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Fatma Nur Korkmaz, Gulsen Ozen, Ali Uğur Ünal, Pınar Kahraman Koytak, Nese Tuncer, Haner Direskeneli
Abstract/ Resumo Behcet's disease (BD) is a multisystem inflammatory disorder characterized by recurrent oral and genital ulcers, skin lesions and uveitis. The nervous system involvement of BD, neuro-Behcet's disease (NBD), is one of the important causes of mortality of the disease. Herein, we present a 29-year-old male with parenchymal NBD who has progressed rapidly and was managed with an uncommon aggressive immunosuppresive combination therapy. The patient first presented six years ago with vertigo and difficulty in talking and walking...
September 28, 2016: Acta Reumatológica Portuguesa
A Jayakumar, R M Savic, C K Everett, D Benator, D Alland, C M Heilig, M Weiner, S O Friedrich, N A Martinson, A Kerrigan, C Zamudio, S V Goldberg, W C Whitworth, J L Davis, P Nahid
The Xpert® MTB/RIF assay is both sensitive and specific as a diagnostic test. Xpert also reports quantitative output in cycle thresholds (Ct), which may provide a dynamic measure of sputum bacillary burden when used longitudinally. We evaluated the relationship between Xpert Ct trajectory and drug exposure during TB treatment to evaluate the potential utility of Xpert Ct for treatment monitoring. We obtained serial sputum samples from patients with smear-positive pulmonary TB consecutively enrolled at ten international clinical trial sites participating in Study 29X, a CDC-sponsored TB Trials Consortium study evaluating the tolerability, safety, and antimicrobial activity of rifapentine at daily doses up to 20 mg/kg...
October 12, 2016: Journal of Clinical Microbiology
Bridget Hodkinson, Kingsley Ross Magomero, Mohammed Tikly
BACKGROUND: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. METHODS: A retrospective record review of adult RA patients treated with LEF/MTX...
October 2016: Therapeutic Advances in Musculoskeletal Disease
Acheenta Gohain Barua, Himangshu Raj, Pranab Konch, P Hussain, Chandana C Barua
OBJECTIVES: The present study was carried out to investigate the in vivo antimycobacterial activity of methanol extract of Alstonia scholaris and Mucuna imbricata in murine model. MATERIALS AND METHODS: Female BALB/c mice were infected with the Mycobacterium tuberculosis H37Rv suspension. Extracts were administered orally for 2 weeks from 7(th) day postinfection at a dose of 200 mg/kg and rifampicin at 20 mg/kg as standard. The synergistic groups were 10 and 100 mg/kg for rifampicin and extract, respectively...
September 2016: Indian Journal of Pharmacology
Malik Asif Humayun, Tristan Richardson, Augustin Brooks
A 17-year-old male presented with diarrhoea and malaise following his return from Kenya and Tunisia. He was managed as a case of traveller's diarrhoea. Stool cultures were negative for pathogenic bacterial growth. Two weeks later he presented with worsening lower back pain. MRI of lumbosacral spine suggested L1 osteomyelitis. CT-guided spinal aspirate grew no organisms and repeat viral serology and blood cultures (including tuberculosis screening) were negative. He was treated with a 6-week course of ceftriaxone...
September 30, 2016: BMJ Case Reports
Guillaume MuasaPatoka Kalonji, Gérard De Connick, Léon Okenge Ngongo, Dieudonné Kazumba Nsaka, Thierry Kabengele, Félicien Tshimungu Kandolo, Félicien Ilunga-Ilunga, Albert Adelin, Didier Giet
BACKGROUND: Tuberculosis still remains a major public health concern in several provinces of the Democratic Republic of Congo, especially in prison settings. The present study aimed at determining tuberculosis (TB) prevalence and associated risk factors in inmates of the Mbuji-Mayi Central Prison. METHODS: This cross-sectional study was performed over a 6-month period (January to June 2015) in Mbuji-Mayi Central Prison. A total of 733 inmates were screened systematically for TB...
2016: Tropical Medicine and Health
Alexandru Oanţă, Marius Irimie
In the last twenty years, the prevalence of individuals with tattoos in the general population has increased in Europe (1) as well as in Australia (2) and the United States of America (3). A series of complications such as acute inflammatory reactions, allergic contact dermatitis (4,5), photoinduced, lichenoid, and granulomatous reactions (6, 7), pseudolymphoma (8), pseudoepitheliomatous hyperplasia (9), skin infections (6), and skin cancers (10) may occur on tattoos. Infectious complications on tattoos include bacterial infections (pyoderma, leprosy, syphilis, cutaneous tuberculosis, mycobacteriosis) (11-14), viral infections (molluscum contagiosum, warts, herpes simplex, hepatitis B and C) (15-17), and fungal infections (sporotrichosis, dermatophytosis) (18,19)...
August 2016: Acta Dermatovenerologica Croatica: ADC
A K Hemanth Kumar, V Chandrasekaran, T Kannan, A Lakshmi Murali, J Lavanya, V Sudha, Soumya Swaminathan, Geetha Ramachandran
PURPOSE: The aim of the study was to compare plasma concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) between tuberculosis (TB) patients with and without diabetes mellitus (DM). METHODS: Two-hour post-dosing concentrations of RMP, INH and PZA were determined in adult TB patients that were studied with (n = 452) and without DM (n = 1460), treated with a thrice-weekly regimen in India. Drug concentrations were estimated by HPLC. RESULTS: The median (IQR) INH [6...
September 20, 2016: European Journal of Clinical Pharmacology
J F Borjas-Howard, W F W Bierman, K Meijer, T S van der Werf, Y I G V Tichelaar
BACKGROUND: Considering the relationship between inflammation and thrombosis, patients with tuberculosis (TB) patients might be at high risk of venous thrombosis. AIM: To evaluate the risk of venous thromboembolism in patients admitted to the Beatrixoord Tuberculosis Centre (BTBC), a tertiary centre for TB. We specifically explored which cofactors elevate the risk of venous thrombosis (VTE), and whether the timing of venous thrombotic events would justify extended primary prophylaxis...
September 10, 2016: QJM: Monthly Journal of the Association of Physicians
Leila C Kahwati, Cynthia Feltner, Michael Halpern, Carol L Woodell, Erin Boland, Halle R Amick, Rachel Palmieri Weber, Daniel E Jonas
IMPORTANCE: Five to ten percent of individuals with latent tuberculosis infection (LTBI) progress to active tuberculosis (TB) disease. Identifying and treating LTBI is a key component of the strategy for reducing the burden of TB disease. OBJECTIVE: To review the evidence about targeted screening and treatment for LTBI among adults in primary care settings to support the US Preventive Services Task Force in updating its 1996 recommendation. DATA SOURCES: MEDLINE, Cochrane Library, and trial registries, searched through August 3, 2015; references from pertinent articles; and experts...
September 6, 2016: JAMA: the Journal of the American Medical Association
Jocieli Malacarne, Diana Patricia Giraldo Rios, Cosme Marcelo Furtado Passos da Silva, José Ueleres Braga, Luiz Antonio Bastos Camacho, Paulo Cesar Basta
INTRODUCTION: Recent studies have shown a high incidence and prevalence of latent tuberculosis infection (LTBI) in indigenous populations around the World. We aimed to estimate the prevalence and annual risk of infection (ARI) as well as to identify factors associated with LTBI in an indigenous population from the Brazilian Amazon. METHODS: We conducted a cross-sectional study in 2011. We performed tuberculin skin tests (TSTs), smears and cultures of sputum samples, and chest radiographs for individuals who reported cough for two or more weeks...
July 2016: Revista da Sociedade Brasileira de Medicina Tropical
Azlan Che-Amat, Maria Ángeles Risalde, David González-Barrio, Jose Antonio Ortíz, Christian Gortázar
BACKGROUND: Diagnosing tuberculosis (TB) in farmed red deer (Cervus elaphus) is challenging and might require combining cellular and humoral diagnostic tests. Repeated skin-testing with mycobacterial purified protein derivatives (PPDs) might sensitize or desensitize the subjects to both kinds of diagnostic tools. We evaluated the effect of repeated (every 6 months) comparative tuberculin skin testing on skin test and ELISA responsiveness in farmed red deer hinds from a TB-free herd. Eighteen 8-month old hinds were inoculated with bovine and avian PPDs and the mitogen phytohaemagglutinin (PHA), as positive control and concurrently tested by ELISA for antibodies against avian (avian PPD, aPPD and protoplasmatic antigen 3, PPA3) and bovine antigens (bPPD and MPB70)...
2016: BMC Veterinary Research
Souhi Hicham, El Ouazzani Hanane, Janah Hicham, Rhorfi Ismaïl, Abid Ahmed
Tuberculous pyopneumothorax is a rare but serious complication of evolutive pulmonary tuberculosis. We report a series of 18 cases with tuberculous pyopneumothorax admitted to the Pneumo-Phthisiology Department of the Mohammed V Military Teaching Hospital in Rabat between January 2005 and December 2009. Our study included 15 men and 3 women, the average age was 35 ± 7 years. 4 patients were diabetic. Smoking was found in 9 cases. Right-sided pneumothorax was found in 13 cases. Chest radiograph showed cavitary lesions in 15 patients and extensive bilateral lesions in 8 cases...
2016: Pan African Medical Journal
Tsedale Semunigus, Belay Tessema, Setegn Eshetie, Feleke Moges
BACKGROUND: Tuberculosis (TB) remains one of the globe's deadliest communicable diseases. The homeless individuals are at high risk to acquire TB and multi-drug resistant TB (MDR-TB), because of their poor living conditions and risky behaviors. Tuberculosis and MDR-TB in the homeless individuals can pose a risk to entire communities. However, the magnitude of the problem is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of smear positive pulmonary TB (PTB) and MDR-TB among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia...
2016: Annals of Clinical Microbiology and Antimicrobials
Hanna Nylén, Abiy Habtewold, Eyasu Makonnen, Getnet Yimer, Leif Bertilsson, Jürgen Burhenne, Ulf Diczfalusy, Eleni Aklillu
Initiation of efavirenz-based combination antiretroviral therapy (cART) is associated with Vitamin D deficiency, but the risk factors including efavirenz pharmacokinetics for cART-induced severe vitamin D deficiency (SVDD) and the impact of anti-tuberculosis (TB) cotreatment are not explored. We investigated the prevalence of SVDD in HIV and TB-HIV coinfected patients and associated risk factors for treatment-induced SVDD.Treatment-naïve Ethiopian HIV patients with (n = 102) or without (n = 89) TB co-infection were enrolled prospectively and received efavirenz-based cART...
August 2016: Medicine (Baltimore)
Matteo Cellamare, Steffen Ventz, Elisabeth Baudin, Carole D Mitnick, Lorenzo Trippa
PURPOSE: To evaluate the use of Bayesian adaptive randomization for clinical trials of new treatments for multidrug-resistant tuberculosis. METHODS: We built a response-adaptive randomization procedure, adapting on two preliminary outcomes for tuberculosis patients in a trial with five experimental regimens and a control arm. The primary study outcome is treatment success after 73 weeks from randomization; preliminary responses are culture conversion at 8 weeks and treatment success at 39 weeks...
August 23, 2016: Clinical Trials: Journal of the Society for Clinical Trials
Tizazu Zenebe, Ermias Tefera
Evaluating the outcomes of tuberculosis treatment and understanding the specific reasons for unfavorable treatment outcome are important in evaluating the effectiveness of tuberculosis control program. A retrospective study was conducted to assess tuberculosis treatment outcomes and associated factors among smear positive pulmonary tuberculosis patients in zone-one health facilities of Afar regional state, Ethiopia. A total of 380 smear positive pulmonary tuberculosis patients' registration book recorded with complete information from Jan 2011 to Dec 2013 were analyzed...
August 20, 2016: Brazilian Journal of Infectious Diseases
Saori Uyeda, Tanjina Sharmin, Tomomitsu Satho, Keiichi Irie, Mineo Watanabe, Masato Hosokawa, Yukihiro Hiramatsu, Takayuki Koga, Yukihiko Nakashima, Nobuhiro Kashige, Akihisa Toda, Kenji Mishima, Fumio Miake
BACKGROUND: MF59, which is an adjuvant belonging to C30 member of the terpene family, is a T helper type-2 (Th2)-biased immune enhancer. Our previous studies showed that pyriproxyfen, a member of the terpene family with fewer carbon atoms (C20) than MF59, enhanced active T helper type-1 (Th1)-biased immune responses. OBJECTIVE: This study was performed to investigate the enhancement of antigen-specific immune responses by myrcene, a member of the terpene family with fewer carbon atoms (C10) than pyriproxyfen...
August 16, 2016: Asian Pacific Journal of Allergy and Immunology
Quan Dong Nguyen, Pauline T Merrill, Glenn J Jaffe, Andrew D Dick, Shree Kumar Kurup, John Sheppard, Ariel Schlaen, Carlos Pavesio, Luca Cimino, Joachim Van Calster, Anne A Camez, Nisha V Kwatra, Alexandra P Song, Martina Kron, Samir Tari, Antoine P Brézin
BACKGROUND: Non-infectious uveitis is a potentially sight-threatening ocular disorder caused by chronic inflammation and its complications. Therapeutic success is limited by systemic adverse effects associated with long-term corticosteroid and immunomodulator use if topical medication is not sufficient to control the inflammation. We aimed to assess the efficacy and safety of adalimumab in patients with inactive, non-infectious uveitis controlled by systemic corticosteroids. METHODS: We did this multicentre, double-masked, randomised, placebo-controlled phase 3 trial at 62 study sites in 21 countries in the USA, Canada, Europe, Israel, Australia, and Latin America...
September 17, 2016: Lancet
Elisa Lopez-Varela, Victor Guillermo Sequera, Alberto L García-Basteiro, Orvalho Joaquim Augusto, Khatia Munguambe, Jahit Sacarlal, Pedro L Alonso
BACKGROUND: There is limited literature regarding adherence rates for the treatment of tuberculosis (TB) in children. We aimed to describe TB treatment outcomes and adherence as well as to evaluate associated factors to poor adherence in Mozambican children. METHODS: This is a sub-study of a community TB incidence study among children <3 years of age. Incomplete adherence included the sum of lost-to-follow-up cases plus those with a delay of > 3 weeks to treatment completion...
August 12, 2016: Journal of Tropical Pediatrics
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