, Lucilene Freitas, Luana M S Martins, Thiago S Torres, Ricardo Vasconcelos, Raquel B De Boni, Peter L Anderson, Albert Liu, Paula M Luz, Valdiléa G Veloso
BACKGROUND: PrEP Brasil was a demonstration study to assess feasibility of daily oral tenofovir diphosphate disoproxil fumarate plus emtricitabine provided at no cost to men who have sex with men (MSM) and transgender women at high risk for HIV within the Brazilian public health system. We report week 48 pre-exposure prophylaxis (PrEP) retention, engagement, and adherence, trends in sexual behaviour, and incidence of HIV and sexually transmitted infections in this study cohort. METHODS: PrEP Brasil was a 48 week, open-label, demonstration study that assessed PrEP delivery at three referral centres for HIV prevention and care in Rio de Janeiro, Brazil (Fundação Oswaldo Cruz), and São Paulo, Brazil (Universidade de São Paulo and Centro de Referência e Treinamento em DST e AIDS)...
February 16, 2018: Lancet HIV
R Manfredini, F Fabbian, A De Giorgi, B Zucchi, R Cappadona, F Signani, N Katsiki, D P Mikhailidis
Transitions into and out of Daylight Saving Time (DST) may disrupt circadian rhythms and lead to sleep disturbance and deprivation. A first report observed an association between DST and acute myocardial infarction (AMI), especially after the spring shift and in women. We tried to identify and evaluate the possible association between DST and AMI, using the MEDLINE, EMBASE and Google Scholar electronic database (years 2009-2016), with regards to the searching terms 'daylight saving time', 'daylight saving time' plus 'gender', and 'daylight saving time' plus 'acute myocardial infarction'...
February 2018: European Review for Medical and Pharmacological Sciences
Diana Angelica Aguilar-Ayala, Margo Cnockaert, Peter Vandamme, Juan Carlos Palomino, Anandi Martin, Jorge Gonzalez-Y-Merchand
Although tuberculosis treatment is dependent on drug-susceptibility testing (DST) and molecular drug-resistance detection, treatment failure and relapse remain a challenge. This could be partially due to the emergence of antibiotic-tolerant dormant mycobacteria, where host lipids have been shown to play an important role. This study evaluated the susceptibility of Mycobacterium tuberculosis to two antibiotic combinations - rifampicin, moxifloxacin, amikacin and metronidazole (RIF-MXF-AMK-MTZ), and rifampicin, moxifloxacin, amikacin and pretomanid (RIF-MXF-AMK-PA) - in a lipid-rich dormancy model...
January 15, 2018: Journal of Medical Microbiology
B Derendinger, M de Vos, R R Nathavitharana, T Dolby, J A Simpson, P D van Helden, R M Warren, G Theron
The scale-up of rapid drug resistance testing for TB is a global priority. MTBDRplus is a WHO-endorsed multidrug-resistant (MDR)-TB PCR assay with suboptimal sensitivities and high indeterminate rates on smear-negative specimens. We hypothesised that widespread use of incorrect thermocycler ramp rate (speed of temperature change between cycles) impacts performance. A global sample of 72 laboratories was surveyed. We tested 107 sputa from Xpert MTB/RIF-positive patients and, separately, dilution series of bacilli, both at the manufacturer-recommended ramp rate (2...
February 16, 2018: Scientific Reports
Carolin Leistner, Andreas Menke
Stress is a state of derailed homeostasis and a main environmental risk factor for psychiatric diseases. Chronic or uncontrollable stress may lead to a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which is a common feature of stress-related psychiatric disorders. One of the key mechanisms underlying a disturbed HPA axis is an impaired function of the glucocorticoid receptor (GR) with an enhanced or reduced feedback sensitivity for glucocorticoids and subsequently altered concentrations of peripheral cortisol...
February 2, 2018: Psychoneuroendocrinology
Yong Chen, Zhengan Yuan, Xin Shen, Jie Wu, Zheyuan Wu, Biao Xu
In high TB-burden countries like China, the diagnosis of multidrug-resistant tuberculosis (MDR-TB) using conventional drug susceptibility testing (DST) takes months, making treatment delay inevitable. Poor outcomes of MDR-TB might be associated with delayed, even inappropriate treatment. The purpose of this study was to investigate the time to MDR-TB treatment initiation, and to assess the association between early treatment and treatment outcomes. Between April 2011 and December 2014, this population-based, retrospective cohort study collected the demographic and clinical characteristics, and the drug susceptibility profiles of all registered MDR-TB patients in Shanghai, China...
February 5, 2018: Antimicrobial Agents and Chemotherapy
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